Struck down by your Achilles heel?

Make sure you read below for tips on how to manage Achilles tendon pain!

Achilles tendon problems can be very painful and frustrating conditions. If you’ve had the pain for quite some time it can start to impact how much you exercise and especially limit how much running you can do. They usually present as pain and stiffness at the back of the heel running up towards the calf muscle. Often they are painful in the morning and upon commencing exercise, but tend to improve once warmed up but may again deteriorate over the course of an exercise session or day. Additionally, they can be very painful the day after a lot of exercise.

The Achilles tendon is an important component for generating power and propulsion during fast paced activities such as running and jumping. Often sub optimal loading of the area can result in pain and irritation. Tendons are generally very robust structures, however they do not respond well to large changes in loading – for example someone increasing their running distance in one week from 10km to 50km (total km’s over the week). 

"Have you recently increased how much activity you are doing?"

Fortunately, if your pain is recent it can be managed fairly quickly with some active rest and proper loading of the area. On the other hand, if your pain has persisted for a long time you will need a highly structured, detailed and personalised rehabilitation plan. This may include:

•           A structured individualised exercise loading program
•           Assessing your biomechanics
•           strength training
•           use of orthoses
•           strapping to assist in deloading the tendon
•           avoidance of  particular aggravating activities

In summary, load management is the most important aspect in both keeping your tendon healthy and rehabilitating your tendon from injury. 

Avoid large spikes in running, walking and your exercise activities and ensure the appropriate amount of rest between sessions.

Some common mistakes we see include:

•          excessive stretching of the tendon
•          aggressive massage over the tendon
•          pushing through the pain

If any of the above applies to you or you are experiencing any of the symptoms outlined, whether recently or for a long period of time, come in to the clinic for a personalised rehabilitation plan to get you back doing the things you love.

How's your Goose's Foot?

How’s your goose’s foot?

If you get pain just below your knee, it may well be your goose’s foot!

We’ve been seeing quite a few people with issues with their goose’s feet lately and thought you should know about yours.

Just below the knee on the inside of the leg there is a structure called pes anserinus, which literally means goose’s foot! As 3 tendons come together at this point, it resembles the appearance of a goose’s foot.

There are usually underlying biomechanical issues, which means that excessive strain is being placed on the tendons and attachment area of the goose’s foot.

Pes anserinus injury is highly painful and usually results in having to cease running or walking and even causes a limp.

The good news is that alleviating the pain can be achieved by:

• using anti-inflammatory measures
• taking the strain off the injured tendons (e.g. taping)
• limiting activity levels
• soft tissue techniques

Whilst getting rid of the pain is all well and good, the most important thing for those with pes anserinus issues is to address the biomechanical issues underlying the condition and allow return to physical activity.

This requires a thorough assessment with an experienced physiotherapist with a sound understanding of lower limb biomechanics. Altered biomechanics can be addressed in a number of ways including:

• specific strengthening exercises
• targeted stretching
• changes in footwear or orthotics

If you think you may may be having issues with your goose’s foot, we can help you get out of pain, get back exercising and improve your biomechanics. To make an appointment with one of our experienced physios phone 8850 7770 or click here.

Do you ever shake your hands to rid pain or regain sensation in your hands?

• Do you find yourself waking at night with hand pain or numbness?
• Are you frequently shaking your hands due to lack of sensation?
• Do you get shooting pain up the forearm?

If so, you may have Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome is more common than you think and we've been seeing it (to varying extents) in a large proportion of our patients. It can also be a highly debilitating condition impacting many aspects of daily life.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is damage or irritation to the median nerve as it passes through the carpal tunnel (a ring of bones in the wrist). The result of damage to the nerve is commonly pains, pins & needles or numbness in the hand (typically the palm side of the hand, including the thumb, index and middle fingers). These symptoms can occur at any time, although they are often worse at night with people frequently waking with a dead hand sensation as well as having severely disrupted sleep.

If Carpal Tunnel Syndrome is left untreated, it can result in:

• Persistent pain, tingling and/or numbness in the hand,
• Weakness in the hand, which may lead to functional impairments (including reduced grip strength and hand dexterity).
• Additional nerve damage further up the arm and even in the neck,
• Permanent damage to the median nerve.

Those with Carpal Tunnel Syndrome will tell you that they will do anything to get rid of it. Why wouldn't you want a pain-free, fully functioning hand with normal sensation? Or perhaps an uninterrupted night of sleep, the ability to open jars again or not having to shake your hand to "wake it up"?

Tailored physiotherapy programs can treat the symptoms of Carpal Tunnel Syndrome that you may have. Physiotherapy treatments for Carpal Tunnel Syndrome include:

• Splinting, which involves wearing an appropriate brace to ease the strain and reduce the irritation on the median nerve.
• Nerve gliding exercises, which are specific exercises to get your median nerve moving well through the carpal tunnel as it often get "stuck" when it is irritated.
• Wrist and forearm stretching and strengthening exercises.
• Addressing postural concerns and neck issues which can be associated with Carpal Tunnel Syndrome.

Our physiotherapists are well-versed in identifying and assessing for Carpal Tunnel Syndrome, as well as differentiating this from other similar conditions.

If you are waking in the night with hand pain or think you may be experiencing Carpal Tunnel Syndrome, a consultation with one of our physios will help put a plan together to put an end to it. Phone 02 8850 7770 or click here and we'll help you get on top of it ASAP.

Ouch! My foot hurts after running/walking...What's going on?

Foot pain can be extremely debilitating, not to mention extremely inconvenient given the amount of time we all spend on our feet during the day.

Lately, with the warm weather and people spending plenty of time out and about being active, we’ve seen an increase in foot complaints and in particular, a high number of stress fracture injuries.

A stress fracture is a nasty injury; however, it is important to note that it differs from a regular fracture in many ways.

So here’s the big question:  How do you know when you have a stress fracture or are at risk of developing one?

As professional physiotherapists, we see a lot of nasty foot injuries and have extensive experience in picking the difference between stress fractures and standard fractures (as well as numerous other foot complaints).

A stress fracture is the result of repetitive stress imparted on a particular segment of bone, and is therefore classified as an overuse injury. It is not the result of acute trauma. Typical activities that can result in foot stress fractures include dancing, running and jumping activities. We have even seen foot stress fractures recently from excessive walking!

The single greatest contributing factor to a stress fracture is load – that is the volume of activity that you are doing and therefore the cumulative stress that you are putting on the bones in your feet.

Other factors that contribute to developing foot stress fractures include decreased strength and flexibility (especially in your calf and toe flexor muscles), reduced balance, poor biomechanics (including feet rolling in), foot anatomical variances including having a 2^nd toe longer than the 1^st (known as a Morton’s foot!) and inappropriate footwear. Believe it or not the surface on which you are exercising (too hard) can play a role as can low bone density, poor nutrition and even menstrual irregularities in females.

Combine any number of these risk factors together with a high load of running, walking, dancing or jumping activities and you place yourself at high risk of developing a stress fracture and spending a lengthy period of time away from these activities.

The reality is that stress fractures can occur in any of your bones in your body with repeated stress applied to them and they do! Due to the complicated biomechanics of the foot, and the fact that we spend large portions of the day on our feet transmitting our body weight through these tiny bones, it should come as no surprise to know that stress fractures are particularly common in the feet.

The most important role that we can play as physios is in the prevention of a foot stress fracture. This is achieved through noting the early signs of bone stress which include foot pain after activity (which may not be severe initially) which progressively worsens with activity and focal pain on palpation.

In most cases identifying what needs to be done to avoid a stress fracture of the foot is as simple as having a thorough discussion with the patient to ascertain activity load (and recent changes to this) and conducting an assessment of the lower limb biomechanics. This allows us to identify activity overload or biomechanical issues in the area, as these are the main contributors to injury and their identification is key to prevention.

Once it has been determined that you are at risk, our physios will take a number of steps in order to help you recover and prevent further injury. This will typically include:

• Altering activity load as appropriate,
• Gait/running/jumping analysis and intervening to make appropriate changes as required,
• Assessment and recommendation of appropriate footwear ,
• Personalised stretches, strengthening & stability exercises,
• Potential prescription of supportive orthotics,
• Soft tissue release techniques (e.g. massage, foam roller),
• Taping techniques to de-load the area at risk or to facilitate changes to biomechanics.

If a stress fracture is actually diagnosed in the foot, the aim of treatment is to facilitate optimal healing, reduce pain levels in the early stages and ultimately facilitate return to pre-injury activity, whilst minimising the risk or recurrence. Treatment may include the following (in addition to the things listed above):

• Immobilisation of the foot for a period of time (e.g. moon boot or cast),
• Rest from foot loading activities (e.g. running, jumping, dancing),
• Mobilising with crutches to eliminate/limit stress applied to the foot,
• Use of anti-inflammatory measures (e.g. medications & ice)
• Personalised plan to return to the loading activities that you desire!

Got a foot complaint?

No problem, we’ve got you covered.

Here’s what you need to do:

Simply call us at the practice on 8850 7770 and we will prioritise you as a matter of urgency.

Keep those feet happy!

I've strained my calf! What now?

Our team of expert physiotherapists have found over the years that whilst summer sports are in full swing, patients experiencing calf strains are at a peak.

Calf strains are very common among athletes, especially runners and those participating in sports that involve lots of explosive movements like tennis. This injury is caused by a combination of overuse and lack of strength, flexibility and general conditioning.

Suffering from a calf strain can cause you a lot of grief. You will fell a lot of sudden pain up the back of your leg (predominantly in the calf area), have difficult standing on your toes and experience swelling and/or bruising of the calf muscles.

If you want to ensure that you don't re-strain your calf, risking further (or repeat) damage, and want to be pain free again, it is highly recommended that you opt to get physiotherapy treatment to restore full function to the area.

What can you do for pain relief?

The best form of relief for the typical initial symptoms of a calf strain (sudden pain, pain rising on tiptoes, swelling and bruising) can be gained by utilising the RICE method - rest, applying ice and compression and keeping the affected area elevated.

In addition to this, physiotherapy treatment is required in order to restore full function to the area and to aide prevention of injury recurrence.

So, what are typical treatments for a calf strain?

Great question! Typical treatments can include manual therapy, strengthening and stretching exercises, footwear analysis, running technique analysis and a range of other options. After initial treatment and once the muscles have returned to full strength, a plan of progressive running and sport-specific exercises will be recommended to build condition and pave the way for return to active sports.

Can you tell who is at risk of developing a calf strain?

Whilst these is no crystal ball to tell who will sustain a calf strain, there are some factors that can indicate who is at risk. These include those having had previous calf and hamstring strains, especially if they were not completely rehabilitated. Many people sustaining calf strains report a feeling of tightness or lack of strength before sustaining the injury!

So if you or someone you know is experiencing tight calves or has a calf strain, contact the clinic today to take the first step on the road to recovery so you get get back to pain free activity.

The original article can be found here.