Tennis Elbow Tendon Pain

Tennis Elbow

Tennis Elbow

By Aaron Woolley, Physiotherapist.

Tennis elbow, also known as lateral epicondylitis, is a condition that affects the tendons in the elbow joint. It is characterised by pain and tenderness on the outer part of the elbow and forearm. This condition is usually caused by overuse of the lateral forearm tendons, resulting in small tears within the tendon that attaches to the lateral epicondyle of the humerus bone (upper arm). Tennis elbow can be debilitating and painful, and can affect everyday activities that involve gripping and lifting. Thankfully, high-quality physiotherapy treatment that is provided at Robina Physio on the Gold Coast can be highly effective at treating this condition and get you functioning again normally without pain.

Tennis Elbow

Source: healthdirect.gov.au/tenniselbow

Symptoms of Tennis Elbow

The primary symptom of tennis elbow is pain and tenderness on the outer part of the elbow, which may radiate down the forearm. The pain is often aggravated by gripping or lifting objects, twisting the forearm, or even by simply shaking hands. Other symptoms of tennis elbow may include stiffness (particularly in the AM), weakness, and difficulty performing everyday tasks.

Treatment for Tennis Elbow

Physiotherapy rehabilitation for tennis elbow can be very effective in reducing pain and improving function. A physiotherapist will work with you to develop an individualised rehabilitation program that may include exercises to strengthen the forearm muscles and tendons, manual therapy techniques including massage and dry needling/acupuncture and some taping and bracing techniques to help reduce pain and improve mobility.

Strengthening exercises for tennis elbow are designed to improve the strength and endurance of the forearm muscles and most importantly gradual load the tendon to restore the tendons tissue tolerance. We typically start with extensor muscles contractions in an isometric nature then progress to contraction through range of motion. From here the physiotherapists at Robina Physio on the Gold Coast will build the functional loading of the muscles and tendons.

Resting your injury is not always the best treatment. Quite often people simply rest and wait for the pain to diminish. Unfortunately, this is not an effective long-term solution as while the tendon is resting the tissue tolerance of the tendons diminishes as well. Meaning once you load it again the pain returns much quicker. The best approach is to slightly decrease your loading of the injured area but not completely stop using it. The physio’s at Robina Physiotherapy on the Gold Coast are experts at training/load modification and can help get your loading patterns right.

The research for physiotherapy treatment is positive and has shown that patients who received physio rehabilitation consisting of manual therapy, stretching exercises, and strengthening exercises experienced significant improvements in pain, function, and grip strength compared to those who received only a corticosteroid injection. Another study published in the Journal of Hand Therapy found that a combination of manual therapy and exercise therapy was more effective in reducing pain and improving function in patients with tennis elbow compared to exercise therapy alone.

If you’re struggling with Tennis Elbow don’t hesitate to get your treatment started as early intervention typically equates to better and quicker outcomes. Our expert Physiotherapists at Robina Physio on the Gold Coast would love to help. Contact Us on (07) 55787233 or BOOK ONLINE.

Dry Needling QL

Dry Needling & Acupuncture

Dry Needling and Acupuncture

By Leigh McCutcheon & Dr Wayne Hing, Physiotherapist.

The effectiveness of western acupuncture and dry needling is seen every day in clinic, so it’s good to see the growing evidence for its use. In the past year since Leigh McCutcheon of Robina Physio on the Gold Coast and Dr Wayne Hing of Bond University on the Gold Coast collaboratively wrote Physio ‘dry needling’ and acupuncture – what’s the difference and what does the evidence say? for The Conversation, almost 400 RCTs in dry needling have been published and almost ten fold of that for acupuncture directly influencing clinical practice and associated outcomes.

Physiotherapists are increasingly offering needling therapies in addition to their standard care. Many Australian physiotherapists in private practice now offer dry needling or Western medical acupuncture as part of a treatment approach.

Is it just a fad or does science support it?

Needling, three ways

Physiotherapists can be trained to use dry needling, Western acupuncture and/or traditional acupuncture.

Dry needling involves penetrating the skin with needles to altered or dysfunctional tissue in order to improve or restore function. This often involves needling muscle trigger points to activate a reflexive relaxation of the muscle.

Western acupuncture uses traditional needling meridians (the ancient idea of energy channels through the body) and trigger points. But these ideas are applied to Western understandings of anatomy. In Western acupuncture, points are stimulated to create local tissue changes, as well as spinal and brain effects. The goal is to trigger pain-relieving chemicals, muscle activation or relaxation.

Even though traditional acupuncture points are used with this style of needling, Western acupuncture is not viewed as traditional Chinese medicine.

Traditional acupuncture uses meridian lines or other points based on traditional Chinese medicine assessment methods and approaches.

Acupuncture chart

A traditional Chinese medicine acupuncture chart from the 1800s. Wellcome Collection, CC BY

All physiotherapists trained in either acupuncture or dry needling meet safety standards which are viewed as within scope by the Australian Health Practitioners Regulatory Agency and the Physiotherapy Registration Board. These standards cover the level of training required, registration to practice and safety standards that include needle safety and hygiene to protect the public.

Minor reported side effects related to acupuncture including pain and bleeding or bruising from needle insertion are fairly common. But major adverse events – pneumothorax (collapsed lung), excessive bleeding, prolonged aggravation – are rare.

What’s needling good for?

Research into the effectiveness of acupuncture and dry needling is variable. Some studies show comparable results between dry needling and acupuncture, while others show more favourable results for one or the other depending on the condition being treated.

review that assessed the effects of acupuncture and dry needling for the treatment of low-back pain found that it is a useful add-on therapy when combined with manual therapy, activity modification and exercise prescription.

For migraine and tension headaches, experts say acupuncture seems to reduce the frequency and intensity of attacks – though more research is needed to compare it to other treatments.

Acupuncture and dry needling may reduce pain and improve function for people with neck pain. A systematic review found significant differences between acupuncture and “sham acupuncture” (which is performed away from acupuncture points) when used to treat certain types of chronic pain. However, some research only shows small and temporary relief for neck pain with dry needling.

Dry Needling QL

Results from randomised control trials support the use of needling for shoulder paintennis elbow and osteo arthritic knee pain. But a recent systemic review of research reported only weak evidence to support needling to treat plantarfasciitis and chronic ankle instability.

Not just for sporting injuries

Similarly, small randomised control trials have shown acupuncture and dry needling might reduce problematic jaw pain (temporo mandibular disorder) and improve mouth opening.Dry Needling of TMJ

Systematic reviews have reported needling and acupuncture were safe and effective recommendations for the treatment of broad conditions of tendinopathy (the breakdown of collagen in tendons) and fibromyalgia (chronic pain in the muscles and bones).

For women’s health, acupuncture has been shown to be effective for reducing pain with periods, compared to no treatment or non-steroidal pain relief medications – but the research had design limitations.

Though widely used in pregnancy, research into the use of acupuncture to induce labour reports it may increase satisfaction with pain management and reduce pain intensity. But it may have little to no effect on the rates of caesarean or assisted vaginal birth.

In summary, it appears needling techniques – whether dry needling or acupuncture – generally show positive effects over no treatment or “sham” treatments, but more research and high quality trials are needed.

Just one part of a treatment program

Needling may be useful as part of multimodal care – that is, when more than one treatment is used in conjunction to treat a problem.

Physiotherapists may combine needling therapies with exercise prescription, hands-on care including massage, mobilisations and manipulations, and taping techniques. They may also employ therapies that apply external energy such as ultrasound, laser, transcutaneous (under the skin) electrical nerve stimulation and biofeedback.Dry Needling Scapula

Finally, while the various needling techniques all use a filiform needle (with a solid filament as opposed to a hollow bore needle), the styles with each can be quite different. Ask what style of needling is being employed to treat you, and if you have a history of finding one style works better for you, discuss this with your practitioner.

Are you struggling with pain and ready to try adding Dry Needling and Acupuncture to your treatment? The Physiotherapists at Robina Physio on the Gold Coast are industry leaders in providing Dry Needling and Western Acupuncture treatments as well as training other health professionals in it use clinically. Please don’t hesitate to Contact Us on (07) 5578 7233 or BOOK ONLINE.

Hamstring Strains Soccer

Hamstring Strains

Hamstring Strains

By Yona Dorzaun, Physiotherapist.

We have decided to add a refresher article about hamstring strains and tears to the Robina Physio blog. This is series due to the high recurrence of hamstring strains that occur when sporting seasons start back on the Gold Coast. In athletic populations hamstring strains account for over 15% of all injuries, with re-injury rates being reported between 12-63% in some studies.

Hamstring Strains Soccer

Hamstring strains are caused by a rapid extensive contraction or a violent stretch of the hamstring muscle group which causes high mechanical stress. These injuries are common in dynamic sports like sprinting, jumping or contact sports such as Australian Rules football (AFL), Rugby and Soccer where quick eccentric contractions are regular. Hamstring injuries can also occur during recreational movements where the knee is forcefully fully extended.Hamstring Strains

Anatomy

The hamstrings consist of three muscles:

  • The Biceps Femoris
  • The Semitendinosus and
  • The Semimembranosus.

Causes and Risk Factors

There are various proposed risk factors which may play a role in hamstring injuries including older age, limited or excessive flexibility, fatigue, poor core stability, and strength imbalances.

During activities like running and kicking, hamstring will lengthen while the hip flexes and the knee extends, this lengthening reaches the mechanical limits of the muscle and can lead to the accumulation of muscle damage. One possibility for a hamstring strain is that the quadriceps (the opposing thigh muscles) do not contract in a coordinated fashion while we lengthen the hamstrings. Another reason might be differences in anatomy between individuals, e.g. differences in where the hamstrings attach on the femur and pelvic girdle.

How do Hamstring Tears / Strains Present?

Hamstring strains and/or tears present with a sudden pain in the posterior thigh ranging from minimal to severe intensity. People also often describe a “popping” sound or tearing impression. Depending on the degree you can expect bruising and swelling but these may not happen straight away. Alongside pain and tenderness hamstring strains cause loss of range of motion and loss of the ability to contract those muscles to different degrees.

Rehab at Robina Physio

At Robina Physiotherapy in the Gold Coast one of our physios will first take a detailed history and thorough physical examination including your gait, range of motion and strength. A lot can be deducted from the mechanism of these injuries, including what structures may be involved and the severity of the injury. This also helps you physio determine the best rehab strategy for you injury.

Hamstring strains are categorised in 3 groups, according to the amount of pain, weakness, and loss of motion. Hamstring Strains Grades

Grade 1 (mild)

  • Just a few fibres of the muscle are damaged / strained. This rarely influences the muscle’s power and endurance but can limit range of motion. Apart from feeling some pain and stiffness on their posterior tight.

Grade 2 (medium):

  • Approximately half of the fibres are torn. The symptoms we recognise at Robina physio are acute pain, swelling and a mild case of function loss. The patient’s gait will be influenced due to lack of ability to fully stretch the muscle, and the physio will be able to reproduce the pain by applying pressure on the hamstring muscle or bending the knee against resistance.

Grade 3 (severe):

  • Ranging from more than half of the fibres ruptured to complete rupture of the muscle. Both the muscle belly and the tendon can suffer from this injury. It typically causes large amounts swelling and pain. The function of the hamstring muscle is greatly impacted showing significant weakness.

Regardless of the degree of muscle strain, the primary aim of the rehabilitation program provided by the Physiotherapist’s at Robina Physio on the Gold Coast will aim to restore your function to the highest degree and to return to your daily or sporting activities at the same level as before the injury.

You can expect the highest level of clinical care using evidence-based rehabilitation protocols that have been proven to get you moving pain free again. With the right care from our expert Physio’s recovery times and re-injury rates are drastically reduced. Using a peer reviewed and renowned rehabilitation protocol that has been shown to reduce re-injury rates to a mere 0.53% we will aim to minimise pain, regain function, and enable you to achieve your goals and return to your usual activities.

The Physiotherapist’s at Robina Physio on the Gold Coast are here to help with any of your muscle injuries. CONTACT US on (07) 5578 7233 or BOOK ONLINE.

TMJ Physio Gold Coast

TMJ Physio

TMJ Physio

By Aaron Woolley, Physiotherapist

Continuing with the Robina Physio blog series, we now delve into Temporomandibular Joint (TMJ) Dysfunction and the role of TMJ Physio. This intricate joint plays a vital part in essential daily activities like breathing, eating, drinking, and speaking, making it undeniably significant. Often, we overlook its importance until we encounter TMJ dysfunction and the ensuing pain that arises when something goes amiss. Understanding the complexity and importance of the TMJ can help us appreciate the need for specialised care when addressing any issues related to this crucial joint.

TMJ pain often presents with the following symptoms:

  • Jaw and/or ear pain
  • Neck, shoulder and upper back pain
  • Headaches
  • Clicking, grinding and popping of the jaw
  • Locking of the Jaw
  • Limited ability to open and/or close the mouth
  • Clenching and grinding of the teeth
  • Change to your bite
  • Dizziness

Problems with the TMJ can be both acute and chronic in nature, are often painful and can be very debilitating for the individual suffering with TMJ dysfunction. So, let’s dive a bit deeper into what the Temporomandibular joint is and ways to manage TMJ dysfunction.

What is the Temporomandibular Joint?

The TMJ (Temporomandibular Joint) acts as a vital connection between your mandible and the temporal bone of your skull, forming your jaw joint. It is categorised as a condylar, synovial, and hinged-type joint. This classification indicates that the TMJ articulates with the condyles of the mandible and temporal bone, has a joint capsule encompassing the joint, filled with synovial fluid, and is equipped with an articular disc (and retrodiscal tissue). The movement of this joint is akin to a hinge, allowing for proper functioning and mobility.

Anatomy of TMJ

https://www.physio-pedia.com/File:TMJdisc.jpg

In addition to its complex structure, the TMJ relies on essential ligaments to provide joint stability. Moreover, the TMJ is supported by crucial muscles, including the Masseter, Temporalis, Medial Pterygoid, and Lateral Pterygoid muscles. These muscles play a vital role in facilitating the proper functioning and movement of the TMJ.

Muscles of the TMJ

As a TMJ Physio, it is crucial to focus on the relevant anatomy that impacts the joint’s well-being. This includes considering the elements contributing to joint stability, such as ligaments, the articular disc, and retrodiscal tissues, which are often associated with pain in various TMJ conditions. Additionally, the surrounding muscles play a pivotal role in TMJ function.

Among the listed muscles, special attention is given to the Lateral Pterygoid muscle due to its unique significance. Cadaver studies have revealed a direct connection between this muscle and the anterior portion of the joint capsule and articular disc, suggesting it may play a substantial role in TMJ dysfunction. Understanding and addressing these anatomical aspects are fundamental in providing effective treatment and management for TMJ-related issues.

Causes of TMJ Dysfunction

There are many possible causes of TMJ pain and dysfunction some of the more common causes include:

  1. Inflammatory Conditions: This can involve inflammation of the articular disc (discitis), synovial capsule (synovitis), retrodiscal tissue (retrodiscitis) and muscles and/or tendons. Although technically speaking, when the tendon is involved, this is not actually considered inflammatory and would be termed a tendinopathy. This occurs as a result of chronic teeth grinding (bruxism), clenching, heavy chewing or prolonged mouth opening e.g. during a dental procedure. But can also occur acutely from a direct trauma including a whiplash injury.
  2. Joint derangement: This involves displacement of the articular disc. This also occurs as a result of chronic teeth grinding (bruxism), clenching, heavy chewing or prolonged mouth opening e.g. during a dental procedure. But can also occur acutely from a direct trauma.
    • Displacement with reduction – is when the articular disc displaces anteriorly (forward), bunching up within the joint. At a particular point in the opening cycle the disc will reposition or reduce causing an audible and palpable clunk in the jaw. The jaw often deviates to the affected side when this occurs.
    • Displacement without reduction – is a more severe circumstance where the disc does not reduce often causing significant pain and loss of range (ability to open). This is called a closed lock. There typically isn’t associated clicking or clunking with this type but patients do report a clunk at the time the lock occurred.
  3. Muscle Spasm: Once again, this also occurs as a result of chronic teeth grinding (bruxism), clenching, heavy chewing or prolonged mouth opening and is heavily affected by cervical (neck) posture. This condition is commonly referred to as Trismus (lock jaw) and can be very painful and cause severe limitation to the movement of the jaw even though structurally the TMJ is not affected. Thankfully a properly trained TMJ Physio like at Robina Physio on the Gold Coast can make a big difference to your pain and dysfunction.
  4. Hyper-mobility: Can be related to laxity of the articular ligaments, joint capsule and articular disc. This laxity often leads to excessive movement of the articular disc, resulting in deviation of the jaw (often away from the affected side). Long term hypermobility can lead to degenerative type changes to the articular disc which can lead to a failure of the disc reducing during closing, causing the TMJ to become stuck open. This is called an open lock and more often occurs after very wide opening such as yawning or very long dental procedures.
  5. Degenerative Arthritis: This is often due to age related degeneration but can also occur prematurely due to a traumatic injury at a younger age. These changes are visible on X-ray as a flattening of the condylar head of the mandible. Joint crepitus is often felt and heard during opening and closing.

Assessment of TMJ Dysfunction

The TMJ Physio’s at Robina Physio on the Gold Coast regularly work very closely with your Dentist and/or Maxillofacial Specialist. This is especially important to help protect your teeth from and any new or further damage and to arrange additional treatments including occlusal splints and in some more severe cases Botox injections or surgery.

When you visit a TMJ Physio at Robina Physio on the Gold Coast, you can expect to undergo a comprehensive assessment. This will include taking a detailed history and conducting a thorough examination. During the examination, we will assess your posture, jaw position, and tongue placement. We will also palpate the TMJ, muscles, and ligaments, looking for any signs of tenderness, swelling, spasms, or hyper-mobility.

The quality of movement of your neck and jaw will be carefully evaluated, with specific attention given to your bite, range of opening, and any deviations observed during opening and closing. Additionally, we will briefly examine your tongue and cheeks for any indications of clenching, such as scalloping, as well as signs of teeth grinding.

In some cases, further investigations may be necessary, and we may recommend scans of your TMJ using OPG X-rays and/or an MRI of your jaw.

At Robina Physio on the Gold Coast, our TMJ Physios work closely with your Dentist and/or Maxillofacial Specialist. This collaboration is especially important in protecting your teeth from any new or additional damage and in arranging additional treatments like occlusal splints. In more severe cases, interventions such as Botox injections or surgery may also be considered. Our aim is to provide comprehensive care and support to address your TMJ issues effectively and improve your overall well-being.

TMJ Physio Treatments

Thankfully TMJ Physio can be highly effective when targeting TMJ dysfunction and pain. At Robina Physio on the Gold Coast we use a number of modalities with very good results for our patients. Treatment modalities we use include:

  1. Soft Tissue Release: This includes manually releasing the muscles around the head, neck and jaw through massage and trigger point therapy. We will also teach you how to do some self-trigger point release at home.
  2. Dry Needling: This involves inserting acupuncture needles to very specific muscles in the neck and jaw. Including the key muscles mentioned earlier in this blog, the Masseter, Temporalis, Medial and Lateral Pterygoid muscles.TMJ Physio Gold Coast
  3. Muscle Strengthening and Postural Correction: It is important we strengthen the muscles that support your head, neck, scapula and jaw. This involves some very small specific exercises for your jaw and more global exercises for your neck and back. We will also give you extensive advice about ways to help improve your jaw, head and cervical posture.Postural Correction Physio
  4. Adjunct Treatments: These would include treatments from other health professionals including Dentists, Maxillofacial Specialists, GPs and Psychologists. The need for each does vary from patient to patient but its importance cannot be underestimated. For example, in some cases stress may be a major factor, therefore additional support from your GP and/or psychologist will be helpful in addition to your TMJ Physio. We would also consider treatments such as anti-inflammatory medications, occlusal splints and in some cases Botox injections depending on the case.

TMJ Physio Gold Coast

I hope you found this information helpful. The Physiotherapists at Robina Physio are one of the few Physiotherapists on the Gold Coast with additional training in the management of TMJ dysfunction and pain. If your struggling with TMJ issues please don’t hesitate to Contact Us on (07) 5578 7233 or BOOK ONLINE.

Headache Physio Robina

Headache Physio

Headache Physio

By Aaron Woolley, Physiotherapist.

Robina Physio are expert physiotherapists that have specialised training in the assessment and treatment of severe and chronic headaches on the Gold Coast. If you are struggling with persistent headaches or migraines please read on for some helpful information or BOOK NOW to visit some of the best headache Physio ’s the Gold Coast has to offer.

Headaches rank among the most widespread disorders affecting the nervous system. Their prevalence is so significant that it is estimated over half of the adult population will experience a headache at some point in their lives. However, it is crucial to acknowledge that these numbers likely underestimate the true extent of the problem. Headache disorders have been consistently undervalued, inadequately recognised, and insufficiently treated on a global scale.

A headache can present in many different ways including, a constant aching or throbbing pain in various regions of the head, behind the eyes and/or the jaw. In some more severe cases (e.g. migraine or cluster headaches) blurred vision, dizziness, feeling faint and aura may be present.Headache Physio

Although headaches, particularly tension-type headaches, pose a significant burden on society worldwide, their underlying mechanisms remain incompletely understood and warrant further investigation. Fortunately, one area of certainty is the efficacy of physiotherapy treatment for individuals dealing with chronic headaches or migraines. Extensive research has demonstrated that headache physiotherapy can surpass the effectiveness of medication, providing a highly beneficial therapeutic option for those afflicted by these conditions.

 Headaches are classified as a Primary (migraine, tension, trigeminal), Secondary (attributed to trauma, vascular or infection) or Painful Cranial Neuropathies (lesions of cranial nerves). There are many mechanisms that can cause headaches and migraines including blood flow, hormones, brain neurotransmitters, sinuses and medications. Although most importantly it has been shown that up to 80% of all headaches originate from the neck.

Of all the types, Tension-type headaches are the most common. These headaches are often described as a severe pressure and/or tightness around the head, often spreading into or from the neck. These headaches are predominantly caused from stiff joints in the upper cervical region as well as tight muscles around the neck and shoulders. Another structure that can cause tension-type headaches is the Temporomandibular Joint (TMJ). When people have chronic tightness in their jaw muscles (related to clenching or grinding) it often refers pain and tension into the head producing tension like symptoms.Headache Physio Robina

At Robina Physio on the Gold Coast, our skilled physiotherapists employ a diverse range of treatment modalities to address chronic and severe headaches effectively. These modalities encompass massage, trigger point release, gentle joint mobilisations of the upper cervical spine, dry needling/acupuncture, as well as providing postural advice and personalised exercise routines, incorporating both stretching and strengthening exercises. We firmly believe in tailoring our approach to each individual’s unique needs, steering away from the one-size-fits-all approach commonly seen in other practices. When you visit Robina Physio, you can expect a thorough and individualised assessment, followed by a hands-on treatment plan designed to align perfectly with your personal treatment objectives.

Please don’t hesitate to Contact us on (07) 5578 7233 or BOOK ONLINE.

Osgood-Schlatters Robina Physio

Osgood-Schlatter Disease

Osgood-Schlatter Disease

By Jonathan ‘Yona’ Dorfzaun, Physiotherapist.

Osgood-Schlatter Disease (OSD) is a common cause of anterior knee pain in adolescents and young adults who are still skeletally immature. OSD usually develops during adolescence between ages 10 to 15 years for males and 8 to 13 years for females. It is more common in boys than in girls and it often presents during significant growth spurts.Osgood-Schlatter Disease Robina Physio

OSD (Osgood-Schlatter’s Disease) usually manifests without any specific trauma or injury. Instead, it develops as gradual anterior knee pain, often accompanied by tenderness at the bottom of the kneecap and on the bony area at the top of the shin, where the patellar tendon attaches to the tibial tuberosity (refer to the picture below). The condition is typically a result of repetitive stress activities like jumping and sprinting. Common sports associated with Osgood-Schlatter’s include Athletics, Netball, Basketball, Volleyball, Gymnastics, Tennis, and various Football codes. Additionally, in 20% to 30% of patients we see in clinic, symptoms can affect both legs.

Beyond rapid growth spurts, other factors that can contribute to the condition are poor flexibility of the quadriceps and hamstrings muscles, as well as incorrect alignment of the knee during activities such as walking, running, jumping, kicking, or cycling.

What will you feel?

Most cases of Osgood-Schlatter’s Disease (OSD) are characterized by increased anterior knee pain, with or without swelling, which intensifies during physical activities like running, jumping, cycling, kneeling, walking up and down stairs, and kicking a ball.

One significant indicator of OSD is tenderness upon touching the bony part at the top of the shin, known as the tibial tuberosity. In certain instances, the tibial tuberosity might undergo growth, leading to the noticeable presence of a lump. It’s crucial to note that the size of this bony prominence does not necessarily correlate with better or worse outcomes of the condition. Additionally, individuals with OSD may experience tightness in the front and back of their thighs and could even feel a sense of heaviness in their legs by the end of the day.

Osgood-Schlatter Disease Physio Robina

OSD predominantly arises as an overuse injury, often becoming apparent after activity or an increase in physical demands. The repetitive strain and microtrauma endured during these activities lead to irritation of the growth plates situated at the top of the shin, specifically at the bony part called the tibial tubercle apophysis. Pain typically indicates irritation of these growth plates. While severe cases may occasionally result in partial avulsion or fracture, such occurrences are rare. X-rays are not routinely necessary, but in severe cases where a fracture or avulsion is suspected, they might be considered.

It’s essential to recognise that Osgood-Schlatter disease can present similarly to several other knee injuries, including Sinding-Larsen-Johansson Syndrome, Patello-femoral Joint Syndrome, and Patella Tendinopathy. Hence, if your child experiences new-onset knee pain, seeking professional medical advice from reputable practitioners like those at Robina Physio on the Gold Coast is highly recommended. An accurate diagnosis made early on and a well-structured treatment plan can ensure effective management of the condition.

Treatment

At Robina Physio on the Gold Coast, our comprehensive treatment plan would typically encompass various approaches to effectively manage your symptoms. We may utilise techniques such as massage, stretching, dry needling, and/or ice therapy to alleviate discomfort and promote healing. Additionally, we would focus on activity modification to minimise activities that aggravate your condition, allowing your body the necessary time to heal through relative rest. Our goal is to provide you with a tailored and holistic treatment plan that addresses your specific needs and facilitates a smooth recovery.
Osgood-Schlatter Disease Running Robina

During your physiotherapy sessions at Robina Physio on the Gold Coast, the primary goal is to discover the optimal balance, that “sweet spot,” where you, as an athlete, can engage in your desired activity or sport with minimal to no pain. Our focus is on effectively managing your running and jumping load in the short term, allowing you to continue participating within the injury’s limits, facilitating the healing process. Complete cessation of activity may not always be the best long-term solution.

We have achieved great success in managing our patients by implementing a comprehensive lower limb mobility, strengthening, and progressive loading program. This approach addresses any stiffness or weakness that contributes to the irritation of the tendon over your kneecap and shin. However, the most crucial aspect of your journey is determining the appropriate level of activity that your body can handle before pain arises.

An essential message we convey to our patients regarding Osgood-Schlatter disease is that it follows a natural progression and is a self-limiting injury. This means that with proper pain management, you can continue with your regular physical activities. Our role is to help you identify the suitable intensity and frequency while also reducing your pain, ensuring a smoother recovery process.

The good news!

Osgood-Schlatter Disease has an excellent prognosis! The condition is self-limiting and acute periods usually recover within a month. However, if unnoticed or untreated pain may persist up to 2 years or when you have stopped growing!

The Physiotherapist’s at Robina Physio on the Gold Coast are here to help with any of your knee injuries, including Osgood-Schlatter Disease. Contact us on (07) 5578 7233 or BOOK ONLINE.

Hamstring Strains

Hamstring Tears

Hamstring Tears

By Aaron Woolley, Physiotherapist.

Hamstring tears and strains are incredibly common injuries. In athletic populations they account for over 15% of all injuries, with re-injury rates being reported between 12-63% in some studies. The Hamstring is made up of three muscles:

  1. Biceps Femoris
  2. Semitendinosus
  3. Semimembranosus

Hamstring TearsThe majority of hamstring tears occur during high speed running. The remaining typically occur from a stretching mechanism. Combine the two (e.g. in a footballer), then you have a recipe for higher hamstring injury rates.

Now that we are in the middle of the winter sports season, hamstring injuries are a common presentation at Robina Physio on The Gold Coast. It has been shown that hamstring tears and strains can occur up to three times more often during a football season. In a football team there will typically be 2-3 hamstring injuries per season, with each player potentially missing between 2-8 weeks to recover.

A common way that acute muscle injuries are defined is to split them into 2 categories.

  1. Functional Muscle Disorder: Acute indirect muscle disorder ‘without macroscopic’ evidence of muscular tear (shown in MRI or Ultrasound).
  2. Structural Muscle Disorder: Acute indirect muscle disorder ‘with macroscopic’ evidence of muscular tear (shown in MRI or Ultrasound).

The location and the tissues involved are also key factors in categorising muscle injuries. In summary a muscle injury can occur in the muscle belly, musculotendinous junction or in the tendon structure itself.

Hamstring injuries come in a variety of types, shapes, sizes and locations. Subsequently, 2 people suffering with a hamstring tear at the same time may have vastly different recovery rates. As expected, injuries on the severe end of the spectrum take longer to recover (e.g. structural muscle disorders). But any injury involving the tendon structures are notoriously problematic, taking significantly longer to heal. Therefore, if the injury site is higher up the thigh then it will typically take longer to recover.

Hamstring Tears ClassificationLike many medical condition/injury prevention is far better than cure. Thankfully there is one specific exercise that can be easily incorporated into your training routine, it’s called the Nordic Drop Out. Doing this one key exercise as 3 x 5-8 reps twice weekly has been shown to reduce acute hamstring injuries by up to 51%.

Nordic Hamstring Tear

Picture from Telehab

In the event of a hamstring injury the Physio’s at Robina Physiotherapy on the Gold Coast use the latest evidence-based practice to guide our treatment protocols. With the right care from our expert Physio’s recovery times and re-injury rates are drastically reduced. Using a peer reviewed and renowned rehabilitation protocol that has been shown to reduce re-injury rates to a mere 0.53% we can have you running again pain free as soon as possible.

The Physiotherapist’s at Robina Physio on the Gold Coast are here to help with any of your muscle injuries. Contact us on (07) 5578 7233 or BOOK ONLINE.

Core Strengthening Program

Core Strengthening In Under 10 Minutes 

By Aaron Woolley, Physiotherapist.

So many of us want that super strong core but struggle to find the time for a core strengthening program, including me. Well today you’re in luck because I have developed and willing to share an excellent core program I have developed to achieve a killer core in minimal time, and I use it myself. The purpose of this core program is build an incredibly strong and functional core not just that elusive 6 pack.

This program is suitable for almost everyone, ranging from the weekend warrior to athletes such as runners, swimmers, cyclists, footballers and golfers. I have put a lot of thought into this core program, making sure in flows with ease going from prone to side to supine, as well as making sure it includes key concepts like plank holds, torso flexion/extension, rotation and anti-rotation.

For those people out there trying to build your core strength after an injury (e.g. back injury) I haven’t forgotten you either. Once you are past the acute stage of your injury and cleared by your Physio the beginner stage should be suitable for you provided you have the adequate core and lumbar control. But please beware as the advanced and expert phases have not been designed for people with a history of lumbar spine injuries.

Disclaimer: There are components in these programs that require a significant amount of core and lumbar spine control. You must be able to maintain a neutral spine through these exercises otherwise you are risking injury (e.g. lumbar disc injury). The advanced and expert levels are only designed for highly fit and strong individuals with no history of back injuries. If this is not you please don’t attempt those levels. I would recommend you seek advice from the Physiotherapists at Robina Physio on the Gold Coast or your local health professional (Physio, GP, Chiro or Osteo) before attempting this as you may need some instruction about how to engage your core and pelvic floor muscles properly and maintain a neutral spine.

Beginner

This level is suitable for people who are new to core training or starting a rehab program that involves specific core strengthening.

To complete this program do 2-3 sets of 10 repetition of each exercise.

1. Plank Knee Drops

Plank Knee Drops Core Strengthening

Starting on your hand and knees, engage your pelvic floor and core muscles.

Transition to the position pictured with control (hand and feet).

Hold for a few seconds and return to the starting position, then repeat.

 

2. Bird-Dog

Bird-Dog Core StrengtheningStarting on your hands and knees.

Engage your pelvic floor and core muscles ensuring you maintain a straight line from your head to your hips.

Raise your arm up and extend your opposite leg back, then lower them to the ground. Then swap sides and repeat.

3. Side Plank (Knees) with Leg Lift

Side Plank Leg Lift Core Strengthening

Lying on your side with your elbow under your shoulder, bottom leg bent at 90 degrees and top leg straight.

Maintain your shoulder position and keep your hips facing forward, lift your hips into the air. Hold this static position while doing the leg lifts

Then slowly lift your upper leg up and down for the prescribed reps. Then repeat on the other side.

4. Dead-Bug

Dead Bug Core Strengthening

Start by laying on your back with your hips and knees bent at 90 degrees and arms raised above your shoulders.

While maintaining control of your core and spine slowly extend one arm above your head and lower your opposite leg towards the floor. Then repeat on the other side.

The lower you drop your leg/arm to the ground the harder the exercise.

5. Glut Bridge

Start by laying on your back with your arms by your side and knees bent.

Engage your core and gluts.

Slowly lift your hips off the ground.

 

 

Intermediate

This level is suitable for people who have an active lifestyle and no back injuries. You should be able to hold a plank on your feet for 30-40 seconds to have success with this level.

To complete this program do 3-4 sets of 10 repetition of each exercise.

1. Plank Walk Ups

Plank Walk Ups Core Strengthening

Start in a plank position on your elbows and feet. (If on feet is too hard can adapt to plank on elbows and knees).

Maintaining your body control push up onto your hands (one at a time).

Then slowly lower back down to your elbows and repeat.

 

2. Mountain Climbers

Mountain Climbers Core Strengthening

Start in a plank position on your hands and knees.

Keeping your core and upper body controlled lift one leg off the ground and slowly bring your knee to your chest.

Return your leg to the starting position and repeat on the other leg. Repeat for the prescribed reps.

 

3. Side Plank with Arm Lifts

Side Plank Core Strengthening

Start in a side plank position on your elbow (or hand) and feet. If feet is too hard adapt to knees.

Maintaining your shoulder and body position, slowly lift your upper arm from your hip to above your head. Then return arm to hip and repeat.

Complete prescribed repetitions on both sides.

4. Windscreen Wiper (Knees Bent)

Wind screen wipers Core Strengthening

Laying on your back with arms by your side and knees and hips bent at 90 degrees.

Keeping your head on the ground and core/pelvic floor engaged slowly lower your legs to the side. Then bring them back to the centre and lower to the other side. 1 x left + 1 x right = 1 repetition.

The lower your legs go the harder this exercise is. Control is the key so don’t push it too far.

5. Russian Twist

Russian Twist Core Strengthening

Start sitting on the ground with you knees bent and heels on the floor.

Slightly lean your torso back maintaining good posture.

Slowly rotate your upper body to the left and right.

1 x left + 1 x right = 1 repetition.

NOTE: If you have a history of lumbar spine injuries swap this for a single leg glut bridge.

Advanced 

This level is suitable for people who have a long history of physical activity and train regularly. You should be able to do 5+ push ups on your feet to have success with this level.

To complete this core strengthening program do 3-5 sets of 10 repetition of each exercise.

Only attempt this level if you have excellent core strength, can maintain a neutral spine and have no history of back injuries.

1. Commando Push Up

Commando Push Up Core Strengthening

Start in a push up position (Hands and feet).

Lower your body to the ground while simultaneously bringing one knee to your elbow. Then return to start position.

Repeat lifting the opposite leg each repetition. Ensure you maintain you body control while lifting your legs.

 

2.  Pike with Alternating Legs

Pike Core Strengthening

Start in a plank position with one leg raised in the air.

Keep your core engaged, spine and arms straight push through your hands lifting your hips into the air.

Lower your body back to start position, swap legs and repeat for the prescribed reps.

(Note: Picture is showing pike with 2 legs on ground. You should only have 1 leg on the ground at a time.)

3. Side Plank Twists

Side Plank Twists Core Strengthening

Side Plank Twist Core Strengthening

Start in a side plank position on your hand and feet with one foot in front of the other. Top hand is raised to the ceiling .

Maintaining your body position rotate your upper body your upper arm under your opposite arm pit.

Return the start positions and repeat. Do on both sides.

4. Windscreen Wipers (Legs Straight)

Windscreen Wiper Core Strengthening

Start by laying on your back with your arms by your side and legs extended straight towards the ceiling.

Maintaining your core control and keeping your head on the ground slowly lower your legs to the side. Then return your legs to the centre and repeat lowering to the opposite side.

 

5. Bicycle Crunch

Bicycle Crunch Core Strengthening

Laying on the ground with legs straight just off the ground and hands behind your head.

Slowly crunch and twist bringing your opposite elbow and knee together. Repeat this movement on the opposite side.

1 x left + 1 x right = 1 repetition.

 

Expert

This level is only suitable for incredibly strong and physically fit people that have a long history of physical activity and train over 3-4 times per week. You should be able to do at least 10-15+ push ups on your feet to have success with this level.

To complete this core strengthening program do 4 sets of 30 seconds on / 15 seconds off (45 second round) for each exercise.

Only attempt this level if you have excellent core strength, can maintain a neutral spine and have no history of back injuries.

1. Commando Push Up with Clap

Commando Push Up Clap Core Strengthening

Start in a push up position (Hands and feet).

Lower your body to the ground while simultaneously bringing one knee to your elbow, then return your leg to the ground.

Explosively return to start position and clap your hands together.

Repeat lifting the opposite leg each repetition. Ensure you maintain you body control while lifting your legs.

2. Plank with Arm/Leg Reaches

Plank Reachers Core Strengthening

Start in a plank position on elbows and feet.

Maintaining your body position, extend one arm in front above your head and lift the opposite leg into the air.

Return to start position and repeat on opposite side.

 

3. Side Plank Twist with Elbow to Knee

Side Plank Rotations Core Strengthening

Start in a side plank position on your hand and feet with one foot in front of the other. Top hand is raised to the ceiling .

Maintaining your body position rotate your upper body your upper arm under your opposite arm pit.

At the top position touch your upper elbow and knee together. Return to start position and start next repetition. Return the start positions and repeat. Do on both sides.

4. Reverse Crunch to Wiper

Reverse Crunch Wiper Core Strengthening

Start by laying on your back with arms by your side on the ground. Your legs should be straight just above the ground.

Maintaining your core and keeping your head on the ground lift your legs up to the ceiling.

Then slowly lower your legs to the right and left, followed by returning to the start position.

5. Toe Touches

Toe Touches Core Strengthening

Start by laying on your back with arms extended towards the ceiling. Your legs should be straight just above the ground.

Keeping your arms straight, engage your abdominal muscles to raise your upper body off the floor, trying to touch your toes with your fingers, then lower to the start position.

Progression: Alternate touching opposite hand and foot together. Don’t attempt if you have a history of lumbar disc issues. Swap in a bicycle crunch instead and make sure you maintain a neutral spine.

I hope you enjoy this core strengthening program. If you would like some help developing a personalised core strengthening routine the Physio’s at Robina Physiotherapy on the Gold Coast are here to help. Contact us on (07) 5578 7233 or BOOK ONLINE.

Image credit: Telehab.

Exercise After COVID

Exercise After COVID Pt 2 (April 2022 update)

Exercise After COVID Pt 2 (April 2022 update)

By Aaron Woolley, Physiotherapist 

Australia is making its way through another COVID-19 wave. Thankfully it appears that our health system has sustained this wave extremely well so far. But with another wave means more people getting ill, isolating, recovering and trying to return to exercise.

For the majority of people this should hopefully be a relatively easy task. But we are still seeing people having ongoing health issues long after COVID has passed.

When I wrote my first part of this blog there wasn’t very much peer reviewed evidence to follow for guidelines. Now there is some more information available as we are able to see how other countries are progressing that were technically further along in the pandemic than Australia.

Below I will provide a new infographic from the British Journal of Sport Medicine which provides some further insight in how to return to exercise after COVID-19 infection. The overall premise and much of the guideline appears to remain unchanged but it has broken the progress down into a few extra steps. I feel this would extra helpful for those that may be recovering a bit slower or perhaps in a vulnerable or elderly population. But first here is a quick recap on the risk categories of patients with COVID.

Low risk – includes:

  • Mild or no symptoms resolved within 7 days
  • Upper respiratory infection only
  • Younger patients (aged <50 years)
  • Recreational exercise goals.

Intermediate risk – any or more than 1 of:

  • Patients who experienced prolonged symptoms or fatigue (>7 days)
  • Ongoing shortness of breath or chest pain, which did not require hospitalisation.
  • Dyspnoea (breathlessness)/chest pain with illness
  • Elite and/or endurance athletes
  • Older patients (aged >50 years)
  • Those with pre-existing co-morbidities that may affect recovery eg asthma, chronic fatigue.

High risk:

  • Individuals who required hospitalisation / ICU
  • Patients with any evidence of system involvement outside the respiratory tract
  • Prolonged shortness of breath or chest pain at rest or with activities of daily living
  • Significant cardiac co-morbidities, history of cardiac disease, or abnormal electrocardiogram (ECG) or blood test findings during the illness.

Low risk patients should be able to return to exercise after COVID without requiring any further investigations. Although intermediate and high risk patients may need further investigations (e.g ECG) and monitoring. Therefore it is always recommended you consult your local medical professional before starting your return to exercise after COVID.

Exercise After COVIDFigure 2 Adapted from Elliot et al 2020

IMPORTANT NOTE: If any symptoms occur (including excessive fatigue) while going through the return to play protocol, the athlete must return to the previous stage and progress again after a minimum of 24 hours’ period of rest without symptoms.

I hope you found this update helpful and get back into exercise after COVID. If you need further assistance the Physio’s at Robina Physiotherapy on the Gold Coast are here to help. Contact us on (07) 5578 7233 or BOOK ONLINE.

Resoures

  1. Elliott N, Martin R, Heron N, et al. Infographic. Graduated return to play guidance following COVID-19 infection. BJSM 2020; 54:1174-1175. [Accessed 19 January 2022]  https://bjsm.bmj.com/content/54/19/1174
Ergonomic Office

Office Ergonomics

Office Ergonomics

By Corinne O’Connor, Physiotherapist.

Over the past few years so many of us have shifted our work space from an office building to working from home, at least part of the time.  And that usually involves finding a workspace that works.  The problem is that without a good set-up, we are more prone to pain and injury.Desk Pain

Office Ergonomics – what exactly is that?

Ergonomics derives from two Greek words: ergon, meaning work, and nomoi, meaning natural laws. Combined they create a word that means the science of work and a person’s relationship to that work.  In practice, ergonomics is about designing and arranging things in a workspace so  that the people and things interact most efficiently and safely.

Our bodies are designed to work most efficiently in certain postures.  Our spines are designed in an S curve, and when this curve is maintained, all the muscles work most optimally.  When we overextend or flatten this natural curve for prolonged periods of time, we put more strain on our muscles, nerves, ligaments and skeleton.Human Spine

Chair selection 

Investing in a high-quality office chair is undoubtedly a wise decision, particularly one that offers adjustable features like height, backrest, and seat tilt. Some chairs come with arms, while others don’t, and the choice depends on personal preference. However, it’s essential to consider that chairs with arms may not always allow for close proximity to the desk. Thankfully, certain office chairs come with adjustable height arms, enabling customization to suit individual body types and requirements.

When it comes to chairs, a one-size-fits-all approach doesn’t apply. Each person has unique dimensions, and the length of our thighs plays a significant role, as it can make certain seats feel either too deep or too short for proper support. Much like testing a mattress before committing to it for eight hours a day, the same consideration should be given to office chairs. Ensuring the chair fits well and provides adequate support is crucial for maintaining comfort and productivity during long work hours.

Ergonomic Office 

Find an office supply store where you can be like Goldilocks and try a few chairs until you can say “this chair is just right!”  Make sure you test it under a desk to make sure any arm supports don’t restrict you from moving in close.

Desk Selection/Set-up

In reality, many of us find ourselves working with whatever desk we have available when setting up a home office, and this article will take that into account. However, it remains essential that the desk space allows for the screen to be positioned at an appropriate distance directly in front of you as you pull your chair under the table. Prolonged neck rotation while looking at a screen can lead to discomfort around the neck and shoulders and possibly even nerve symptoms in the arms. If you use multiple screens, it’s best to arrange them towards the back of the desk to minimize neck rotation.

Moreover, ensuring adequate legroom is crucial, so it’s a good idea to declutter under the desk. Having enough space to move your legs while sitting can improve circulation and overall comfort.

For those who spend extended hours at their desks, considering a stand-up desk might be a beneficial option. This allows for regular changes in posture throughout the day, which promotes the health of muscles, joints, and ligaments. Varying your position between sitting and standing can be advantageous for overall physical well-being.

Finding the right chair vs desk height combo

Strive for a setup that incorporates 90-degree angles. Your posture should ideally maintain right angles at your hips, knees, ankles, and elbows. In practical terms, begin by adjusting the chair height so that your shoulders feel relaxed, neither raised nor drooping, while your arms rest on the desk to reach the keyboard comfortably. Once you’ve found the right chair height, ensure that your lower limbs are also at approximately 90-degree angles. If they aren’t, you might consider using a footrest to achieve the optimal posture.
Ergonomic Desk Set Up

Computers

Computer placement is of utmost importance for maintaining proper ergonomics. Surprisingly, many people position their screens too low in relation to their eyes. For optimal posture, the top of the screen should align with your eye level when sitting upright. If needed, you can use books or suitable risers to achieve the correct height (and maybe even impress your colleagues with your resourcefulness!). For laptop users, investing in a laptop stand and using a wireless keyboard and mouse can provide the same benefits.

Moreover, most keyboards come with adjustable feet underneath them. Utilising these feet to elevate the keyboard slightly puts your wrists in a more efficient position for typing. Ensure that the keyboard is placed far enough back on the desk to allow support for your forearms. Neglecting forearm support can lead to overused neck and shoulder muscles, resulting in discomfort and pain.

To prevent injury from sustained or repetitive movements, consider using a good ergonomic mouse and/or a mousepad. These accessories can help protect your operating arm and improve overall comfort during prolonged computer usage. Prioritising proper computer placement and using ergonomic tools can significantly contribute to your well-being and productivity at work.

Documents and Phones

If you work from documents when using your computer, putting them on a document stand not only improves your posture, but also means you are less likely to spill your coffee on them!

If you spend a lot of time on the phone, a headset or at least using a handsfree speaker will reduce the temptation of poor posture.   

Microphone Icon

Have you ever thought about using voice to text to save on typing effort?  Incidentally, did you know your mobile probably has a little microphone at the bottom of the text message screen where you can speak and it converts it to text?  It’s faster, and so much better for your arms and hands. 

Lighting

We often forget about light!  Make sure your work space has adequate light but no glare so that your eyes don’t have to work hard at reading.  This will reduce your risk of headaches and dry eyes. 

Good workday practice

We are all aware of this, but it’s essential to be reminded: MOVE REGULARLY! This is the best thing you can do for your body. Prolonged postures can tire active muscles, strain ligaments, and cause inactive muscles to shorten. The key is to take short breaks regularly. It doesn’t have to be a long interruption; a quick break for a cuppa and some shoulder circles, head movements (up, down, and side to side), as well as stretching your arms and legs can do wonders. Don’t forget to take a few deep breaths too. Not only will this benefit your body, but it will also boost your mental clarity and productivity.

Consider setting an alarm on your phone as a gentle reminder, and most importantly, don’t ignore it!

Oh, and let’s not overlook the importance of staying hydrated. Remember to drink water throughout the day. While coffee may be a go-to for many, it can dehydrate your tissues, making you more susceptible to injury and discomfort. It’s essential to balance your caffeine intake with adequate rehydration to maintain your well-being while staying focused and alert.

Office Ergonomics Joke

But I have pain already … what should I do?

At Robina Physio on the Gold Coast we can provide a thorough assessment and treatment with regards to your particular problem. Whether it is a chronic condition or an acute pain, we can provide individualised treatment and advice on exercises, postures and work set-up to help you on the road to recovery. Contact us on (07) 5578 7233 or BOOK ONLINE.