Snapping Hip Syndrome

Affecting between 5-10% of the population, Snapping hip (also known as dancer’s hip) is a condition where hip joint movement causes a snapping sensation that is either felt or heard (Musick and Varacallo, 2019). The snapping can be either painful or pain free and is often caused by overuse. People who perform repetitive extreme hip movements such as ballet dancers and weight lifters are most at risk.

Diagnosis of snapping hip can be performed in clinic and a physiotherapist will determine the structure responsible for the snapping sensation. The iliotibial band and the iliopsoas muscle group are the most common sources of the condition. 

The majority of snapping hip cases are pain free and do not require imminent intervention, however the snapping sensation can cause discomfort and become painful over time. The preferred treatment for snapping hip is rest and a return to activity with physiotherapy input (Jenkins, 2010). 

Once the structure responsible for the snapping has been identified, treatment for snapping hip generally involves stretching of the tight structures (Byrd, 2005) and eccentric strengthening (Brosseau et al., 2009). Once the stretching and strengthening of the related structures has been completed, a graduated return to activity can begin with an effort to avoid activities and movements which trigger the snapping.

If you think you may be suffering from snapping hip our friendly team at capital physiotherapy can complete a comprehensive assessment of your hip and design a targeted treatment plan to help you return to doing what you love.  We are conveniently located at South Yarra, Footscray, and Balwyn. You may call 0401 865 333 or drop an email at info@capitalphysiotherapy.com.au.

Hamstring Strain

A hamstring strain is a tear in your hamstring muscle which runs down the back of your thigh. Often occurring during strenuous exercise or when the muscle is excessively lengthened, this is an injury which can take between 2 weeks to 6 months to recover from depending on the severity of the strain. 

The severity of the strain can be determined clinically by tenderness with contraction and palpation, often more a severe strain will also affect your ability to weight bear and walk with a normal gait. In some cases, an MRI or ultrasound may be used to better diagnose the severity of the strain.

Age, as well as having previously suffered a hamstring strain have been identified as risk factors for further hamstring strains (Freckleton and Pizzari, 2013).

Treatment for a Hamstring will often begin with managing the swelling and inflammation which will occur initially, before incorporating strengthening and stretching exercises and finally a graduated return to activity. The “L protocol” which involves three exercises with an emphasis on muscle loading while lengthening is one treatment approach which has shown to be effective. The protocol, which includes the “extender”, “glider” and “slider” was shown to allow athletes to return to sport in an average of 28 days compared to 51 days for those who completed a traditional hamstring rehabilitation (Askling, Tengvar and Thorstensson, 2013). 

If you think you may have suffered a hamstring strain, or would like to better prevent yourself from sustaining one in the future, our team at Capital Physiotherapy can design an effective treatment plan to keep you doing what you love. We are conveniently located at South Yarra, Footscray, and Balwyn. You may call 0401 865 333 or drop an email at info@capitalphysiotherapy.com.au.

Get Back to Exercise

Are you looking to get back to being active? Increasing your physical activity can be a great way to lose weight, build fitness and improve your overall health. However, returning to sport or physical activity after a long period of rest or trying out a new sport can come with its own risks. Both returning to sport after rest and performing a new can place you at an increased risk of injury (St Pierre and Sannes, 2001).  Typically sports involving eccentric, or lengthening, movements such as running or soccer (Falvo and Bloomer, 2005) are activities which may place you most at risk of injury.

In order to avoid injury or recover properly following an injury it is important to undertake an individualised and gradual strengthening program which will allow you to get fitter, get stronger and avoid injuries.

The type and intensity of the exercise you do is important and depends on what facilities you have access too. Running, walking, boxing, team sport, rock climbing, dancing or a combination of any of these are great ways to start getting back to getting active and each come with their own strength and fitness demands. 

At Capital Physiotherapy we offer both in room physio consultations to treat any injuries you may have as well as offering Pilates classes. Our Pilates classes are a great way to return to exercising with supervised and individualised exercise programs devised and supervised by our qualified physiotherapists. Pilates has been shown to improve both flexibility and muscular endurance (Kloubec, 2010) and can be targeted at meeting the demands of what you love to do.

If you’re looking to get back to exercise or have recently suffered an injury, be sure to get in contact with our team here at Capital Physiotherapy. We are conveniently located at South Yarra, Footscray, and Balwyn. You may call 0401 865 333 or drop an email at info@capitalphysiotherapy.com.au.

Exercise Over The Holiday Period

Exercise at all times is an essential part of maintaining a healthy body and mind. Over the festive season however it can be all too easy to find ourselves indulging in a third serving of Christmas Pud rather than our third set of burpees. Whilst relaxing over the holiday period is important, and the odd treat here and there is perfectly fine, when we allow the festive season to take hold from early December into January it can become a problem. 

Indeed, studies of the effect of the holiday period on weight gain have shown that we do indeed tend to put on weight (Hull, Hester & Fields, 2006; Helander, Wansink & Chieh, 2016). Now, whilst this makes sense, the good news is that it doesn’t mean that you shouldn’t enjoy yourself over the holiday period and nor does it mean that there isn’t something you can do the avoid weight gain.

Using the extra time off over the festive season to start up a new fitness regime is a great way to stay in shape over summer and start the new year or pre-season feeling great. A recent study by Mason, Pallan and Easter (2018) demonstrated that a program identifying the physical activity costs of foods over the Christmas period was effective at preventing weight gain and a new fitness program is a great way to meet these targets.

If you are looking to start a new fitness program or maybe need to overcome an injury first our friendly and highly qualified team at Capital Physiotherapy will complete a comprehensive assessment and treatment plan to get you on track for summer including Pilates. . We are conveniently located at South Yarra, Footscray, and Balwyn. You may call 0401 865 333 or drop an email at info@capitalphysiotherapy.com.au.

Medical Imaging

I’m experiencing pain, should I get a scan done?

Medical imaging can take many forms including X-Rays, MRI’s and CT scans. These tools allow both you and your healthcare professional to have a greater insight into you, your body and why you might be experiencing pain or dysfunction. Often confirmation of a diagnosis by using medical imaging is vital when considering treatment of many conditions including broken bones and some ligament tears.

It is important, however, that we take into consideration your pain and your condition in the context of you as an individual. Often medical imaging can show things which may not be causing pain at all and it is important to understand that a finding on an MRI does not mean something is necessarily wrong with you!

In people with absolutely no pain or disability. MRI or CT images have been shown to find:

  • osteoarthritic features in 19-43% of individuals over 40 years old
  • meniscal tears in 13-26% of individuals over 40 years old (Culvenor et al., 2019)
  • Spinal disc bulges in 30% of 20 year olds
  • Spinal disc bulges in 84% of 80 year olds (Brinjikji et al, 2015). 

It is always important to think holistically about why we may be experiencing pain and often an imaging diagnosis may be misleading. In order to start feeling better and getting back to doing what you love it’s necessary to consider all the possible sources for your pain. 

Here at Capital Physiotherapy our experienced and qualified physiotherapists will complete a full assessment and create an individualised treatment plan. We are conveniently located at South Yarra, Footscray, and Balwyn. You may call at 0401 865 333 or drop an email.

Femoroacetabular Impingement

photo courtesy of Mayo Clinic website

Femoroacetabular impingement- what a mouthful! Really, it’s just a fancy name for when your leg bone or your femur impacts with your hip bone or your acetabular. This occurs because the hip bone or femur is an irregular shape and not smooth causing the joint to impinge. 

Normally your hip bone is the socket and your femur is the ball, fitting perfecting together. However, in individuals with FAI, because of the irregular shape the joint is no longer a perfect fit, causing pain when moving the hip.

People can have FAI all their life and not be symptomatic, however sometimes due to overuse or muscle in balance, symptoms start appearing. These can include hip and groin pain on certain movements as well as clicking, pinching and restricted range of movement. 

FAI can be diagnosed by a physiotherapist in conjunction with MRI images to confirm the type of FAI present and thus determine how to manage it. Sometimes it can be conservatively managed through rest, avoiding aggravating factors and hip strengthening to help support the joint. However, in other cases, surgery is needed to alter the shape of the joint and prevent any further complications from constant impinging. After surgery, a strengthening program prescribed by a physiotherapist is essential to return to sport and everyday activities.

Early diagnosis and intervention is the key, so book an appointment today at Capital Physiotherapy and we can have you back to doing what you love in no time! You may make an online booking or email us at info@capitalphysiotherapy.com.au

Peroneal Retinaculum Tear

“POP”- went my ankle!

If this happened to you, could have a peroneal retinaculum tear. But what actually is it? 

Your peroneal muscles sit on the outside of your shin bone and run down to the outside of foot. They help stabilise the ankle when walking, running and jumping. Normally the tendons are kept in place alongside the outside of your ankle by a specialised structure called a retinaculum. But sometimes a forceful landing on a flexed foot or twisting action can cause these structures to tear and go “pop”. When these structures are no longer holding the tendons in place, they can move over the outside of your ankle when walking, pointing and flexing your foot. Not only can this be quite painful, but it can also be visible. 

Depending on the severity of tear, sometimes surgery is needed to repair the retinaculum.  After surgery, a cast or boot is used to help stabilise the ankle and allow the new tissue to heal successfully. Once the cast is off, a strengthening program is prescribed by a physiotherapist to help you return back to normal function.

In some cases, conservative treatment is used. This can also include a period of time in a boot or cast for approx. 4-6 weeks or the use of ankle strapping to help stabilise the ankle joint. Additionally, a physiotherapist will provide exercises to strengthen the calf and other foot muscles to in order to support the ankle in the long term and prevent any further complications. 

While it does sound like a scary injury, physiotherapists at Capitol Physiotherapy are here to help. We can help you manage and decide the best course of treatment suited to you and your situation and have back to normal in no time! If you’re near the area in any of our clinics, contact us via online booking or drop us an email at info@capitalphysiotherapy.com.au.

Posterior Ankle Impingement in Dancers

Posterior ankle impingement is a very common injury in dancers that can be managed and treated by physiotherapists. It is caused when the ankle joint is constantly forced into excessive plantarflexion or pointe, thus why its common in ballerinas who dance in pointe shoes. The bones at the back of the foot impinge and compress the tendons and muscles in this area causing pain and restriction when pointing the foot. The repetitive trauma created by the impingement can cause scar tissue to form, thickening the tendons in the area and restricting movement of the ankle further. In some rare cases, posterior ankle impingement is caused by an os trigonum, which is an extra piece of bone attached to the back of the ankle and is present at birth in some individuals. Most of the time people are unaware they have this extra piece of bone until it becomes an issue. 

Common signs and symptoms can include:

  • Localised pain at the back of the ankle during excessive ankle plantarflexion or pointing 
  • Tender to touch at the back of ankle
  • Restricted plantarflexion or pointing 

While this injury can be quite painful and sometimes a significant issue especially in ballerinas, it can be easily treated by a physiotherapist. Initially, some rest and avoidance of painful activities may be needed to reduce inflammation, however a rehabilitation program needs to be developed in order to reduce pain and improve function in the long term. This can include mobilising the joints of the ankle to create more space within the joint, strengthening and stretching the surrounding and deep muscles and improving balance and proprioception in the ankle. 

If you are experiencing similar ankle issues or have any concerns, contact us today at info@capitalphysiotherapy.com.au. At Capital Physiotherapy, we have a special interest in dance injuries so book an appointment today and we can have you back in pointe shoes in no time. 

Marathon Preparation

With the Melbourne Marathon less than 4 weeks away (13th Oct, 2019), you are likely to have increased your mileage on your running. However, if you are overtraining and are being repeatedly pushed over your limits without adequate recovery, your chances of injury are dramatically increased. 

The reasons for your injuries are variable and could result from lack of strength, poor running gait, inappropriate shoe attire, not warming up or overtraining (Saragiotto et al, 2014). These “little niggles” in your training can be further explored by a physiotherapist so you can optimise your marathon training regimen. Most importantly, research suggests a strength program can improve performance and reduce injury risk. However, strength training may take a while for it to yield its results, so with the Melbourne Marathon just around the corner, a physiotherapist can help create short-term strategies to overcome the barriers to your run. However, it is important to create a strength program to yield long-term results for your next marathon!

As you prep for your marathon, make sure you keep a few things in mind:

  • Give yourself adequate rest and sleep! Muscle recovery is just as important as being active, so give your body enough breaks. 
  • Eat well. Proper nutrition gives the body adequate fuel during your runs and recovery. If you need help with nutrition, it will be beneficial if you seek assistance from a registered dietician. 
  • Strength and conditioning (S&C) routine 
  • Schedule your runs appropriately

Every person is different on what works best for them. If you need assistance, a physiotherapist at Capital Physiotherapy can help create a plan with your goal in mind! Capital Physiotherapy can also do running assessments, manages sports injuries, and can create a strength program. We are conveniently located at South Yarra, Footscray, and Balwyn. You may call 0401 865 333 or drop an email at info@capitalphysiotherapy.com.au.

Corticosteroid Injection for Tennis Elbow

Tennis/Golfers/Climbers

You may have heard of corticosteroid injection (CSI) or autologous blood injection (ABI) to help relieve pain from your tennis or golfers elbow. CSI is when corticosteroid is injected to your tendons where it has the ability to act as an anti-inflammatory. CSI is a very strong drug in which it can control symptoms of pain, however, there are risks of long-term use of CSI. The risks include:

  • Induced osteoporosis 
  • Impaired ligament repair 
  • Injection site reaction

ABI is a medical procedure whereby your blood is injected into your tendon to stimulate a healing process for the tendon. Although, these procedures may seem promising to reduce your pain, evidence has suggested that CSI provides short-term pain relief (Coombes et al., 2010), but there were worse outcomes a year after CSI (Coombes et al., 2013). Comparatively, ABI has shown to have a better effect than CSI, but only lasting effects of 6 months to one year after multiple injections (Chou et al., 2016; Elmajee et al., 2016).

A more preferable, non-invasive and friendly treatment for tennis/golfer’s elbow is to visit a physiotherapist for the management of your elbow pain. Physiotherapy has more benefits and have fewer to no risks compared to CSI and ABI. Tennis/golfer’s elbow is a condition where the tendons of your elbow are affected and painful. Although, tendons LOVE load, they are very sensitive to change of loads. Change of loads are:

  • Increased activity of the arms above what it is normally used to. For example, if you normally work at a computer job, then you start gardening.  
  • Change of tools. Tools come in different weight and size and a slight change of tools can change the load of the tendons. 
  • Using the arms in a different way 
  • A quick change of arm movement. For example, quickly catching a falling object may be a movement you’re not used to and can be the tipping point of what your tendon can tolerate 

At Capital Physiotherapy, a physiotherapist can help explore management strategies of your elbow pain. If you require advice on CSI, ABI, and physiotherapy, we are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at info@capitalphysiotherapy.com.au or do an online booking here.