Ankle 2

Does Kinesiology Taping Help to Hasten Your Recovery Time from Swelling or Bruising?

Researchers, Bialoszewski et al. 2009, have discovered that kinesiology tape can quicken the reduction in joint swelling (oedema) and a  bruise (haematoma). The theory is that the elasticity of kinesiology tape lifts the skin away from the swollen tissue below by loosely "crinkling" the skin. This skin lift is known as a sub-dermal vacuum, which provides less physical resistance to the removal of the retained fluid by your lymphatic and venous drainage systems. Test this theory out by a quick squeeze of your skin. It will resemble an "orange-peel" appearance. You'll notice loose skin between your fingers. The lower skin tension allows your venous and lymphatic systems to drain the sub-dermal fluid away quicker. Now isn't that clever!
Tendinopathy (tendon injuries) can develop in any tendon of the body. You may have heard of tendinopathies being referred to as its aliases: tendonitis, tendinitis, tenosynovitis and tendinosis. In simple terms, they are all tendon injury pathologies so the medical community now refers to them as tendinopathies. Typically, tendon injuries occur in three areas:
  • tendon insertion (where the tendon attaches to the bone)
  • mid-tendon (non-insertional tendinopathy)
  • musculotendinous junction (where the tendon attaches to the muscle)

What is a Tendon Injury?

Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to occur suddenly, but usually, it is the result of repetitive tendon overloading. As mentioned earlier, health care professionals may use different terms to describe a tendon injury. You may hear: Tendinitis (or Tendonitis): This means "inflammation of the tendon". Mild inflammation is actually a normal tendon healing response to exercise or activity loading, but it can become excessive, where the rate of injury exceeds your healing capacity.

Tendinopathy Phases

The inability of your tendon to adapt to the load quickly enough causes the tendon to progress through four phases of tendon injury. While it is healthy for normal tissue adaptation during phase one, further progression can lead to tendon cell death and subsequent tendon rupture.

1. Reactive Tendinopathy

  • Normal tissue adaptation phase
  • Prognosis: Excellent.
  • Normal Recovery!

2. Tendon Dysrepair

  • Injury rate > Repair rate
  • Prognosis: Good.
  • The tendon tissue is attempting to heal.
  • It is vital that you prevent deterioration and progression to permanent cell death (phase 3).

3. Degenerative Tendinopathy

  • Cell death occurs
  • Prognosis: Poor!
  • Tendon cells are dying!

4. Tendon Tear or Rupture

  • Catastrophic tissue breakdown
  • Loss of function.
  • Prognosis: very poor.
  • Surgery is often the only option.

What is Your Tendinopathy Phase?

It is very important to have your tendinopathy professionally assessed to identify it’s current injury phase. Identifying your tendinopathy phase is also vital to direct your most effective treatment since certain treatment modalities or exercises should only be applied or undertaken in specific tendon healing phases.

Systemic Risk Factors

The evidence is growing that it is more than just the tendon and overload that causes tendinopathy. Diabetics, post-menopausal women and men with high central adiposity (body fat) seem to be predisposed to tendinopathies and will need to carefully watch their training loads.

What are the Symptoms of Tendinopathy?

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.
  • The pain may get worse when you use the tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.
The symptoms of a tendon injury can be similar or combined with bursitis.

How is a Tendon Injury Diagnosed?

To diagnose a tendon injury, your physiotherapist or doctor will ask questions about your past health, your symptoms and recent exercise regime. They'll undertake a thorough physical examination to confirm the diagnosis. They will then discuss your condition and devise an individualised treatment plan. They may refer you for specific diagnostic tests, such as an ultrasound scan or MRI.

Tendinopathy Treatment

Tendinopathies can normally be quickly and effectively rehabilitated. However, there is a percentage of tendinopathies that can take months to treat effectively. As mentioned earlier in this article, it is important to know what phase your tendinopathy currently is. You physiotherapist can assist not only your diagnosis but also guide your treatment to fast-track your recovery. Before you seek the advice of your physiotherapist or doctor, you can start treating an acute tendon injury at home. To achieve the best results, start these steps right away:
  • Rest the painful area, and avoid any activity that makes the pain worse.
  • Apply ice or cold packs for 20 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
  • Do gentle range-of-motion exercises and stretching to prevent stiffness.

When to Return to Sport

Every tendinopathy is different, so please be guided by your physiotherapist assessment. It may take weeks or months for some tendon injury to heal and safely cope with a return to sporting loads. Be patient, and stick with the treatment exercises and load doses prescribed by your physiotherapist. If you start using the injured tendon too soon, it can lead to more damage, and set you back weeks!

Tendinopathy Prevention

To minimise reinjuring your tendon, you may require some long-term changes to your exercise activities. These should be discussed with your physiotherapist. Some factors that could influence your tendinopathy risk include:
  • Altering your sport/activities or your technique
  • Regular prevention exercises.
  • Closely monitoring and record your exercise loads. Discuss your loading with your physiotherapist and coach. They will have some excellent tips.
  • Always take time to warm up before and cool down / stretch after you exercise.

Tendinopathy Prognosis

While most acute tendinopathies can resolve quickly, persisting tendon injuries may take many months to resolve. Long-term or repeat tendinopathies usually have multifactorial causes that will require a thorough assessment and individualised rehabilitation plan.  Researchers have found that tendon injuries do respond differently to muscle injuries and can take months to solve or potentially render you vulnerable to tendon ruptures, which can require surgery. For specific advice regarding your tendinopathy, please seek the advice of your trusted healthcare professional with a special interest in tendinopathies.

Ankle Strapping

How to Strap an Ankle

how to strap an ankle Ankle strapping or taping can be used effectively in both the prevention and treatment of ankle injuries. As an aid to prevention, the role of ankle strapping is to decrease the frequency and severity of the injury. In particular, a sprained ankle. Ankle strapping aims at preventing damage or minimising the risk of injury.

Prevention is Better than a Cure

In many professional sports, clubs have significant financial investments in their players and cannot afford to lose a player at any stage of the playing season. Therefore, clubs use preventative strapping tape as a form of insurance against ankle injuries. This injury prevention strategy, in turn, helps to reduce the loss of performance time by any player.

Which Strapping Tape is Best?

Most ankle strapping uses a rigid sports tape. In most cases, 38mm width strapping tape will suffice. Larger ankles may prefer 50mm width. 25mm strapping tape usually is too constrictive for ankle strapping. In amateur sport, athletes risk the same injuries. However, there is generally little encouragement to take such preventive measures even though the amateur risks the consequence of time off work and paying medical bills. In these situations, the use of strapping tape, particularly for the high-risk sports such as Football, Netball, Basketball, Hockey etc., is potentially far more critical to the individual where the cost of prevention could be far less than the value of the treatment. There are many methods to strap an ankle, and it depends upon how much you need to protect your ankle versus the necessary flexibility for you to perform your sport. Some ankle strapping techniques include simple stirrups, figure-6, figure-8, basket weave and heel locks. For more information, please seek the advice of your trusted physiotherapist.

More info:

Sprained Ankle High Ankle Sprain

What is the PhysioWorks Difference?

You'll be impressed with the experienced physiotherapists, massage therapists and reception staff who represent PhysioWorks.  To ensure that we remain highly qualified, we are committed to participating in continuing education to provide optimal care. If you've been searching for health practitioners with a serious interest in your rehabilitation or injury prevention program, our staff have either participated or are still participating in competitive sports at a representative level. We also currently provide physiotherapy and massage services for numerous sports clubs. Our experience helps us understand what you need to do to safely and quickly return to youryouryour sporting field, home duties, or employment.

How You'll Benefit from the PhysioWorks Difference?

At PhysioWorks physiotherapy and massage clinics, we strive to offer our clients quickeffective and long-lasting results by providing high-quality treatment. We aim to get you better quicker in a friendly and caring environment conducive to successful healing. With many years of clinical experience, our friendly service and quality treatment is a benchmark not only in Brisbane but Australia-wide.

What are Some of the BIG Differences?

Our therapists pride themselves on keeping up to date with the latest research and treatment skills to ensure that they provide you with the most advantageous treatment methods. They are continually updating their knowledge via seminars, conferences, workshops, scientific journals etc. Not only will you receive a detailed consultation, but we offer long-term solutions, not just quick fixes that in reality, only last for a short time. We attempt to treat the cause, not just the symptoms. PhysioWorks clinics are modern thinking. Not only in their appearance but in the equipment we use and in our therapists' knowledge. Our staff care about you!  We are always willing to go that 'extra mile' to guarantee that we cater to our clients' unique needs. All in all, we feel that your chances of the correct diagnosis, the most effective treatment and the best outcomes are all the better at PhysioWorks.

What is Therapeutic Ultrasound?

Therapeutic ultrasound is an electrotherapy modality which has been used by physiotherapists since the 1940s. Via an ultrasound probe through a transmission coupling gel in direct contact with your skin, ultrasound waves are applied. ultrasound Therapeutic ultrasound may increase:
  • healing rates
  • tissue heating
  • local blood flow
  • tissue relaxation
  • scar tissue breakdown.

How Could Ultrasound Help?

Ultrasound increases local blood flow. This increase may help to reduce local swelling and promote soft tissue healing rates. A higher power density may soften scar tissue.

Specific Ultrasound Uses

Mastitis or blocked milk ducts successfully respond to therapeutic ultrasound. The effect is quite dramatic, with improvement within 24 to 72 hours. The most common conditions treated with ultrasound include soft tissue injuries such as muscle, ligament injuries or some tendinopathies. Phonophoresis uses ultrasound in a non-invasive way of administering medications to tissues below the skin. This method may assist patients who are uncomfortable with injections. With phonophoresis, the ultrasonic energy forces the drug through the skin.

What is an Ultrasound Dose?

A typical ultrasound treatment will take from 3-10 minutes. Where scar tissue breakdown is the goal, this treatment time could be much longer. During the procedure, the head of the ultrasound probe is in constant motion. If kept in continuous motion, the patient should feel no discomfort at all. Some conditions treated with ultrasound include soft tissues injuries such as muscles or ligament injuries, tendinopathy, non-acute joint swelling and muscle spasm.

How Does an Ultrasound Work?

A piezoelectric effect, caused by the vibration of crystals within the ultrasound head of the probe creates the sound waves. The ultrasound waves generated then pass through the skin cause a vibration of the local soft tissues. This repeated cavitation can cause a deep heating locally though usually no sensation of heat will be felt by the patient. In situations where a heating effect is not desirable, an athermal application occurs. Athermal doses are typical during acute fresh injury and the associated acute inflammation.

When Should Ultrasound be Avoided?

Contraindications of ultrasound include:
  • local malignancy,
  • over metal implants,
  • local acute infection,
  • vascular abnormalities,
  • active epiphyseal regions (growth plates) in children,
  • over the spinal cord in the area of a laminectomy,
  • over the eyes, skull, or testes
  • and, directly on the abdomen of pregnant women. Treatment ultrasound differs from diagnostic ultrasound!
Like all medical equipment, when used by highly trained professionals, such as your physiotherapist, therapeutic ultrasound is very unlikely to cause any adverse effects. Please consult your physiotherapist for their opinion on whether therapeutic ultrasound could assist your injury. Therapeutic Ultrasound differs from Real-Time Ultrasound Treatment.

What is Osteoarthritis?

Osteoarthritis is one of the most common forms of arthritis, often referred to as degenerative arthritis. The joints show signs of wear: joint cartilage becomes thin, extra bony spurs grow in response to stress, and joint motion lessens. In advanced stages, osteoarthritis can be painful, functionally limiting and depressing.

What is the Osteoarthritis Cure?

Unfortunately, there is no cure for osteoarthritis. But the good news is that there are some better ways to manage your osteoarthritis and slow the degeneration process. This improvement will result in making your life easier and more comfortable. Physiotherapy is a significant part of making your life living with osteoarthritis less painful, comfier and keeping you active. Research supports physiotherapy. Physio can reduce the pain and disability associated with arthritis, especially knee osteoarthritis. http://dx.doi.org/10.1136/bjsports-2016-096458 Seek the professional and helpful advice of your physiotherapist to start enjoying life again today!

Your Osteoarthritis Diagnosis

X-rays are the most straightforward test to confirm osteoarthritis. An experienced practitioner will have an excellent idea of whether you have osteoarthritis when they examine you.

How Does Osteoarthritis Affect Older People?

As you age, most people develop some degree of osteoarthritis. Our joints' wear and tear may occur due to ageing, injury, prolonged microtrauma, overuse of joints, or excess weight. Permanent bony changes occur and will exist even when there are no painful symptoms. Your degree of suffering varies. Whereas some people may be symptom-free others may suffer continuous disabling pain. The most common is mild or intermittent pain provoked by episodes of increased use or minor trauma. The joints most commonly affected are the weight-bearing joints: hip, knee, ankles, feet and spine. However, osteoarthritis can affect any joint in the body and is quite common in the hands and shoulders. Severe cases may require surgical treatment, but most will respond very well to your doctor's physiotherapy and medication.

Osteoarthritis Symptoms

You can suspect osteoarthritis if you experience one or more of the following symptoms:
  • joint pain or tenderness that intermittently returns
  • stiffness, particularly early morning stiffness
  • joint swelling or deformity
  • noticeable joint heat and redness
  • joint movement is strenuous.

Osteoarthritis Treatment

For advice on your osteoarthritis diagnosis, self-help tips or the best treatment of your osteoarthritis, please contact your physiotherapist or trusted health care professional.

Shoe Size Conversion Chart

Aust. Mens 4 5 6 7 8 9 10 11 12
Aust/US Womens 6 7 8 9 10 11 12 13 14
US Mens 5 6  7 8 9 10 11 12 13
European 37 38 39.5 40.5 42 43 44.5 46 47
UK 4 5 6 7 8 9 10 11 12
Centimetres 22.8 23.7 25.1 25.4 26.3 27.1 28 28.8 29.6

Growing Pains

Growing Pains are a concern for most teenagers, pre-teens and their parents. As a rule, growing pains are poorly understood and often brushed aside as something you must go through during adolescence. This is not necessarily true. In fact, most "growing pains" can be eliminated or at least eased with some quality care and attention.

What Causes "Growing Pains"?

A prevalent time to suffer  "growing pains" is when your bones are quickly lengthening.  Consequently, your muscles also have to lengthen to keep a normal "muscle length-tension ratio".  Unfortunately, this doesn't always happen naturally. If your muscles do not lengthen adequately, it increases muscular tension pulling on the soft bone growth plates. Commonly we find that those kids who suffer "growing pains" have excessively tight muscles that cause their pain.

What Can Be Done to Help Growing Pain?

The good news is that your physiotherapist is trained to assess your child's normal muscle length.  Immediately after their assessment, your child will be prescribed corrective techniques to lengthen any tight soft tissue. Every child is different, and they do have individual genetics. As you would be well aware, not everyone can be a contortionist! Therefore, the rate your child's improvement, techniques used, or exercises performed will vary from individual to individual.

What Results Can You Expect?

Luckily, growing pains usually disappear within days or just a few weeks once the correct treatment commences. Considering that most untreated "growing pains" can last 18 months or more, that's very pleasing news for your child.  Why let your child needlessly suffer when there is a straightforward, safe and effective solution available?

Common Youth Leg Injuries

youth sports injuries

Why are Children's Injuries Different to Adults?

Adolescent injuries differ from adult injuries, mainly because the bones are still growing. The growth plates (physis) are cartilaginous (strong connective tissue) areas of the bones from which the bones elongate or enlarge. Repetitive stress or sudden large forces can cause injury to these areas.

Common Adolescent Leg Injuries

In the adolescent leg, common injuries include:

Osgood-Schlatter's Disease

Pain at the bump just below the knee cap (tibia tubercle). Overuse injuries commonly occur here. The tibia tubercle is the anchor point of your mighty quadriceps (thigh) muscles. It is because of excessive participation in running and jumping sports that the tendon pulls bone off and forms a painful lump that will remain forever. This type of injury responds to reduced activity and physiotherapy. More info: Osgood Schlatter's Disease

Sinding-Larsen-Johansson Disease

Pain at the lower pole of the knee cap (patella). Overstraining causes Sinding-Larsen-Johansson disease. It is because of excessive participation in running and jumping sports that the tendon pulls bone off the knee cap. This type of injury responds to reduced activity and physiotherapy. More info: Sinding Larsen Johansson Syndrome

Anterior Knee Pain

Anterior knee pain or patellofemoral syndrome frequently gets passed off as growing pains. Cause of this pain includes overuse, muscle imbalance, poor flexibility, poor alignment, or more commonly, a combination of these. Anterior knee pain is one of the most challenging adolescent knee injuries to sort out and treat. Accurate diagnosis and treatment with the assistance of a physiotherapist with a particular interest in this problem usually resolves the condition quickly. More info: Patellofemoral Pain Syndrome

Knee Ligaments

The cartilage between the leg bones have a better blood supply and are more elastic in adolescents than in adults. As adolescents near the end of bone growth, their injuries become more adult-like, hence more meniscal and ACL (anterior cruciate ligament) injuries are likely. MCL (medial collateral ligament) injuries result from a lateral blow to the knee. Pain felt on the inner side (medially) of the knee. MCL injuries respond well to protective bracing and conservative treatment. More info: Knee Ligament Injuries

ACL (anterior cruciate ligament) injuries

This traumatic knee injury is significant. Non-contact injuries of the ACL are becoming more common than contact injuries of the ACL. Adolescent females are at high risk. Combination injuries with MCL or menisci are common. Surgical reconstruction is needed if the adolescent wishes to continue participating in "stop-and-start" sports. More info: ACL Injury

Meniscal injuries

Your meniscus is crescent-shaped cartilage between the thigh bone (femur) and lower leg bone (tibia). Meniscal injuries usually result from twisting. Swelling, catching, and locking of the knee are common. If physiotherapy treatment does not resolve these types of damages within six weeks, they may require arthroscopic surgery. More info: Meniscus Tear, Discoid Meniscus

Sever's Disease

Heel pain is commonplace in young adolescents due to the stresses of their Achilles tendon pulling upon its bony insertion point on the heel (calcaneum). It is a common overuse injury as a result of excessive volume of training and competition, particularly when loads are increased dramatically in a short period. Diminished flexibility and muscle-tendon strength mismatching may predispose you. Physiotherapy, reduced activity, taping and orthotics are some of the best ways to manage this debilitating condition for the active young athlete. More info: Sever's Disease

Ankle Sprain

An ankle sprain is probably the most common injury seen in sports. Ankles sprains involve stretching of the ligaments and usually occur when the foot twists inward. Treatment includes active rest, ice, compression and physiotherapy rehabilitation. An ankle sprain usually improves in 2-6 weeks with the correct treatment. Your ankle physiotherapist should check even simple ankle sprains. A residually stiff ankle post-sprain can predispose you to several other lower limb issues More info: Sprained Ankle

Patellar Instability

Patellar (kneecap) instability can range from partial dislocation (subluxation) to dislocation with a fracture. Partial dislocation treatment is conservative. Dislocation with or without fracture is a much more severe injury and usually will require surgery. More info: Patella Dislocation

Osteochondritis Dissecans

The separation of a piece of bone from its bed in the knee joint is Osteochondritis Dissecans (OCD). This injury is usually due to one major macro event with repetitive macro trauma that prevents complete healing. This injury is potentially severe. Treatment varies from rest to surgery. An Orthopaedic Surgeon's opinion is vital. More info: Juvenile Osteochondritis Dissecans (JOCD)

Growth Plate Fractures

A fracture through the growth plate can be a severe injury that can stop the bone from growing correctly. These fractures should be treated by an Orthopaedic Surgeon, as some will require surgery.

Avulsion Fractures

youth pelvis hip avulsion
Image source: https://radiologyassistant.nl/pediatrics/hip/hip-pathology-in-children
An avulsion fracture occurs when a small segment of bone attached to a tendon or ligament gets pulled away from the main bone. The hip, elbow and ankle are the most common locations for lower limb avulsion fractures in the young sportsperson. Treatment of an avulsion fracture typically includes active rest, ice and protecting the affected area. This period of active rest is followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. Your physiotherapist should supervise your post-avulsion exercises. Most avulsion fractures heal very well.  You may need to spend a few weeks on crutches if you have an avulsion fracture around your hip. An avulsion fracture to your foot or ankle may require a cast or walking boot. In rare cases, an excessive gap between the avulsed bone fragment and main bone may not rejoin naturally. Surgery may be necessary to reunite them. In children, avulsion fractures that involve the growth plates also might require surgery. All avulsion fractures should be reviewed and managed by your trusted physiotherapist or an Orthopaedic Surgeon. For more information regarding your youth sports injury, please consult your physiotherapist or doctor.

Common Youth Leg Injuries

Pelvis & Hip

Knee

Heel & Ankle

Common Youth & Teenager Sports Injuries

Common Youth Neck & Back Pain Common Youth Arm Injuries

Yes! You Can Definitely Improve Your Balance.

The research has confirmed for many years that balance retraining works. It can also take only a few weeks progressed balance exercises to improve or normalise your balance and corrective reactions. You can perform simple exercises initially, such as standing on one leg with eyes open and progress to eyes closed. Still, after that, the best way to improve your balance is to exercise on an unstable surface. For more information about balance assessment and retraining, please contact your physiotherapist.

Balance Enhancement Products:

Over the years, there have been numerous devices developed to assist clinicians in improving their clients' balance. This has greatly reduced the incidence of ankle and knee ligament sprains and, at the same time, improves the athlete's performance. These balance devices can be used by you, in your own home to improve your balance and reduce your injury chance or eliminate your joint pain.
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