Common Injuries:
Back Pain: Should I be worried?
Lower back pain can arise from many different causes including mechanical (eg: muscle imbalances, poor posture or lifting techniques), traumatic (falls or car accidents) or degeneration over time (eg: arthritis or loss of water in our discs). All causes result in one thing…PAIN. Determining the structure that is causing the pain is essential in treatment of the condition. Aushealth Physiotherapists take a full history of the patient’s pain including mechanism of injury and current symptoms. From the injury history the physiotherapist will determine what special tests are required to differentiate between possible injured structures. A patient’s symptoms can tell the physiotherapist a great amount of information and help determine whether the condition needs urgent attention. If serious symptoms are reported (“red flags”) our physiotherapists will communicate with your doctor and assist organising any recommended actions or additional diagnostic testing.
Symptoms
Less Serious: Dull achiness across the lower back or on one side increased with specific movements, pain with prolonged sitting, pain with prolonged standing. This type of pain can come on over a long period of time.
More Serious: Sharp shooting (electric-like) pains into the leg or legs, numbness and/or pins and needles in the leg(s), extreme weakness in the foot. These types of symptoms start immediately and may calm down for long periods. Regardless, these situations require urgent investigation and/or treatment.
Treatment
Lower back pain is the leading out patient orthopaedic complaint and thus the most treated. Depending on the structure that is injured, the AusHealth Physiotherapist’s aim is to reduce pain levels so you are able to regain normal movement patterns. When specific movements are too painful for the patient, the physiotherapist uses a variety of techniques to promote better movement and healing including gentle joint mobilisations, specific types of massage and active exercises performed in a pain-free range. When proper movement is restored, healing takes place much more rapidly and limits how many secondary issues arise from the back pain (eg: discomfort in the hip from walking awkwardly).
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Tennis Elbow vs. Golfers Elbow
Epicondylitis is the medical term for a Golfers or Tennis elbow and can occur in individuals that don’t even play the sport! The single major difference between Golfers Elbow and Tennis elbow is simple. One injury is located on one side of the elbow and the other is located on the opposite side of the elbow.
Golfers Elbow or medial epicondylitis got its name due to the common occurrence of the injury in the sport. Golfers who have weak wrist musculature or tend to overuse their wrist during their game (eg: during chip shot) may develop an overuse injury to the respective musculature.
Tennis Elbow or lateral epicondylitis also got its name due to the common occurrence of the injury in the sport. Similar to golfing, Tennis players who emphasise use of their wrist (eg: in their backhand) may develop an overuse injury of the muscles that extend the wrist.
Unlike Golfers Elbow, Tennis elbow is much more likely to become chronic if untreated. Studies have indicated poor blood flow in this area of the body as being a contributing factor to prolonged healing time frames.
Symptoms:
Golfers Elbow: Pain on the inner side of the elbow with grasping and/or wrist flexion especially with resistance. (Note: Wrist flexion is when you hold your palm up and bend your palm/wrist toward you).
Tennis Elbow: Pain on the outer side of the elbow with grasping and/or wrist extension especially with resistance. (Note: Wrist extension is lifting the back of your hand toward the sky).
There is usually no numbness or tingling associated with these disorders. If you do feel numbness or tingling, then it is important for you to communicate this with the Aushealth Physiotherapist to get clarification of your diagnosis.
Treatment:
Epicondylitis – whether Golfers or Tennis Elbow, is a common injury seen at Aushealth Physiotherapy. We urge individuals with this type of pain to see the physiotherapist as soon as possible to limit complications in healing.
Initially, the Aushealth Physiotherapist’s aim is to reduce the loading on the tendon through taping or specialised forearm supports. Early in the treatment regime ultrasound and specialised massage is introduced. Dry needling (an Acupuncture-like treatment) may be used in some cases depending on the severity and past medical history of the patient. Once the frequency, duration and intensity of pain is reduced our physiotherapists implement stretches and strengthening exercises of the wrist and forearm.
End-stage exercises are then commenced at one of our gym based sites emphasising sport specific movements to assist in getting back on the court or back on the green!
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Frozen shoulder
‘The Inconvenient Diagnosis’
Adhesive Capsulitis is the medical term used for a “Frozen Shoulder.” Although there is no known cause, a Adhesive Capsulitis usually occurs after a traumatic injury to the shoulder. What we do know is that the capsule of the shoulder (comprised of ligaments and muscles) tightens down on the ball and socket joint and dramatically restricts movement.
A frozen shoulder usually runs its course over an 18 month period in which there are 3 phases… freezing, frozen and thawing! Individuals who suffer from a frozen shoulder can usually raise their arm 30-45 degrees from their waist level which substantially limits functional use of the extremity. Muscle wasting occurs from this non-use which can then make the individual susceptible to other injuries.
In rare cases, a misdiagnosis can be made by the treating doctor. What appears to be a frozen shoulder turns out to be the result of a nerve irritation. Individuals who suffer from this injury cannot lift their arm away from their side due to stretch (and pain) associated with the irritated nerve. The only differentiation of the two diagnosis would be under a general anaesthetic where the surgeon attempts to move the extremity. Those who have full shoulder movement do not have a frozen shoulder! Nerve root blocks done at the neck level have proven effective for this condition.
Symptoms:
- Shoulder pain, usually a dull aching pain that is more pronounced in the freezing stage.
- Limited movement of the shoulder
- Difficulty sleeping or doing daily activities like brushing hair or dressing
- Associated neck stiffness
Treatment:
Depending on the phase of the condition, the aim of the Aushealth Physiotherapist is to maintain as much function in the individual’s shoulder as possible. Gentle shoulder mobilisations and strengthening of the musculature around the shoulder blades is essential to help reduce the effects of pain and muscle atrophy. Hydrotherapy is also a treatment of choice and is recommended by many shoulder surgeons. In extreme cases that do not respond to physiotherapy, an operation called a ‘Capsular Release’ can be performed by your shoulder surgeon, usually followed by intense shoulder rehabilitation.
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