February 22, 2019Matthew LewingtonUncategorized

Have you often heard of osteoarthritis being described as a ‘wear and tear’ condition of the joint?  It is a common misconception that osteoarthritis is a condition based only on heavy or repetitive loads going through the joints, over years and years of our working and recreational lives.  This would imply that only people working in heavy industries would get osteoarthritis, and that everyone in that industry would be expected to get the same levels of osteoarthritis.  Likewise, people who work behind a desk or in a relatively sedate role shouldn’t be exposed to the toils of osteoarthritis.

With this basis of assumption, some people incorrectly concur that if ‘activity’ is what causes their pain, then ‘rest’ is what will fix it.  Unfortunately, this couldn’t be further from the truth.  Osteoarthritis is a condition of the joints that is a culmination of many factors, but fundamentally it is an imbalance between the body’s natural degradation of old cells and regeneration of new cells in the body’s natural ageing process. This progression of the condition can be affected by

• Cartilage being exposed to too much load all at once (an acute injury)
• Loads over a long time (over use injury)
• Can happen with a normal load if the cartilage is diseased to start with.

Core to the common mis-management of osteoarthritis is the concept that people shouldn’t be exercising or exposing their joints to ‘further wear and tear’, as this will only accelerate their condition.  A systematic review of randomised control trials was completed by Brica et. al. (2018) in the study Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised control trials.  In this review, Brica et. al. (2018) found 9 trials with a total of 14 comparisons of supervised exercise programs versus a control group that did not exercise. These control group comparisons included a range from non-exposure to exercise, to the use of TENS and heat packs, to the use of diet control medications.  Whilst the quality and consistency among the studies was not optimal, the one consistent outcome that was shown was that the exercise groups did not suffer any further loss or damage to the articular cartilage.

For further advice on the correct type and amount of exercise you should be undertaking to optimally manage your osteoarthritic knees and hips, book in today with one of our physiotherapists and discuss our GLA:D program, which provides all the information and exercise you need to revolutionize your activity levels again.

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February 21, 2019Matthew LewingtonUncategorized

Should you be sitting on the couch bingeing on Netflix and popcorn? Definitely not! A rest day can and should still include physical activity, it just doesn’t need to be as intense. Going for a walk, a swim, a gentle bike ride, or doing a yoga or Pilates class can be a great way to break up your more intense training days. However, if your body is really craving a rest day or two, where you do absolutely nothing – take it! By taking some time to rest, varying the intensity of your workouts to match your lifestyle, and being mindful with your sleep and nutrition you give your body and mind the best chance of recovery so you’re fitter and stronger next time you hit the gym. Enhance Physiotherapy has two fantastic items that can aid in your rest and recovery – our Hyperbaric Chamber and Floatation Tank! 

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February 12, 2019Matthew LewingtonUncategorized

Most tissues in the body have healed completely in six to 12 weeks following an injury, however, many people have severe pain that lasts much longer than this. We know that the intensity of the pain you feel is not always associated with a similar amount of damage. In some cases, there can be a severe amount of pain with almost no detectable damage. On the other hand people cant experience little to no pain despite extensive tissue damage. With this in mind, we explore some reasons why your pain might not be getting better, long after the tissues have healed.

You’re afraid of the pain.

Pain can mean many different things, for some of us pain can affect our ability to work or can be a symptom of a serious disease. What you believe about your pain can either amplify or reduce the symptoms you experience. If you feel that every time you experience pain you are causing more damage, you will naturally pay more attention to this and your nervous system will amplify the signals in an attempt to keep you safe.

If you understand the cause of your pain and know that while there is discomfort, you are not in danger of causing more damage, often the pain will feel less severe. This is one of the benefits of seeing a physiotherapist after your injury as they can help you to understand your pain, giving you more control over your recovery.

You started moving differently after the injury. 

Immediately after an injury, it’s natural to change the way you move to avoid painful movements. After a while, these changed movement patterns can actually begin to cause pain and discomfort on their own due to the altered load and stress patterns placed on your body.

Correcting these adaptive movement patterns can often go a long way in reducing pain after an injury. You might not have noticed these changes and might need a physiotherapist to identify and help you to return to your usual movement pattern.

You have lost muscle strength since the injury.

While a certain amount of rest following an injury is always helpful, if we stop moving altogether, our muscles can lose strength. This can mean that our posture changes, we fatigue easier during our usual activities and that we are more susceptible to further injury. Less movement also means we actually focus on the pain more when it does happen. Physiotherapists are able to advise you on the right types and amounts of excercise for you in the period following your injury.

The pain has affected your lifestyle.

When pain affects your ability to sleep, work and even concentrate, it’s not surprising that this can have a negative affect on your overall wellbeing and mental health. This can create a negative cycle of anxitey and depression that perpetuates and increases the experience of pain. If your pain is really getting you down, speaking to a mental health professional can actually be a valuable part of your physical recovery.

Enhance Physiotherapy are experts in treating and assessing musculoskeletal injuries that cause pain and are experienced in working with patients to over come chronic pain.

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February 11, 2019Matthew LewingtonUncategorized

After exercise, do you cool down? Go for a light jog after an event or game, do a couple of slow laps in the pool or a walk after a training session? Many of us do a short period of light to moderate intensity exercise after a more intensive bout in the belief that it will aid our recovery and improve future performance. This type of cool down is referred to an as an active cool down. Alternatively, a passive cool down may consist of rest e.g stretching, sitting, standing or lying down after physical activity.

Despite beliefs, recent evidence suggests that an active cool down may not provide us the benefits that we have thought. Alternatively, an active cool down may in some cases have a slight detrimental impact on our recovery and performance in future physical activity.

An active cool down has been shown to remove lactate from blood and muscles faster and enhance performance in activities conducted less than 20 minutes after the completion of first bout of exercise. However, a slight detriment to performance has been suggested for exercise with more than 4 hours between bouts and no benefit for activity completed the following day.

An active cool down has been shown to have no benefit in preventing post exercise soreness (delayed onset muscle soreness) or muscle damage from physical activity. It is also suggested that there is no evidence of reduction in future injury risk by completing an active cool down.

Despite these findings, many people complete active cool downs and find them beneficial for a range of reasons. As a result, the psychological benefits of an active cool down can aid recovery and performance.

If you would like to know more about recovery from sport or physical activity and the best cool down options for you, an Enhance Physiotherapist can provide you a tailored program and advice.

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February 8, 2019Matthew LewingtonUncategorized

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February 7, 2019Matthew LewingtonUncategorized

What is it?

Our knees are complex hinge joints, designed to provide stability from side to side and smooth movement forwards and back as you walk, kick and run. The patella, or kneecap, is a small bone embedded in the tendon of the quadriceps muscle that protects the knee and also provides extra leverage to the quadriceps, amplifying their strength. The patella moves up and down in a groove at the front of the knee as the knee bends and straightens. Usually this movement is smooth, with little friction, however, if something causes the patella to move in a dysfunctional way, the soft tissue between the kneecap and the knee can become irritated, causing pain in a typical pattern. This condition is often referred to as ‘runner’s knee’, PFJ Syndrome or patellofemoral pain syndrome (PFPS).

What causes it?

The patella usually sits in a balanced position in the shallow groove at the front of the knee and moves easily without friction. The patella is attached to the quadriceps muscle at the top and connected to the lower leg via the patella tendon at the bottom. When the quadriceps contracts, this pulls on the patella and acts to straighten the knee. If one side of the quadriceps is stronger or tighter than the other, it can cause the kneecap to pull to one side and over time become irritated.

A weakness in your hip muscles or a lack of hip control and also lead to an altered knee posture which results in a dysfunction in the way that the patella moves up and down the groove at the front of your knee.

Certain postures and leg positions require the outer muscles to work harder and the inside muscles to become less active. Lack of arch support in your feet or simply a physical abnormality of the knee can also place stress on the movement of the patella.

Our Physiotherapist’s at Enhance Physiotherapy are EXPERTS at identifying the underlying cause of your knee pain and developing rehab programs specifically for you, to improve your pain and function.

What are the symptoms?

This condition is characterized by pain felt on the inside or behind of the patella with activities that require repetitive bending of the knee. There may be a sensation of crepitus, clicking or grinding and some people report that their knee suddenly gives way. The pain is commonly felt when running, going up and down stairs or when doing squats and is relieved with rest. The pain may start as a small niggle and gradually become worse over time.

How can physiotherapy help?

The first step in effective treatment is to exclude any other conditions and have a physiotherapist confirm the diagnosis. Enhance Physiotherapy is able to determine which factors are contributing to this condition, which could include poor posture, a lack of arch support in your feet or poor running technique.

Once these factors have been identified, you will be provided with a specific treatment program to best approach your condition. PFP syndrome usually responds quite well to biomechanical analysis and correction of any muscular weakness and imbalance. Having the correct shoes and orthotics can also make a huge difference. There are some short-term treatments, such as patella taping, dry needling, and trigger point therapy which may help alleviate symptoms quickly and keep you active while you address the other factors contributing to your pain.

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