Articles in Category: Sporting Injuries

Shockwave Therapy

on Tuesday, 05 March 2019. Posted in Massage, Newsletters, General Health, Sporting Injuries, Training and Performance

Shockwave Therapy

Shockwave Therapy

Shock wave therapy is a low frequency shock wave focused treatment that targets a specific acute or chronic condition. It is classified as a non-invasive treatment that generates acoustic shock waves, via a hand held device. Shock wave is a multidisciplinary device that can be utilised by chiropractors, physiotherapists, remedial massage therapists, sports medicine, urology and veterinary medicine. This hand held device helps kick start the body’s natural healing ability within the tissue, this is done by stimulating the metabolism, and increasing blood circulation. Its main assets are fast pain relief and mobility restoration.

Some of the conditions that can be treated from shock wave therapy are:

-          Plantar fasciitis

-          Heel Spurs

-          Tennis elbow/Golfer’s elbow

-          Chronic Tendinopathy

-          Shin Splints

-          Calcifications

-          Hip pain

-          Hamstring injuries

-          Shoulder pain

-          Muscle, Myofascia & Trigger Points

Shock wave therapy has been said to be an ideal therapy for injuries/conditions that have been unresolved by medications, rest and other therapies, but with the combination of shock wave and other therapies it can be utilised to help speed up injury recovery times. The treatment of shock wave can be a little painful, but depending on the patient and the type of condition being treated the intensity can be changed throughout the session.

Written By Luke Attkins

Dip Remedial Massage, Certificate IV of Massage Therapy

The Benefits of Stretching

on Wednesday, 06 March 2019. Posted in Massage, Newsletters, General Health, Sporting Injuries, Training and Performance

Stretching

There are many benefits to regular stretching, not only can stretching help increase your flexibility; it may also improve posture and body aches.

Increases Flexibility:

Regular stretching may help to increase your flexibility. Improved flexibility can help you perform daily activities with ease and may also help delay reduced mobility that can come with aging.

Increases Range of Motion:

The ability to move a joint through its full range of motion gives you more freedom of movement. Regular stretching may help increase your range of motion. A study found that both static and dynamic stretching are effective for increasing range of motion, although proprioceptive neuromuscular facilitation stretching may be more effective for immediate benefit.

Improves Performance in Physical Activities:

Dynamic stretching prior to physical activity has been shown to help your muscles prepare for the activity.

Increases Blood Flow to Muscles:

Regular stretching may improve your circulation which increases blood flow to your muscles. This may shorten your recovery time and reduce delayed onset muscle soreness.

The most common types of stretching are dynamic and static.

Dynamic Stretching:

Dynamic stretching involves the movement of joints through their full range of motion in a slow and controlled manner. They are often used as a warm-up prior to physical activity and there are no extended holds. Generally, the type of movement, or dynamic stretch used will be similar to the activity about to be performed. “High knees” or ‘butt kicks” are examples of dynamic stretching that may be performed before running.

Static Stretching:

Static stretching involves moving the body into a stretch and holding for an extended period of time. Timing of the extended stretch varies though they are commonly prescribed for 15-30 seconds at a time for 3-5 times. Static stretching can be performed actively by using your own muscles to hold the positions, or passively, using an external force such as a strap, a wall or another person. Bending down and touching your toes or letting the heels drop down off the edge of a step are examples of static stretching.

Dynamic and static stretching can be effective for increasing flexibility

Pre-activity dynamic stretching may improve performance

Post-activity static stretching may prevent delayed onset muscle soreness

Stretching is generally a safe activity that can be included as part of your daily activity

Written by Maharlia Kennedy

Dip. Remedial Massage

The Knee

Written by Don Williams BSc, MChiro, ICSSD. on Wednesday, 23 September 2015. Posted in General Health, Sporting Injuries, Training and Performance, Chiropractic

The Knee

By Don Williams

B.Sc., M.Chiro., ICSSD., PG Dip. NMS Rehabilitation,

Cert. DNS.   Memb: CAA, FICS, CEA.

 

This month I thought I would write a brief article about the knee.

 

The Knee is such a fascinating joint and unfortunately, is a regularly injured joint, necessitating visits to our clinic for many people.  We regularly receive referrals to assess knee injuries to identify what is actually wrong and how to manage the problem. This often necessitates us referring out for MRI scans and in some cases on referral to some of the excellent orthopaedic surgeons that we deal with.

 

The Knee 1  

 

Types of Knee Injuries:

Knee injuries and pain associated with those injuries generally fall into 3 categories.

 

Firstly, degenerative problems:

This can be osteoarthritic change or general wear and tear due to age or overuse of the knee.

Often age correlated or a result of lots of aggressive sport in the younger years.

 

Secondarily, biomechanical overload injuries:

These are often the result of;  genetic mechanical issues such as pronation of the feet and ankles, “Knock knee”, “bow legged” posture of the knees,  inappropriate footwear, poor technique in running, walking and other fitness activities, poor setup on bike position or sporting equipment or weaknesses and imbalances of the supporting musculature.

 

Thirdly, the pathological or traumatic injuries:

These are things like anterior cruciate ruptures (ACL), Meniscal tears (often referred to as the cartilage), fractures, and collateral ligament tears and issues. Bursitis and tendonitis issues are sometimes grouped into this category but are often more accurately grouped into the second category.

 

But what makes the knee so susceptible to injury:

Several factors really. The knee can be thought of as a force transducer. When we are walking, running, turning and jumping, our knee is subjected to high forces or loads in a multitude of directions.

 

The mechanics of the knee are complex and this article will be far from exhaustive in the description of the knee. But in basic terms the knee is a rolling/gliding hinge joint. Thinking simply, the knee is not a simple hinge (like a door), as the knee straightens, the femur glides across the tibia as it rolls towards the straightened position. This is why the end of the femur has a lengthened cam-like shape, in contrast to the relatively flat shape of the top of tibia. This means that the contact point and force vectors through the joint constantly change as the knee bends and straightens, combine this with the fact that the knee also pivots slightly right at the end of the straightening process make the knee a regularly injured joint.

 

Many health practitioners are taught at university that for the knee to have a pathological or major injury, there must be a large impact or nasty injury mechanism occurs to cause the damage. However, this is very clearly not the case with many of the patients we see at Institute of Sports and Spines.

 

In fact, the 2 worst knee injuries I have seen this year came from very low force activities; one from standing up after sitting on the ground and one from walking along the ground at work and turning to speak to someone. In fact, my own knee injury was not the result of a twist, fall or accident, but purely jogging along a flat footpath, the articular cartilage got caught and tore and it has been a problem ever since.

 

Scans and Imaging for the knee:

Depending on the injury or suspected injury, a range of scanning options are used.

Xrays and pretty good for looking at fractures of and around the knee, gross degenerative change and biomechanical position, they are not good at assessing soft tissue and ligament issues.

Ultrasounds are used to look at tendonitis and bursitis issues and muscle tears around the knee.

MRI scans are generally the image of choice for the knee and are the only means to effectively view meniscal tears, cruciate ligament injuries, collateral ligament injuries and articular cartilage defects.

I have included a couple of images below for interest.

 

Image 1                                                                                             Image 2

The Knee  2  The Knee 3 

The Knee 4

                                                                                              

Image 1 above, the green oval shows reasonable articular cartilage with some thinning. The red circle shows a tear or defect in the cartilage (the white area), the end of the bone has a light area which is bone swelling.

 

Image 2 The blue circle shows good articular cartilage and a healthy meniscus in the correct position (black triangle on the right side).

The red circle shows the lateral meniscus in the wrong place (this is bad ;)) and the green arrow shows us where it should be.

 

 Image 3 to the left shows a vertical tear in the meniscus and a little bit of swelling to the left of the arrow.

 

Management of Knee Pain:

When you have knee pain, correct assessment and diagnosis of the problem is critical. We have unfortunately seen many patients who have had a lot of treatment for the wrong diagnosis, resulting in poor outcomes.  A comprehensive physical and orthopaedic examination should give a working diagnosis which may then indicate treatment direction or relevant investigations to confirm the suspected diagnosis.

 

At IOSAS, we generally start our assessment with gait analysis, looking at joggers, work shoes etc, analysis of movement patterns and muscle strength to look for weakness and imbalances, followed by an orthopaedic joint assessment. This then directs how we will manage the presentation to move you towards the outcome you desire.

 

Most biomechanical issues of the knee and overload syndromes can be managed conservatively and don’t progress to surgery.  Advanced degenerative change of the knee will often require joint replacements and ruptures of ligaments and meniscal tears which catch or lock will usually require surgery with a degree of urgency.

 

Treatment options:

For many overload / degenerative and biomechanical issues, addressing mechanical issues and contributing factors can be a big part of the solution. Acupuncture, Massage and Chiropractic and other physical therapy interventions can be useful to address the current pain presentation. Progression towards rehabilitation and retraining may be indicated to prevent recurrence.

 

Due to the nature of the cases that we see, some patients require surgical intervention to help resolve their issues. It is vital in the post-operative phase to focus on rehabilitation and strengthening to make sure there is relatively good balance or symmetry in the strength and control of the knees to hopefully prevent future recurrences.

 

Generally, effective assessment and management of knees gives a greater probability of a good outcome.

 

If you have a new or ongoing issue with your knee, come in and see us, we might be able to help you get a better outcome.