Sports Injury Rehabilitation Resources | Anytime Physio

Orthotic Options, Which One Is Right For Me?

Alan Wan — Thu, 30 Jun 2022 03:59:22 +0000

When it comes to orthotics not all are created equal. So when trying to decide which option is best for your particular needs, here is a brief summary of the available options.

Off The Shelf Innersoles/Orthotics

The entry level option is the over-the-counter or store purchased inserts/orthotics can add some cushioning and support. For some patients who are just looking for a little extra cushioning or to compliment an existing pair of footwear, these can be all that is needed. The limitation of these devices is they don’t address the individual need of each patient’s foot shape, biomechanics and are not designed to be pathology specific.

Custom Orthotics

As the name suggests, these are completely customized to each individual, anatomy, biomechanics, activities, pathologies and footwear requirements.

After conducting a thorough physical assessment including gait analysis, the orthotics are created by taking a 3D digital image of your foot using a 3D scanner.

From there, your podiatrist will then design your custom devices in CAD software and then send them away for 3D printing.

So Who Would Benefit From Custom Foot Orthotics?

Custom foot orthotics are used to treat many foot problems such as plantar fasciitis, ankle pain, arthritis, bunions, swelling, limb length discrepancy, and heel pain.

In addition to lasting much longer then off the shelf innersoles, custom foot orthotics prescribed by your podiatrist are also eligible for a private health fund rebate, meaning the out of pocket cost may be quite minimal.

Before you decide on purchasing an insole from the chemist or other retailer, book in for a biomechanical assessment for us to evaluate your feet. Not everyone requires a custom made device and many people do not require any device at all! In fact, some people will find store bought insoles actually increase their pain, not reduce it

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How to Fix Shoulder Pain During Bench Press

Jacky Chiang — Tue, 27 Aug 2019 02:04:32 +0000

If you have been lifting weights at the gym for any length of time, no doubt you or someone you’ve met at the gym has experienced shoulder pain. Unless there has been a serious injury, the cause of shoulder pain is from an overload of one of the structures of the shoulder. This could be due to poor form, muscle imbalances such as muscle weakness, poor muscle activation patterns or muscle tightness. Overzealous progression of the training program can also be a factor. In this post, we go over 3 exercises that our Brisbane-based physiotherapists use to help our clients get on top of sore shoulders.

Bench press shoulder pain

You may experience shoulder pain due to your posture with bench press. If your shoulders are rounded forward during bench press they will be more internally rotated. This will cause impingement or excessive stress on the rotator cuff muscles. To prevent this, ensure that you pull the shoulders back by squeezing the shoulder blades together and push up at mid chest level. Also, check your range of extension by pulling your elbows backwards in standing. Be careful with the depth of bench press as it should not pass the end-range of your shoulder. This puts excessive stress on the joint. Likewise, do not flare out the elbows too much as it can decrease the space in the shoulder joint as you bench up.

Is the bench press bad for shoulders?

Bench press is not harmful to the shoulders with the correct technique. However, without the correct technique the following conditions may arise. These include shoulder impingement, instability or rotator cuff injuries. Bench pressing with dumbbells may be a safer option compared to barbell bench press.

Avoiding a bench press blowout: Rotator cuff exercises!

The rotator cuff is an important group of four muscles that attach to the shoulder to stabilise the head of your arm bone within the socket. Strengthening of the rotator cuff muscles may assist with bench press or prevent future injuries. You can do rotator cuff exercises can with a resistance band and a pair of dumbbells.

1. Rotator cuff exercises with resistance band
Stand in an upright position. Hold a tensioned exercise band in both hands and bend your elbows to a right angle. Keep your shoulder blades back and down and rotate your symptomatic arm outwards, keeping your elbow loosely by your side and your shoulder blades in a good position. Control the movement then return back to the start position. Relax and repeat.

2. Rotator cuff exercises with dumbbells
Lie on your good side with a weight in your affected hand. Keep your upper arm against your body and bend your elbow to 90 degrees Keeping your elbow at your side rotate your forearm upwards to lift the weight. Ensure you do not roll backwards during the movement.

Ensure that you start with the lowest weight and progressively increase the weight once you are comfortable with three sets of 10 repetitions. You may warm up with light weights or do the exercises after bench press – do no exhaust the rotator cuffs before heavy bench press.

How do I know if I have damaged my rotator cuff?

The cause of rotator cuff injuries may involve overloading from sudden increase in exercise intensity. Contributing factors may involve poor lifting technique, muscle tightness or weakness. Initial presentation may be pain in the shoulder. Pain whilst lifting the arm, or pain and weakness with outward rotation of the upper arm. Muscle tears may be partial or full-thickness. Our physiotherapist will determine if your shoulder pain originates from rotator cuff injuries.

Why do my front deltoids hurt when I bench?

You may be experiencing pain in anterior deltoid area due to referred pain from rotator cuff. If you are bench pressing with the shoulder rolled forward, it places excessive force on the muscle tendons in a compromised position. Ensure that you squeeze your shoulder blades together so that the head of the upper arm is in an optimal position in the socket. Weakness of rotator cuff muscles may also contribute. This is because of the positioning of the head of arm bone inside the shoulder joint. Another common condition involving pain with lifting arm is bursitis. This is an inflammation of the fluid-filled sac as the space in the joint decreases, secondary to shoulder impingement.

What helps shoulder pain from lifting?

Depending on the contributing factors, management can vary. If rotator cuff tear is the underlying cause, 6 weeks of physiotherapy treatment is recommended as high-level evidence has suggested non-conservative management for rotator cuff tears. Treatments may involve soft tissue release, manual therapy, postural education, exercises or taping.

If bursitis secondary to impingement is suspected. The initial management involves exercises and ice. 15-20min every 2-3h with towel for first 48h. Avoiding aggravating postures such as reaching arm across or overhead activities. It is recommended to see a physiotherapist for a thorough examination of your shoulder pain for a specific exercise program. Please consult with one of our physiotherapists to check the safest form and exercises for your shoulder.

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Muscle Strain, Tear or Contusion?

Jacky Chiang — Thu, 15 Aug 2019 01:55:36 +0000

Strain or tear?

Muscles are strained or torn when some or all the fibres are unable to cope with the force. These injuries commonly occur in sports. This can affect muscles such as the quadriceps, hamstrings, calves (gastrocnemius or soleus) or the rotator cuffs. Muscles are more prone to tears from training error, sudden acceleration or deceleration. Risk factors involve insufficient warm-up, inadequate rest periods, muscle or joint tightness, muscle weakness or previous injury. The treatment depends on the severity of the injury.

Grades of muscle strain or tear

Grade I – The strain of a small number of muscle fibres, causing pain and minimal decrease in range of motion but usually no loss of strength. Recovery usually take 2-3 weeks.

Grade II – a large number of muscle fibres are torn but not completely ruptured. This causes pain and swelling and a loss of range of motion and strength. Partial tears may require 2-3 months before returning to sports.

Grade III – complete tear of muscle fibres or tendon causing severe pain, swelling, loss of strength and range of motion. Full rupture may require surgery to reattach the fibres. These injuries can take more than 3 months to heal.

Treatment of muscle strain/tear

Acute management of muscle strains or tears is similar to ligament strains treatment. This involves RICE

Rest – Taking care not to make the injury worse avoiding activities that put stress on the muscle. This may include standing for long periods or running.

Ice – Apply an ice or cold pack straight after the injury occurs to prevent and minimize swelling. Apply the ice for 10 to 20 minutes, 3 times a day for up to 48 – 72 hours. Avoid apply ice directly onto the skin.

Compression – Apply a compression bandage to the injury. This will help to reduce swelling.

Elevation – Elevate the injury above the level of the heart, whilst applying ice and when you are sitting or lying down.

Nonsteroidal anti-inflammatory drugs such as ibuprofen will also help to relieve pain and swelling. We may recommend a short period of immobilisation, depending on the severity of the injury. An ultrasound or MRI can be helpful in differentiating the grade of the injury

What is muscle contusion?

The cause of muscle contusion is commonly a direct blow or collision in sports, resulting in localised muscle injury and bleeding. Symptoms can involve pain, swelling, bruising or a lump over the skin called haematoma. In severe cases, this may be related with bone fractures and dislocations. Acute management also involves the RICE protocol for 48-72 hours followed by heat. See your doctor or physiotherapist to determine the severity of the injury. You may need an X-ray, ultrasound or an MRI. Contusions usually heal fast. Rehabilitation will be required to to restore pain-free range of motion, strength and flexibility. This will allow a return to sport.

Relevant Links

Ankle Sprains and Strain Treatment

The link between stress and muscle strain

Knee Injuries Explained

Strains-and-sprains-self-care

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Knee Pain – Patellofemoral Pain Syndrome

Jacky Chiang — Thu, 15 Aug 2019 00:58:27 +0000

What is patellofemoral pain syndrome?

Patellofemoral pain syndrome (PFPS), is one of the most common causes of knee pain. It is commonly presented as a diffuse ache around the knee cap that is worse with knee movements. The can occur particularly with loaded activities such as climbing stairs or running. Sometimes, prolonged sitting can also cause pain, known as the “theatre sign”. Crackling or popping sounds may also suggest PFPS due to malalignment or instability of the kneecap. Typical onset of PSPS is usually gradual with recent change in training frequency or load. The cause of the pain is an imbalance of forces on the kneecap which causes malalignment

Risk factors of patellofemoral pain

Many other risk factors can also contribute to PFPS, including:

Altered biomechanics (e.g. foot rolling inward)
Previous injury or surgery
Quadriceps weakness
Reduced kneecap mobility
Poor lower limb flexibility
Change in footwear

Therefore, a thorough examination by a physiotherapist is recommended to explore the underlying cause of your knee pain and to also rule out other conditions such as patellar tendinopathy or fat pat syndrome.

How can physiotherapy help?

Studies have shown that physiotherapy can help with PFPS and that good outcomes are maintained after long-term follow-up. Effective treatment of PFPS involves a thorough physical assessment to target the underlying cause. Initial treatments may involve resting from aggravating activities, soft tissue massage, manual therapy to improve joint mobility, taping or strength and flexibility exercises. Orthotic devices may also be beneficial for some people to address biomechanics of the lower limb. However, there is no one-size-fits-all treatment as an individually tailored program is essential to address the underlying cause of your knee pain. See one of our physiotherapists for a thorough assessment and specific exercises to help you get back to previous level of function as quickly as possible.

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Common Cause of Heel Pain – Plantar Fasciitis

Jacky Chiang — Thu, 15 Aug 2019 00:07:59 +0000

What is plantar fasciosis?

Plantar fasciosis, or commonly known as plantar fasciitis, is pain at the attachment site of plantar fascia. The plantar fascia is a thick connective tissue stretching from the bottom of the heel along the sole of the foot to the toes. It is important for shock absorption and arch support of the foot. Plantar fasciitis is more correctly termed as “plantar fasciosis” as the underlying cause is more related to overuse and degeneration rather than inflammatory changes.

What causes plantar fasciosis?

Activities that involve repetitive movements of the ankle can cause microtears in the fascia leading to cellular changes. Sudden increase in load such as running or unsupportive footwear can contribute to development of plantar fasciitis. Obesity, low or high arch of the foot, decreased ankle range-of-motion or muscle tightness are other risk factors that can cause plantar fasciosis.

What are the symptoms?

Typically, someone with plantar fasciitis usually presents with gradual onset of sharp or throbbing pain over the inside of the heel. The heel pain is usually aggravated by weight-bearing activities such as running, prolonged walking or climbing stairs. Symptoms usually worsen during the push-off part of walking. The pain may also be worse after a period of inactivity such as prolonged sitting, standing or first thing in the morning.

How can physiotherapy help?

An experienced physiotherapist will conduct a series of examinations to correctly diagnose your heel pain. An initial 6-week conservative treatment is recommended to treat plantar fasciosis. Treatments can involve ice, rest, activity modifications, massage, taping, stretching and specific exercises to gradually reduce the symptoms. An ultrasound scan is usually not required but may be useful to investigate the degree of swelling and thickness of the fascia. Nonsteroidal anti-inflammatory drugs may also assist in reducing pain. Speak to one of our experienced physiotherapists today for pain relief and gradual return to previous level of exercise.

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Ankle Sprain Treatments

Jacky Chiang — Wed, 10 Apr 2019 01:22:52 +0000

Treatment for Acute Ankle Sprains

Acute ankle sprains are one of the most common sporting injuries treated by physiotherapists. Fortunately, most are simple to treat and can be managed a series of exercises and stretches taught by your physiotherapist.

What is an ankle sprain?

Ankle sprains cause stretching of ligaments around the ankle which can result in minor to complete tears. The most common sprain occurs when the ankle rolls outward with the foot turned inward. Causes for ankle sprains may be from twisting of the foot on uneven surfaces, falls or trauma from sports activities.

What are the symptoms?

Ankle sprains and ligament tears may cause:

Pain
Swelling
Bruising
Tenderness to touch
Ankle instability

What are the grades for ankle sprains?

Grade I: Minor tear or stretching of the ligament(s) with mild pain and swelling around the ankle. There should be minimal or no pain with weight-bearing activities (e.g. walking).

Grade 2: Partial tear of the ligament(s) with moderate pain, bruising and swelling. Walking is painful and ankle may feel unstable.

Grade 3: Complete tear of the ligament(s) with severe swelling, bruising and tenderness around the ankle. It is usually too painful to walk and the ankle feels unstable. Severe tears may be associated with fractures or high ankle sprains.

What is the treatment for ankle sprains?

Ankle sprains usually heal without surgical intervention. For severe tears, immobilisation with moonboot and crutches is recommended for initial management. Further investigations such as X-ray, ultrasound or MRI may be required for moderate to severe tears.

General initial treatment for ankle sprains in the first 48-72 hours is the RICE protocol (rest, ice, compression and elevation).

R – Rest from any activity that aggravates the pain to promote tissue healing.

I – Wrap a towel around ice pack, a bag of crushed ice cubes or frozen peas. Ice the affected area for 15-20 minutes every two hours. There should be no extreme pain.

C – Apply firm pressure with bandage or brace. Ensure that there is no discolouration or increase in swelling which indicates restricted blood flow.

E – Elevate the affected foot above the level of your heart.

Initial goal is to reduce pain, swelling and restore full range-of-motion. Your physiotherapist may tape your ankle to protect it from twisting or rolling. Next phase of rehabilitation will focus on improving strength, flexibility, balance and then gradual return to activities.

How long does it take to heal?

Grade I	Approx. 2-3 weeks
Grade II	Approx. 6 weeks
Grade III	Approx. 6-12 weeks.

According to a systematic review, ligament healing and mechanical stability of ankle occurs from 6 weeks to 3 months after injury, particularly Grade III ankle sprains. However, you may still experience mechanical laxity or subjective ankle instability up to one year depending on the severity of injury.

Need Help With An Ankle Sprain?

Book an appointment online with one of our expert Brisbane physiotherapists.

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More information

Foot and Ankle Injuries

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Finger Pulley Injury Rehabilitation

Alan Wan — Mon, 17 Dec 2018 06:21:13 +0000

How To Treat a Finger Pulley Tear or Rupture

Treatment

Finger Pulley Tear treatment is vital to ensure the full recovery. These injuries can be devastating for rock climbers. Around 40% of all reported rock climbing injuries occur at the A2 and A4 pulleys of the flexor tendons. The mechanism of injury is predictable and involves:

Closed crimp hand position
Repetitive motion
Excessive force
Acute loading

What is a Finger Pulley Injury?

The finger pulleys are the connective tissue encasing the tendons in the fingers. These keep the tendons close to the bone when the finger is bending. As a result, an injury to the finger pulley is serious. It is usually caused by lack of warm up or improper climbing technique. It can happen during a desperate dynamic move to a small crimp. The use of a full crimp increases the risk of injury because of the added strain to the tendons. A sign of an injury to the finger pulley would be a loud “pop” followed by significant swelling and pain, with the pain getting worse when opening the fingers.

Regardless of whether you have sustained a grade I or a grade IV finger pulley injury, we have you covered. Our physios Alan and Joy are both passionate climbers. They understand the importance of a full recovery. Below is an overview of the recovery and rehabilitation following a finger pulley injury.

Finger Pulley Infographic

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Related Links

Climbing.com

The Climbing Doctor

Very Well Health

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