Osteoarthritis of the Hip

Osteoarthritis (OA) is a degenerative disease that affects the cartilage of joints. Cartilage is a firm, flexible connective tissue that lines the surface of many joints and provides shock absorption and cushioning for the bony surfaces of those joints as they move. During the process of OA, cartilage gradually begins to break down and is worn away. This means that the bony surfaces below the cartilage start to rub together, creating increased stress and friction. The body reacts to this increased stress by creating small bony deposits around the joint, as more of these are created the joint becomes increasingly painful and difficult to move.

The hip is one the joints most commonly affected by osteoarthritis. While OA is generally considered to be a disease associated with aging, younger people can be affected, particularly following trauma to the hip. As a general rule, however, the cartilage in our bodies loses elasticity as we age, making it more susceptible to damage. Other risk factors for the development of OA are a family history of OA, previous traumatic injury of the hip, obesity, improper formation of the hip at birth (developmental dysplasia), genetic defects of the cartilage, impingement of the hip (femoroacetabular impingement) and a history of intense weight bearing activities.

What are the signs and symptoms?

The most common symptoms of hip OA are pain and stiffness with reduced movement of the hip, particularly in the direction of internal rotation. These symptoms in a person over the age of 50, in the absence of a trauma that may have caused a fracture, indicate possible OA. Pain originating from the hip joint can be felt as a deep ache that can be noticed in the groin, buttocks, thigh or even knee. It is also typical for sufferers of OA to experience stiffness in the morning upon waking that lasts less than 30-60 minutes. Grating or cracking sensations with hip movements are also common complaints, along with mild to moderate joint swelling.

In the early stages, mild pain may be felt with activities such as walking or running. As the disease progresses these activities will become more painful with the muscles that provide additional support to the joint becoming weaker, exacerbating the disease process. For many people, a total hip replacement may be necessary to reduce pain and restore function.

How can physiotherapy help?

For mild to moderate cases of OA, physiotherapy can help to reduce pain and maintain function for as long as possible. Keep the musculature around the hip as Strong and healthy as possible can have a significant impact on your quality of life and your physiotherapist work with you to help you to set and reach your goals for treatment
Treatment will also include stretching, trigger point therapy, joint mobilization to increase the joint’s mobility, and a personalised exercise program, including hydrotherapy and isometric exercises that work to increase muscle strength while putting less pressure on the joint.

For those whose best course of treatment is surgical joint replacement, physiotherapy can help to achieve great outcomes by helping with effective preparation and rehabilitation, getting you on your way to recovery as quickly as possible.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Are Your Kids Finding Studying a Pain?

28/09/2016

Back Pain Headaches Physiotherapy No Comments

As we head towards the final part of the school year, our school kids are studying for school exams and carting ever increasing amounts of text books home. Unfortunately for a lot of kids, the long hours spent hunched over the books results in neck pain, back pain and headaches. Sitting puts a lot of strain on the spine, especially when combined with the flexed postures often seen when using a computer or reading for prolonged periods. Despite the need to study, there are ways to minimise the strain on the spine and prevent the pain and headaches from occurring.

Firstly, having a good posture and desk set-up for studying are essential. Make sure that you are sitting with your bottom as far back in the chair as possible and if your lower back is sore, place a small cushion in the curve of your lower back to support it. If your feet cannot touch the ground, get a small stool to place them on. If you have an adjustable chair, ensure that the height of the chair allows you to look at your computer screen without looking up or down too far. When reading textbooks, use a book support or place them on a cushion, bringing them closer to your eyes and requiring less forward bending of the neck and rounding of the shoulders.

Secondly, taking mini breaks every 30-60 minutes allows some relaxation and stretching of the muscles which become tight when studying. Make sure you stand up, walk around and stretch the neck and back muscles. These short breaks will allow you to continue to study for longer with less pain. In addition to mini breaks, ensuring that you get regular exercise is important for numerous factors. Exercise has many positive effects including keeping your muscles strong and flexible, improving your concentration and memory, as well as improving your sleep quality. Despite these positive effects, many people stop exercising when they are studying due to time constraints. As you can see though, a small time sacrifice for exercise will be outweighed by the benefits.

If you are suffering with neck or back pain from studying, get some assistance as soon as possible so that you are not sitting through exams in pain. Seek assistance from your local qualified health professional. Hinteractive Physio has experienced therapists who can assess and treat the cause of your pain as well as offering a youth Yogalates class which combines yoga and pilates to improve posture, flexibility and strength. Hinteractive Physio can be contacted on 5442 5556 or visit our website: www.hinteractivephysio.com.au

Abdominal Muscle Separation – In pregnancy and Beyond

28/09/2016

Abdominal Muscle separation (rectus diastasis) is a common occurrence during pregnancy, although many women are unaware that they have this condition. Whilst this separation is a natural occurrence to accommodate a growing baby, it is important to prevent or minimize the degree of separation during pregnancy and monitor it carefully postnatally to ensure that it does not become problematic.

Diastasis Recti is simply a term for separation of the rectus abdominis muscle which is the outer “6 pack” muscle running from the breastbone to the pubic bone. The muscle comprises a left and right half which is joined down the centre by thick connective tissue called the linea alba. During pregnancy, this connective tissue stretches due to the growing baby and can become thinner and in some circumstances develop tears. This causes the outer abdominal muscles to function ineffectively with the possibility of developing other issues such as lower back pain, core instability, incontinence, hernias, postural issues and the much complained about “mummy tummy”.

If you are pregnancy, there are some ways to assist in preventing a large diastasis. Ensuring good posture, appropriate core muscle exercises, and avoiding excessive weight gain during pregnancy call all be beneficial. Some people have a genetic predisposition to developing a large diastasis due to weaker connective tissue. Pregnant women may notice a bulge or dome of the centre of the abdominal wall when they go to rise from a reclined position. This is a tell-tale sign of an abdominal separation.

After having a baby, women should have their abdominal muscles assessed within the first month to determine degree and severity of any diastasis present. Specific exercises can be prescribed by a physiotherapist along with supporting garments/braces to assist the recovery of the abdominal muscles. In severe cases, surgery may be necessary but is generally not encouraged until you have finished having children unless hernias are present. Early intervention offers the best chance of recovery so don’t delay in seeking help if you think that have may have an abdominal muscle separation.

Rebecca Steele is a physiotherapist with a special interest in the area of Women’s Health and can be contacted at Hinteractive Physio in Cooroy on 5442 5556.

Avoiding Sporting Injuries – A Guide for Adults and Older Athletes

By Craig Steele (Sports Physiotherapist)

With winter well and truly upon us, we tend to start seeing the injuries flow into the clinic from various sports such as soccer, rugby, touch football and tennis. With Australians being encouraged to take up more activity and organised sport, it is timely to take a look at the causes of sports injuries and what we can do to minimise the risks of being injured in the first case.

The broad term of “sports injuries” refers to injury sustained whilst undertaking not only organised sport, but also physical activity/exercise. They can occur for a number of reasons including accidents, poor training surfaces, poor equipment, poor technique, lack of conditioning or inadequate warm up or stretching.

If starting a new sport, it is important to seek coaching to ensure that your technique is correct, you are using the correct equipment for your shape and size and you are exercising on the correct surfaces. Sports injuries can affect any part of your body, but typically relate to the musculoskeletal system (muscles, bones and joints). Some of the most common injuries are sprains, strains and fractures.

A sprain refers to stretching or tearing of the ligaments – the thick band that joins one bone to another. Sprains can range from Grade 1 (minimal stretch) to Grade 3 (complete tear of the ligament) and usually result from trauma such as a fall or knock from fellow competitors. It is important to know the Grade of sprain, as this dictates the course of rehabilitation. Symptoms include pain, swelling, laxity or inability to weight bear through the joint.

A strain is a pull or tear of the muscle or it’s tendon (attaches the muscle to the bone). It usually results from overstretching or overcontracting the muscle. Symptoms may include pain, muscle spasm and weakness.

How to Treat Sports Injuries:

If you experience a sporting injury, you should follow these principles until you can seek further assessment from a physiotherapist or suitably qualified health professional:
1. Rest – it is important to immobilise the area injured if the pain is severe, or reduce your activity as your pain dictates, especially in the first 24 hours.
2. Ice – apply ice packs to the injured area to reduce inflammation and swelling. Always put ice pack in a damp tea-towel to reduce the risk of ice burns and apply for no longer than 20min at a time. This can be applied regularly in the first 24-48 hours.
3. Compression – is used to support the area and reduce swelling. Bandages or tubular bandages such as “tubigrip” may be used
4. Elevation – elevating the injured area (especially for lower limb injuries) helps to reduce swelling in the area.

Tips for Preventing Injury

1. No weekend warriors! – don’t be inactive through the week, then go and play lots of physical sports or overdo the exercise. Try to spread your activity throughout the week.
2. Increase your exercise level gradually, especially when starting back at sport or exercise
3. Ensure you have a good technique – coaching may be necessary
4. Accept your bodies limits and modify your activities as needed
5. Use the correct safety gear
6. Maintain good overall fitness. It is important to combine cardiovascular activity with weight training and stretching exercises.
7. Seek treatment early on if experiencing pain or discomfort.

Remember, it is always easier to treat conditions early before they become chronic. Physiotherapists are trained to accurately assess sports injuries and implement an appropriate treatment program. Sports

Physiotherapists have undergone extra tertiary level training to refine their skills in assessing the biomechanics of sport, assessment of injuries and the implementation of thorough and sports related treatment programs.

Craig Steele has a Masters Degree in Sports Physiotherapy and owns Hinteractive Physio. He can be contacted on 5442 5556.

Taking the Pain out of The Road Trip

Back Pain Headaches Physiotherapy No Comments

Well school holidays are just around the corner and Christmas is less than a month away, so many of us will be packing up the cars and starting the traditional road trip. For many people though, the thought of long car drives makes them cringe, with the memories of back aches and neck stiffness flooding back quickly. But it needn’t be such a painful experience! With some easy tips and a few exercises, you’ll be arriving at your destination full of the Christmas spirit instead of a belly full of paracetamol.

But like most things, preparation is the key. If you have any niggling problems, get them sorted out before you go away. This way, you are starting your trip in good physical condition, rather than having to stop half way for urgent treatment. If you have room in your vehicle, be sure to pack your own pillows. This reduces those “wry” necks when you wake on the first morning of sleeping in a strange bed with a strange pillow. Next step- check your car set-up. Make sure that your seat is adjusted to provide optimum lumbar support and reduced arm straining to reach the steering wheel. Headrests need to be positioned so that they are not pushing the head forward, as this will cause neck pain and stiffness.

Most people, and especially those with back pain, will find that the in-built lumbar support in their car seats is not enough to support the lower back on a long drive. Lumbar rolls (round or d-shaped foam rolls) are a cheap and effective way to support the lower back while driving. They are simply placed in the curve of the lower back between the chair and the spine, and help to hold the natural lumbar curvature of the spine. Place your backside as far back in the chair as it will go, to help reduce “slouching”.

Try and stop every hour or so to reduce muscle and joint fatigue. Simply go for a short walk and try the following stretches.

Place your hands in the hollow in the lower back and gently arch backwards as far as comfortable. Repeat this 5-10 times.
Place one heel on the ground with the toes pulled back. Lean forward, poking the bottom out the back until you feel the stretch in the back of the thigh. Hold 20 seconds and sway sides.
Stretch your neck by looking on a diagonal into your armpit. Hold 20 seconds and swap sides.

Obviously, if you have any specific problems you should consult a therapist before you go, to get more specific exercises for your body. So with regular breaks, not only will you be protecting yourself from driver fatigue, but you will be doing your body a favour.

For more information on back supports or exercises, contact your health professional. Craig and Rebecca Steele own Hinteractive Physio and can be contacted on 5442 5556.

Ladies – How’s your “core and pelvic floor?”

By Rebecca Steele

With Mother’s Day fast approaching, it is timely for all women to have a think about the health of their “core and floor”. The “core” muscles, refers to the deep muscles of the abdomen and lower back which have a stabilising role in the body and help to maintain a good posture. In addition to this important function, in women who are pregnant or have had a baby, they are vital for minimising the strain placed on the lower back while pregnant, and help to re-gain abdominal tone post pregnancy. A lot of women perform sit-ups diligently, but still have the tell-tale “pot belly” in the lower abdomen due to the lack of tone and endurance in the core muscles. The deep abdominal “core” muscles do not just return to normal function after they have been stretched, cut (caesarean section) or inhibited by moderate to severe back pain. They need specific exercises which can be taught to you by a physiotherapist or other suitably qualified fitness professional. The up-side to getting your core muscles working again is that the overall tone of your abdomen will improve, along with your posture.

The other essential health area for women to be aware of is their pelvic floor. Most women have heard of pelvic floor exercises but aren’t exactly sure of what they need to do and if they are doing it correctly. There are also some myths surrounding whether or not they should be performed while pregnant. The pelvic floor muscles are a sling of muscles which run from the tail bone at the back, through to the pubic bone at the front of the pelvis. The openings for the bladder, womb and bowel, all pass through the pelvic floor muscles, which are essential for the optimal functioning and support of the pelvic organs. Weak pelvic floor muscles can develop for numerous reasons, including pregnancy, childbirth, hormone changes, straining to pass bowel motions and chronic coughing. It is essential for all women, regardless of their age, to understand how to correctly perform a pelvic floor contraction, and ensure that they exercise the muscles regularly, especially when pregnant and following the birth. Like any muscle, if you don’t use it, you lose it. This is even more important as we age, as the hormone effects contribute to muscle weakness. Weak pelvic floor muscles can contribute to prolapses, incontinence and urgency symptoms in the bladder and bowel.

The “core” and “floor” (pelvic floor muscles) work together to provide a support network to the trunk from around and below. Squeezing up your pelvic floor while you are training your core muscles can assist the core muscles to work. However, if you suffer from pelvic floor weakness or incontinence, it is important to ensure you are performing an adequate pelvic floor contraction before doing core exercises, otherwise, more strain can be placed on the already weak pelvic floor. The good news is that pelvic floor weakness and incontinence can often be managed by a physiotherapist who has had extra training in assessing and treating conditions of the pelvic floor. Core muscle exercises can be provided by a physiotherapist, or suitably qualified health/fitness professional.

If you have any concerns about your “core and floor” please contact an appropriate health professional. Rebecca Steele co-owns Hinteractive Physio in Cooroy and can be contacted on 5442 5556.

Keep Your Body Merry This Festive Season

Well Christmas is nearly here, yet again. As physio’s, we often seen a great deal of people who either injure themselves over the festive season, or who find that their aches and pains increase over this period. So, why is that you ask? Well there are probably a number of reasons.

Firstly, we all tend to take a break from our regular exercise routines, and over indulge in some Christmas cheer. Regular exercise is essential for maintaining muscle strength, co-ordination and joint mobility. It takes a long time to improve muscle strength, but only a short period of rest to undo all of that good work. Without regular exercise, the receptors in our joints that send feedback to the brain don’t function as well as they should. This can increase the likelihood of an injury while sending some fast ones down the pitch in backyard cricket, or while hurtling down the ‘slip and slide’.

Alcohol is another major contributor to festive season injuries. Most people are aware of the balance effects of alcohol, so it is easy to see how it leads to increased falls and ligament damage. Ladies tottering around on high heels at Christmas parties are at a significantly higher risk of hurting an ankle or knee, especially if consuming alcohol. So ladies, no dancing in soaring high heels after a few champers’ at the Christmas party! At least take off the heels!

Overnight visits to relatives houses often involve sleeping in a strange bed, on a strange mattress and pillow. This often results in a wry neck upon waking, which is certainly not what you want during the Christmas break. Remember to take you own pillow when possible, and stretch your neck and back regularly to avoid muscle tightness.
So there you have it! Keep active, limit the alcohol (especially while wearing those killer heels) and stretch regularly to avoid a painful Christmas break. If you do happen to injure yourself this holiday period, seek help straight away. The sooner your injuries are attended to, the quicker you will be back to the holiday fun.

Craig and Rebecca Steele operate Hinteractive Physio and can be contacted on 5442 5556.

What is Physiotherapy and Can it Help Me?

12/10/2011