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Biceps Tendinopathy: Symptoms and Solutions

What is Biceps Tendinopathy?

The biceps brachii muscle, commonly known as the biceps, sits between the shoulder and elbow. It has two parts: the long head and short heads. These come together to form the main muscle bulk, which is the “Popeye” part of your upper arm. The biceps brachii muscle runs from the top and front of the shoulder all the way down to the upper forearm. The biceps tendon is the part that attaches the muscle to the bone, both at the shoulder and the elbow.

The biceps muscle functions to bend the elbow and turn the hand to face palm-up. The term “tendinopathy” is used to describe injury and pain of a tendon. This is most commonly due to overuse. Biceps tendinitis tends to affect the long head of the biceps more commonly. Both the tendon itself and the tendon sheath can be the source of pain.

How does it happen?

This condition occurs most commonly due to repeated use of the biceps over a long period of time. People with this condition often present in the later stages of tendon damage, when they begin to experience pain. This means that biceps tendinopathy is a slow-developing condition, without any symptoms until it reaches the point that the tissues become injured and painful. This is the body’s way of self-defence; it is telling you that it doesn’t like the activity you are asking it to do.

While specific tasks such as throwing sports, tennis or golf can increase the risk of developing a biceps tendinopathy, often it is simply caused by usual daily activities throughout the course of an adult’s life. With aging comes a decrease in the collagen and elastin components of tendons. This contributes to a reduced ability to sustain a high load, which can cause degeneration or inflammation over a longer period of time.

What are the symptoms?

Biceps tendinitis is painful; often aching at night and increasing in intensity when performing overhead tasks such as reaching and lifting. The pain is usually at the front of the shoulder and can radiate downwards along the front of the arm.

People with this condition often have developed adaptations to their usual movement patterns in order to avoid aggravating this pain. This in itself can lead to other issues such as strained or overworked muscles. An example of this is hitching up the shoulder to the ear when going to use the affected side, as this will help to offload the affected muscle, allowing the biceps to be under less stress. Unfortunately, this will eventually increase the stress on the muscles of the upper neck and shoulder, leading to secondary aches and pains.

How can physiotherapy help?

Your physiotherapist will assess and diagnose this condition, which will, in turn, allow for a comprehensive management plan to be put in place. A combination of strengthening, stretching and muscle release is often beneficial to assist in the management of this condition.

If you have developed secondary complications with changes to your normal movement patterns, your physiotherapist can assist you in addressing these and training your body to avoid causing further damage.

If further imaging or onward referral is needed, your physiotherapist can help in guiding you through this process.

 

This information is not a replacement for proper medical advice. Contact our practice and speak with one of our physiotherapists for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Hamstring Tears: Symptoms, Causes and Prevention

What is a hamstring tear?

The hamstrings are a large group of muscles found at the back of the thigh. The primary role of these muscles is to bend the knee and collectively, these muscles are some of the strongest in the body.

Despite their strength, the hamstrings are very prone to injury especially when overworked or undertrained. Hamstring strains and tears are quite common in sports that involving sprinting, jumping and sudden changes in speed.

Football and soccer players are some of the athletes most commonly affected by hamstring tears.

Hamstring strains are categorized into three grades, these are:

Grade 1 (mild) – A few muscle fibres are either damaged or ruptured; there may be some pain a day after the injury but no loss of movement.

Grade 2 (moderate) – Roughly half of the muscle fibres are torn; there may be acute pain and mild loss of function; walking may be affected.

Grade 3 (severe) – More than half of the muscle fibres are ruptured and pain and swelling are immense; definite muscle weakness and loss of function.

What are the symptoms?

The symptoms of a hamstring tear depend on the severity of the injury. Common symptoms include pain at the back of the thigh – which could range from mild to severe, swelling, bruising, loss of knee motion, tenderness at the back of the thigh, reduced length and muscle weakness of the hamstring. In some cases, tingling, numbness and weakness of the structures below the knee are seen. However, these are rare.

What are the causes?

A single cause of hamstring tears can be difficult to determine however, it is thought that a lack of coordination between the hamstrings and quadriceps muscles during sudden changes of speed or when kicking can cause the hamstrings to contract excessively or become overstretched, causing a tear.

There are also recognised risk factors, that increase the possibility of hamstring tears including increased age, fatigue, strength imbalance, previous injury of the hamstrings, poor core stability, poor hamstrings flexibility and tight hip flexors.

How can they be prevented?

Understandably, trying to prevent hamstring tears is important business. Research has consistently shown that the most important factor in preventing hamstring tears is having high eccentric strength in the hamstrings. Eccentric muscle contractions occur when a muscle is contracting while also lengthening. For example, when you lower your straightened leg slowly to the ground, your quadriceps muscle will be working eccentrically.

Your physiotherapist can show you some exercises that target eccentric muscle strength specifically as well as identifying any risk factors that may be contributing to your individual risk. Contact our practice for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Ankle Sprains: can physiotherapy help?

What is an ankle sprain?

Almost everyone has twisted their ankle at some in their life; in fact, it is one of the most common reasons for people to visit an emergency department.

Technically an ankle sprain has occurred when an ankle twists, causing damage to one of it’s supporting ligaments. The ligaments can be overstretched, partially torn or completely ruptured, depending on the force of the injury. The ligament that is most often involved is the ATFL, or the anterior-talofibular ligament, located on the outside of the ankle.

While there are many ligaments surrounding and supporting the ankle, this ligament is the most vulnerable as it stops the ankle from rolling inwards, which is the way that most ankles are injured. Athletes who jump while moving in different directions, such as basketball players, are the most prone to this injury as they often land on their foot when it is not completely flat, twisting it and injuring the ligaments.

What are the signs and symptoms?

Most people won’t have any problem diagnosing that they have a sprained ankle. The symptoms are pain, swelling and tenderness over the area of damage, usually the outside of the ankle.

Depending on the severity of the injury, there may be bruising, reduced range of movement, instability and pain with weight bearing. In more severe injuries there may even be a loss of function, where you are unable to walk on the ankle and numbness and/or a feeling of coldness in the foot.

Why should I see a physiotherapist?

Twisted ankles can also cause a fracture of the ankle, not just ligament damage and many times a bad sprain and a fracture cannot be told apart without proper medical assessment and an X-ray. Your physiotherapist is able to identify if your sprain is severe enough to need further investigation to rule out a fracture.

They will also classify the severity of the sprain, providing you with a clear course of treatment. There are many factors that can lead someone to be more prone to fractures, including general hyper flexibility, unsupportive footwear and anatomical structure, however by far the most common reason for an ankle sprain is the existence of a previous sprain without complete rehabilitation.

This is because, following an ankle sprain, many people are left with weakness, instability or stiffness, reduced balance and proprioception – which is a sense of where your body is positioned. These things can mean that the next time your ankle is in a vulnerable position you don’t have the strength, awareness of position, balance or structural control to ensure it is in the correct position before putting all your weight through it, causing another injury.

As well as helping you reduce and recover from the pain and swelling of the injury in the early days. Your physiotherapist is trained to identify which issues are likely to affect you in the future and assist you with a personalized rehabilitation program to ensure your ankle is as strong and stable as possible to prevent future injuries.

The information in this newsletter is not a replacement for proper medical advice. Please contact the Caboolture Physical Therapy Centre for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Patella Dislocations: What are they and how can your physio help?

What is it?

The knee joint is composed of the thigh bone, (femur) and leg bone (tibia) and a small floating bone at the front, commonly known as the kneecap (patella). The interaction between these bones allows for smooth movement of the knee as it bends and straightens.

During movement, the kneecap sits in a groove at the front of the knee and acts as a mechanical see-saw. This protects the knee joint and improves the efficiency of the muscles working to move it. When the patella moves out of this groove it is called a subluxation. If the patella moves far enough out of this groove it becomes a dislocation.

What are the symptoms?

The first time the patella dislocates is usually the most traumatic and painful. The knee may give way, and a visible lump can be noticed where the patella has dislocated. There will often be bruising, swelling and the knee may feel unstable. First-time dislocations may also cause a heamarthrosis or bleeding within the knee joint. If there is damage to the ligaments of the knee, subsequent dislocations can happen more easily, and from everyday activities, causing the knee to give way suddenly.

What are the causes?

First-time dislocations often occur due to a traumatic event. The most common cause of patellar dislocation is a non-contact injury to the knee with a twist of the leg (the thigh bone rotates internally on a fixed leg and foot). In addition, a direct blow to the side of the knee can also dislocate the patella.

If there is some instability of the joint, dislocations can occur more regularly and from smaller forces.

Dislocations usually occur when the knee is bent and the kneecap slips back into place when the knee is straightened again. While the kneecap can be dislocated in both directions, it usually dislocates towards the outside of the knee.

Certain factors can make dislocation more likely, including overall hyper-flexibility, damage to the ligaments of the knee and muscular imbalance of the quadriceps. The structure and angle of the knee joint itself can also make dislocation more likely. This can be seen in the increased prevalence of dislocations for women as they have a slightly different angle of femur compared to the tibia than men. A traumatic dislocation can cause instability that can lead to future dislocations.

How can physiotherapy help?

An acute patellar dislocation should be treated like any traumatic injury and assessed by a medical professional to reduce pain and swelling, make an accurate diagnosis and check for fractures. While the kneecap may relocate itself quickly, ensuring that it is able to heal correctly to prevent further dislocations may require immobilization for up to six weeks.

Your physiotherapist will be able to identify any factors that may predispose you to further dislocations and provide you with a personalized treatment program to address any stiffness, weakness or instability surrounding the knee. Balance and proprioception (your sense of where your body is in space) are often reduced following an injury and your physiotherapist will help to rehabilitate these. Your therapist may provide you with education and advice regarding bracing or taping. In severe cases of instability, surgery may be recommended to stabilize the knee however this is usually not considered unless there has been a fracture or until a full rehabilitation with physiotherapy has been completed.

This info is not a replacement for proper medical advice. Please get in touch with one of our expert physios for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

A focus on Anterior Ankle Impingement

What is it?

Anterior ankle impingement, also known as anterior impingement syndrome, is a musculoskeletal condition where repetitive forces compress and damage the tissues at the front of the ankle, causing pain and stiffness. It is a common injury that can affect people of all ages, however, is usually seen in athletes of sports involving repetitive or forceful upward movements of the ankle, such as sprinting, landing from long jump, uphill and downhill running.

What are the symptoms?

Pain at the front of the ankle is the primary symptom of anterior ankle impingement. This can be felt as an intense, sharp pain occurring with ankle movements or a dull ache in front of the ankle following periods of exercise. Pain can also be felt when putting weight on the ankle while standing, walking or running. Night-time aching, stiffness, swelling and reduced ankle flexibility are also common symptoms of anterior ankle impingement.

How does it happen?

Anterior ankle impingement is caused by traumatic or repetitive compression of the structures at the front of the ankle as the tibia and talus move towards each other during ankle movements. The tissues that are affected become damaged and inflamed, causing the pain typical of ankle impingement. Chronic inflammation can lead to further stiffness, exacerbating the impingement process.

The most common risk factor for ankle impingement is a previous ankle sprain that was not adequately rehabilitated, as this can result in a stiff or unstable ankle. Another cause of impingement is the growth of small osteophytes or bony spurs around the ankle joint that press against the nearby soft tissues. These can be due to osteoarthritis or grow as a reaction to impingement itself. Training errors, muscle tightness, unsupportive footwear and a hypermobile ankle have also been shown to be risk factors for anterior ankle impingement.

How can physiotherapy help?

Depending on the cause, mild cases of anterior ankle impingement usually recover in one to two weeks with rest and physiotherapy intervention. For more severe impingement, the ankle may require up to six weeks of rest and rehabilitation to recover. In rare cases, surgical intervention will be required to remove any physical causes of impingement, such as osteophytes to restore impingement-free movement of the ankle. Your physiotherapist will first identify the cause of your ankle impingement and help you to choose the best course of action to reduce your symptoms. They are able to advise you on the appropriate amount of rest and provide stretches and exercises to restore strength and flexibility to the ankle.

Mobilisation techniques and range of motion exercises can also reduce stiffness of the ankle, restoring normal joint movement. Moreover, balance and proprioception exercises are included to prevent further ankle injury. Balance exercises challenge the way your body reacts to outside forces. With this, your balance will be improved, and you’ll have a more stable ankle.

Ideally, physiotherapy treatment is the first step before considering surgery. If surgery is required, your physiotherapist can help you to make a full recovery with a post-surgical rehabilitation program.

The information in this article is not a replacement for proper medical advice. Please contact the Caboolture Physical Therapy Centre for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.