Month: August 2020

Physiotherapy for Patellofemoral Syndrome. Patellofemoral pain syndrome is broad term to describe pain in the front of the knee, around the knee cap or patella that Physiotherapists deal with.

Runners knee or jumpers knees are other common names for this condition as it commonly occurs in those who participate in these sports. https://orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-pain-syndrome/

What are the causes of patellofemoral pain syndrome?

– Overuse and thus repetitive loading and stress to the knee (common in runners)

– A recent change in the frequency, duration and intensity of physical activity, for example increasing the number of days and/ or the length of time spent doing the activity.

– Certain external factors can affect the onset, these being: surfaces and terrain of where the exercise is preformed and the different types of shoes or a recent change in shoe/ equipment.

– Anatomical and bio-mechanical weakness or abnormalities https://www.physio-pedia.com/Patellofemoral_Pain_Syndrome

– Direct trauma to the knee can also cause the onset of patellofemoral pain syndrome.

– Muscle imbalance between the quadriceps and the hamstrings

– Orientation of the patella/ alignment can also affect the onset of the syndrome. This can cause gliding to one favorable side of the femur, thus placing pressure on this side of the femur. Consequently this will result in pain and discomfort.

What are the signs and symptoms?

– Pain during weight bearing activities (such as climbing the stairs, squats or running)

– Pain after sitting for long periods of time with the knee bent

– A dull and achy pain in the front of the knee (made worse by sitting for longer periods of time)

– Pain and stiffness around the knee

– Clicking or cracking sounds when climbing the stairs or standing up after sitting for longer periods of time

– Gradual onset of pain behind the knee cap

– Increased pain levels might be reported the day after exercise

How Physiotherapy can help with Patellofemoral Pain Syndrome:

Your physiotherapist will be able to provide a comprehensive assessment of the onset of symptoms of your pain as well as a objective examination of the knee and your biomechanics to determine the source cause of your pain.

Some of the treatments which our physiotherapists at Sunninghill and Sandton will make use of are https://www.laraphysio.com/about/#Services%20Offeredhttps://www.laraphysio.com/about/#Services%20Offered:

– Manual therapy and pain treatment

– Bio-mechanic correction

– Advice on correct loading, exercise duration, exercise frequency and exercise intensity

– Specific exercises. These start with eccentric and progress to isometric and concentric.

– Strapping and laser therapies are additional supportive methods we use if indicated for

– Advice on correct shoe wear or referral to a podiatrist

Differential diagnosis for patellofemoral pain syndrome:

There are various other knee conditions that can present with similar signs and symptoms (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588869/)

– Patellar tendinopathy

– Chondromalacia Patellae

– Fat pad impingemet

– Osteoarthritis

– Knee instability

We at Lara Brookstein Physiotherapy are trained and able to diagnose and manage conditions such as patellofemoral pain syndrome. Feel free to contact us to find out more and if Physiotherapy will be effective for the management of your pain. http://www.laraphysio.com / 0735052961

Achilles tendon pathologies can either be due to an acute injury, mostly occurring in relation to sports, or have a chronic background and are called tendinopathies. Achilles tendinopathy is one of the most frequent tendon pathologies caused by overuse or overload stresses, which lead to repetitive micro-trauma. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855626/#:~:text=Achilles%20tendon%20pathologies%20can%20either,micro%2Dtraumata%20%5B1%5D.

What is Achilles Tendinopathy?

Achilles tendinopathy is occurrence of pain, swelling and stiffness of the Achilles tendon. The Achilles tendon is the band that joins the calf muscles to the heel bone. Pathology to the tendon can cause discomfort and limit freedom of movement. https://patient.info/foot-care/heel-and-foot-pain-plantar-fasciitis/achilles-tendinopathy.

What are the causes of Tendinopathy?

The most common cause for the occurrence of an Achilles tendinopathy is from overuse and overloading of the tendon. When the tendon is unable to adapt to the load placed on it, pathology can occur due to the repetitive micro trauma placed on the area and the tendon attempting to adapt and heel itself. Other terms for the same occurrence that people may use to describe tendinopathy are: Tendonitis or Tendonosis https://www.ouh.nhs.uk/patient-guide/leaflets/files/11924Ptendinopathy.pdf.

Overloading of the tendon can occur in one specific incidence, alternatively it can be an accumulative effect over time. Factors that can influence load, for a runner for example are: increased volume or intensity, a change in the running shoes as well as a sudden change in the running terrain.

What are the symptoms of Achilles tendinopathy?

– Pain and stiffness around the area by the back of the ankle, as a result of where the tendon is located

– Thickening of the tendon, thereby resulting in decreased activity function

– Tenderness locally at the area of the tendon, usually from the discomfort and inflammation to the area

– Pain during or after exercise, however one will usually feel more symptomatic the morning after exercise

– Commonly there is a warm up phenomena, whereby athletes experience the pain decreases after a warm-up, thus allowing them to continue through the exercise. When this occurs, the pain will unfortunately usually return on the stopping of the exercise or the cool down.

– A very common feature of achiles tendinopathy is the presence of morning stiffness/ pain on waking

– https://www.ouh.nhs.uk/patient-guide/leaflets/files/11924Ptendinopathy.pdf

Physiotherapy management of Achilles Tendinopathy

There are several ways in which a Physio can assist with the diagnosis, treatment and management of Achilles Tendinopathy. Contact us should you want to understand more about how we can assist in Sunninghill with the management or to gain further insight.https://www.laraphysio.com/contact-us/.

Exercise prescription by your physiotherapist, as well as rehab programs are a very important way in which we treat this condition. Loading the tendon accurately is key to improving on the symptoms. To manage load we will decrease the current load to control and settle the symptoms. Following this we will gradually progress the load placed on the tendon to improve its ability to withstand the forces placed on it. https://www.healthlinkbc.ca/health-topics/tr2261#:~:text=For%20Achilles%20tendinopathy%2C%20physiotherapy%20can,and%20help%20the%20tendon%20heal.

Deep massage and shock wave therapy treatments can also assist in the healing process and improved blood flow to the area.

Symptoms, Causes and Physio Treatment for Back and Neck Pain

There is a high occurrence of Back and neck pain, thus these are very common conditions that a physio will see and treat.

Among adults, 60% to 80% will experience back pain and 20% to 70% will experience neck pain that interferes with their daily activities during their lifetimes. As a result of this, At any given time, 15% to 20% of adults will report having back pain and 10% to 20% will report neck pain symptoms

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440123/#:~:text=Among%20adults%2C%2060%25%20to%2080,daily%20activities%20during%20their%20lifetimes.&text=At%20any%20given%20time%2C%2015,will%20report%20neck%20pain%20symptoms.

Back Pain can be mild to severe and even debilitating. In other words it can affect your range of movement and quality of life. The neck is located closer to your cervical spine, between the shoulders and your head, as a result of this this it also be easily subjected to injury. https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain#:~:text=Even%20with%20today’s%20technology%2C%20the,Trauma%2C%20injury%2C%20or%20fractures.

Causes of back and neck pain:

– Trauma

– Injury

– Fractures

– Infection

– Overuse (consequently, from strenuous activity)

– Postural factors (for example: bad ergonomics or underlying postural conditions such as scoliosis)

– Poor muscle tone

– Muscle tension or spasm

– Degenerative conditions to the spine

– Ligament or muscle tears

– Protruding discs

– Irritated nerves

– Stress and anxiety

– https://www.thephysiocompany.com/blog/pain-in-the-back-common-symptoms-causes-treatment-for-back-pain

The goals for Physiotherapy treatment:

A Physio first aim is to decrease pain and stiffness. Secondly to improve the range of motion. Thirdly to prescribe functional strengthening to the area. Finally they aim to impliment strategies to prevent the long term occurrence of pain. https://www.spine-health.com/treatment/physical-therapy/physical-therapy-neck-pain-relief

How Physiotherapy can help with back and neck pain:

The treatment of your back and neck pain will depend on what the physiotherapist will find on assessment and comprehensive diagnosis. As a result of this, We at our Physiotherapy practice (Sunninghill) https://www.laraphysio.com/contact-us/ are OMT trained. This allows us to determine if and how physiotherapy can help your neck and back pain.

Our common treatments in Sunninghill include, to sum it it : https://www.laraphysio.com/about/#Services%20Offered

– Soft tissue mobilisation and release. In order to improve movement and decrease pain

– Spinal Joint mobilisation and manipulation by the physio. This is as a method to increase function and movement at the spine interface

– Heat can be applied to the back or neck by the physio. tThereby assisting in decreasing the symptoms

– A Physio can use dry needling to aid in the treatment plan. Thus to also decrease pain

– Ergonomic assessment and re-adjustment is usually conducted by the physiotherapist. This in order to determine this could be causing to your neck and back pain

– Exercise prescription will often be given by your physio. In other words ways to to aid in strengthening and stretching your back and neck muscles.

– Stress management strategies are areas that a physiotherapist can help if they assess your pain to be affected by your stress levels. For example breathing techniques and improved sleep patterns. https://www.physio-pedia.com/Chronic_Neck_Pain

How Physiotherapy can help with your sciatica pain and discomfort?

First off, what is Sciatica ?

Sciatica is a condition which Physiotherapy has success treating. Because sciatica is a common occurrence for people experiencing lower back pain, we as Physiotherapists therefore see a lot of patients coming in complaining of “Sciatica” . The term Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg”. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435

What are the causes of Sciatica that Physiotherapy can assist with?

– Injury to the lumbar disc

– Herniation of the lumbar disc

– Direct damage to the lumbar nerve

– Arthritis in the joints

– Stiffness of the joints

– Stenosis (Narrowing of the spinal canal where the nerve runs)

– Movement of the lumbar vertebra (lumbar stenosis)

– Changes to the sacroiliac joint

– https://www.spine-health.com/conditions/sciatica/sciatica-causeshttps://www.spine-health.com/conditions/sciatica/sciatica-causes

What are the Symptoms of Sciatica which a Physiotherapist will ask you about?

The affects caused by sciatic, will often mean you experience the sensation of discomfort down your leg, resulting in you seeking help from a physiotherapist. The symptoms of sciatica are often broad, therefore they can be different between those experiencing them. The common symptoms for sciatica and thus one seeking help are:

– Pain or discomfort running that runs down the back of the thigh/buttocks, and sometimes all the way down the back of the calf.

– There can be a decreased amount of power in the leg, therefore resulting in reduced strength of the leg

– The type of pain can vary, which can mean a sharp pain, a dull ache or a burning sensation

– You might experience numbness and tingling down the leg and into the foot

– https://www.integrityphysio.com.au/physio-for-sciatica/

How Physiotherapy can help in the treatment of Sciatica symptoms:

The Physios at our practice in Sunninghill (Sandton) https://www.laraphysio.com/ who are trained to accurately diagnose and assesses are able to therefore successfully manage patients that present with Sciatica.

To start with the treatment of your sciatica, a physio would take a full history and complete an assessment of you in order to fully understand the cause that would be causing your discomfort, thus guiding us in our treatment plan.

Secondly, the physio will plan a treatment in order to decrease the sciatica pain, educate you on the cause, and most importantly to provide strategies to correct what we might find to be wrong during the physical and subjective examination, resulting in increased function and decreased levels of discomfort.

Using evidence based therapies, in order to allow for the most appropriate care, some of our Physiotherapy treatments for Sciatica involve the following:

– Postural correction in order to allow for better loading onto the back and lower body

– Education from the physiotherapist, therefore promoting knowledge about the problem and the methods used to treat it

– Soft tissue release to improve on muscle length, circulation and thus decreasing pain

– Spinal joint mobilization, this helps to increase mobility, together with reducing the sensation of pain and discomfort

– Mobilization of the neural tissue, therefore to guide movement of the nerve, in order to allow the nerve to glide more smoothly within the surrounding joints

– Correcting the posture and ergonomics to aid in decreasing the potential factors which could be influencing the onset of the discomfort.

Physiotherapy for the treatment of headaches.

Physiotherapy is an effective way to treat and manage headaches, especially those caused by neck pain. In our blog bellow we will explain more about the ways in which we as physiotherapists can help you.

Do headaches disrupting your quality of life?

Are you a victim of headaches?

Are headaches disrupting your productivity at work?

Have you experienced neck pain with the headaches?

Types Of Headaches:

There are many types of headaches that can occur, as a result, most of us will experience headaches at some stage in our life. For example, Two of the most common types of headaches are:

1. Tension Headaches (These are caused by physical and emotional stress)https://www.health.harvard.edu/a_to_z/tension-headache-a-to-z
2. Neck Headaches/ Cervicogenic headaches (These are triggered by underlying spinal issues) https://www.medicalnewstoday.com/articles/324108

Factors Affecting Headaches:

Although there are many possible causes for headaches, the main causes for those mentioned above (Tension and Neck headaches) are primarily lifestyle elements such as:

– Stress

– Work Postures

– Sleeping Postures

– Exercise Habits

– Studying Postures

Physiotherapy For Headaches:

Due to Physiotherapy Techniques being effective for treating headaches, we strive to improve on how we can help decrease your pain. Therefore, Our OMT trained Physiotherapists in Sunninghill (Sandton) use a number of evidence based modalities to alleviate the discomfort. In other words, preventing the re-occurrence of chronic pain.

Techniques that we use for treating headaches:

– Dry Needling

– Joint Mobilisations

– Spinal Manipulations

– Postural Correction

– Exercise advice and prescription

– Massage and Soft tissue release

As a result of their understanding of the body, A Physiotherapist is therefore able to provide a thorough assessment of your pain. In other words, it allows them, for instance, to guide you to a specialist should they determine that it is more appropriate for you to see one, as a result of what they have found. Above all, keeping your best interests in mind.

Due to the fact that Physiotherapists are movement experts, this therefor, this means that they aim to improve your quality of life through pain free movement. In addition to this, they are able to determine through an assessment what would be contributing to the pain, and thus from this what methods of treatment will be most appropriate

Quick Tips From Us!

Posture: This is important for headache management, due to the effect on your postural muscles. Therefore, aim to keep your shoulders level, your chest forward and your chin tucked in

Ergonomics: Make sure your that desk is the correct height, for example, that your back is supported by the chair, your knees are at 90 degrees, your feet flat on the group/ stool and your screen at eye level. Thus allowing your to be supported correctly.

Sleeping: Ensure your neck is supported correctly, therefore providing longer periods of comfort (a Physio can advise you on this)

Call us or contact us to find out how we can help you with your headaches and neck pain: https://www.laraphysio.com/contact-us/