Running Physio

Running Physio

By Aaron Woolley. Gold Coast Physio, Robina Physiotherapy.

Running is an excellent activity that offers numerous health benefits. Not only does it help with cardiovascular fitness, it also is great for building soft tissue strength, bone density and has huge benefits for mental health. Running also has great community engagement and therefore has great social interactions whether you’re just starting out or a seasoned competitor. Almost all runners will experience an injury during their running journey. Thankfully, the majority of running injuries are minor and with good quality physiotherapy rehabilitation like you would receive with a Running Physio at Robina Physio on the Gold Coast these injuries can be treated quickly and effectively.

In this article, we will delve into the common causes of running injuries, signs to watch out for, and tips to help you remain injury-free. We will also highlight the pivotal role a Running Physio at Robina Physio on the Gold Coast can have in both managing and preventing future injuries.Runner at Sunshine Coast Marathon

Common Running Injuries

  • ITB Syndrome: The ITB, running from the hip to the ankle, aids in knee stabilization. However, its structure makes it prone to injuries, especially when there’s excessive tension on the lateral knee. Symptoms include pain on the knee’s outer side, worsening pain during runs, discomfort when ascending or descending stairs, and post-run soreness.
  • Patellofemoral Joint Syndrome: The kneecap endures significant force during runs. An imbalance or excessive force can lead to pain around the kneecap. Symptoms often include a vague, shifting pain that might intensify during a run but occasionally diminishes for some runners.
  • Muscle Tightness and Strains: Muscles tightness and pain is highly common in runners. Muscles in the legs, gluts and lower back are the most common sites for muscle pain. But considering that running involves the entire body, running related muscle pain could affect any muscle in the body. Getting an assessment and soft tissue release from an expert running physio at Robina Physio on the Gold Coast can quickly improve this and get you running again. BOOK ONLINE HERE!
  • Shin Splints: Shin splints are characterised by pain along the inside border of the tibia. Swelling in the area may or may not be present. It is common for shin splint related pain to feel like Be dull and throbbing pain that occurs during and after running. Shin splints is often worse at the beginning of running, gets better as you warm up, then worse again following running.Shin Splints Robina Physio
  • Plantar Fasciitis: This condition affects the thick band beneath the foot, crucial for arch support. Symptoms typically include pain near the heel, which may extend across the foot, exacerbated pain during runs, and post-run soreness. Poor running and foot biomechanics highly impact the likelihood of experiencing plantar fasciitis.
  • Achilles Tendinopathy: Tendons, especially the Achilles, can get injured if they can’t handle the exerted load. Symptoms include pinpointed tenderness, a “warm-up effect” where pain decreases during a run, post-run discomfort, and recurring pain after resuming runs post-rest.
  • Stress Fractures: Stress fractures are caused from multiple factors including training overload and poor technique. A stress fracture is a small crack in the bone and presents with persistent pain which is aggravated by running. The most common sites for stress fractures in runners are the tibia and foot. These injuries can often be mis-diagnosed as shin splints so getting an examination from a running physio at Robina Physio on the Gold Coast is highly recommended if you are experiencing shin or foot pain from running.

Factors Increasing Injury Risk:

  • Mis-managed training loads: Arguably the most significant risk factor, poor load management refers to how much running you undertake. Many who visit our clinic fall into the ‘overtrained’ category. Overtraining happens when your body hasn’t had the chance to adapt to the volume of running you’re doing, leading to injuries. It’s a delicate balance between building endurance and managing your running load. See my previous load management blog HERE.
  • Changes in Footwear and/or Technique: It’s common for runners to experience discomfort after switching to a new pair of shoes. Even if the new pair is of the same model and make, the change can introduce a risk. It’s vital to break in new shoes gradually before committing to long runs. You also need to be careful when adjusting your technique. Small changes can drastically transfer forces to new muscles, tendons and bones. This can easily lead to injury if you don’t also adapt your training loads during this time.
  • Inadequate Strength: Strength training plays a vital role in injury prevention. A strong body can handle more stress and protect itself better as your tissues can improve their tolerance to the high impacts involved with running. Some of our joints and tendons experience upwards of 4 times your body weight every stride. Doing a full body strength session that incorporates running specific lower limb exercises (e.g. lunges and step ups) is a must, and don’t forget that core strength.
  • Excessive Muscle Tightness: Running tends to load specific muscles more than others (e.g. calf, quadriceps, hamstrings, gluts and TFL). Overtime these muscles can easily become pathologically tight leading to imbalance and pain. Making you incorporate some mobility work into your training program either with some stretching, foam rolling and/or massage. Getting some massage and dry needling from a Gold Coast Running Physio at Robina Physio will help considerably with this. Foam Roller Calf Muscle

How to Stay Injury Free:

  • Structured Training Plans: Planning is very important in load management and decreasing overuse injuries. Gradually increasing your volumes and strategically adding intensity will make your training more effective and minimise your injury risk. Try to aim for an increase in volume of approximately 10-15% per week, any higher and your injury risk skyrockets.
  • Add Resistance Training: The age-old debate about whether distance runners should incorporate strength training rages on in some communities. But the evidence is clear that strength training is key to preventing and treating injuries. It has also been shown to improve running performance, so really, it’s a no brainer in my book. Adding strength training 2-3 times per weeks can be a huge boost. Try working your entire body in a session and include some more running specific exercises that use “split type stances” e.g. lunges, step ups and single leg deadlifts.
  • Early Intervention: Early detection and timely professional intervention can hasten recovery. Prolonged neglect only exacerbates the injury, making recovery more challenging. Even if it only feels like a small niggle get in and see our Gold Coast Running Physios at Robina Physio straight away for prompt and effective treatment to keep you running harder and longer.

At Robina Physio on the Gold Coast our mission surpasses mere injury diagnosis and treatment. After a comprehensive assessment, we focus on a swift, effective rehabilitation process to get you back on track. Our multifaceted approach includes hands-on treatments, tailored exercise programs, and structured return-to-running plans.

Remember, as Physiotherapists, our goal isn’t just recovery; it’s prevention. We’re deeply invested in injury prevention, frequently conducting running assessments to help avid runners remain injury-free.

If you’re suffering with an injury or need guidance to prevent injuries and set up a training plan, Contact Us on (07)55787233 or BOOK ONLINE with our expert Physiotherapists today! Stay safe, keep running!

Tendon Pain

Tendon Pain

By Aaron Woolley, Physiotherapist – Robina Physio Gold Coast

Why am I Getting Tendon Pain?

Tendinopathy is a condition that affects many tendons in the body and often leads to extensive tendon pain. People who participate in activities that require repetitive high-level loads including running and jumping, gripping with force and heavy lifting often experience tendinopathy related pain. Managing Tendon pain is bread and butter for the Physiotherapists at Robina Physio on the Gold Coast, so don’t hesitate to BOOK ONLINE and receive expert care.Tendon Pain Gold Coast

Tendons play a crucial role in our musculoskeletal system. These tensile structures connect our muscles to the bones, transferring the force produced by muscles, enabling us to move. Similar to muscles, tendons also respond to load. For instance, rigorous strength training at the gym can result in muscle growth. Likewise, when tendons are appropriately loaded, they become stronger and better equipped to handle intense forces.

However, tendons have their limits. If we subject them to sudden and severe forces they may suffer an acute tear but also if load them in an improper and excessive manner over a long period of they, they might not adapt correctly. This can lead to a change in their structure, resulting in a pathological state. Indicators of this pathological change include an increase in water content within the tendon, disturbances in the type and structure of collagen (cells of the tendon), and the growth of nerve and blood vessels in the tendon area. All these changes can result in pain and a feeling of weakness in the affected area.

What is a Tendinopathy?

Tendinopathy can be visualized on a continuum. At one end, you have a mechanically frail tendon. Move along the spectrum, and you find a healthy, robust tendon, which can then shift to a state of reactive tendinopathy, further morphing into tendon disrepair, and ultimately, a degenerative tendon. The position of a tendon on this continuum is determined by the loads it’s subjected to and can oscillate based on varying conditions.

Tendinopathy, in clinical terms, is often defined as a failed healing response of the tendon. This involves irregular growth of tenocytes (tendon cells), intracellular abnormalities within these tenocytes, a disruption in the collagen fibres, and an increase in non-collagenous matrix. The term “tendinopathy” serves as a broad descriptor for clinical conditions associated with tendon overuse, encompassing both pain and pathological attributes. Furthermore, tendinopathy is characterized by pain, diminished function, and intolerance to exercise.

Common sites for tendinopathy include:

  • Lateral Elbow (Tennis Elbow)
  • Medial Elbow (Golfers Elbow)
  • Patella Tendon
  • Achilles Tendon
  • Rotator Cuff
  • Hamstring and Gluteal Tendons

    Tennis Elbow Tendon Pain

    Source: healthdirect.gov.au/tenniselbow

Typically, individuals with tendinopathy type tendon pain describe a progressive increase in pain at the affected tendon’s site, often linked to escalated activity levels. The tendon pain is generally associated with the load exerted on the tendon. In early tendinopathy stages, the pain might be present only at the activity’s onset, disappearing during the activity but returning once the activity is concluded.

Tendinopathy Treatment

Thankfully high-quality physiotherapy intervention can fix your pain and with the right loading and management plan even lead to repair of the tendon structure and return to sport. At Robina Physio on the Gold Coast we use a multifaceted approach to tendon management and get great long-lasting results with our patients.

Early intervention can mitigate further damage and expedite recovery. At Robina Physio on the Gold Coast, our skilled physiotherapists will aid in alleviating your tendon pain. Furthermore, we’ll delve deep to identify and address the root causes contributing to your discomfort. Through strengthening exercises, running drills, technique modifications, functional exercises, and/or a comprehensive load management plan, we aim to set you back on the path to pain-free movement.

CONTACT US on (07)55787233 or BOOK ONLINE today and get you tendon pain resolved ASAP.

Neck Pain

Neck Pain

By Aaron Woolley, Physiotherapist.

Neck pain (NP) is a prevalent condition that affects a significant portion of the global population. Studies suggest that approximately two-thirds of the population will experience neck pain at some point in their lives. The prevalence of NP varies across different studies, with mean reported estimates indicating 7.6% for point prevalence and 48.5% for lifetime prevalence. This condition is more commonly observed among women, individuals suffering from anxiety or depression, and office workers with poor ergonomic positions. To effectively address neck pain, it is crucial to understand its anatomy, potential causes, and available physiotherapy treatments.Neck Pain Physio

Anatomy of the Neck

The neck is a highly complex structure composed of bones, joints, muscles, tendons, ligaments, and nerves. It consists of seven bones, C1 to C7, which make up the cervical vertebrae. These bones articulate with each other with the intervertebral disc at the front and facet joints at the rear.

There are numerous large and powerful muscles supporting the neck, including the trapezius, sternocleidomastoid, levator scapulae, splenius capitis and cervicis and deep neck flexors. These muscles facilitate gross motor movements in the neck as well as provided postural control and support. Any condition involving these muscles and tendons can be a strong pain generator and severely impact cervical spine mobility.

The cervical spine nerves, a set of eight nerves (C1 to C8), provide functional control and sensation to various body parts based on their respective spinal levels. Compression or irritation of these nerves can lead to pain and tingling sensations, often felt in the upper limb or shoulder girdle.

Common Causes of Neck Pain

  1. Muscle Pain: Overuse of neck muscles due to poor posture, prolonged sitting, or incorrect ergonomics is a leading cause of neck pain. Strained neck muscles can be painful and restrict motion.
  2. Muscle Imbalance: Focusing excessively on training the upper trapezius muscles, neglecting the lower and mid traps, may lead to overstimulation of the upper traps, resulting in neck pain.
  3. Osteoarthritis: As we age, the neck’s joints can become worn down, leading to conditions like osteoarthritis. Deterioration of cartilage between vertebrae and the formation of osteophytes can impact range of motion and cause pain.
  4. Nerve Compression: Herniated disks or osteophytes in the vertebrae can press on the nerves branching out from the intervertebral foramen, causing pain and discomfort.
  5. Injuries: Motor vehicle accidents and sporting injuries, especially those resulting in whiplash, can strain the soft tissues of the neck, leading to pain and reduced mobility.
  6. Diseases: Certain diseases like rheumatoid arthritis, meningitis, or cancer can also contribute to neck pain.

Managing Neck Pain

At Robina Physio on the Gold Coast, we offer effective strategies for managing neck pain and improving the overall health of the neck and surrounding structures. Here are some essential physiotherapy techniques:

  1. Therapeutic Exercises: A physiotherapist can design a personalised exercise programs to strengthen weak neck muscles, improve flexibility, and correct muscle imbalances. These exercises may include neck stretches, range of motion exercises, and strengthening routines.
  2. Manual Therapy: Hands-on techniques, such as massage, joint mobilisation, and trigger point therapy, can help alleviate muscle tension and therefore pain and mobility.
  3. Postural Correction: Proper posture can play a crucial role in reducing pain. A physiotherapist can assess your posture and provide guidance on maintaining correct alignment during various activities.
  4. Ergonomic Recommendations: For office workers, optimising workspace ergonomics is essential. A physiotherapist can suggest adjustments to your workstation setup to reduce strain on the neck and promote better posture.
  5. Heat and Cold Therapy: Applying heat or cold packs to the affected area can help reduce inflammation, relieve pain. If you have a spasmed muscle, opt for heat most of the time.
  6. Dry Needling and Acupuncture: Dry needling has been shown by research and in the clinical setting to be highly effective for managing pain. The main aim of this technique is to release your tight muscles and restore pain free range of motion as quick as possible.Neck Pain Robina Physio

Neck pain is a prevalent condition that can significantly impact an individual’s quality of life. With the help of a skilled physiotherapist, like those at Robina Physio on the Gold Coast, you can implement a personalised treatment plan to alleviate your symptoms, improve mobility, and prevent future occurrences of neck pain.

The Physiotherapists at Robina Physio on the Gold Coast are experts with additional training in the management of neck pain and dysfunction. If you’re struggling with neck pain please don’t hesitate to Contact Us on (07) 5578 7233 or BOOK ONLINE.

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 & 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

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

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

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-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 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.