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.

Stiff Back from Prolong Sitting Can Lead to Shoulder Pain

Shoulder pain is one of the most common issues treated by physiotherapists in this day and age. While there can be many causes of shoulder pain, poor posture is one of the main factors. 

The “hunched” position or curved upper back as a result of prolonged desk and computer work can change the way your shoulder moves in everyday activities and cause our upper back to become stiff. Over time muscles can become tight at the front of the shoulder, pulling it forward. As well as this, muscles at the back become weak and cannot support the shoulder blade correctly and the joints of the upper back become stiff, restricting movement. This changes the position of the shoulder blade and causes impingement and pain during everyday activities such as lifting and dressing.

Common signs and symptoms include:

  • Pain felt at the front of the shoulder 
  • Pain with lifting to the front and side 
  • Decreased range of movement
  • Feeling restricted and stiff in the upper back 

When we have good posture, our shoulders can move freely without pain and restriction. Here at Capital Physiotherapy, we can help strengthen and retrain your posture so your muscles can support your shoulders correctly and allow the shoulder to move correctly. As well as this, we can help release tight muscles at the front of the shoulder and tight joints in the upper back to aid movement and decrease pain. 

To learn more about our physiotherapy programs and exercises, email us at info@capitalphysiotherapy.com.au or make online booking at https://www.capitalphysiotherapy.com.au/online-booking/.

Shoulder Impingement

The shoulder is a “ball and socket” joint, which means the shoulder can move in all kinds of directions. The cause of shoulder pain is not only isolated only to the shoulder, as many different factors may play a role in shoulder pain such as the neck, your posture, and how you use your arms.

A common shoulder condition in physiotherapy is called Rotator Cuff Impingement, which can be presented as pain in the front, back, or top of the shoulder. The rotator cuff are muscles that act to keep your shoulder joint centred in the socket of the shoulder blade, allowing your shoulder to move in many different ways. The tendons of the rotator cuff travel through and around the shoulder, which may be susceptible to impingement. When there is weakness to the rotator cuff, it can cause the shoulder joint to be off centred and move in the direction where it may irritate the tendons of the rotator cuff.

As mentioned above, muscle imbalance is one of the many ways to develop a shoulder impingement. Your posture, neck, and how you use your arms in your daily life can affect how impingement happens.

You may consult with a physiotherapist at Capital Physiotherapy to discuss about your shoulder pain and investigate if you have a Rotator Cuff Impingement. The physiotherapists at Capital Physiotherapy are trained to assess and treat shoulder conditions like impingement. 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.

Cervicogenic Headaches

Are you experiencing headaches? A large proportion of headaches are migraines and tension-type headaches; however, a common type of headache physiotherapists can assess and treat are cervicogenic headaches. Neck pain and headaches are frequently associated with headaches (Ashina et al., 2015), indicating the structures around the neck and shoulder may contribute to the headaches.  

Cervicogenic headaches are characterised by 

  • Pain and headache starting in neck and behind head and travels to the front
  • Usually only on one side 
  • Headache does not move from left to right 
  • Headaches are associated with posture, sustained positions such as sitting at a computer for too long, or turning neck in a particular position 
  • Neck pain 
  • Tight neck movement 

The development of cervicogenic headaches may involve your joints and muscles, which have pain generators that can create a headache. Your daily habits, posture, trauma to the head, or stress are ways you can develop a cervicogenic headache. Physiotherapists can trial different treatments to help relieve your headache, which may include:

  • Exercise: An important factor in long-term effects to help with strength and endurance of postural muscles and optimally using your muscles. High quality evidence has supported the use of exercise to help with long-term effects of headaches    
  • Dry Needling: A technique in which acupuncture needles are strategically placed to relieve tight muscles and improve range. This technique is short term and should be reinforced with stretching and exercise
  • Deep tissue massage: A technique that uses firm pressure to help relieve pain generators that travels up to create a headache. 
  • Joint Mobilisation: A technique that focuses on loosening up the neck joints to improve movement. This technique should be reinforced with active treatments such as self-mobilisation, massage, stretching and exercise
  • Taping: A short-term technique to help with postural awareness  

If you are experiencing headaches, you can visit Capital Physiotherapy to further assess and treat your condition. At Capital Physiotherapy, there are a wide range of treatments that can be done to help relieve and allow your take control of your condition. We are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at info@capitalphysiotherapy.com.au

Facet Joint Stiffness

Back pain is a common condition that everyone experiences at some point in their lives. It may become debilitating to the point it can stop you from enjoying activity, working, or even sleep.  

Back pain can involve multiple components of your spine, which includes:   

  • Joints
  • Muscles 
  • Ligaments
  • Nerves 

Back pain is not only limited to mechanical issues, as levels of pain can increase due to stress, duties of work and daily activities, sleep pattern, eating and drinking habits, which can be addressed in later blogs. Today’s blog topic will focus on the lumbar facet joint pain, which are the connecting points on the sides of your spine that allows and restricts certain movements such as bending forward and backward, twisting, and side-bending. The facet joints can become stiff or irritated due to various reasons, including:

  • repetitive or overuse twisting or rotating 
  • abrupt/unexpected movements of the spine
  • increased loads to the spine (i.e. weight, running, jumping) 
  • excessive side-bending or twisting of the spine

Your spine is especially strong and can withstand many aspects of load to it. However, sometimes, excessive movements that don’t allow the facet joint to rest can irritate the facet joints. Rest assure, physiotherapists are specialised in treating and planning programs to help reduce and prevent future back pain events.

If you have been experiencing back pain that includes but not limited to:

  • Pain or tenderness in lower back 
  • Local tenderness/ stiffness alongside the spine of the lower back 
  • Pain, stiffness, or difficulty in certain movements (i.e. side-bending, standing up straight) 
  • Referred pain down the butt or legs

At Capital Physiotherapy, we have clinicians who have experience in treating back pain. The service may include deep tissue massage, mobilisation, dry needling and exercise, depending on your presentation. 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.

Warming Up

Many people neglect the warm-up part of physical activity. Some people simply don’t have enough time because they arrive late to training and want to get into it as soon as possible. Others feel it’s simply a chore and unnecessary to complete. While it does take some time to complete a good warm up, doing a warm-up has a tremendous amount of benefits which you shouldn’t ignore.

Increase Muscle Temperature

Pretty obvious that a warm-up is suppose to increase your body temperature. But why is this so important? Think about your car engine on a cold day; for the best performance you should actually leave it running for a bit before the trip. Same thing with your body. If your muscles are cold when you jump straight into activity, you won’t be able to move as well. There is a good chance you will perform poorly simply because you haven’t taken the time to warm-up. 

Joint Lubrication

Not only should your muscles be warm, your joints need be warm-up as well. As per your muscles, getting blood pumping to your joints allows your joints to move the way you want. Think about if you are trying to use a pair of rusted scissors; it’s difficult to move and takes a lot more energy to move it. This can also impede with your performance with your activity if you don’t have a proper warm-up. It’s best to warm up and scrape off that rust rather than during your activity.

Injury Prevention

Likely the most important reason to complete a good warm up, you reduce the chances of getting injury. Using the rusted scissors example, not only does it not work properly, it also has a higher chance of breaking. Warming up increases blood flow and elasticity of your muscles, which reduces the chance of sustaining a muscle injury. If your muscles are compromised, there is an increased load onto your joints, which also increases the risk of injury.

Mental Preparation

Aside from physiological preparation, getting mentally prepared sport is equally or even more important. Even if your muscles are warm and joints are loose, it is difficult to perform your fullest if your head isn’t in the game. While general warm-ups works the body, specific warm up drills that are related to your sport or activity is very important to get your mindset in the game. To be able to switch on as soon as your activity begins allows you to perform your best.

It is quite unfortunate to sustain an injury because your didn’t have a proper warm up, so take that extra time out of the game and prevent that from happening. If you have unfortunately sustain an injury, best to check up with a physiotherapist to get you back to your activity as safe and efficiently as possible.

At capital physiotherapy, we have physiotherapist who are familiar with all injuries from all types of sports, work or daily activity. If you’ve got any inquiries about your injury, or are in need of a solid warm up routine, come by one of our clinics conveniently located at Balwyn, Footscray and South Yarra. You can also send an email at info@capitalphysiotherapy.com.au or book online at https://www.capitalphysiotherapy.com.au/online-booking/.One of our physiotherapist will place you in a rehabilitation program best suited for you and give some advice towards how to safely return to activity.

Tips On Continuing With An Exercise Program

As physiotherapists, we highly promote exercise as a form of therapy to keep your body strong and healthy. Really, there should be no restrictions to what type of exercise you do as long as you remain within your skill level. This can range from your gym based exercise to a group fitness class to dancing on your own. As much as it is beneficial to exercise, many would agree it is difficult to start and even more difficult to sustain. The right exercise to engage in is definitely based on individual preferences. So, how do we find which form of exercise is right for you?

Keep it fun

The truth is, not everyone likes to exercise. Exercise requires work, takes time and just isn’t fun for everyone. This point is really important for those who don’t like “exercise”. If you are able to view “exercise” as an entertainment, it wouldn’t even be considered “exercise” anymore. It would be just like watching a good show on the tele. Easy enough right? However, if the show is boring, you would stop watching it. This means you have to find the right show to continue to watch it for a long time. Same with exercise; if the exercising like a drag, the likelihood of continuing drops significantly. So go experiment with dancing, team sport, gym activities, you name it. Make sure it’s something you enjoy.

Bring a friend, or even friends

It makes it that much more entertaining if you exercise with a friend. Bringing a motivated individual also increase your own motivation. This is definitely true if you make it into a competition. Within the gym, you can’t expect to jump from 10kg squat to 30kg within a week. This needs to build up. And if you miss a day, you are giving your friend an advantage. This level of competition motivates people to continue your program. Not just the competition aspect, it’s simply more fun to chat to someone about the things you are doing. So bring a friend to fuel that motivation. It’s good fun and healthy for all of you.

Get some advice

For some people, there is that fear of starting exercise for because you’ve never been before. If you fall under this category, it’s helpful to get started with a bit of guidance. You can definitely turn to someone who has more experience in the field of exercise, including personal trainers, specific sport instructors and even friends who have a bit more experience with exercise. For other barriers to exercise like you’ve hurt yourself doing exercise or unsure if your injuries has healed enough to continue, it might be a good idea to consult with a physiotherapist to make sure you are healed and strong enough to continue the specific exercise.

At capital physiotherapy, we strongly promote exercise as a form of treatment for rehabilitation, recovery, strengthening, injury prevention and entertainment. If you are seeking advice on safety of exercise, come down to get a thorough assessment and some recommendations. We are conveniently located in Balwyn, Footscray and South Yarra so send us an email at info@capitalphysiotherapy.com.au and lets get you on track with your goals.