Tag: sports physiotherapy

Osteoarthritis of the Hip

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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.

What are spondylolysis and spondylolisthesis

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One of the primary roles of the spine is to protect the spinal cord. This means that the spine needs to be strong while maintaining the flexibility required for a movable trunk. While the spine is very sturdy, spinal injuries do occur. Health professionals often use terms to describe and classify injuries of the body, two of these terms that you may have heard are Spondylolysis and Spondylolisthesis.

What are they?

Spondylolysis refers to a stress fracture of the pars interarticularis of the vertebra. This is the part of the vertebra that connects the body of the vertebra with the rest of the vertebra that surrounds the spinal cord. A separation of this fracture where the body of the vertebra is displaced forwards or backwards is called a spondylolisthesis.

Spondylolisthesis is a progression of spondylolysis and is given grades to classify its severity. Both spondylolysis and spondylolisthesis commonly affect the fourth and fifth lumbar vertebrae, found at the base of the lower back.

What are the causes?

Spondylolysis and spondylolisthesis can be a result of trauma with the spine being moved forcefully into extension, particularly in younger people. Certain sports such as gymnastics, football and weightlifting require repetitive backward movements of the spine and this can eventually lead to a stress fracture of the pars interarticularis. Growth spurts in teens have also been known to be responsible for the development of these conditions.

 

In older adults, common causes of spondylolysis or spondylolisthesis are degenerative changes in the spine due to aging, osteoporosis, infection or even a tumour. Some people have a genetic vulnerability in this area of their spine making them more susceptible to developing spondylolysis and then spondylolisthesis.

 

What are the symptoms?

 

Many people with spondylolysis and spondylolisthesis may be asymptomatic, which means they perform their normal activities without experiencing any symptoms. However, when symptoms do occur, common complaints are pain and tightness, much like a muscle strain, spreading across the lower back. This pain may be eased by bending forwards and aggravated by walking, running or leaning backwards.

 

In more progressive cases of spondylolisthesis, the shift of the vertebral body can cause narrowing of the spinal canal that can lead to nerve compression. This may cause hamstring tightness and even numbness and weakness of the lower limbs, affecting gait and daily activities.

 

How can physiotherapy help?

 

Your physiotherapist will work closely with you and any relevant medical professionals to determine exactly what is needed for your particular condition. Severe instability in the spine may require stabilization surgery, however this is rare and in most cases symptoms of spondylolisthesis can be improved with regular physiotherapy management.

 

Physiotherapy that focuses on strengthening and improving the flexibility of both the lower back and the abdominal muscles has been shown to have positive effects on both pain and function for those with symptomatic spondylolysis and spondylolisthesis.

 

Speak to your physiotherapists for more information regarding your individual condition. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Osgood Schlatters – The Sporting Knee

Sports Injuries No Comments

The Sporting knee: Osgood Shlatters
Osgood Shlatters is an overuse injury of the knee which commonly affects children and adolescents. Symptoms usually develop during a growth spurt due to an increase in tension on the tendon that attaches from the kneecap to the shin, placing excess load onto the growth plate (a cartilage point in immature bone) of the shin bone. This condition tends to affects boys more than girls between the ages of 10-15 years old with symptoms typically presenting during activity or exercise and improving with rest. There will be tenderness on the bony prominence of the shin bone with possible swelling and the child may be reluctant to put weight on the affected side resulting in limping or a change in walking pattern.
Children who regularly play sports involving repetitive running, jumping and twisting such as soccer, netball and tennis have a higher risk of developing Osgood Shlatters due to the increased load on the knee. Other factors which may cause an onset of symptoms are tightness in the thigh muscles or hamstrings, a history of a previous knee injury, weakness around the hips and pelvis, poor foot posture or non supportive footwear. There can also be external factors such as a sudden increase in training frequency and intensity and competitions.
A physiotherapist is able to diagnose Osgood Shlatters through a detailed review and examination. In some cases, especially if the symptoms have been ongoing for a long period of time X-ray imaging may assist with diagnosis but is not essential. Once diagnosis is confirmed it is important to rest from sport and aggravating activities. A physiotherapist is then able to begin a gradual, pain free return to sport program when the child is able to manage. Tapping or bracing is an effective way to offload the tendon and can assist with pain relief. Other treatment techniques include massage, ultrasound therapy, advise on footwear and strengthening and stretching techniques.
If your child has been complaining of knee pain with their sport it is important to have them assessed to ensure they have effective treatment and management. Our physiotherapists at Hinteractive Physio will be able to assist with an evidence based approach of management and return to sport.

Return to Sport: Ankle Injuries

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It’s coming up to sport season again. Footie boots, netball gear, orange slices and all of the aches and pains that are synonymous with kids sports. But how bad should an ache or a pain be before you go and see someone? Ankle sprains are the most common injury in active and sporting individuals. From a simple rolling of the ankle to a ligamentous tear, a physiotherapist can help. Mild sprain injuries result in a stretching of the ligaments which normally act as a passive restraint and support the ankle with twisting movements. As these ligaments stretch, it becomes easier and easier to re-injure the ankle. Ankle injuries can present with swelling, stiffness and pain.
Sometimes, pain may present in three ways; 1) pain only during activity, 2) pain upon rest following activity, or 3) pain upon waking the following morning after an activity. The presence of pain is the body’s way of warning you that a certain activity may be causing you harm, such as the stretching and tearing of the ligaments around the ankle. Pain following an activity indicates the presence of inflammation. Playing through pain may create a cycle of chronic inflammation which will hinder healing and prolong an injury. Inflammation is commonly treated with rest, ice, compression and elevation.
If your child is complaining of persisting pain and swelling around the ankle, it may be time to visit your local physiotherapist. With ligamentous stretching, the ankle becomes unstable and people may also experience a loss of balance. Commonly physiotherapists advise rest for 3-5 days in an acutely inflamed ankle, giving a compression bandage to help alleviate swelling. As pain diminishes with rest, your physio will prescribe exercises to help improve ankle stability to reduce recurrence risk.
The next big question is should your child use tape or a brace during sport? Ideally, the exercises prescribed by your physiotherapist will aim to improve stability. Though while the ankle is strengthening (which can take six to ten weeks) your child will be heading back to sport. There are pro’s and con’s to both options as seen in the table. Ultimately it is personal preference. If you are concerned about your children’s ankles in the upcoming sporting season, why not give our friendly physiotherapists a call at Hinteractive Physio on 5442 5556 and book an appointment.

PRO CON
TAPING
Not Bulky Skin irritation and pain with removal
Improves joint position awareness Expensive long term
Difficult to self apply
BRACING
Long lasting Bulky, difficult to fit in shoe
Easy to self apply Brace slipping with movement
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