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Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome, or PFPS, can be a very debilitating condition which can stop you from doing a lot of activities. At its worse, most patient will report of pain and inability to walk far.

PFPS is a term given to describe pain around the knee cap. This is usually due to repetitive damage around the knee cap as it contacts abnormally with the femur. Most patient will report of having a gradual build up of pain. Initially, the pain is niggling but does not stop a person from doing their exercises. Continued activity result in increasing pain which will in turn stop them from participating further. With rest, the pain would abate. However, returning to sport is usually short lived due to the returning pain.

There are multiple causes of PFPS. This include:

  • Foot and ankle misalignment
  • Poor hip control
  • Poor core strength
  • Leg length discrepancies
  • Poor training schedule (not enough rest, sudden increase in intensity)

Usually there are multiple factors that contribute to PFPS. It is important that you seek a trusted physiotherapist that can do a comprehensive assessment on your body. Taking the time with the assessment will result in identifying the causative factors, which means a better prognosis! You can trust our physiotherapists at Capital Physiotherapy to understand your body and get you back on track! Our initial appointments are industry-leading 1 hour. This gives our physiotherapists time to do full assessment, to make sure you are looked after!

Depending on what caused your PFPS, you may expect your physio at Capital Physiotherapy to:

  • Reduce any muscular tightness
  • Give exercises to improve muscle control
  • Suggest different types of footwear, or refer you onto our trusted network of podiatrists
  • Help plan an exercise program to make sure your body do not burn out

Our physiotherapists are trained at making sure all your concerns are listened to and provide you the best care you need.

If you have any questions, please do not hesitate to contact Capital Physiotherapy. Our physio clinics are located in Footscray, South Yarra, and Balwyn.

BULGING Disc? Herniated Disc?

One of a common reason for lower back pain is due to a bulging disc. But what exactly is a disc?

The disc is a gel like substance that sits in between our bones in the spine, the vertebrae). These discs acts to help with: shock absorption, spinal stability and allows a more efficient movement from the spine. The discs are made up of two parts: the more elastic outer shell, which keeps the shape of the disc together, and the gel like inside.

 

In normal movements, the disc will get compressed and extend in certain parts, depending on the movement. For example, bending forwards will result in the front part of the disc to be compressed, while the back part will be distended.

When you have a ‘disc bulge’, what happens is, instead of the outer elastic part keeping the disc’s shape, it has protruded out (this is called Bulged Disc). Depending on the severity of the injury, the gel like content can actually seep out as well! (This is called a Herniated Disc). 

Symptoms

Apart from pain, this bulging disc may be severe enough that it touches the nearby nerve root. When this occurs, you may also experience the following symptoms: pins and needles, numbness, burning, electrical shocks as well as loss of power in your legs. 

 

 

 

 

Diagnosis and Treatment

It is important that you seek a trusted physiotherapist that will be able to do a comprehensive assessment on you to get the correct diagnosis quickly. Without the right diagnosis, your treatment will be ineffective.

At Capital Physiotherapy, our initial appointment is 60 minutes, instead of the normal 20-30 minutes. This allows our physiotherapists the time to complete a full assessment so that the right treatment be implemented. The quicker your back is treated, the better your outcome is!

We are well equipped at providing you the best care to get you back on your feet. Treatments may include:

  • Mobilisation
  • Massage
  • Electrotherapy
  • Exercise prescription, including building core strength
  • Pilates equipment, including: reformers and Wunda Chair.

Anterior Cruciate Ligament Injury

The knee joint itself involves a multitude of structures to keep it stable and strong. The Anterior Cruciate Ligament (ACL) is one such structure that helps achieve these objectives. It originates from the posterior (back) part of the femur and attaches to the anterior (front) part of the tibia. The Posterior Cruciate Ligament (PCL) meanwhile, originates from the anterior part of the femur and attaches to the posterior part of the tibia. These two ligaments crosses in the middle and provide specific stabilities to the knee.

The ACL is important in securing the knee joint by preventing the forward movement and rotation of the tibia (lower leg bone) in respect of the femur (thigh bone).

There are many ways that a knee can be injured. On the one hand, there could be an obvious traumatic incident, where you were tackled while playing football. On the other hand, it could also be due to an inconspicuous activity, where you were simply running and trying to turn one way and injured yourself.

Most ACL injuries, in fact, are done via the later method. There may also have been a factor of jumping/landing prior to the injury.

A full tear of the ACL, may actually not cause significant amount of pain in some cases. In fact, some athletes would feel that they can continue their sporting commitments, only to find themselves unable to perform due to significant instability in the knee joint.

It is highly suggested that you stop your activities and seek diagnosis immediately. Our physios at Capital Physiotherapy are trained to ensure you get the correct diagnosis first and foremost. They will spend the time that is required to make you feel at ease and give you the correct advice that you need. Our appointments are 1-on-1 which ensures you get the most out of your physiotherapy sessions. A treatment plan will be drafted for you, so that you can go back to your best quickly! Capital Physiotherapy is also able to get you crutches as well as braces if required.

In the meantime, make sure you RICE; Rest, Ice, Compression and Elevation!

Know When to Change Your Shoes

Commonly, manufacturers have advised to change your runners after 500-800 km; this is an extremely rough guide. While this figure has some use, we’re going to let you know of other signs that will help you find out if your shoes are still good to run in.

But before we get to WHEN you should change your shoes, let’s talk about WHAT makes up a shoe.

Shoes Anatomy

Your shoe is made up of an: upper, midsole and outsole. The upper can be made from cloth (like Adidas’ Primeknit or a mesh material). The midsole of a shoe is usually made of EVA, which is basically a type of foam. The outsole of the shoe, meanwhile, is made of hard rubber which helps to protect the midsole from the ground.

So now that we know what makes up a shoe, let’s talk about WHEN and, more importantly, WHY you need to change your shoes!

Changing Your Shoes

Quite a lot of people that come into our rooms at Capital Physiotherapy, would say that their shoes are fine. They would show how the outsole is minimally worn out (especially if the shoe has good quality outsole like Continental), or they would show how there are no tears in the upper. While these are good indications the shoe may be ok, you must look at the midsole.

The function of the midsole is the most important part of the shoe. The EVA foam is there to ensure that when you land on your feet, it can absorb any impact forces (so that your bones and joints don’t have to!) EVA foam can be likened to a kitchen sponge. When you squeeze a fresh sponge, you can feel the springiness as it returns to its original form. But over time, the physical properties of the sponge degrades.

Similarly, as you pound the pavement or the treadmill, the midsole of your shoe degrades over time. Here are the signs of when you should change your shoes:

  • Visible and permanent horizontal creases along the midsole of your shoes.
  • The presence of compression marks from where the insoles are.
  • You would also see the outsole ‘digging’ into the midsole.

Basically the EVA foam has been compressed from the top and bottom! The result is, with each step you take in your run, the forces are not being absorbed by your midsoles anymore; but to the joints and muscles in your feet, knees and hips. So here’s another sign to look out for: if you start to feel more aches and pain than normal, it’s probably your shoe not giving the support you require anymore.

Continuing to wear your shoe could result in muscle and tendon injuries, including tears!

Hopefully that has helped you to find out when to change your running shoe. As much as we want to use the shoe until the upper is torn and your toes are showing, or the outsole is worn out completely, the truth of the matter is that your midsole will usually be the first to go.

Come into Capital Physiotherapy and our friendly and knowledgeable physiotherapists would be happy to help you!

KIM K WORKOUT- HOW TO GET YOUR DREAM BOTTOM

Youtube Video for this blog

What are gluteal muscles?

The muscles of the gluteal region can be broadly divided into two groups:
• Superficial abductors and extenders – A group of large muscles that abduct and extend the femur. Includes the gluteus maximus, gluteus medius, gluteus minimus and tensor fascia lata.
• Deep lateral rotators – A group of smaller muscles that mainly act to laterally rotate the femur. Includes the quadratus femoris, piriformis, gemellus superior, gemellus inferior and obturator internus.

Why are gluteal muscles important?

You might be concerned about how to make your bottom looks toner to have a better fit for your jeans however, there’s so much more to glutes strength than the way your pants fit! This important group of muscles extends the hip (pulls the thigh behind you), abducts the hip (your lateral movement to the side), and does internal and external rotation of hip. In short, they’re incredibly important.

Unfortunately, in today’s society, they are often weak and under work.In this first work society, spending time in front of the desk becomes an inevitable task. Long hours sitting caused our glutes to “turn off” or stop firing. This in turned caused the muscles to weaken without us realising it.
Once our glutes stop firing, our hip flexors (the muscles that pull the thigh forward) get tight and can lead to injury. When you build a stronger booty, here are a few of the benefits you can expect.

Having a strong glutes can help:

Prevent back pain: Your glutes work to stabilize the pelvis and keep integrity of movement in the hip joint. When they’re strong, your lower back doesn’t bear the brunt of your motion.

Increase athletic performance: If you want to be a stronger athlete, it’s time to start working your glutes! Stronger glutes will improve your speed, agility, and jumping skills, and quick side-to-side movements will also become much easier.

Prevent knee pain: Strong glute keep the pelvis stable from swaying side to side. When your pelvis isn’t stable, it puts a lot of pressure on your knees and ankles to compensate. When your glutes are strong, it helps prevents this naturally, keeping you safe from injury.

Exercises to help gluteal muscles strengthening

There are many exercises that help strengthen our glutes. In our video, we demonstrate the 3 basic exercises that we normally start our client with, and progress to more sports specific gluteal exercise as required.

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Shoulder Blades Sticking Out? Is it Bad?- Ask a Physio

What is scapula winging?

Scapula winging is when the borders of the scapula (shoulder blade) stick out away from the ribcage. Normally the scapula is meant to lie flat against the rib-cage. Scapula winging usually results from muscle imbalances of the muscles attaching to the scapula. Imbalances commonly occur between the pectoralis minor, upper trapezius, lower trapezius and serratus anterior muscles.

Consequences of scapula winging:

Scapula winging can result in inefficient movement of the glenohumeral (shoulder) joint. The scapula and shoulder joint are connected. If the resting position and movements of the scapula are not in optimum position, it can lead to restricted movements of the shoulder joint. This in turn can lead to impingement of the rotator cuff tendons and associated pain and dysfunction.

Weakness of the cervicothoracic postural muscles and subsequent scapula winging can also lead cause increased tension and pain in the muscles between the shoulder blades and the muscles attaching from the scapula to the neck. This in turn can lead to joint stiffness and potentially tension-headaches in more severe cases.

How can Capital Physiotherapy help reduce scapula winging?

After thorough assessment to determine which muscles are contributing to the winging scapula, our physiotherapists may use a variety of different treatment to try and relieve symptoms associated with scapula winging and reduce the winging itself.

Treatment options include:

  • Postural education and correction
  • Postural taping
  • Massage to relieve tension of tight muscles
  • Dry needling to relieve muscle pain and tightness
  • Muscle strengthening and re-training to correct muscle-imbalances causing the winging
  • EMG activation prior to strengthening to help activate muscles that have difficulty firing due to altered neuromuscular activation patterns

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Why Do I Have Knee pain? Quick Fix For PFPS

Patellofemoral Pain Syndrome, or PFPS, can be a very debilitating condition which can stop you from doing a lot of activities. At its worse, most patient will report of pain and inability to walk far.

PFPS is a term given to describe pain around the knee cap. This is usually due to repetitive damage around the knee cap as it contacts abnormally with the femur. Most patient will report of having a gradual build up of pain. Initially, the pain is niggling but does not stop a person from doing their exercises. Continued activity result in increasing pain which will in turn stop them from participating further. With rest, the pain would abate. However, returning to sport is usually short lived due to the returning pain.

There are multiple causes of PFPS. This include:

  • Poor Activation of VMO
  • Poor Hip Control
  • Tight ITB and lateral Quads (tight lateral knee structures)
  • Poor training habits
  • Leg length discrepency

Usually there are multiple factors that contribute to PFPS. It is important that you seek a trusted physiotherapist that can do a comprehensive assessment on your body. Taking the time with the assessment will result in identifying the causative factors, which means a better prognosis! You can trust our physiotherapists at Capital Physiotherapy to understand your body and get you back on track!

Depending on what caused your PFPS, you may expect your physio at Capital Physiotherapy to:

  • Reduce any muscular tightness
  • Give exercises to improve muscle control
  • Suggest different types of footwear, or refer you onto our trusted network of podiatrists
  • Help plan an exercise program to make sure your body do not burn out

Our physiotherapists are trained at making sure all your concerns are listened to and provide you the best care you need.

If you like our video please do like, subscribe and

Follow us at:
https://www.facebook.com/CapitalPhysiotherapy/

https://www.instagram.com/capital.physio/?hl=en

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HOW TO FIX GROIN/HIP PAIN? TIGHT HIP FLEXOR!

HIP FLEXOR TIGHTNESS

The role of the hip flexors:

The hip flexor muscles include the iliacus and psoas major. Together these muscles act to lift the thigh up closer to the abdomen, which is the movement known as hip flexion. Excessive tightness of the hip flexor muscles is more likely to occur in certain people. It can lead to biomechanical abnormalities and be a source of pain.

 

 

 

 

 

 

 

 

People that are more prone to hip flexor tightness:

People that have occupations that involve prolonged periods of sitting are prone to hip flexor tightness as the hips are in a sustained flexed position during sitting. People that engage in regular exercise such as running and cycling are also more prone to tight hip flexors. Sportspeople playing kicking sports such as soccer and football are also more likely to experience excessive flexor tightness as the kicking motion involves repetitive hip flexion movements.

The consequences of tight hip flexors:

Tight hip flexors can be a local source of pain around the hip joint which can be present during prolonged periods of sitting or during sporting activities that utilise the hip flexor muscles. Excessive tightness of the hip flexors can change lumbo-pelvic posture as it pulls the pelvis into an anteriorly tilted position. Increased anterior pelvic tilt increases the curve within the lumbar spine (lordosis) which in turn can cause the facet joint of the lumbar spine to be compressed more and tighten up surrounding back extensor muscles such as the erector spinae; this can lead to associated lower back pain.

Tight hip flexors and altered alignment of the pelvis can also lead to over-activity of the hip flexor muscles and altered neuromuscular activity of the gluteal and core muscles which can further be a source of hip pain.

What can we do to reduce hip flexor tightness?

Our experienced physiotherapists at Capital Physiotherapy can help to reduce hip flexor tightness and associated aches and pains through various treatment options which include:

  • Massage and trigger point release
  • Gluteal and core strengthening to improve lumbo-pelvic stability
  • Neuromuscular training
  • Stretches

What can you do to reduce hip flexor tightness?

To manage tight hip flexors stretch the hip flexors daily, try and stand up every 30-60 minutes to avoid sitting for prolonged periods.

Drop down into lunge position. Tilt pelvis backwards to activate glutes. Then lean forward at the hips, keeping the back in a neutral position. A stretch should be felt near the groin/front of the thigh. Hold for 30 seconds. Repeat up to 4 times a day. Stretch at least once a day.

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What people don’t tell you about PLANK/PUSH UP/SQUAT

Correct Exercise Technique

Correct technique is crucial to ensuring the correct muscles are recruited during specific exercises. Poor technique leads to increased risk of injuries.

Correct Squat Technique:

  • Straight back
  • Knees behind the toes
  • Stick the bottom out
  • Keep heels on the ground

Common mistakes performing squats:

  • Not sticking the bottom out far enough
  • Arching the lower back
  • Slouching the upper back
  • Knees going over the toes
  • Heels coming off the ground
  • Weight on the toes rather than the heels

Correct push-up technique:

  • The head, back and bottom are aligned to form a straight line
  • When going down towards the ground, the chest should move forwards so that it lies in front of the shoulders
  • The shoulder blades should be stabilised before descending so that they don’t stick out relative to the upper back

Common mistakes performing push-ups:

  • Arching the lower back
  • Dropping the head down towards the ground
  • Shoulder blades sticking out
  • Chest going straight towards the ground rather than moving forward as the body descends

Correct plank technique:

  • Head, back and glutes should be aligned to form a horizontal line
  • Glutes and core should be engaged
  • Shoulder blades should be in line with the upper back

Common mistakes performing planks:

  • Arching the lower back
  • Head/neck drop down towards the ground
  • Shoulder blades sticking out

At Capital Physiotherapy, our physiotherapists can create a personalised workout program just for you. Capital Physiotherapy will tailor to individual needs and wants. We will make sure that the program is challenging yet safe to do.

All our therapist are highly trained, prevention is always better than cure! Get fit? Start today 🙂
Hope that through this video, viewer can gain a better understanding on tips to improve your exercise technique. If you like our video please do like, subscribe and share 🙂

5 Steps to Fixing Tennis Elbow Pain

Tennis Elbow/Lateral Epicondylitis

One of the most common causes of elbow pain is the dreaded tennis elbow or, as it’s formally known, Lateral Epicondylitis. Tennis elbow affects predominantly the wrist and finger extensors that is located on the outside part of your forearm; specifically the Extensor Carpi Radialis Brevis and Longus). These muscles originates from the small bone bump on the outside of your elbow, and attaches to different parts of your hands.

The usual cause of a tennis elbow is usually due to a repetitive movement; specifically gripping activities. This is the reason why it’s called tennis elbow, this involves gripping a racquet. However, there usually is an issue with the person’s hitting technique. A common mistake is to use wrist extension to hit the ball. Your physio at Capital Physiotherapy can assess you in this regard.

Other common ways you can get tennis elbow are: prolonged computer work (typing), home renovations (hammering, painting) as well as carrying/lifting objects. In some cases, tennis elbow may also be as a result of some neck issues, including stiffness and nerve root irritation.

As you can see, it is important that you seek professional help when you have elbow pain. Inappropriate care will result in worsening of your symptoms as well as delayed healing. This may result in you requiring corticosteroid injections.

Your physio at Capital Physiotherapy is well equipped to look after you. They will spend the time that it takes to ensure you are cared for and get the results you need. They will make sure all contributing factors are considered and assessed. A thorough assessment is required so that you receive the correct treatment to get you back to your activities quickly!

Hope that through this video, viewer can gain a better understanding on tips to help with your tennis elbow pain. If you like our video please do like, subscribe and share 🙂

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