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

The post Orthotic Options, Which One Is Right For Me? appeared first on Anytime Physio.

A Comprehensive Guide to Jaw Pain

Alan Wan — Wed, 21 Jul 2021 01:59:31 +0000

A Comprehensive Guide to Jaw Pain

If you’re experiencing jaw pain, stiffness and clicking, physiotherapy may be the answer. Jaw pain, stiffness and clicking fall under the category of temporomandibular joint disorders (TMD). The jaw (or temporomandibular joint) is a biarticular sliding hinge joint that connects the skull to the lower jaw. When people think about physiotherapy, most will think about sports injuries or rehabilitation after surgery. Not many will consider seeing a physiotherapist for a sore jaw. In this blog post, we’ll discuss common jaw conditions that physiotherapists treat, how physiotherapists can help and self-management strategies. We’ll also give you our top exercises to try at home!

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is a bi-articular hinge joint that connects the skull to the lower jaw. The TMJ allows us to open our mouths wide enough for food intake and speech production as well as close it tightly in order to chew foods with strong textures. It is a relatively complex structure and is one of the most important joints in our body.

The TMJ comprises two main components, namely the mandibular condyle and the articular disc that form a gliding surface for jaw movement. Outside of these two structures, the TMJ also includes the supporting ligaments, retrodiscal tissue and the muscles that produce opening, closing, protrusion/retrusion and deviation movements of the jaw.

Common temporomandibular joint conditions

Many conditions can cause dysfunction and pain in the jaw. These include:

myofascial (muscular) pain
articular disc displacement
retrodiscal tissue inflammation
arthritis of the TMJ
trigeminal neuralgia

A physiotherapist trained to assess and treat temporomandibular disorders will be able to examine your jaw and determine the cause of your symptoms.

In the next section of this post, we’ll discuss each of the conditions listed above including the common symptoms of each and treatment strategies.

Myofascial pain

Myofascial pain is pain that is felt in the jaw muscles, usually on one side of the face. This pain can be caused by a variety of factors including overuse of the muscles on one side of the face, clenching of the jaw or grinding of the teeth overnight.

Symptoms of myofascial pain

pain on one side of the face
a sensation of tightness in the jaw
pain and stiffness triggered by use of the jaw (i.e. chewing or yawning)
tenderness in the affected muscles

Treatment of myofascial pain

A specially trained physiotherapist will be able to assess and treat myofascial pain in the jaw. Physiotherapists may prescribe a personalised exercise program, teach you self-massage techniques or make adjustments to your diet – all of which are effective treatments for myofascial pain.

Exercises for myofascial pain

Exercises for myofascial pain focus on reducing overactivity of the muscles involved in chewing. This can include self-massage, jaw stretches and jaw posture correction.

Self-massage of the jaw muscles helps to relax tight muscles such as the masseter and temporalis. These muscles are involved in producing the powerful closing action of the jaw and can become tight if a person clenches their jaw in stressful situations or grinds their teeth overnight. To massage these muscles, we recommend placing your index and middle finger on the muscle bulk on the painful jaw and massaging gently in a circular motion. Do this three times for 30 seconds and repeat three times per day.

Jaw stretches can also help relieve jaw stiffness. To stretch your jaw, gently open your mouth and place your thumb on the back teeth on the lower jaw. Press down through the teeth as you open your mouth wider to increase the stretch. Be careful so you don’t overdo the stretch, as pushing too far can irritate your jaw. Your physiotherapist will teach you how to perform the stretch safely and comfortably in the clinic so that you can do this at home. We recommend performing the stretch for 30 seconds, three times per session and three sessions per day.

Lastly, jaw posture correction helps to reduce tension in the jaw muscles when you are resting. The recommended position is called the ‘Upright Posture Position of the Mandible’ or UPPM for short. Here are the steps to get into this posture:

Sit up tall in your chair
Place your tongue on the roof of your mouth behind your front teeth as if you were about to pronounce the letter ‘N’
Separate your teeth very slightly (i.e. 1-2mm apart)
Close your lips gently

If you feel your jaw muscles in this position, you will find that the muscles are more relaxed than if your teeth were touching. You can even give it a try by gently closing and separating your teeth while feeling the jaw muscles.

To build the habit of relaxing your jaw into this posture, we recommend that you set a reminder to correct your jaw posture every 20-30 minutes during the day.

Articular Disc Displacement

The articular disc of the temporomandibular joint is a thick, circular disc of fibrocartilage that helps to create a seal between the ball and socket joint.

The articular disc may be displaced when there is repetitive stress or trauma to the jaw. The most common direction for articular disc displacement is forwards. This is called anterior disc displacement. In anterior disc displacement, the articular disc sits in front of its usual position inside the temporomandibular joint in a closed mouth position. When the mouth is opened, the movement of the jaw can cause the disc to slip back into its normal position with a clicking sound. This is called anterior disc displacement with reduction. If the disc does not return to its normal position and, instead, restricts opening range of motion of the jaw, then this is called anterior disc displacement without reduction.

Your physiotherapist will thoroughly assess your jaw to determine whether the your articular disc has been displaced and whether it returns to its normal position during movement of the jaw.

Symptoms of anterior disc displacement with reduction

jaw clicking with opening and closing
pain on one side of the face, usually the side that clicks
usually no loss of range of motion

Treatment of anterior disc displacement with reduction

Anterior disc displacement in the TMJ can be effectively treated by a physiotherapist. Most treatment programs for anterior disc displacement with reduction take between 6 and 12 weeks. The main goals are to reduce the pain associated with inflammation resulting from the disc displacement as well as to minimise the click.

Conservative treatment of anterior disc displacement with reduction involves reducing the overactivity of the muscles that produce forwards translation of the disc (the lateral pterygoid muscle), stretches for the joint capsule of the temporomandibular joint and an exercise to assist in the relocation of the articular disc.

Exercises for anterior disc displacement with reduction

There are two main exercises that physiotherapists prescribe for anterior disc displacement with reduction. These are the disc recapture drills and stretching of the jaw joint capsule.

To perform the disc recapture exercise:

Open your mouth fully so that the jaw clicks. This click typically indicates that the disc is relocated in its normal position
With your mouth open, push your bottom jaw forwards
While maintaining this forward positioning of the jaw, slowly close your mouth. Ensure that the jaw does not click as you close your jaw. A click during closing movements typically indicates displacement of the disc in front of the joint. Avoiding this click means that the disc has been relocated and maintained in the correct position during the closing movement
Once your mouth is closed, slowly slide your bottom jaw backwards. Do not allow your jaw to click during this movement
Repeat the entire sequence 10-15 times, ensuring that the jaw does not click during the closing movement

The disc recapture exercise should be performed 3 times per day. Stop this exercise if it causes any pain or discomfort in the jaw.

To stretch the jaw joint capsule:

Open your mouth wide so that the jaw clicks
With a clean hand, place the pad of your thumb on the back molar on the side of the jaw that clicks
Gently apply a downwards pressure, encouraging the jaw to stretch into an open position
Hold this stretch for 30 seconds and repeat for 3 sets

You should perform this capsular stretch 3 times per day. When starting this stretch, ensure that you do not push too hard. Increase the stretch over time as your jaw mobility improves.

Symptoms of anterior disc displacement without reduction

significant restriction to opening range of motion
restricted lateral deviation movement of the jaw (away from the side of disc displacement)
pain on one side of the face
no clicking because the disc does not return to its normal position

Treatment of anterior disc displacement without reduction

Treatment of anterior disc displacement without reduction involves physiotherapy to manage pain and improve joint mobility. Your doctor may also prescribe pain relief or muscle relaxants to assist in reducing pain and discomfort.

Physiotherapy for anterior disc displacement without reduction is focused on manual therapy to the affected joint and massage of the muscles around the TMJ. The goal is to stretch the jaw joint to improve the range of motion into opening.

In some cases, the stiffness caused by anterior disc displacement without reduction does not improve with conservative treatment. If this is the case, your physiotherapist will refer you to a maxillofacial surgeon for opinion on surgical management.

Exercises for anterior disc displacement without reduction

Your physiotherapist will prescribe exercises for you to do at home to stretch your jaw. The most common exercise is the TMJ capsule stretch. To perform this stretch:

Open your mouth as wide as you comfortably can
With clean hands, place the pads of your thumbs on the back molars of the bottom jaw. Cross your hands over so that your right thumb is on the left molars and the left thumb is on the right molars
Gently apply a downwards pressure with both hands, encouraging the jaw to stretch into an open position
Hold this stretch for 30 seconds and repeat for 3 sets

Perform this stretch at least 3 times per day. Do not push your jaw as this may increase the pain associated with the disc displacement.

Retrodiscal tissue inflammation

The retrodiscal tissue is located behind the articular disc in the TMJ. It is richly supplied with blood vessels and nerve endings. It is susceptible to inflammation and can be a source of aching or throbbing pain in the jaw. It can even refer pain into the ear, causing confusion for people with retrodiscal tissue inflammation who have seen their doctors but do not have any signs of ear infection.

The retrodiscal tissue can become inflamed due to a single excessive loading event (i.e. chewing tough meat) or due to repetitive irritation associated with anterior disc displacement. Because the retrodiscal tissue is located behind the articular disc, the forwards translation of the disc in anterior disc displacement pulls the retrodiscal tissue into the jaw joint space. This places significant pressure on the retrodiscal tissue and can lead to inflammation of the tissue.

Symptoms of retrodiscal tissue inflammation

aching or throbbing pain in the jaw or ear
earache
pain with chewing and opening
tenderness behind the jaw
potentially associated with anterior disc displacement, so may also present with some clicking

Treatment of retrodiscal tissue inflammation

Retrodiscal tissue inflammation can be effectively managed through conservative means. These include heat or ice, rest for the jaw, anti-inflammatory medications and physiotherapy.

Often, resting from excessive chewing or clenching can make a big difference to pain caused by inflammation of the retrodiscal tissue. This rest gives the tissue a break from the irritating activities and allows the tissue time to heal.

Your physiotherapist will teach you the best posture to rest your jaw to reduce pressure on the retrodiscal tissue. This posture is called the upright posture position of the mandible (UPPM). Here are the steps to get into this posture:

Sit up tall in your chair
Place your tongue on the roof of your mouth behind your front teeth as if you were about to pronounce the letter ‘N’
Separate your teeth very slightly (i.e. 1-2mm apart)
Close your lips gently

To build the habit of relaxing your jaw into this posture, we recommend that you set a reminder to correct your jaw posture every 20-30 minutes during the day.

Arthritis of the temporomandibular joint

Arthritis of the temporomandibular joint can be associated with previous injury, infection, autoimmune diseases like rheumatoid arthritis or simple wear-and-tear over time.

The symptoms of temporomandibular joint arthritis

pain in the affected jaw
stiffness of the jaw
difficulty chewing
tenderness to touch
light clicking or grating noise with movement of the jaw

Treatment of temporomandibular joint arthritis

Physiotherapy for temporomandibular joint arthritis focuses on maintaining range of motion of the jaw, strength of the jaw muscles for chewing and minimising pain in the jaw joint. Your physiotherapist will use techniques such as joint mobilisations, soft tissue massage, heat and exercise to achieve these treatment outcomes.

Exercise for temporomandibular joint arthritis

The most common exercises for temporomandibular joint arthritis are stretches of the jaw joint and postural correction.

Because arthritis causes stiffness in multiple directions of movement, gentle stretching should be performed in all affected directions. You can stretch your jaw by moving your jaw through the full available range of motion, pausing for 2 seconds before moving back the other way. Repeat this gentle movement for 10 repetitions and 3 sets. You can do this stretch 3 times per day.

Postural correction for the jaw follows the same steps as above for UPPM:

Sit up tall in your chair
Place your tongue on the roof of your mouth behind your front teeth as if you were about to pronounce the letter ‘N’
Separate your teeth very slightly (i.e. 1-2mm apart)
Close your lips gently

Trigeminal neuralgia

Trigeminal neuralgia is a rare condition that is often characterized by stabbing sharp facial pain or electric shock-like sensations on just one side of the face (mostly affecting areas around the mouth and teeth). The pain can last for seconds to minutes at a time, leaving sufferers with sudden spasms of pain.

Trigeminal neuralgia is caused by compression or irritation of the trigeminal nerve. The trigeminal nerve is the fifth cranial nerve. It is made up of three brances; the Ophthalmic nerve (V1) 1st branch (sensory), the Maxillary nerve (V2) 2nd branch (sensory), and the Mandibular nerve (V3) 3rd branch (sensory and motor, controlling the muscles of mastication – the temporalis and masseter).

Symptoms of trigeminal neuralgia

The most common symptoms are:

Painful sensations on one side of the face that come and go at intervals ranging from a few seconds to minutes
Burning pain
Muscle spasms
Constant aching in one side of the face
Increased sensitivity on one side of the face
Cold sensitivity

Treatment of trigeminal neuralgia

Physiotherapy for trigeminal neuralgia typically involves a combination of electrical stimulation (TENS), acupuncture or dry needling for pain management and neck exercises.

Your physiotherapist may also advise you to see your doctor for appropriate medical management for trigeminal neuralgia. There are a range of medications that have demonstrated efficacy in the management of trigeminal nerualgia.

Summary

In this blog post, we provided a comprehensive guide to jaw pain treatment. We discussed the normal function of the jaw, some common jaw disorders that physiotherapists treat and also provided self-management strategies and our top exercises for managing temporomandibular joint disorders.

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How to Treat Lower Back Pain: A Physiotherapist’s Comprehensive Guide

Alan Wan — Wed, 30 Jun 2021 04:42:43 +0000

How to Treat Lower Back Pain: A Physiotherapist’s Comprehensive Guide

Lower back pain is a common complaint that physiotherapists see in their practices. It can be debilitating and make individuals feel low on energy, so it’s important to know how to manage the condition as quickly as possible. In this blog post, we will discuss low back pain causes and symptoms, treatment options, self-management strategies, exercises for low back pain relief and more!

What causes low back pain?

Low back pain can be caused by an injury, such as a muscle strain or sprain from sudden or repetitive movements. Some low back pain is the result of overuse, such as prolonged sitting or standing. Sometimes, low back pain can be caused by a lack of low back strength and stability in everyday movements.

Lower back injuries are common among athletes because they often involve sudden twisting motions that may put too much stress on one side of your lower spine (especially if you have an imbalance in your lower back and pelvis). Sometimes this leads to herniated discs or other spinal damage. Other causes include being overweight, which puts more pressure on your low back, having poor posture while sitting for long periods of time, moving incorrectly during pregnancy, especially when lifting heavy objects, or wearing high heels all day every day.

The first step in treating low back pain starts by identifying what may be causing it. Most low back injuries are due to overuse or repeat injury (such as from a previous fall), but some people might also have an underlying condition that needs treatment such as conditions like arthritis, osteoporosis, or lupus, spinal disorders including herniated discs or degenerative disc disease. It is also important to exclude other causes of low back pain such as infections or tumours around the spine.

Here are the most common causes of low back pain that we see in our physiotherapy practice:

Lumbar disc bulge
Lumbar disc herniation
Sciatica
Lumbar facet joint sprain
Sacroiliac joint pain

In this blog post, we will explore each of these conditions, discussing common symptoms, treatment options, self-management strategies and our recommended exercises for relief from your low back pain.

Lumbar disc bulge

A lumbar disc bulge is a low-grade spinal condition. It occurs when there is a small protrusion at the outer edge of one or more intervertebral discs in the lower back. The exact cause of this condition isn’t known but it may be related to age, lifestyle factors such as work and sport, as well as genetic factors. Disc bulges may occur during a sudden loading event, but may also be the result of repetitive overuse. Many people cannot remember the exact moment when their back pain started.

A disc bulge may produce mild-to-moderate central lower back pain. Larger disc bulges may also compress the nerves in the lumbar spine, resulting in sciatica.

Common symptoms of lumbar disc bulges

Central lower back pain
“Band-like” radiation to both sides of the low back
Pain with bending forwards
Pain with lifting
Pain with twisting movements
Pain with sneezing and/or coughing

Treatment options for lumbar disc bulges

If you suspect that you have lumbar disc bulge injury, then we recommend seeking physiotherapy treatment first before undertaking muscle strengthening exercises because you need to have a good functional range of motion in the low back before you start strengthening it.

Possible physiotherapy treatments may include:

Spinal mobilisation and manipulation
Soft tissue massage
Dry needling and acupuncture
Exercises and stretches
Clinical Reformer pilates

The good news for people with disc bulges is that, in the majority of cases, the pain associated with a mild-to-moderate disc bulge is easily treatable with physiotherapy, rest and gradual return to sport and work.

Exercises for lumbar disc bulges

Knee to chest stretch
Knee rocking stretch
Lumbar spine twist
Trigger point release of the lower back and gluteal muscles
Glute bridges
Transversus abdominus activation drills

There are many other great exercises for treating lower back pain and we recommend that you see a physiotherapist for more specific advice about your back pain.

Lumbar disc herniation

A lumbar disc herniation is another common cause of low back pain. It occurs when there is a larger protrusion of one or more of the lumbar discs. Often, lumbar disc herniations cause more severe pain that disc bulges. On top of this, because of the increased size of the disc protrusion, irritation and compression of the spinal nerves is more likely in disc herniations. This can lead to lumbar radiculopathy, which is a common cause of sciatica.

Symptoms of lumbar disc herniations

Central lower back pain (potentially worse on one side)
Radiation of pain into one leg
Numbness
Tingling (pins and needles)
Weakness
Bladder and/or bowel dysfunction (if this occurs, you must seek immediate medical attention)
Pain with bending, twisting and lifting
Pain that worsens with prolonged sitting or standing
Pain with coughing or sneezing

If you have the symptoms of a lumbar disc herniation that we have listed above, then it is important for you to see a physiotherapist early so that they can help you get your low back pain under control and to avoid more serious complications.

Treatment options for lumbar disc herniations

Physiotherapy is the first recommended treatment option for lumbar disc herniation injuries as it is considered to be one of the most effective and safest treatments. Your physiotherapist will be able to assess for the severity of the injury and provide you the right treatment and exercises to relieve your symptoms.

Your physiotherapist will provide treatment to help you recover and reduce the likelihood that it will happen again in the future. They may also recommend exercises for your home program which should be done daily to maintain good strength while recovering so the symptoms don’t return.

Possible physiotherapy treatments may include:

Advice and education on posture and ergonomics
Spinal mobilisation and manipulation
Soft tissue massage
Dry needling and acupuncture
Exercises and stretches
Lower back and core muscle strengthening exercises
Clinical Reformer pilates

Your physiotherapist will also be able to assess for any potential spinal nerve compression and refer you for an MRI scan. A referral to a spinal orthopaedic specialist may be required if there is a very severe nerve injury that is affecting your muscle power and skin sensation. If you experience any bladder and bowel issues such as difficulty voiding or inability to pass urine or stools, you require an immediate medical attention. A small percentage of people with the severe disc herniation and nerve compression injury may require a surgical intervention followed by physiotherapy rehabilitation to return to function. This is usually recommended if low back pain persists despite conservative treatment.

Exercises for lumbar disc herniations

The following exercises should not worsen your low back pain. If they do, you need to stop immediately. If there is any worsening or unusual signs such as numbness in your legs while doing these exercise, it indicates the exercise is likely too difficult for your current injury. We strongly recommend that you see a physiotherapist so that they can prescribe more appropriate exercises for you.

Sciatic nerve gliding
Knee to chest stretch
Knee rocking stretch
Piriformis stretch
Trigger point release gluteal muscles and piriformis

Other general exercise, such as walking, can be helpful in the management of lumbar disc herniations. However, it is important to remember that low back pain and sciatica are often triggered by excessive movement of the spine, so minimise activities such as bending, twisting and lifting.

Sciatica

Sciatica is a cluster of symptoms that includes pain radiating down the leg with numbness, pins and needles and weakness. This is most commonly caused by irritation of or damage to the sciatic nerve or the spinal nerves that form the sciatic nerve.

Sciatica occurs when there is pressure on the sciatic nerve which can result from compression by disc herniation, bone spur formation or spinal stenosis (in older people) and muscular tightness or spasm (such as piriformis syndrome). The worst symptoms are usually felt down one leg but they can also radiate into the hip and buttocks region.

Symptoms of sciatica

Low back pain radiating into the buttock, thigh or leg – this may worsen when sitting down; walking up stairs or changing position after periods of rest
Numbness down the leg which may be worse at night
Tingling (pins and needles) in the leg which may be worse at night or in prolonged sitting
Weakness of the leg
Pain with bending forwards
Pain with lifting
Pain with walking

Treatment options for sciatica

There are a number of physiotherapy treatment options for sciatica. Your physiotherapist will discuss the most appropriate and effective treatment plan to get you back on track as quickly as possible.

Physiotherapy focuses on restoring function and reducing pain and nerve compression symptoms by using manual therapy techniques such as soft tissue release and trigger point release, joint mobilisation, nerve mobilisation, dry needling and postural rehabilitation exercises.

Exercises for sciatica

Sciatic nerve flossing/gliding
Piriformis stretch
Hamstring stretch
Trigger point release of piriformis
Lumbar rotation stretch
Knee rocking stretch
Knee to chest stretch

Lumbar facet joint sprains

The lumbar facet joints (otherwise known as the zygapophaseal joints or z-joints) are located on the posterior or back side of each lower vertebrae. Sprains of the facet joints occur with sudden twisting or side-bending movements such as a golf swing or a tennis serve.

Symptoms of lumbar facet joint sprains

Low back pain on one side of the back
Sharp, localised pain
Pain with extending the back
Pain with twisting and side-bending
Muscle spasm on one side of the back

Treatment of lumbar facet joint sprains

Physiotherapy treatment for lumbar facet joint sprains involves identifying the affected joint and performing manual therapy techniques to reduce pain and restore movement. These techniques include joint mobilisations, soft tissue massage, trigger point release and dry needling.

Your physiotherapist will also prescribe you with exercises to help you restore movement and manage your pain at home.

Exercises for lumbar facet joint sprains

lumbar rotation
knee to chest stretch
child’s pose
knee rocking stretch

Sacroiliac Joint Pain

The sacroiliac joint (SIJ) is one of the low back’s most important joints. It connects the spine to the pelvis and lower limbs. The sacroiliac joint is a large and stable joint. Injuries to the sacroiliac joint typically require large uneven forces (such as missing a step on a staircase or a direct fall onto the pelvis). In pregnancy, however, hormonal changes result in an increase in flexibility of the ligaments around the pelvis. This can lead to instability of the sacroiliac joint and is a risk factor for pain of the sacroiliac joint.

Symptoms of sacroiliac joint pain

Low back pain and/or pelvic pain
Pain with walking or uneven pelvic postures
Pain with going up and down stairs
Pain with single leg stance or uneven weight bearing

Treatment for sacroiliac joint dysfunction

Physiotherapy treatment for low back pain caused by sacroiliac joint dysfunction involves identifying the cause of the joint dysfunction and performing manual therapy techniques to reduce pain, improve function and restore full range of movement. These techniques include spinal mobilisations, pelvic mobilisations, soft tissue massage, trigger point release and dry needling.

In pregnant women, sacroiliac joint instability is a common problem that physiotherapists see in practice. In these cases, treatment focuses on increasing strength of the muscles around the joint to improve stability of the joint. This helps to relieve pain by supporting the joint during daily activities.

In many cases, a physiotherapist will recommend sacroiliac joint compression to improve pain and stability of the joint. This can be done with a sacroiliac joint brace or compression shorts or stockings.

Exercises for sacroiliac joint dysfunction

Pelvic tilts
Gluteal bridges
Knee to chest stretch
Pelvic floor muscle training
Mini squats

How to prevent low back pain

The best way to avoid low back pain is by maintaining a healthy lifestyle. This includes exercising, not smoking and eating a well-balanced diet that provides enough calcium and vitamin D daily. Regular physical activity such as walking or swimming for at least 20 minutes three times per week reduces the risk of lower back pain. On top of this, it is important to include exercises that strengthen the muscles around the lower back. This can be achieved through a gym-based program or Pilates exercises. Finally, reduce stress in your life through relaxation techniques like yoga or meditation.

Summary

In this blog post, we’ve discussed the common causes of low back pain that physiotherapists treat, our recommended strategies for managing and treating low back pain as well as prevention strategies. We looked at ways of maintaining a healthy lifestyle that reduces low back pain risk as well as exercises for reducing lower back pain such as Pilates or gym-based programs.

Now you know what causes low back pain and some techniques on how to treat low back pain! If you have any questions about your low back pain please ask in the comments section below. Thanks!

The post How to Treat Lower Back Pain: A Physiotherapist’s Comprehensive Guide appeared first on Anytime Physio.

3 Reasons to Consider Online Physiotherapy Treatment – What to Know

Alan Wan — Mon, 20 Apr 2020 08:28:17 +0000

Physiotherapy refers to a form of physical treatment that aims to restore movement and function to patients who suffer from injuries, illnesses, or disabilities. It uses a mix of exercises, manual therapy, education, and advice to facilitate recovery. It’s particularly popular among athletes, but it is also highly beneficial to the general population with a wide range of physical conditions.

Seeing as physiotherapy treatments involve physical analysis and therapy, this begs the question: how is it possible that online physiotherapy treatments are circulating the internet as part of the growing wave of digital therapy?

Removing the geographical limitations between you and your physiotherapist, quality assessment, and treatment has become feasible at the comforts of your own home. To that end, the list below explores some of the reasons online physiotherapy treatment is trending in this digitally-oriented era.

Benefit #1: Quality Physiotherapy Treatment Becomes Accessible to Patients in Any Parts of the Globe

Suffering from physical injuries can be stressful enough as it is, but it can be more of a challenge if you don’t have instant access to quality care or clinics in your area. In that regard, online physiotherapy treatments break away geographical barriers in patients that live in rural or remote places.

The best part is that you can acquire the same level of expertise and advice – from prevention and active rehabilitation, all within your living room at an affordable price.

Benefit #2: Online Physiotherapy Treatment is Personal and Makes Information More Accessible

Patients often encounter problems throughout their treatment plan, but getting answers can be time-consuming as traditional physiotherapy would require you to get an appointment first. Some issues also involve misunderstandings with the exercise plan given to you, even if your physiotherapist provides video samples.

With online physiotherapy, you can quickly contact a professional in just a few clicks and even show how you conduct your daily exercises. This will ensure that nothing is lost in translation when you’re providing updates to your physiotherapist and also allow you to take in more enriched information on the dot.

Having various ways to communicate with your therapist also opens up a channel where you can get reliable assessments and discussions moving forward your recovery phase.

Benefit #3: Online Physiotherapy Treatment can Keep You Accountable

Even if you are determined to stick to your exercise program, having off-days is normal and inevitable. Fortunately, you can keep yourself on track by using a physiapp, a mobile application that provides comprehensive access to your exercise routine.

It allows you to send pictures and video updates of your exercise while online alerts serve as a reminder to ensure you won’t miss a single day. This can help you stick to your routine and achieve your goals for a speedier recovery.

The Bottom Line: How is Online Physiotherapy Treatment Different?

Based on findings over the last decade, physiotherapy has adjusted its techniques as researchers find that massage treatment and physical manipulation only provide short-term solutions to patients.

To achieve long-lasting relief and change, daily exercise, load management, and advice on injuries prove to be the most effective form of treatment for pain. In that regard, this paves the way for the rise of online physiotherapy as the treatment plan eliminates the need to be physically present.

If you’re looking for a physiotherapist in Brisbane, get in touch with us today to see how we can help!

The post 3 Reasons to Consider Online Physiotherapy Treatment – What to Know appeared first on Anytime Physio.

3 Ways to Maximize Your First Online Physiotherapy Consultation – Our Guide

Alan Wan — Mon, 20 Apr 2020 08:18:46 +0000

Although it is still a relatively new concept in the world of medicine, online physiotherapy has quickly become an essential alternative for any patient dealing with a physical injury.

From ACL rehabilitation to fractures, the advent of online consultations has made way for a more convenient and effective approach towards providing care. If you have an area of concern that needs to be treated right away, then it’s safe to say that a simple search, email, and call will suffice in getting the help your injury needs.

Now, if you haven’t had this particular treatment option before, it is important to note that some preparation can go a long way in making sure that you’ll be able to maximise the experience. Before you schedule an online physiotherapy consultation appointment and attend it, we will share with you three ways you prepare yourself for your first online physiotherapy consultation:

1. Expect to have the same experience as you would with an in-person session

To the uninitiated, the idea of attending an online consultation session can seem like a completely unknown experience. The truth, however, is that it works the same way as a traditional consultation would. When you jump right into the consultation, the entire process will begin with your assigned physiotherapist asking a specific set of questions about your injury so that they can assess it properly.

In terms of the actual physical examination, you will have to get involved in the process by moving specific body parts as requested and describing sensations that come with each movement. This specific part of the session is carried out to assess both the flexibility and range of motion of the concerned area.

With the help of the findings that they’ve uncovered with the help of your cooperation and the answers you’ve provided, the physiotherapist can diagnose your situation and provide a treatment plan for you.

2. Don’t be afraid to ask questions  

Similar to an in-person appointment, an online consultation provides you with the opportunity to ask questions to your heart’s content. If this is your first time dealing with the very condition that you’re seeking online assistance for, then it will be a good idea to write down a list of questions and feel free to inquire about important details during your session. This same idea applies to every consultation after that!

3. Set aside an ample amount of time and choose an appropriate environment

When you schedule an online consultation with a physiotherapy provider, it is important to ensure that both the timeslot you’ve chosen and the environment you will have the call-in is suitable for progress.

It may seem like a no-brainer at first, but many first-time patients end up cutting themselves short of a full and quick recovery because they couldn’t hear key details over the barking of dogs or shouting from their kids. Once you’ve finally set the date for the physiotherapy consultation, choose the quietest place in your home and make sure that you have enough time in case the session extends a bit!   Conclusion

Thanks to the advent of technology, getting the right physiotherapy treatment for an injury is far more convenient than ever, even more so when you sign up for an online physiotherapy consultation. By taking note of the tips mentioned above and sticking to them before, during, and after your session, you can effectively treat your current problem and maximise the expertise of your assigned physiotherapist!

Looking to seek help for your current injury right from the comforts of your own home or office? Our Brisbane’s most caring team of physiotherapists can help you with that. Schedule a free initial 15-minute physiotherapy consultation with us today!

The post 3 Ways to Maximize Your First Online Physiotherapy Consultation – Our Guide appeared first on Anytime Physio.

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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Shoulder Pain – Impingement and Bursitis

Jacky Chiang — Thu, 15 Aug 2019 00:30:00 +0000

What is shoulder impingement?

Shoulder impingement is a condition where the bursa or rotator cuff tendons are compressed in the subacromial space. This is the area between the head of the arm bone (humerus) and the acromion, a bony prominence at the top of the shoulder joint. The cause of shoulder impingement can be a bony spur on the acromion, poor posture, weakness of the rotator cuff muscles or muscle tightness. This can also relate to a rotator cuff tear or tendinopathy, this is an overuse injury.

What is bursitis?

Bursitis is an inflammation of a fluid filled sac in the joint called bursa. The bursa reduces friction between muscles, ligaments and bones. The shoulder is a ball-and-socket joint and the bursa is often inflamed in the subacromial space. Another term for shoulder bursitis is subacromial bursitis

What causes shoulder bursitis?

The cause of shoulder bursitis is usually due to overuse of the shoulder. This can be from activities such as throwing, swimming, cleaning or gardening. Subacromial bursitis is commonly related to shoulder impingement. The onset of pain is usually gradual, but sudden onset of pain can happen from direct trauma to the shoulder, such as a fall.

Symptoms

Shoulder bursitis results in pain with reduced range of motion (painful arc). Activities that may aggravate this injury include lifting and overhead movements, or lying on the affected side. For example, reaching across, hands behind back or rotating arm inward.

How is shoulder bursitis diagnosed?

Your physiotherapist will assess the shoulder with a series of tests to assist in the diagnosis of shoulder bursitis. Shoulder bursitis may be concurrent with other conditions. Sometimes X-ray, ultrasound or MRI scans can be helpful to differentiate between other pathologies.

Treatment of shoulder bursitis

The first step to treat shoulder bursitis. Avoid aggravating positions and activities that cause the microtraumas. This will reduce exacerbation of symptoms. Icing for 15min every 2-3 hours may be beneficial to reduce the inflammation for the first 48-72 hours. Nonsteroidal anti-inflammatory drugs such as ibuprofen can useful to reduce pain. Rehabilitation involves postural correction, manual therapy, and taping. There will also be exercises that strengthen and stretches weak or tight muscles. In severe shoulder bursitis, your physiotherapist may refer to your medical practitioner. This will be for an ultrasound-guided corticosteroid injection. This will help to reduce the inflammation. Evidence suggests that the effects of corticosteroid injections are only short-term. You should avoid favoring the injection over physiotherapy. It is crucial to continue with the exercises prescribed by your physiotherapist. This will ensure positive long-term outcomes.

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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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