Muscle Pain & Injury

Muscle Pain & Injury

Article by I.Kelly, J.Ferguson, N.Stewart

Muscle Pain

No matter how you describe it –  “pulled muscle”, “muscle strain”, “muscle injury” or “muscle tear” the end result is an injury to your muscle resulting in muscle pain, muscle weakness and reduced muscle performance. These common muscle strains and their general treatment will be discussed shortly.

Other common causes of sports-related muscle pain include muscle contusions such as a corked thigh or an overtraining condition such as delayed onset muscle soreness (DOMS) or muscle cramps.

You should also be aware that not all muscle pain is injury-related and can be due to systemic conditions such as fibromyalgia or rheumatoid arthritis. Please consult with your trusted healthcare practitioner for a thorough assessment and diagnosis of your muscle pain.

How to Care for Your Muscle Pain?

Muscle pain can be caused by any strain, injury or tear. The most common is the high speed and load muscles such as your hamstrings, thigh (quadriceps), calf, back and biceps.

More info:

Muscle tears can range from a mild strain (Grade 1), moderate strain (Grade 2) to a complete rupture (Grade 3). Treatment options vary depending on the severity of your muscle strain, tear or rupture.

Grade 1 muscle strains will usually respond well to conservative treatment including protection and active rest with a gradual introduction to flexibility, strength, power and speed exercise depending upon the functional needs of the injured muscle. Massage therapy and dry needling are other treatment options available.

Grade 2 muscle tears may require some professional assistance from a sports physiotherapist or other healthcare practitioner with a special interest in muscle injuries.  Grade two injuries are more likely to have scarring, inflexibility and reduce strength and performance. They are generally a higher risk of re-injury on your return to sport or work, so professionally guided rehabilitation is advised.

Grade 3 muscle rupture often require surgery. Please consult with a healthcare practitioner for more advice. Most muscle rupture repairs will require a very gradual and progressed rehabilitation program under the guidance of your surgeon and your physiotherapist.

Symptoms of a Muscle Strain

  • Muscle tightness
  • Bruising
  • Weakness
  • Inability to fully stretch your injured muscle
  • Loss of function

What’s the Best Treatment for a Muscle Strain or Tear?

Until you’ve been accurately diagnosed, use the following guidelines:

  • Ice and a compression bandage.
  • Elevate the region if it is swollen.
  • If it’s painful to walk you should be using crutches.
  • Reduce your training to a level where you feel no pain. That may include stopping all exercise.
  • Seek the advice of your physiotherapist, massage therapist or your trusted healthcare practitioner.

Return to Sports Post-Muscle Strain

Returning to a sport can be easy or complicated depending on the muscle affected. Some muscle tears such as hamstrings are notoriously difficult to get right.

Ideally, you should undertake:

  • an assessment of your muscle function, core stability and biomechanics to avoid injury recurrence.
  • a remedial or sports style massage to ensure that any scar tissue doesn’t clump.
  • a muscle rehabilitation program that incorporates components of strength, endurance, flexibility and speed that is specific to your chosen sport.
  • a neural tissue dynamics assessment to ensure that no nerve tissue has become entrapped in the scar tissue.
  • application of a heat retainer to the area when you return to sport.
  • application ice therapy after any training sessions.

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Muscle Pain Injuries

Myalgia, or muscle pain, can have many sources. Here are some of the more common sources of your muscle pain. Please click the links for more information.

Muscle Strains By Region

Neck & Back:

Leg:

Arm:

Haematoma-related Myalgia

Fatigue-related Myalgia

Systemic Causes of Myalgia

More Information: Myalgia

Muscle Strain Treatment

Muscle strain treatment will vary depending upon an accurate diagnosis from your health professional. The severity of your muscle strain, and what function or loads your injured muscle will need to cope with, will impact the length of your healing and rehabilitation process. Until you’ve been accurately diagnosed with a muscle strain, use the following guidelines:
  • Ice and a compression bandage.
  • Elevate the injured region if it is swollen.
  • If it’s painful to walk you should be using crutches.
  • Cease or reduce your exercise or activity level to where you feel no pain.
Muscle strain can take anywhere from a few days to several weeks to rehabilitate successfully. Please seek the advice of your physiotherapist, doctor or your health care practitioner who specialises in muscle injuries eg massage therapist, to guide your treatment.

Common Treatments for Muscle Strain

The following options are available to your physiotherapist to assist the rehabilitation of your muscle strain. Please seek their professional advice prior to self-managing your injury to avoid aggravating your muscle strain. These are general guidelines only and should not be treated as individual treatment advice.

Acute Muscle Strain Treatment

Subacute Muscle Strain Treatment

Later Stage Muscle Strain Treatment Options

Other Factors to Consider

General Information

massage.calf

Massage Techniques

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FAQs about Muscle Pain, Tears & Strains

Sports Injury Management

You probably already know that a sports injury can not only affect your performance, but also your lifestyle. The latest research continues to change sports injury management considerably.  Our challenge is to keep up to date with the latest research and put them to work for you.

How we treated you last year could vary greatly to how we treat you this year. The good news is that you can benefit significantly from our knowledge.

What Should You Do When You Suffer a Sports Injury?

Rest?

Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases.  The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days.  After that, you need to get it moving or other problems will develop.

Ice or Heat?

We normally recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.

Once the "heat" has come out of your injury, heat packs  can be used. We recommend 20 minute applications a few times a day to increase the blood flow and hasten your healing rate. Heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to specifically discuss your situation.

Should You Use a Compressive Bandage?

Yes. A compressive bandage will help to control swelling and bleeding in the first few days.  In most cases, the bandage will also help to support the injury as the new scar tissue is laid down. This should help to reduce your pain. Some injuries will benefit from more rigid support such as a brace or strapping tape. Please ask us if you are uncertain what to do next.

Elevation?

Gravity will encourage swelling to settle at the lowest point.  Elevation of an injury in the first few days is very helpful, especially for ankle or hand injuries.  Think where your injury is and where your heart is. Try to rest your injury above your heart.

What Medication Should You Use?

Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek their professional advice as certain drugs can interfere with other health conditions, especially asthmatics.

When Should You Commence Physio?

In most cases, "the early bird gets the worm".  Researchers have found that intervention of physiotherapy treatment within a few days has many benefits.  These include:

  • Relieving your pain quicker via joint mobility techniques, massage and electrotherapy
  • Improving your scar tissue using techniques to guide the direction it forms
  • Getting you back to sport or work quicker through faster healing rates
  • Loosening or strengthening of your injured region with individually prescribed exercises
  • Improving your performance when you do return to sport - we'll detect and help you to correct any biomechanical faults that may be affecting your technique or predisposing you to injury

What If You Do Nothing?

Research tells us that injuries left untreated take longer to heal and have lingering pain.  They are also more likely to recur and leave you with either joint stiffness or muscle weakness. It's important to remember that symptoms lasting longer than three months become habitual and are much harder to solve.  The sooner you get on top of your symptoms the better your outcome.

What About Arthritis?

Previously injured joints can prematurely become arthritic through neglect. Generally there are four main reasons why you develop arthritis:

  • Previous injury that was inappropriately treated (eg old joint or ligament sprains)
  • Poor joint positioning (biomechanical faults)
  • Stiff joints (lack of movement diminishes joint nutrition)
  • Loose joints (excessive sloppiness causes joint damage through poor control)

What About Your Return to Sport?

Your physiotherapist will guide you safely back to the level of sport at which you wish to participate.  If you need guidance, simply ask us.

What If You Need Surgery or X-rays?

Not only will your physio diagnose your sports injury and give you the "peace of mind" associated, they'll also refer you elsewhere if that's what's best for you. Think about it. you could be suffering needlessly from a sports injury.  Please use our advice to guide you out of pain quicker . and for a lot longer.

If you have any questions regarding your sports injury (or any other condition), please contact your physiotherapist to discuss. You'll find our friendly staff happy to point you in the right direction.

Acute Sports Injury Clinic

PhysioWorks has established an Acute Sports Injury Clinic at our Ashgrove, Clayfield and Sandgate practices to assist with the early assessment and management of acutely injured sports injuries.

The acute sports injury consultation fee is significantly lower than a routine assessment and treatment consultation. In most cases, your private health will cover the full cost of your full acute injury physio assessment fee.

How to Best Care for Your Sports Injury?

There is never an excellent time for an injury. But we do know that most sports injuries occur over the weekend! That's why at PhysioWorks, we have established an Acute Sports Injury Clinic at a selection of our clinics on a Monday and Tuesday.

Why Use an Acute Sports Injury Clinic?

Your Acute Sports Injury Assessment Consultation allows us to provide you with:

  • A quick and accurate diagnosis. One of our Sports Physiotherapist's or an experienced sports injury-focused Physiotherapist will confidently guide your new injury management.
  • Early acute sports injury care, professional advice and education. What to do this week?
  • Fast referral for X-rays, ultrasound or MRI scans to confirm your diagnosis.
  • Prompt referral to Sports Physicians, GPs or Surgeons with whom we work if required.
  • Immediate supply of walking boots, braces and rental crutches if needed.
  • Low-cost professional service.

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sports physiotherapist brisbane

Who is a Sports Physiotherapist?

Sports Physiotherapy is the specialised branch of physiotherapy which deals with injuries and issues related to spokespeople. Practitioners with additional formal training within Australia are Sports & Exercise Physiotherapists.

What is Sports Physiotherapy?

Sports injuries do differ from common everyday injuries. Athletes usually require high-level performance and demand placed upon their body, which stresses their muscles, joints and bones to the limit.  Sports physiotherapists help athletes recover from sporting injuries, and provide education and resources to prevent problems.

Each sports physiotherapist usually has sport-specific knowledge that addresses acute, chronic and overuse injuries. Their services are generally available to sportsmen and women of all ages engaged in sports at any level of competition.

Members of Sports Physiotherapy Australia (SPA) have experience and knowledge of the latest evidence-based practice, skilled assessment and diagnosis of sports injuries, and use effective 'hands-on' management techniques and exercise protocols to assist recovery and prevent future damage. SPA members have access to the most recent advances in sports physiotherapy. You'll be pleased to know that most of PhysioWorks physiotherapists and massage therapists have a particular interest in sports injury management.

What is Physiotherapy Treatment?

Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice.  Physiotherapists maintain physical health, help patients to manage pain and prevent disease for people of all ages. Physiotherapists help to encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing activities of daily living while assisting them to remain functionally independent.

There is a multitude of different physiotherapy treatment approaches.

Acute & Sub-Acute Injury Management

Hands-On Physiotherapy Techniques

physiotherapy treatment

Your physiotherapist's training includes hands-on physiotherapy techniques such as:

Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, just to name a few.

Physiotherapy Taping

Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.

Alternatively, your physiotherapist may recommend a supportive brace.

Acupuncture and Dry Needling

Many physiotherapists have acquired additional training in the field of acupuncture and dry needling to assist pain relief and muscle function.

Physiotherapy Exercises

Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.

Biomechanical Analysis

Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.

Hydrotherapy

Aquatic water exercises are an effective method to provide low bodyweight exercises.

Sports Physiotherapy

Sports physio requires an extra level of knowledge and physiotherapy skill to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.

Vestibular Physiotherapy

Women's Health

Women's Health Physiotherapy is a particular interest group of therapies.

Workplace Physiotherapy

Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.

Electrotherapy

Plus Much More

Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your individual problem, please contact your PhysioWorks team.

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Ashgrove Ph 3366 4221
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Salisbury Ph 3275 1044
Sandgate Ph 3269 1122

Post Running Muscle Soreness:

Is it an Injury or just DOMS?

Have you ever finished a big run and felt sore right after it? What about two days afterwards? Do you ignore it or have it checked out? The most common causes of post-run pain are either a legitimate muscle injury or delayed onset muscle soreness (DOMS).

Tips to Determine if it is a Muscle Injury or is it DOMS?

Differentiating between a muscular injury and DOMs is essential to ensure you are not overlooking a potentially sport-limiting injury and you are getting the injury managed appropriately. Early identification is key!

What is DOMS?

Delayed Onset Muscle Soreness or DOMs for short, is an exercise-related muscle condition that arises after intense, unaccustomed, physical exercise. The condition gets its ‘delayed’ name as symptoms are not usually felt until 24 to 72 hours after the exercise, normally peaking at the 48-hour mark after exercise. Research has demonstrated that DOMS is associated with tearing of myofibrils often at multitudinous junctions - best described as microtrauma. This process is followed by inflammation and a shift in intramuscular fluid and electrolytes. This process in combination with other local factors at the cellular and increased intramuscular pressure promote are what causes the soreness and stiffness experienced in DOMS. Tenderness is typically felt at the end of the muscle (at the tendon) where it attaches down along the affected limb and then as the condition progress. This can be felt throughout the muscle belly itself. The swelling, inflammation, tenderness and pain that arises can manifest as decreased joint range of motion, decreased strength and a decreased ability to absorb shock while exercising. This alteration is muscle function can last up to 10 days!

Muscle Injuries

Acute muscle injuries are quite different in how they present compared to DOMS. Typically, pain and stiffness is felt immediately in the affected tissue or shortly after. A ‘pop’, twinge, feeling of being kicked - without anyone actually kicking you - or an immediate collapse to the ground. As expected, the amount of damage to the tissue with a muscle injury exceeds that of DOMS. Any general movement of the muscle will reproduce your symptoms and if the injury is severe enough - bruising can begin to develop with some associated swelling. At the time of injury, following the RICE protocol (Relative Rest, Ice, Compression, and Elevation) is your best go-to treatment. You should also avoid HARM factors. No heat should be applied to the affected area. You should also avoid alcohol consumption, running or other painful movements.  Initially, it is a good idea to avoid massage until a professional has assessed the injury. All the HARM factors have the potential to increase bleeding, which may exacerbate your injury. Research suggests no anti-inflammatory drugs following a muscle strain is the best way to go. If you are seeking pain relief, it is best you consult your regular GP or a pharmacist for pain relief options that don't slow down your healing rates. More info: How to Treat an Acute Soft Tissue Injury

Benefits of DOMS?

Thankfully yes! The body adapts to the physical exercise that was undertaken once the DOMS resolves. So when you go and perform the same exercise again, the chance of DOMS onset decreases! However, adaptation to the causative exercise occurs rapidly after DOMS resolves. This adaptation with repeated exercise is called the “repeated-bout effect.” More info: Delayed Onset Muscle Soreness (DOMS).

How to Tell the Difference?

Your physiotherapist will be your best option for an efficient and accurate diagnosis between the two conditions, however, there are some simple factors to help piece together your injury when it comes to deciding whether or not to consult help. DOMS is more unpleasant when commencing a movement but eases as the muscle is warmed up, whereas a muscle injury will reproduce pain with any movement of the injured muscle. The most definitive factor is taking a detailed history of the injury. If pain was experienced during the event or immediately after, you are most likely looking at a muscle injury. If the pain is worst the day after and gets worse over the following days, you are most likely dealing with DOMS.

What to Do if You Have DOMS or a Muscle Injury?

If you suspect you have a muscle injury, it is best to consult your physiotherapist earlier rather than later. A thorough assessment is required to ascertain what exactly it is you have injured and start rehabilitation immediately to help minimise your time out of the sport! If you suspect you have DOMS, you need to avoid therapeutic interventions that increase muscle pain (e.g. excessive stretching, deep tissue massage) and vigorous physical activity should be postponed until resolution of pain and restoration of function due to:
  • Decreased shock absorption
  • Decreased coordination of muscle sequencing motion
  • Compensatory recruitment of uninjured muscle groups
  • Increased relative work intensity of the affected muscles at the same workload
  • Altered strength balance of agonist and antagonist groups
  • Inaccurate perception of functional deficits
There is evidence suggesting that compression garments, remedial massage and heat packs that all aim to increase blood flow will decrease your pain. If you’re unsure if it is a muscle injury or DOMS - we’re only a call away and our physiotherapists will happily answer your questions and establish the best plan of attack for you! At PhysioWorks, our physiotherapists are highly experienced in giving an accurate diagnosis and establishing an individualised rehabilitation program. We will look at what caused it, how bad the injury is, treat the root cause and implement a plan to prevent it from coming back! If you are in doubt or require more information, please don’t hesitate to contact your nearest PhysioWorks clinic.

Explaining the Different Massage Techniques

Longitudinal gliding is a traditional effective massage technique administered in the direction of the blood flow. It aids the fluid dispersion from the injury site and thus helps reduce inflammation and swelling. It is also instrumental in relaxing tight muscles.

massage techniques

Kneading can be performed in different ways and described by the part of a hand used to accomplish the massage, e.g. thumb kneading and palm kneading. The massage pressure applied must vary according to the purpose of the massage. The rhythm and rate of the movement are equally important as the load is applied intermittently.

Myofascial release is a manual technique for stretching the fascia to balance the body. Your fascia, located between the skin and the underlying structure of muscle and bone, is a seamless web of connective tissue that covers and connects the muscles, organs, and skeletal structures in our body. Injuries, stress, trauma, and poor posture can cause restriction to the fascia, and the goal of myofascial release is to release fascia restriction and restore its tissue.

Trigger point therapy is a bodywork technique that involves the applying of pressure to tender muscle tissue to relieve pain and dysfunction in other parts of the body. Trigger points are active centres of muscular hyperactivity, which often cross-over with acupuncture points. You will also find that common trigger points are what the average person refers to as muscular "knots".

Transverse friction is transverse connective tissue therapy applied directly by the fingers. Transverse frictions use an oscillating pressure applied across the direction of the tissue fibres. This technique is primarily used on tendon or ligament injuries to help break down thickened, pain-producing scar tissue. Unreduced lesions are likely to cause further irritation and degenerate more quickly than they should.

Rhythmic compression into muscles is used to create deep hyperaemia and softening effect in the tissues. This technique may occur as a warm-up for more in-depth, more specific massage work. Sports massage utilises compression massage.

Cross-fibre friction techniques create a stretching and broadening effect. It can also assist in reducing adhesions and in helping build reliable, flexible repair during the healing process.

PNF Stretches (Proprioceptive Neuromuscular Facilitation) combine passive stretching, and isometrics with your muscle alternatingly stretched passively and contracted. The method targets nerve receptors in muscles to extend the muscle length.

What Massage Style is Best for You?

Yes. Massage styles and techniques can be confusing, which is why your PhysioWorks Massage Therapist is a highly-trained professional who understands was is right for your body. If you have any questions as to what massage techniques are the best for you, please call us to discuss your massage requirements. Or, let your massage therapist works their wonders on your body during a consultation.

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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.

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.

Electric Muscle Stimulation (EMS)

EMS Machines

Electronic muscle stimulation (EMS) may help you to strengthen weak muscles. ems-electronic-muscle-stimulation

How Does Electric Muscle Stimulation Assist Strengthening?

There are several theories on how an EMS Machine may assist in muscle strengthening. One potential reason is that when you maximally contract a muscle, at best, only 30% of all your muscle fibres are in a state of contraction. The remaining 70% are dormant and awaiting recruitment when the contracting fibres fatigue. With EMS, you can potentially electrically stimulate these resting muscle fibres to improve their strength. Clinically, EMS appears to be more effective when the muscles are frail, and you have difficulty performing regular anti-gravity exercises. Another reason that EMS potentially works is via an improvement in the recruitment of nerve conduction rates. Explained simply, it takes approximately 10000 repetitions for your brain to learn how to quickly send a message to your muscles via the quickest nerve pathways. This contraction pattern becomes your "memory engram". The more frequent your muscle recruits, the better your body becomes at finding the fastest way to recruit that muscle. EMS can potentially provide you with repeated contractions to accelerate this learning process. To achieve your best outcome, we recommend that you seek professional advice on how to best utilise your EMS machine from your local physiotherapist who has a particular interest in EMS muscle retraining.

Important EMS Machine Information

Use your machine only as directed. A TENS machine and EMS machine are electronic medical devices. Always read the label and instruction manual. A TENS machine may assist you in modest short-term pain relief. Consult your doctor/healthcare professional before use and if symptoms persist.

EMS Machines

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 the 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 the young adolescent 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

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

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What is Back Muscle Pain?

Back muscle pain or its aliases: pulled back muscle, back muscle spasm, torn back muscle or back muscle strain, is very common. Back muscle pain is the most common source of back pain. The good news is that it is also one of the quickest to heal and rehabilitate.

What Causes Back Muscle Pain?

Most causes of low back pain are muscle, ligament or joint-related. Commonly, these muscular strains, ligament sprains and joint dysfunction arises suddenly during or following physical loading of your spine. Muscle fatigue, excessive loads, high speeds or poor lifting postures are the most common causes. The causes of pure back pain are numerous but roughly fall into the following categories.

Back Muscle Strains

Muscle pain is the most common source of back pain. Muscle fatigue, excessive loads or poor lifting or sitting postures are the most common problems. Inefficient, weak, or back muscles that lack endurance or normal contraction timing can lead to reduced joint stabilisation and subsequent injury to your back muscles, ligaments, joints or even spinal discs.

Poor Posture

Poor posture, when sitting, standing and lifting at work, can place unnecessary stress upon your spine. With muscle fatigue or overstretching, your ligaments and discs can stretch, and this puts spinal joint muscles and nerves under pain-causing pressure or strain, that results in back pain.

Ligament Sprains

Ligaments are the durable, fibrous bands that limit the amount of movement available at each spinal level. Stretching ligaments too far or too quickly will tear them with subsequent bleeding into the surrounding tissues, causing swelling, muscular spasm and pain. Awkward lifting, sports injuries and motor vehicle accidents are prevalent causes. Just as in other regions of the body, physiotherapy hastens ligament healing and relieves pain so that you can enjoy life again as soon as possible.

What are the Symptoms of Back Muscle Pain?

Back muscle pain symptoms may range from a mild ache to sudden debilitating back pain. Typical back muscle pain symptoms include:
  • Localised back pain, with no radiation into your buttock or leg.
  • Back muscle tenderness and spasm.
  • Protective back stiffness.
  • Sudden back pain onset.
You will usually feel better when resting and may find a change of position painful, e.g. sit to stand, rolling in bed, walking or bending.

How is Back Muscle Pain Diagnosed?

Differentiating a back muscle strain from a ligament sprain can be difficult, as both injuries will show similar symptoms. In general, it doesn't significantly matter what you call the problem because the treatment and prognosis for both back muscular strains and ligament sprains are similar. Most spinal practitioners refer to both injuries as a category called a "Back Strain" or "Musculoligamentous Strain". X-rays and CT scans do not identify muscle or ligament injury. MRI scan is probably the best diagnostic test to determine the muscle or ligament structures injured.

What is Back Muscle Pain Treatment?

Seek a Professional Diagnosis!

A spinal healthcare practitioner, such as your physiotherapist, should thoroughly; examine you to exclude more severe sources of back pain. Numerous injuries can cause back pain, and the treatment does vary significantly depending on your diagnosis. Physiotherapy treatment aims to protect your damaged tissue while hastening your muscle and ligament healing and then look at strategies to prevent a recurrence. Your physiotherapist has some nifty tricks for quickly relieving your back pain so that you can enjoy life again as soon as possible.
A British Medical Journal study found that pre-event stretching does not reduce the overall risk of injury. However, stretching does slightly reduce the risk of specific kinds of damage (injuries to muscles, ligaments and tendons). These soft tissue injuries are common in both elite and recreational sportspeople. It seems reasonable and common sense that stretching may not prevent you suffering a broken bone or a joint dislocation, but it could reduce your chance of a soft tissue injury. The other main finding was that stretching reduces the risk of experiencing soreness, which always makes exercising more enjoyable! While sustained stretches in isolation may not be the answer, other studies have shown that warming up does reduce your injury rate. While there is no "absolutely proven"method of warming up yet, the preferred options appear to be a graduated progression to prepare you for your sport. In simple terms, warm-up steadily from gentle exercises that increase in intensity and speed as you progress through your warm-up period. It makes common sense for you to warm things up slowly to start and then prepare with replicate skills, to what you will require shortly on the field, at the end of your warm-up. For more specific warm-up and injury prevention advice particular to your sport or work, please ask your physiotherapist to prescribe a warm-up and warm-down routine specific to you and your sport or physical activity.

Why Do Physiotherapists Prescribe You Exercises?

The prescription of exercise appropriate to you and your injury or fitness level is one of the many professional skills of a physiotherapist. Whether you have suffered an acute injury, chronic deconditioning or are recovering from surgery, the correct exercise prescription is essential. That's why your physiotherapist's knowledge and skills will personalise your exercise dose. Your physiotherapist not only is educated in injury diagnosis but also exercise physiology or the science of exercise. This training enables your physiotherapist to assess and diagnose your injury, plus also to prescribe injury, fitness or age-appropriate activities targeted to you now.

What Exercises Should You Do?

Your exercises shouldn't be painful. Please take caution with some overzealous exercise prescribers who believe that the more painful the activity, the better. Thus simply isn't true—notably, the frail, immunosuppressed, deconditioned or post-operative person. You'll find that your physiotherapist will thoroughly examine you and prescribe a series of exercises suitable for you in quantities that will not injure you further. Please seek an exercise expert, such as your physiotherapist, when you are planning your rehabilitation.

What Happens When You Stop Exercises?

Without some simple exercises, we know that specific muscles can become weak. When these supporting muscles are weak, your injured structures are inadequately supported and predispose you to linger symptoms or further injury. You can also over-activate adjacent muscles that may lead to further damage. It is also essential to understand that even if you are "in good shape", you may have crucial but weak localised or stability muscles. When you have an injury, you should perform specific exercises that specifically strengthen the muscles around your injury and the adjacent joints. Your physiotherapist will assess your muscle function and prescribe the right exercises specific for your needs. The exercises prescribed will usually be relatively simple, and do not require any special weights equipment, and can be performed safely at home.

Would You Stop Your Daily Prescription Drugs?

Your physiotherapist will prescribe your individualised dose or exercises. They are using their professional expertise to optimise your exercise dose. Would you just stop taking your regular blood pressure medication because you were too busy or didn't think it was working? We would hope not! Exercise, when prescribed by an expert such as your physiotherapist, should be treated as your recommended dose. Just like when you don't take your blood pressure medication, you can't expect the drugs to work of you don't take it as prescribed by your health professional. So, next time you skip your "exercise dose" just remember that you are not putting your health first. If you have any questions, please contact your Physio Works physiotherapist for your best care.

Private Health Insurance Rebates

PhysioWorks Physiotherapy and Remedial Massage are more affordable than you think. Your Private Health Insurance (PHI) usually pays for the majority of your treatment fees, leaving you with only a small gap payment.

However, Private Health Funds do vary their rebates payable depending upon the level of cover that you have taken. Some funds have kept up with the costs of modern medicine whereas, sadly others haven't, with rebates similar to what they were a decade ago.

HICAPS - Instant Health Fund Claims


Most health funds are members of the HICAPS instant claims system.  Swipe your health insurance card at our reception counter, and you can instantly claim your physiotherapy treatment via our online Hicaps System. Remedial Massage is claimable via Hicaps for some but not all funds. For more information, please visit Hicaps for the latest funds which can use their instant claiming system.

Private health insurance rebates are available for all of our physiotherapists. Instant claims are possible via our in-practice Hicaps system.

Third-Party Insurers

PhysioWorks practitioners are registered providers for government, Workcover and insurance companies including:

  • Workcover
  • InjuryNet
  • Australia Post; Coles Myer; Woolworths
  • Medicare
  • Department of Veterans' Affairs
  • CTP & Sports Insurers

Book Now!

Call Us or Book Online 24-hours

TeleHealth Online Appointments

Ashgrove Ph 3366 4221
Bulimba Ph 3899 1226
Clayfield Ph 3862 4544
Loganholme Ph 3801 3417

Mansfield Ph 3849 3099
Rochedale Ph 3841 0277
Salisbury Ph 3275 1044
Sandgate Ph 3269 1122