Tennis elbow. It’s a name most of us have heard at one stage or another. We more than likely know someone who has had it.

Like a lot of injuries, we see day to day, however, it’s often misdiagnosed. Often this is self-diagnosed or from a friend, family member or coach. This is seen time and again with injuries like sciatica, rotator cuff injuries, disc bulges and jumpers knee. With tennis elbow, it’s no different.

People come in every week with ‘tennis elbow’ often though it’s more a generalised pain around the elbow. It’s important to differentiate this pain from such things as nerve entrapment, golfers elbow, muscle strain, ligament tears or joint immobility.

Before we delve into how we can do this and the factors that can cause tennis elbow it’s important to dispel a myth.

You don’t have to be a tennis player or have ever even played tennis to have tennis elbow. Truth be told that is more the lay name. Its clinical name is lateral epicondylalgia or lateral epicondylitis.

A quick anatomy lesson for you. We have two areas of our humorous bone (condyles) where tendons attach onto in our elbow one on the inside (medial) and one on the outside (lateral). The terms -itis and -algia describe inflammation or break down of the integrity of the tendon.

 

 

The typical client will present to us with:

• Pain and tenderness on the outside of the elbow
• A dull ache that has progressed over a few weeks/months
• An increasing weakness with particular tasks (lifting a jug, opening a door, shaking a hand)
• The pain lingers after an aggravating task for a couple of hours

This onset is usually due to a rapid increase in load eg you have played tennis for the first time in a long time, started the gym rapidly with a lot of arm exercises, been doing handy work/gardening around the house which is outside of the normal tasks you do. The other main aggravator is a change in equipment eg new grip on your tennis racquet/golf clubs, a new hammer/drill handle if you are a builder.

So how is it managed?

After the diagnosis is confirmed we need to find out what the aggravating factor was and look to modify the load as best we can.

At the same time, it’s important to strengthen the area to increase the tensile strength or the tendon to prevent reinjury. One commonly overlooked area is the shoulder.

A lack of strength and stability around the shoulder leads to overload in the elbow. This can actually be the initial cause of the tendon overload.

These exercises will be different for everyone depending on the level of activity and future demands. There is no one size fits all for your tennis elbow physio treatment.

There are multiple other treatment options that can be used including, bracing, massage, acupuncture, taping, economic training, nerve mobility exercises and more. Obviously, this is dependent on having a thorough examination from a skilled physio and mapping out the best treatment plan.

If you or someone you know is suffering from what you might think is tennis elbow we would love to have a look at it for you.

Book a time below to see one of our experienced team. Located in the heart of Spring Hill, close to the CBD and with ample free parking. We look forward to helping you get back to your pain-free best.

Spring Physio and Rehab is proud to be part of the Australian Physiotherapy Association and the choose.physio movement. Physio is the GP’s number one most recommended therapy.

Sciatica is one of the most common issues I encounter. Truth be told it’s usually self-diagnosed by the client coming to see me. The typical presentation is some sort of lower back pain with an associated pain down the back of one or two legs.

I often liken the diagnosis to someone going to the mechanic and saying my cars not working. It’s very broad There could be several reasons causing it. Let me explain.

That referred pain down your leg is due to a pressure or irritation of your sciatic nerve. The sciatic nerve itself is actually made up of the combination of several nerves that all originate from your lower back.

These nerves combine together and later down the leg separate back out. Each nerve supply’s sensation and muscle innervation to a different segment of the leg. They also must pass a lot of different structures (muscles, joints, ligaments and tendons).

If any of these areas are not functioning correctly they cause an increase in pressure on the nerve. This can send a sharp shooting pain down the leg or a dull ache the comes on in particular positions.

These positions are generally although not always aggravated in flexion-based positions (sitting, bending, lifting, driving or the foetal position in bed). The majority of us now live in a heavily flexed world. Take a minute to think what percentage of the day you spend in any of the above positions.

Disc bulges or herniations are also an injury that can cause similar symptoms.

So why does it send pain down my leg?

Most of us have hit our ‘funny bone’ at some stage in our life. The nerve that sits in a notch in the area that you bump supplies down your arm. Although you now feel pain in your hand you haven’t got an actual issue there. Its further up the chain that has been aggravated.

As you can probably understand the variety of factors that could cause increased pressure on your sciatic nerve it’s often higher up towards your glutes and back than further down that needs to be addressed.

Regardless of the cause if you are currently suffering from sciatica or have an underlying disc bulge these are both potentially reversible with the right treatment plan.

At Spring Physio and Rehab, the first step involves a thorough history and use that to guide further testing. Once the underlying cause is identified we can start with the best-personalised treatment plan. This may involve any of the following:

• Mobility exercises
• Deep tissue massage/trigger point release
• Joint Mobilisation
• Postural changes
• Core and full body strengthening
• Activity modification
• Self-Release
• Neural Mobility Exercises
• Acupuncture and Dry Needling
• Taping

 

Sciatica isn’t something that you need to live with. Its something that a physio can help with and that can be alleviated with the right approach to your specific case.

If you or someone you know is suffering from any of the above book in below to see the experienced team located in Spring Hill Brisbane. With plenty of on-site parking, pool and gym we can get the Spring back in your step.

Spring Physio and Rehab is proud to be part of the Australian Physiotherapy Association and the choose.physio movement. Physio is the GP’s number one most recommended therapy.

I’ve just spent the last 3 weeks as a sports physio at the Commonwealth Games in the Gold Coast. I closed shop in Spring Hill in Brisbane picked up my new uniform and away I went.
So, what is it like working with the world’s most elite athletes?

This isn’t my first time working with elite athletes having previously worked with a professional rugby side in New Zealand and also run a varsity sports program and clinic in a North American University. This, however, was slightly different.

You see usually I have been just with one team over a period of months or multiple teams (at a University) daily from pre-season until finals. It started with applying with the 15000 others to be selected in the final few hundred.

I was rostered to be the triage physio at three different training venues for Netball, Triathlon/Hockey/Cycling, and Athletics/Swimming.

Although I am an avid sportsman this still required a lot of research due to the vastly different types of athletes that I would encounter.

The main objective is to get the athlete safely back into their given sports ASAP. In the clinical setting, we would also be looking at avoiding future injury, correcting technique, imbalances and loading.

In this case, though the aim is to get the athlete back to doing what they came here to do.
As a physio, I have always been a big advocate of keeping people active when they have injuries. This is usually in a modified way but it is a nice halfway point for those who like to be active.

When working as a sports physio courtside it’s a different story. You have to weigh up risk vs reward. For example, I had a netballer who was playing her last game ever for her country that night. During there morning training she picked up an issue with her glute (bottom) and was getting some pinching in her hip.

The athlete was beside herself and reported a high level of pain. Upon addressing the primary issues causing her restriction and pain and treating courtside, the athlete reported a 1/10 pain level and was able to move freely.

Later that night while eating dinner I switched on the games and to my delight saw her playing her heart out.

Had this been a regular season game, things would have been different. This isn’t to say the athlete wasn’t safe to play more so the fact that a full rehab program would have helped ensure it was unlikely to return.

The hardest times of being a sports physio is breaking the news to an athlete when they won’t be making it back. Unfortunately, this also occurred a few times. Intense contested last training sessions meant badly sprained and broken limbs.

When it comes to this I have always found that being confident in my diagnosis and telling them the likely outcome is the toughest but best way. Anything better than that is a bonus. Telling someone they will miss the next game and be fine for the following is better than them pushing and failing for the first game and missing both.

If they have a faster than expected recovery, then it’s a win/win. This not only helps the athlete reset goals it helps the whole team plan for their absence.

Having dealt with athletes from all levels of skill and competition there aren’t huge amounts of difference. Motivation and compliance to rehab are usually a bit higher in the professional athlete because they are focusing on it for hours a day. Conditioning is often higher due to the amount of training they do and having team trainers that they work with.

Outside of that behind it all, we are all humans. We all have body parts that break, sprain, tear and pull. We all at times need to see a physio to fast track us back to what we love.

If you have a sports injury or are looked to get screened click below to book a session with me to get you need to see an experienced sports physio on the right track ASAP. I promise I will treat you like a gold medallist!

Runners knee is the most common non-traumatic injury runners experience around the knee. Here’s the thing though it’s not just runners who experience this. It’s extremely common in the general population particularly those who are active.

It’s fairly common that patients present with a diagnosis of runners knee but it actually falls under one of three more specific diagnosis.

• Patellofemoral Syndrome (PFS)
• Iliotibial band friction syndrome (ITBFS)
• Chondromalacia patella

PFS and ITBFS are generally caused and worsened by two things. The first is an overload of particular structures in your lower limb. Overload is not when you physically can’t do an activity anymore. It occurs when certain muscles fail to control and stabilise the area as they are meant to.

This leads to biomechanical changes and overload to other areas. This can often manifest in pain in the knee. Imagine going for a run with muscles not doing their job. The first few steps may be fine even the first few kms or runs. Fast forward to when you have done 1000’s upon 1000’s of steps, eventually one of these steps is the straw that breaks the camels back.

This isn’t just running, I often see this in gym goers who may have a breakdown in their chain with things like squats, box jumps and particularly lunges.

When this occurs, most people take a week or so off, attempt to get back at it to find the pain is still there. They then take longer and longer off hoping that time will be the saviour.

As we now know time won’t strengthen that underlying weakness.

So what will?

As a physiotherapist, we look to address two important things.

• How do we get you out of pain and back to full activity?
• How do we keep you injury free and performing to your full potential?

These two aspects aren’t independent of each other and often overlap.

Once we have confirmed the diagnosis we look towards how to get you out of pain. This could be one or a combination of multiple techniques such as taping, deep tissue release, self-release techniques, joint mobilisation and exercises.

This is often the techniques we can apply in the clinic. Outside of it, we work towards modification of your aggravating factors (the things that set it off). Looking at your technique (running, squatting, lunges, jumping) is often the first point to address.

Once we look at your actual technique we can see where the weaknesses are, and the subsequent overload is occurring. If it is purely a technique issue we will develop strategies to address this. More likely than not the technique issue is underpinned by a muscular or stability issue.

Getting you out of pain is generally easy. The plan to keep you out of pain is where it takes some effort from both parties. Often it can be a case of two steps forward one step backwards. For example, winding back the distance or intensity of your workouts to allow you to keep active and be pain-free.

The knee can be a complex region due to the other contributing areas such as the hip, foot and other leg but with the right assessment, tools and plan it is highly likely to have a full recovery and be back to doing what you love pain free.

To see one of our experienced knee physiotherapists book an appointment below.

The ankle sprain is commonly thought of as a sports-related injury. Truth be told it’s one of the most common injuries for all ages. Ankle sprains are most frequently seen in the younger population after rolling their ankle while playing a sport. In the older population, it is a lot more common when walking or running on uneven surfaces. In the elderly, these are frequently seen to cause hip fractures which can be debilitating or even fatal.

I have personally seen it time and time again. A client comes to me and says ‘ I’ve sprained my bad ankle again’. It doesn’t have to be this way.

The general recovery process of your typical ankle sprain has the injured person walking around pain-free at 6 weeks. This includes if they do nothing at all for rehab.

The reason as physiotherapists we see so many people with recurrent ankle sprains is because people they only focus on being pain-free.

Only focusing on this aspect is often likened to drink driving. You may be able to do the task but you are playing Russian roulette before something bad happens again.

In a small proportion of the population, this is due to unfortunate circumstances. For the majority, however, this is caused by a combination of 4 things.

• Lack of range of motion
• Muscular Weakness
• Poor proprioception (balance and control)
• Lack of functional conditioning

Trying to compete at your highest level whether that be in sport or daily activities is extremely difficult with a restriction in your range of motion.  This leads to compensations in other areas. Not only that its impossible to get full strength without having a full range of motion.

After any type of injury and the subsequent inactivity, there is an atrophy (decrease in muscle size and strength). Although pain may go after those first 6 weeks the strength will still be lacking if not addressed. When push comes to shove with daily and sporting activities that lack strength means a decrease in control and often reinjury.

Research has constantly shown that poor proprioception (balance and control) leads to increased injuries. Specifically, tailored balance programs are crucial in your rehabilitation and prevention following an ankle sprain.

This involves more than just standing on one foot for a few seconds. Making sure your rehabilitation reflects your life demands. If your day involves walking on uneven surfaces, running on a sports field or dodging your kid’s lego toys everyone has their own demands.

Once all of these are individually developed its crucial to start working on your functional demands in a controlled environment. Particularly with athletes this is replicating demands and building confidence in the athlete.

When this is combined not only is your confidence brimming but you have significantly decreased your risk of future ankle injury.

If you have just sprained your ankle or are looking to stop telling people you have a ‘bad ankle’ book click below to see one of our experienced staff to tailor the best plan to get the Spring Back In Your Step.

Achilles Tendinopathy and tendonitis like many tendon overuse injuries can be debilitating and frustrating if not managed appropriately. It usually presents with pain, swelling, and stiffness in the area between the bottom of your calf and top of your heel.

All tendon injuries have one main underlying cause overload.  Overload is not when you physically can’t do an activity anymore. It occurs when certain muscles and tendons fail to control and stabilise the area as they are meant to.

Common factors to set off Achilles tendinopathy centres around sudden increases in load. Think when you have started off running. Many of us go from couch potato to trying to run distances that we did back in high school.

Others we see it in are those looking to get fit (usually around January the 2^nd) same situation they go from nothing to working out 5+ days a week. Usually at high intensity to boot.

If your tendons aren’t adapted and are deconditioned to this amount of activity it will lead to overload and subsequent injury.

Tendons connect your muscle to bone. In this case your calf muscle to your heel. If your calf can’t handle the load this will mean more stress on the tendon, again leading to overload.

As this overload builds it causes micro tears in the tendon making it even weaker. Picture a rope that as more load is added progressively the strands start to fray. It gets weaker and weaker.

These tears trigger swelling, fluid retention and thickening of the tendon. Unfortunately, this thickening doesn’t strengthen the tendon.

It’s fairly common that patients present with a diagnosis of Achilles tendinopathy or Achilles tendonitis, but it actually falls under one of three more specific stages of tendinopathy.

• Reactive Phase (Tendonitis)
• Disrepair (Tendonitis)
• Degenerative (Tendinopathy)

The common presentation into the clinic is usually around 2-3 months, mainly because the pain /10 you experience is usually quite low and can for a period of time be pushed passed to allow you to keep being active.

It isn’t until people have tried a few things themselves and the pain hasn’t settled that they make their way in. This usually comes in the form of a week off the aggravating activity, then when they get back into activity it is still sore. They usually rest for 2 weeks and then a month all with the same result when they return to activity.

The amount of time off further leads to weakening of the tendon. Tendons don’t respond well to over or underloading.

So how do we manage this?

As a physiotherapist, we look to address three important things.

• How do we get you out of pain and back to full activity?
• How do we keep you injury free and performing to your full potential?
• How to manage load in rehab and resumption

The first two aspects aren’t independent of each other and often overlap.

Getting you out of pain usually involves a combination of treatment techniques including activity modification, taping, deep tissue release, joint mobilisation, orthotics and exercises.

It’s important we look at your actual technique we can see where the weaknesses are, and the subsequent overload is occurring. If it is purely a technique issue we will develop strategies to address this. More likely than not the technique issue has a muscular or stability issue.

The plan to keep you out of pain is where it takes some effort from both parties. Often it can be a case of two steps forward one step backwards. For example, winding back the distance or intensity of your workouts to allow you to keep active with minimal pain while we strengthen.

The Achilles can be a complex region due to the other contributing areas such as the hip, knee and load control but with a thorough assessment, tools and strategic plan we can give you the best options and path to get you back to your best.

To see one of our experienced Achilles Tendinopathy physio’s book an appointment below.

 

 

Pre-employment assessments

They are the new staple amongst Brisbane businesses, those that are looking to decrease their workplace injuries. Pre-employment assessments save businesses money with a decrease in their LTI (lost time due to injury).

The important fact, however, is these help create a safer workforce walking in the door each day.

One of the big things that businesses struggle with is having people walk into the door for their first day with pre-existing underlying injuries.

Businesses need to understand that 75% of injuries at a workplace are occurring during manual handling tasks. The solution with most companies is to try and remedy this with manual handling training.

This has now become commonplace in most businesses.

The stats, however, have shown this doesn’t help enough to prevent injuries. This is where a well-constructed pre-employment assessment can save your company by decreasing injuries.

With a correctly tailored Pre-Employment Assessment you can screen and find out high-risk applicants before they walk in the door.

The big problem these days is the majority of pre-employment work on just ticking the boxes to make companies happy.

Do Applicants Ever Fail?

The average pre-employment assessment is failing approximately one to 1.5 percent of applicants.

Research has shown that number should be closer to 14%. Over time this decreases costs and injuries by anywhere between 25 to 60%.

So what should you be looking for when you are sending your applicants in for a pre-employment assessment. Ask the physio that is giving the pre-employment assessment if they have processes to identify risks in both the questioning and assessment stages.

To find out if people are at a higher risk ask them what those processes are. Make sure that it’s just not can they safely lift a box or can they safely squat five times.

There are aspects that are critical in the questioning that a skilled Occupational Health Physiotherapist will know.

What to Expect?

So you have decided on the practice and type of assessment that will be undertaken.  Next the applicant will book for an assessment usually lasting between 1-2 hours depending on what requirements need to be assessed.

That can be anywhere from Drug and alcohol screening functional testing, job specific testing as well as baseline things like blood pressure, heart rate, vision and hearing. Once completed an in-depth report will be sent to you ideally within one business day. This allows your business to get hiring the right people faster.

What should applicants expect on the day?

Arrive in loose-fitting sports clothes with covered shoes. Ensure you don’t have too much caffeine before the assessment is that can often affect heart rate and blood pressure.

Need Help?

If as a business owner you are unsure on how to put together your own pre-employment assessment.

This is something that here at Spring physio and Rehab we help businesses with. We have completed over 2000 assessments for all industries.

If you’re in the Spring Hill or the surrounding inner-city suburbs give us a call.

So you think you may have injured your ACL. Your first stop should be visiting an experienced ACL physio.

Your Anterior Cruciate Ligament (ACL) is a ligament that sits inside your knee. It prevents your Tibia (Shin Bone) and Femur (Thigh Bone) from separating apart.

It is the most common knee injury in the athletic population. The cause of ACL rupture is usually the result of running and cutting/stepping activities in sport. This is when your ACL is put under the most stress.

It is particularly common in sports where this movement happens a lot such as Netball, Basketball, AFL, Soccer, Rugby Union, Rugby League, and Touch rugby.

It’s also seen in activities like water and snow skiing due to the rapidly changing directions and environments.

Unfortunately when we compare the rate of injury the research shows that females and 3 to 1 more likely to rupture their ACL compared with males.

As an athlete, you will typically feel a snapping sensation and your knee buckling during the game or training. Generally, this will result in immediate pain and swelling. If a physiotherapist is at the game this would be the best time to assess the ACL integrity before further swelling and muscle guarding kicks in.

You should immediately get your knee into a brace and get around with a pair of crutches. If you need either of those give us a call and we will be able to loan you a pair.

The best course of action following your injury is to get it assessed by a experienced ACL physio. If we think it’s likely you have a tear we have a personal relationship with Brisbane’s top knee surgeon.

We can organise an immediate referral from our team of in-house doctors to the specialist. From there we can contact their office organise you an appointment get a referral for an MRI.

The faster we can get a clear diagnosis and recovery plan the quicker we can get you back doing what you love.

The most common treatment is to undergo surgery. It’s generally recommended over non-surgical options if you want to get back to competitive or demanding sports safely.

Furthermore, the majority of ACL ruptures also result in a full rupture of the Medial Collateral Ligament (MCL) and a tear of the medial meniscus (your cartilage). In contrast to the healing time of your ACL, these injuries won’t overly affect your rehabilitation time frames.

After surgery, the rehabilitation road is 9-12 months. This is guided us as your physiotherapist and reviewed by your surgeon.

It comprises initially of getting you back up and moving then moving towards improving your balance, the range of motion and building your strength. In the later stages of rehabilitation if heavy focused on preparation towards return you to sport and minimizing the risk of re-injury.

On a positive note, our team has been trained in the latest science being used with the worlds top athletes to significantly minimise their risk of ACL and knee injuries.

Whether you have just injured your knee, just had surgery and are looking to minimise your future risk. Come on in a see the Expert ACL Physio’s at Spring Physio and Rehab in Spring Hill.

Click below to book in now!