Golf Injuries

Golf Injuries

Article by J. MillerS.Armfield

Golf injuries are relatively low incidence. However studies have shown that 60% of professionals and 40% of amateurs can experience injury. 80% are typically overuse injuries. The remainder are traumatic, for example hitting a tree!

Lower back pain has affected about 1/3 of professional golfers. This is due to the mildly bent position and twisting action at speeds of up to 200kph. The combination is unfavourable if your back core muscles are weak or lack control and there is underlying spinal stiffness.

The second most common golf injury is the elbow. Golfer’s elbow and wrist injuries can occur with abnormal ground impact eg hidden rock or gripping the club. Tennis elbow can also be experienced via excessive gripping and poor swing biomechanics eg overswinging.

Shoulder pain may also be experienced. The rotator cuffshoulder impingement and shoulder arthritis are to blame for most shoulder pain.

Professional golfers experience more wrist injuries whereas amateurs experience more elbow and shoulder pain.

Knee pain can occur due to twisting (meniscus tear) or walking (knee arthritis). Walking can also annoy your feet eg plantar fasciitis or heel spur.

Golf Injury Prevention

Swing correction and warming up before golf has been shown to decrease injuries. There are specific ranges of motion that a golfer should be able to attain. Your golf physiotherapist can provide you with a golfer physical screen that assesses your body’s range of motion, strength etc and provide you with exercises to correct any deficits. They will help optimise your body to best suit your golf swing and body’s limitations.

A golf professional should obviously be sought to correct any golf swing issues.

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What Causes Arm Pain?

Arm pain and injuries are extremely common. Arm pain can occur as a result of either sudden, traumatic or repetitive overuse. The causes can be related to sports injuries, work injuries or simply everyday arm use.

Arm pain can be a local injury, musculoskeletal injury or could even be referred from nerves in your neck (cervical radiculopathy). This can result in neck-arm pain.

What Arm Pain is Associated with a Heart Attack?

Left-arm pain can be an early sign of a life-threatening cardiac issue. Based on this, a professional medical assessment that involves an accurate history, symptom analysis, physical examination and diagnostic tests to exclude a potential heart attack is important to exclude this potentially life-threatening source of arm pain.

For more information, please consult with your health practitioner, call an ambulance on 000, or visit a hospital emergency department to put your mind at ease.

Good News. Most Arm Pain is NOT Life-Threatening.

Luckily, life-threatening arm pain is far less likely than a local musculoskeletal injury. Arm pain caused by a localised arm muscle, tendon or joint injury should be assessed and confirmed by your health practitioner before commencing treatment.

Referred Arm Pain

As mentioned earlier, arm pain can be referred from another source. Cervical radiculopathy is a common source of referred arm pain. Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury (e.g. your neck joints).

Professional assessment from a health practitioner skilled in the diagnosis of both spinal-origin and local-origin (muscle and joint) injuries (e.g. your physiotherapist) is recommended to ensure an accurate diagnosis and prompt treatment directed at the arm pain source.

Common Causes of Arm Pain

The most common sources of arm pain include shoulder painwrist pain and elbow pain.

Arm Pain has Diverse Causes

The causes of your arm pain can be very wide and varied. Due to this diversity, your arm pain should be assessed by a suitably qualified health practitioner to attain an accurate diagnosis, treatment plan and implementation specific to your arm pain.

Arm Pain Prognosis

The good news is that arm pain and injury will normally respond very favourably to medical or physiotherapy intervention when early professional assessment and treatment is sought. Please do not delay in consulting your healthcare practitioner if you experience arm pain.

Causes of Arm Pain by Region

Causes of Arm Pain by Structure

Neck-related Arm Pain

Shoulder-related Arm Pain

Elbow-related Arm Pain

Wrist-related Arm Pain

Hand-related Arm Pain

Muscle-related Arm Pain

Other Sources of Arm Pain

Common Arm Pain Treatments

With accurate assessment and early treatment, most arm injuries respond extremely quickly to physiotherapy or medical care allowing you to quickly resume pain-free and normal activities of daily living.

Please ask your physiotherapist for their professional treatment advice.

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

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FAQs Golf Injuries

Elbow Pain

Please visit the links below for some of the more common sources of elbow pain.

Elbow-related Arm Pain

Neck-related Arm Pain

Muscle-related Arm Pain

Other Sources of Arm Pain

Common Treatments For Elbow Pain

With accurate assessment and early treatment, most elbow pain responds extremely quickly to physiotherapy that will allow you to quickly resume pain-free and normal activities of daily living. Some conditions may require diagnostic investigations such as X-rays, ultrasound, MRI or CT scan. Fractures, dislocations and some severe or chronic injuries may require surgical opinion and/or intervention Please ask your physiotherapist for their professional treatment advice.

What Causes Arm Pain?

Arm pain and injuries are extremely common. Arm pain can occur as a result of either sudden, traumatic or repetitive overuse. The causes can be related to sports injuries, work injuries or simply everyday arm use.

Arm pain can be a local injury, musculoskeletal injury or could even be referred from nerves in your neck (cervical radiculopathy). This can result in neck-arm pain.

What Arm Pain is Associated with a Heart Attack?

Left-arm pain can be an early sign of a life-threatening cardiac issue. Based on this, a professional medical assessment that involves an accurate history, symptom analysis, physical examination and diagnostic tests to exclude a potential heart attack is important to exclude this potentially life-threatening source of arm pain.

For more information, please consult with your health practitioner, call an ambulance on 000, or visit a hospital emergency department to put your mind at ease.

Good News. Most Arm Pain is NOT Life-Threatening.

Luckily, life-threatening arm pain is far less likely than a local musculoskeletal injury. Arm pain caused by a localised arm muscle, tendon or joint injury should be assessed and confirmed by your health practitioner before commencing treatment.

Referred Arm Pain

As mentioned earlier, arm pain can be referred from another source. Cervical radiculopathy is a common source of referred arm pain. Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury (e.g. your neck joints).

Professional assessment from a health practitioner skilled in the diagnosis of both spinal-origin and local-origin (muscle and joint) injuries (e.g. your physiotherapist) is recommended to ensure an accurate diagnosis and prompt treatment directed at the arm pain source.

Common Causes of Arm Pain

The most common sources of arm pain include shoulder painwrist pain and elbow pain.

Arm Pain has Diverse Causes

The causes of your arm pain can be very wide and varied. Due to this diversity, your arm pain should be assessed by a suitably qualified health practitioner to attain an accurate diagnosis, treatment plan and implementation specific to your arm pain.

Arm Pain Prognosis

The good news is that arm pain and injury will normally respond very favourably to medical or physiotherapy intervention when early professional assessment and treatment is sought. Please do not delay in consulting your healthcare practitioner if you experience arm pain.

Causes of Arm Pain by Region

Causes of Arm Pain by Structure

Neck-related Arm Pain

Shoulder-related Arm Pain

Elbow-related Arm Pain

Wrist-related Arm Pain

Hand-related Arm Pain

Muscle-related Arm Pain

Other Sources of Arm Pain

Common Arm Pain Treatments

With accurate assessment and early treatment, most arm injuries respond extremely quickly to physiotherapy or medical care allowing you to quickly resume pain-free and normal activities of daily living.

Please ask your physiotherapist for their professional treatment advice.

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, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities 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, 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 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 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 problem, please contact your PhysioWorks team.

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 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.

calf-exercises Arthritis Treatment

If you think that there’s nothing you can do about arthritis? Great news! You can act right now. Some of the ideas here are simple, one-time actions. Others are the first steps toward longer-term goals. All can directly or indirectly improve your health, outlook or pain levels and generally make life with arthritis a little easier.

Get an Accurate Diagnosis

If you have pain, stiffness or swelling in or around a joint for more than two weeks, it's time to see your doctor, physiotherapist or health professional. These symptoms can develop suddenly or slowly. Only a well-trained health professional doctor can tell if it's arthritis. But "you have arthritis" is not a diagnosis. Ask for a specific diagnosis of the type of arthritis you have. There are more than 100 types – including osteoarthritis (the most common type of arthritis) and rheumatoid arthritis – each of which has different treatments. Getting the right treatment requires getting the right diagnosis.

Protect Your Joints

Avoid excess stress on your joints. Use larger or stronger joints to carry things. Assistive devices can make tasks at home and work easier. Look for them in the kitchen (rubber jar openers, reachers), bedroom (zipper pulls, buttoning aids), bathroom (tub bars, handrails) and for other areas of your life. Look for products with the Arthritis Foundation’s Ease-of-Use Commendation. These are items that are comfortable, easy-to-use or have user-friendly packaging. Also, staying close to your recommended weight helps relieve damaging pressure on hips and knees.

Get Moving

Exercise helps lessen pain, increases range of movement, reduces fatigue and helps you feel better overall. A well-rounded workout routine for people with arthritis includes flexibility exercises to increase motion, aerobic exercises to improve endurance, decreased fatigue, and strengthening exercises to improve muscle fitness. Your physiotherapist can show you range-of-motion exercises and strengthening exercises that are good for arthritis. The Arthritis Foundation also offers general exercise, aquatic, Tai Chi and walking programs. The key is to have a regular exercise program. We commonly recommend that adults do a minimum of 2 hours and 30 minutes of moderate-intensity aerobic activity (brisk walking, gardening) a week or 1 hour and 15 minutes each week of vigorous aerobic physical activity (jogging, aerobic dancing). Whether your activity is moderate or vigorous, the goal is to keep moving.

Lose Weight

Lose weight. You won’t just look better. You’ll feel better, too. Why? Every extra kilogram you carry around translates to added stress to your knees and hips. Excess weight can mean more pain, no matter which form of arthritis you have. It can also contribute to and aggravate osteoarthritis while increasing your risk of gout.

Bone Up

Stock up on your favourite source of calcium. A diet rich in this important mineral can help decrease your risk of osteoporosis. Besides, inflammatory arthritis conditions accelerate bone loss, so getting the optimum calcium intake is critical. Recommended daily doses of calcium are 1,000 mg for adults 50 and younger and 1,200 mg for adults over 50. If you don’t like drinking milk – or want some variety – try consuming more milk products, such as yogurt, cheese and ice cream. Or add powdered milk to puddings, gravies, shakes and other recipes. Other good sources of calcium: broccoli, salmon (with the bones) and kale.

Do Drugs – the Right Way

Take your medication just as your doctor prescribes. If you’re tempted to stop because you feel it’s not working or believe it’s causing side effects, call your doctor first. It can take weeks – or even months – for a medication's full benefits to become apparent, and some side effects ease over time. Stopping medication abruptly may not only cause you to miss out on its benefits – in some cases, but it can also be downright dangerous.

Begin with Breakfast

Grab some fruit, fibre (like oatmeal) and a tall glass of water instead of coffee. Like you’ve always heard, a healthy breakfast is a great way to start the day. Without it, the bad results can range from higher cholesterol, lower energy and overeating throughout the day.

Walk

Please choose your favourite spots (indoors and out) and make plans to walk them at least once a week. Walking is the ideal exercise for most people with arthritis. It burns calories, strengthens muscles and builds denser bones – all without jarring fragile joints.

Sit, Soak and Soothe

A warm bath before bed can relieve muscle tension, ease aching joints and help you get a good night’s sleep.

Treat Your Muscles

Find a remedial massage therapist and treat yourself to a good rub down. The benefits vary from person to person but may include decreased pain and stiffness associated with arthritis, increased circulation, energy and flexibility, eased muscle spasms, and improved body’s sleep and immune functions. Mentally, massage can also decrease stress and depression. Besides, it just feels good. Be sure to find a skilled massage therapist working with people with arthritis, as some massage elements may not be appropriate for you.

Stretch Your Legs

Stretching is a simple way to keep joints and muscles flexible. It relieves stress and can help enable you to maintain your daily activities. Try this to keep your calf muscles strong and flexible: Stand two feet from a wall, with your toes pointed inward, palms against the wall. Keeping your knees straight and feet flat, lean forward onto your hands without bending at the waist. Feel your calf muscles pull and extend. Hold this position for 10 seconds, then gently push away from the wall. Repeat.

Take the Plunge

Exercising in the water can build strength and increase motion range, while the water’s buoyancy reduces wear and tear on sore joints. Some many aquatic programs and exercises are great for people with arthritis. Try water walking, for example. Water provides 12 times with the air resistance, so you’re getting a great workout without the wear and tear on your joints.

Ice it!

When joints are hot and inflamed, applying something cold can decrease pain and swelling by constricting blood vessels and preventing fluids from leaking into surrounding tissues. Our favourite ice pack: a bag of frozen peas or corn that can be moulded to the shape of your body.

Quit Smoking

If only for a day, and then another … and another. Smoking can increase your risk of complications from lupus and rheumatoid arthritis. It can increase your risk of developing psoriasis and can predispose you to osteoporosis. Also, if you have to undergo joint surgery, smoking can prolong your recovery. Arthritis drugs can also be less effective for smokers and smoking can contribute to sleep problems.

Enjoy Your Exercise

Take the work out of working out. Sign up for a class that makes exercise fun – country line dancing, ballroom dancing, swimming, yoga or tai chi. Some have specific benefits for people with arthritis. Tai chi, for example, specifically reduces the pain and impairment for people with severe knee osteoarthritis. The slow, graceful exercise – originally a Chinese martial art – also reduces stress and can improve balance. Yoga strengthens and relaxes muscles stiff from arthritis, as well as helps with weight loss programs. For individual advice, we urge you to seek the opinion of your physiotherapist or trusted health professional.

Evidence Suggests a Rethink on Corticosteroid Injections

Tennis elbow affects 1-3% of the general population and 15% of workers in at-risk industries. Medical practitioners following an evidence-based approach will find little high-level evidence for treating tennis elbow. Bissett et al. (2006) investigated the short term, and long term efficacy of a physiotherapy intervention (elbow joint techniques and specific exercise) compared with corticosteroid injections and “wait and see”.

Research Results

Corticosteroid Injection

Patients who received a corticosteroid injection showed significantly better effects at six weeks. However, there were very high recurrence rates after six weeks (47/65 of successes subsequently regressed). This setback persisted until at least 12-month post-injection.

Physiotherapy

Physiotherapy was significantly superior to the “wait and see” group until the six-month review. Compared to the corticosteroid group, the long-term recurrence was significantly lower in the physiotherapy group. Participants who had physiotherapy also sought less additional treatment, such as non-steroidal anti-inflammatory drugs, than the other groups.

Wait and See

"Wait and See"significantly lagged the physiotherapy group until the six-month review. Compared to the corticosteroid group, the long-term recurrence was significantly lower in the “wait and see” group. Long-term recurrence was similar to the physiotherapy group, but “wait and see” participants required additional treatment, such as non-steroidal anti-inflammatory drugs.

Conclusion

Physiotherapy combining elbow joint techniques and specific exercise had a superior benefit to “wait and see” until six months and to corticosteroid injections after six weeks, providing a reasonable alternative to injections in the mid to long term. The significant short term benefits of corticosteroid injection are paradoxically reversed after six weeks, with high recurrence rates, implying that this treatment should be used with caution in tennis elbow management.