Are you suffering from low back pain? If so, then physiotherapy might be the answer to your problem. Physiotherapists are trained allied health professionals who specialise in treating musculoskeletal disorders such as arthritis, sports injuries, and back pain. They provide treatment through manual therapy, exercise therapy, electrotherapy, and various other methods.
Physiotherapy is a holistic approach to healing. The goal is to restore function and reduce pain. This involves assessing the patient’s condition, diagnosing the underlying causes, and providing appropriate treatments and exercise programs.
The 2 main reasons people experience low back pain
- Prolonged sitting – e.g. office workers.
- Excessive bending and lifting – e.g. tradies and childcare workers.
The top 3 strategies to reduce your low back pain
- Move regularly – get up and move every 45 minutes
- Stretch in the opposite direction – 10 x 10second extension based exercises either in sitting, standing or laying on your stomach
- Strengthen your core and gluteal muscles, focusing on a posterior pelvic tilt. This will improve your posture, unload your back muscles and help to improve your manual handling technique and endurance.
Exercises that maintain normal flexibility and muscle strength support the spine and provide the best defence against low back pain.
Good spine posture and safe lifting techniques (at home, at work, and during exercise) decrease your chances of developing lower back pain. Your physiotherapist can assist you in discussing the specific postures and activities you perform regularly. Learning how to position yourself and move safely will minimise your chances of low back pain.
Is physiotherapy effective for low back pain?
Physiotherapy is one of the most effective treatments for low back pain. There is a substantial amount of research to back up the techniques that we employ. Most low back pain cases respond well to manual therapy and an exercise programme.
Manual therapy examples include massage, joint mobilisation, manipulations and myofascial release. These techniques help to reduce pain and restore movement.
The exercise programme usually consists of range of motion and mobility exercises, trunk and leg muscle strengthening, and a progressive return to activities.
Acupuncture, taping, and Transcutaneous Electrical Nerve Stimulation (TENS) are standard treatments that physiotherapists may use.
How does a physiotherapist treat back pain?
To rule out more serious causes of back pain, your physiotherapist will examine you extensively.
Various injuries can cause back pain, and treatment varies greatly depending on your diagnosis. The goal of physiotherapy treatment is to protect your damaged tissue while also accelerating muscle and ligament healing and looking at ways of preventing a recurrence.
At Enhance Physio, we typically use the following techniques:
- Mobilisation and manipulation of joints.
- Stretching of soft tissues and muscles.
- Exercises for stabilisation and strength.
- Back pain relief through postural correction.
In addition, we offer ergonomic and occupational guidance, i.e. workstation set-up and lifting technique.
Exercises to avoid if you have lower back pain
- Back squats
People with chronic low back pain should avoid carrying weights completely.
- Standing toe touches
It increases the risk of stress to the lower back’s discs and ligaments as it causes increased extension of the lower back.
- Overhead or shoulder lifting of weights
Lifting weights overhead while suffering from low back pain places undue strain on the spine and back muscles, increasing the risk of muscle spasms and ligament tears.
This puts additional strain on the spine and aggravates back pain.
- Abdominal crunches
This hyperextends the spine and ligaments, so it should be avoided.
- Leg lifts or leg raises
This exercise requires a strong core and heavy strain on the back.
- Superman back extensions
This position involves the most core and back muscles and causes the most stress. As a result, anyone experiencing even minor low back pain should avoid it entirely.
How do I know if my back pain is serious?
A sudden injury most commonly causes acute low back pain. The muscles and ligaments that support the back are the most commonly injured. Muscle spasms or a strain or tear in the muscles and ligaments are the most likely sources of the pain.
The following neurological symptoms should be evaluated as soon as possible:
- Loss of bladder or bowel control.
- Muscle weakness in the legs.
- Feeling of pins and needles (paraesthesia).
- Alterations in reflexes.
- Walking difficulties.
- Feeling of numbness (anaesthesia).
In these cases of neurological deficit, be sure to get in touch with your nearest physiotherapist as soon as possible.
At Enhance Physio, our expert physiotherapists can perform a full assessment and customise a program to help relieve your low back pain.
Your physiotherapist will assess the severity of your low back pain and establish a customised pain treatment plan based on your assessment. No two cases of low back pain are ever the same.
If you suffer from low back pain, book an appointment today and learn more about strengthening your core and gluteal muscles to reduce your low back pain.
This week is World Continence Week (20-26th June) which aims to raise awareness about bladder and bowel continence and continence related issues. It is a commonly misunderstood area of health, with many myths surrounding what it is, who it affects and how it affects people. Let’s look at some of the more common myths around continence.
Myth 1: Incontinence is a normal and inevitable part of ageing
Despite many older people, especially women, reporting bladder and bowel incontinence, these issues are not inevitable, and in fact, can be very successfully managed or resolved with the careful assessment, management & treatment. Changes in our bodies as we age do make us more susceptible to continence issue down the track, however that does not mean that it is a normal and acceptable part of ageing.
Myth 2: Only women have urinary incontinence
While there is a higher percentage of women who experience urinary incontinence, approximately 38%, urinary incontinence affects around 10% of Australian men as well. This can be due to prostate surgery, enlargement of the prostate, or prostate cancer. Bowel incontinence also affects both men and women, with around 6% of men and 10% of women reporting some degree of bowel incontinence.
Myth 3: Incontinence is normal after childbirth, and I should just accept it
In some cases, yes, incontinence of the bowel or bladder can be caused by childbirth, or the interventions involved in delivery of a baby. However, there are a significant number of women who suffer from incontinence who have never been pregnant or given birth. Needing to brace or cross your legs to sneeze, cough or laugh, or not being able to jump or play with your children after childbirth is common but should not be considered normal and a ‘just part of life’. There are many ways in which we can reverse post-natal incontinence that don’t involve invasive treatments or surgery, and simply work on strengthening muscles and retraining our bladders to gain more control and quality of life.
Myth 4: Once you have incontinence, you have it for life
Absolutely incorrect! There are many strategies that Women’s & Men’s Health Physiotherapists have at their disposal that can help manage, reduce, or even eliminate incontinence that are safe, simple and evidence based. That is why it is so important that anyone experiencing issues with continence, no matter how large or small, reach out to their GP, local Continence Service or Women’s & Men’s Health Physiotherapists locally to work on solutions.
Regardless of your age, gender, stage of life or activity level, any changes to continence, whether it be bowel or bladder, should be discussed with your primary healthcare provider, GP, or Women’s & Men’s Health Physiotherapist. Often, there is a simple and manageable cause for these issues, however without discussion, these issues often linger far longer than they need to, impacting your quality of life. Don’t hesitate to reach out if you’re feeling like something has changed or you are needing advice and treatment to best manage your symptoms.
The Women’s & Men’s Health Physiotherapists at Enhance Physiotherapy can assist you in managing new and old continence symptoms with evidence based, personalised treatments to give you back your quality of life.
The Achilles tendon is the strongest tendon in the lower limb and provides a huge amount of power for running, jumping and changing direction. Achilles ruptures are a common traumatic injury in running, acceleration-based sports including athletics, rugby, AFL and netball. The Achilles ruptures with a sudden push off mechanism when sprinting or changing direction. Patients often describe a feeling of sudden pain and being kicked in the back of the leg or calf, only to see no one is behind them. This is a cardinal sign of an Achilles rupture.
Achilles ruptures can be managed surgically or non-surgically. This decision is based on any medical history and other medical conditions, age, location of the tear and the goals of the injured person or athlete.
For younger, athletic patients with goals of returning to their sport, surgery is the most common method of management as it promotes a quicker return to play. After surgery to repair the torn tendon, patients are placed in a cast for 2 weeks, followed by a CAMboot (moonboot) for a period of 6-8 weeks with a series of heel wedges to reduce the stretch on the Achilles and allow it to heal in a shortened position. Weight bearing is gradually increased over this time. If the Achilles is allowed to heal in a stretched position, this reduces the tendons’ tensile strength, which increases the risk of re-rupture and will result in reduced calf power in the long-term. This is why Achilles surgery needs to be done as soon as possible after injury to result in the best outcome.
For older patients (40-50+), those with other medical conditions (such as diabetes) or those who have no goals of returning to sport, non-surgical management may be an option. This is best to be discussed with an orthopaedic specialist before following this management pathway. The patient is placed in a CAMboot immediately after injury with multiple heel wedges to shorten the Achilles and promote better healing. This is progressively weaned (reduced), generally over a 2-3 month period (dependent on your surgeons advice and protocol).
After this period, a 6-9 month rehabilitation program is undertaken to restore range of motion, endurance, strength, power, returning to running and finally a return to sport specific activities for athletes. This is best to be undertaken with the guidance of your physio to ensure you rebuild the required strength and power in the Achilles tendon and calf to return to sport.
Who is affected?
Osgood-Schlatters is a condition that causes knee pain in the adolescent population.
This condition affects approximately 10% of adolescents, more commonly affecting boys aged 13-15 years old compared to girls.
This condition is extremely common during a growth spurt especially in sports involving running and jumping e.g. basketball and football.
Symptoms of Osgood-Schlatters can include:
- Painful lump at the front of the shin
- Swelling/redness at the front of the shin
- Pain increasing with hopping, running, jumping, and kicking
- Muscular tightness especially of Quadriceps muscle
- Pain that eases with rest
Osgood-Schlatters occurs when contraction of the quadriceps muscle causes excessive traction at the Tibial tuberosity (a bony protrusion on the shin bone where the patella tendon attaches to the shin bone – as shown above). This can occur as children progress through puberty due to their growth plates not being completely fused yet.
This can often result in the child having a painful lump at the front of their shin bone that is exacerbated with these high intensity activities.
Weather to continue playing sport is dependent on the severity of the symptoms however the amount of sport played does not seem to affect the time taken for the pain to disappear. The resolution of the pain is dependent upon the fusion of the tibial tuberosity/ growth plate, and symptoms may persist until full bone maturity.
Long term consequences of Osgood-Schlatter’s can lead to thickening and prominence of the tuberosity and occasionally a separate part of bone can develop at the site of the traction.
As this condition is self-limiting management can include:
- Activity modifications
- Pain guided limitation to activity
- Stretching and strengthening program
- Manual Therapy
- Some symptomatic relief with taping, bracing, and anti-inflammatory modalities such as ice
Correct diagnosis and management of such a condition is crucial to ruling out other causes and ensuring appropriate management. Hence assessment and management of this condition by a qualified health professional is an important component of Osgood-Schlatters.
Our muscles play an important role in the movement of our body. Without our muscles, we wouldn’t be able to bend our elbow or straighten our leg. As our muscles are soft and designed for flexibility, they are also prone to injury and if you have ever had a muscle tear, you know that they can be surprisingly painful.
In the period following a muscle tear, there are a few mistakes we see people make, that can actually make their injury worse and delay healing times. Here are a few of the most common mistakes we see.
After a muscle tear, the damaged fibres slowly begin to heal and reattach to each other. This process can be quite fragile and during the early stages, aggressive stretching of recovering tissue can impair healing or even lead to more tearing. While gentle stretching a few days after the injury can have a positive effect, you should check with your physiotherapist to ensure you’re not stretching too far and causing further damage.
2. Applying H.A.R.M.
Most of us are aware of the acronym R.I.C.E (rest, apply ice, compress the area and elevate) as the recommended treatment in the early stages of an acute injury. The acronym H.A.R.M is less well known and is used to remember the things you shouldn’t do after an injury. This stands for applying heat, drinking alcohol, running or massage. All of these activities can increase swelling, pain and increase the damage of the injury in the first 48-72 hours.
3. Failing to see a physiotherapist
The diagnosis of a muscle tear might seem straightforward, however, there might be more going on than you realize. Many conditions can mimic a muscle tear, or you may have suffered a tear due to an underlying weakness or pathology. Having a physiotherapist confirm your muscle tear or identify another condition is vital to ensuring you recover fully.
Your physiotherapist is also able to identify any factors that could lead to further injury and is able to help restore your tissue to its previous level.
4. Returning to sport too early
One of the most confusing things about muscle tears is that often they become less painful while the tissues are still not completely healed. Many people suffer another tear simply because they return to sport too early. While you may feel as though your tissues are back to full strength, the muscle fibres can still be healing and vulnerable to a tear. It is important to test your injury gradually, starting with gentle exercise and building up to high-intensity activities.
Your physiotherapist is able to guide you with a full rehabilitation program. This can help to restore strength, flexibility and control to your damaged muscle, keeping you injury free for the future.
It is come to that time of year again where we make our new year’s resolutions to be better than what we were last year. These resolutions range from potentially giving something up, starting a new venture or changing something significant in our lives in the aim of improving our occupation, health and well-being. However, many of these resolutions often go by the wayside once we get back into our daily and weekly routines. Where your resolutions revolve around increasing your fitness, losing a few Christmas/Covid Kilo’s, or reducing symptoms of an injury, here’s a few tips on how to make these resolutions stick, and how to achieve the goals that you have every intention of achieving at this point in the New Year.
- Make your health goals S.M.A.R.T.
If you are trying to increase fitness, lose weight or reduce injury symptoms, be specific about what you are wanting to achieve. “Run a Park Run in under 30 minutes, lose 10kg, wake up with no hip or knee pain” are all specific, measurable, achievable, realistic and time limited (we give ourselves 2022 by default).
- Highlight the SMALL steps
Many people make a goal that’s at the “top of the mountain”, and they want to get to the top of the mountain, but they fail to see the mountain that’s in front of them. If you want to run a distance in a particular time, start with your current time and try and beat that time, then try and beat the next time. If you want to lose 10kg, focus on losing the first 1kg. Success breeds success and with repetition, it gets easier as the momentum grows.
- Celebrate the small goals
When you make your small achievements, celebrate them like you’ve just reached the top of the mountain because that will release the hormones and endorphins that become addictive. It will help striving for the next goal even easier.
- Be accountable to someone other than yourself
It’s time to rustle up that friend who said at the Christmas party that they wanted to achieve a similar goal and hold them accountable to it too. We can often make excuses to ourselves that make it easy to settle for second best, or failure. But if you have someone waiting for you at 6am to go for that run around the block, we are less likely to let them down. There’s also a fair bet that you are helping them achieve their goals just as importantly as they are a part of you achieving yours!!
So, make sure you spend some time setting up your 2022 goals and ensuring there is a solid pathway for success. If you have any aches or niggles that you think may stop you from achieving your goals, contact us on (02) 6041 3609 and book in with one of our therapists to help you get started in making 2022 your year of achievement.
The Humerus is the long bone of the upper arm. It attaches via a ball and socket joint to the shoulder and runs down to the elbow joint. Most fractures occur at the neck (top part) or mid shaft (middle) and are quite painful and debilitating.
This bone is often broken from a fall with an outstretched hand or in a car accident. Usually the fracture can be treated without surgery if the bone is stable and not out of position.
Whether you need to have surgery or not, your Physiotherapist can guide you through the early to later stages of recovery. In the early stages, the focus will be on ensuring you’re wearing the sling correctly, managing your pain adequately and moving the adjacent joints such as the neck, wrist and elbow to prevent stiffness. In the later stages, the focus then shifts to progressive strengthening and range of movement of the shoulder. Humerus fractures can take approximately 8-12 weeks to heal.
Having osteoporosis (softer bones), lower limb muscle weakness and poor balance puts you at greater risk of a Humerus fracture. Your Physiotherapist can design an exercise program to address these risk factors thereby reducing your risk of injury.
The Physiotherapists at Enhance Physiotherapy are caring and experienced professionals who can guide you through your recovery and back to the activities you enjoy.
2020 certainly packed a punch when it came to our lives surrounding the global Covid pandemic. A mixture of multiple lockdowns and differences in conditions between states certainly made for some trying times. However, health care continued throughout the pandemic and the GLA:D Australia team have recently released their Annual Review of the program for 2020.
It was noted in the report that whilst these results were not compared against a control group and were taken from people who were motivated to improve their lives (thus potentially adding an outcome bias), it is refreshing to see the following outcomes:
- Between January 2018 and December 2020, 7,641 participants had taken part in the GLA:D Program throughout Australia.
- 71% of GLA:D participants were female.
- Average age of all participants was 65 years old, with the youngest being a 23 year old male and the oldest being a 93 year old female.
- 81% of GLA:D participants reported their knee as their primary problem, and 19% reported their hip as the primary problem.
- A total of 80% of knee participants and 71% of hip participants were classified as overweight or obese on the BMI scale.
- 45% of knee participants and 28% of hip participants had undergone previous surgery before starting the GLA:D Program
- 50% of participants were retired, 22% had full-time jobs, 18% had part time jobs and 10% were unemployed or had home-duties.
- Average reported knee/hip pain reduced by 33% for knee participants and 27% for hip participants
- After the GLA:D Program, 49% of knee participants and 45% of hip participant reported taking less or much less pain relief medication.
- For both hip and knee participants, the average number of sit to stands in 30 seconds (one of the outcome measures) raised by 27% from 11 reps to 14 reps after the program
- The average walking speed increased by 14% from 1.54 m/sec to 1.74 m/sec in the knee participants, and 12% from 1.54 m/sec to 1.73 m/sec in hip participants.
- Participant’s average joint-related quality of life increased by 29% for knee participants and 20% for hip participants.
At 12 months post-course:
- Knee participants reported an average pain reduction of 31% and hip participants reported an average pain reduction of 30%
- Joint related quality of life remained at 36% improvement for knee participants and 30% for hip participants.
- 50% of knee participants and 53% of hip participants reported taking less or much less medication.
- 26% of knee participants desired surgery prior to the GLA:D program. 65% of these participants had not received surgery and no longer desired surgery one year after starting the GLA:D program.
- 25% of hip participants desired surgery prior to the GLA:D program. 67% of these participants had not received surgery and no longer desired surgery one year after starting the GLA:D program.
So as can be seen from the above outcomes, a vast range of participants had several measurable improvements by completing the GLA:D program. With Chris Oberson (who is also a trained GLA:D physiotherapist) joining Dave Rossiter and Sarah Hamilton, we have plenty of availability to assist you in improving your quality of life from the potential negative effects of Osteoarthritis.
Further information about the GLA:D program can be found at https://gladaustralia.com.au/
Contact Enhance Physiotherapy on (02) 6041 3609 to book your appointment in and start your personal management of your osteoarthritis!
Hamstrings are often injured during sports or everyday activities such as running, cycling, or lifting weights. Left untreated, they can cause long-term damage to muscles and ligaments, leading to chronic pain and reduced mobility.
Physiotherapists are trained professionals who specialise in treating musculoskeletal injuries. We diagnose and treat conditions ranging from sprains and strains to fractures and dislocations. Hamstring tears are therefore commonly treated at our practice.
What are hamstring muscles?
The hamstrings are a large group of muscles located at the back of the thigh. Their job is to bend the knee, move the hip backwards and stabilise the leg. The muscles can be injured at any point but are most vulnerable where the tendon and muscle fibres join together. This is a common injury for players of all sports involving running, particularly those involving quick movements and kicking.
Common causes of hamstring tears
A sudden, vigorous contraction or stretch of the hamstring muscle group that results in substantial mechanical stress causes hamstring strains.
As the hamstrings cross two large joints, they must perform complicated movements, often activating suddenly and with great force. They are often stretched during a fall, big kick or sudden take-off.
Common risk factors for hamstring tears
Factors that increase the chance of a tear include poor flexibility, strength deficits and neural mobility.
Hamstrings are often injured due to overuse. This is usually caused by repetitive movements, especially those involving running and jumping.
Other factors contributing to hamstring injuries are muscle imbalances, abnormal lower limb biomechanics, fatigue, and inadequate warm-up. In addition, poor posture can also cause injuries.
It seems, however, that the most significant predictor of a future hamstring tear is a previous hamstring injury.
Common symptoms of hamstring injuries
The most common symptom of a torn hamstring is a sharp pain at the back of the thigh, often immediately after intense activity. There may also be swelling, bruising, difficulty walking and pain with knee movements. The symptoms of a hamstring tear are similar to many other conditions, as the lower back often refers to pain at the back of the thigh, mimicking a hamstring tear.
Your physiotherapist can confirm that the pain is due to a torn hamstring and tell you how bad the tear is. Although not usually required, diagnosis can be confirmed by having an MRI or real-time ultrasound scan.
Can physio help a torn hamstring?
Once a diagnosis is made, the first step is to follow the R.I.C.E protocol (Rest, Ice, Compression, Elevation). During the first 48 hours, you should apply ice for 20 minutes every hour to reduce swelling and bruising.
A consultation with one of our physiotherapists will include advice about your recovery and when it is appropriate to return to sport. Your physiotherapist has many techniques that can promote healing and reduce scar tissue formation, including ultrasound, deep tissue therapy, laser, TENS and dry needling.
They will also prescribe an exercise program to return strength, flexibility and control to the muscle, getting you back to your sport quickly and safely. Due to the high chance of recurrence, rehabilitation is crucial and usually takes 6-12 weeks. Surgery may be required before rehabilitation can start if the hamstring muscle is completely torn.
The fundamental goal of physiotherapy and the rehabilitation program is to restore the patient’s functions to the greatest extent possible and to return the athlete to sport at the previous level of performance while minimising the risk of re-injury.
How to avoid hamstring injuries
Hamstring strains can be avoided by ensuring the hamstrings are strong and flexible enough to resist the rigours of work, sports, and daily activities.
The following strategies will help you lower your risk of suffering a hamstring strain injury:
- Before engaging in any sports activity, always warm up.
- Avoid starting a new activity too quickly to allow your body to adjust to the new movement patterns. Instead, gradually increase the frequency and intensity of the activity.
- Make sure your hamstring muscles are strong through strength training.
- Stretch effectively after exercise to improve range of movement and mobility.
- Before repeating the same exercise program, pay attention to your body after working out. Stretch, apply ice, or take rest days as necessary.
Final thoughts on Physiotherapy for Hamstring Tears
A hamstring tear occurs when the muscle fibres at the back of the thigh become damaged. The injury usually happens after repeated strain or overuse.
Physiotherapists can perform various treatments depending on the severity of the injury.
There are several treatment options for hamstring tears. Physiotherapists can provide exercises to stretch and strengthen the muscles. They can also recommend other treatments such as injections, massage therapy, ultrasound treatment, electrical stimulation, or even surgery for severe injuries.
Book an appointment with one of our highly qualified physiotherapists at Enhance Physio before starting a rehabilitation program. We can advise you on the best course of action for your condition.
Cervical Radiculopathy involves an irritation of a nerve root in the neck, via either compression or inflammation in the region.
This can cause signs and symptoms including:
- Unilateral (one side) neck pain with sharp/burning pain radiating down the arm
- Numbness or pins and needles in the neck, shoulder and/or arm
- Symptoms are aggravated with particular neck movements eg turning your head over your right shoulder, looking upwards etc
- A deficit in reflexes, sensation and/or muscle power in your arm, shoulder or hand
The two main mechanisms of nerve root impingement or irritation include:
- Spondylosis leading to stenosis or bony growth in the cervical joints (common in older patients)
- Disc herniation leading to compression/inflammation of the nerve root (more common in younger patients)
This injury often comes on gradually, rather than due to a traumatic incident. Some contributing factors include:
- Restricted cervical (neck) range of motion
- Restricted thoracic spine range of motion
- Reduced muscle strength and control through the neck, shoulder and back
Your physio will complete a thorough assessment to identify your diagnosis, and potential problems causing the issue. Their assessment may include looking at:
- Cervical spine (neck) range of motion
- Thoracic spine (mid-back) range of motion
- Neurological testing of your sensation, reflexes, and muscle power
- Grip strength
- Neurodynamic testing
- Manual hands-on assessment and palpation
Your physiotherapist can use a variety of treatments to manage this issue. This may include hands-on techniques, such as joint mobilisation and soft tissue massage to reduce your symptoms and manage pain.
Exercise prescription is also part of management to improve deficits in cervical spine range of motion, thoracic spine range, scapula control and global neck & shoulder strength. Alongside this, addressing other factors such as ergonomics, sleeping positions and posture may also be included to prevent the issue reoccurring once your symptoms have settled.
Your physiotherapist may also discuss with you the use of pain management strategies including the use of anti-inflammatories or other medication which can be prescribed by your GP.
Referral on to a specialist may be an option recommended to you depending on the severity of your signs and symptoms. Your physiotherapist can guide on you on these options and refer on as needed.