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RHP Physiotherapy by Office Manager - 3M ago

Post by Will Thwaite, BPhty (Hons), BSc, APAM

1 – Physical screenings and assessment.

A physiotherapy football screening involves a thorough assessment of flexibility, joint range of motion, strength, co-ordination and movement control of the lower limb. It is important to assess the areas prone to injury in footballers including the main leg muscles as well as the hips, knees and ankles.

The RHP Physiotherapy football screening also examines landing technique and single leg control using a single leg squat test. The way an athlete lands can increase their risk of significant knee injury (eg. ACL injury).The information gathered in a screening can then be used to direct an athlete towards areas that need improvement– for example strength of the glutes, landing control, hip mobility or muscle length.

2 – Load management 

The long summer holiday means a consistent training volume generally drops off. Its highly unlikely that the physical activity done during the break matches the duration and intensity of football training. Its common to get muscle strains in this period purely because of the change in training and relative deconditioning of your muscles. Its particularly important to build back into high intensity sprinting over several weeks and let your body re-adapt to these high loads. Its not wise to come out of the holidays and do a full session of sprinting in the first week “to get your fitness back”.

3 – Strength Training

Prevention is the best cure, and being a footballer isn’t just about kicking a ball. Injury prevention exercises addressing strength, mobility, flexibility and stability of various parts of the body should be completed by all footballers. As mentioned before, strong muscles attenuate the high forces from running, jumping and kicking. In particular, being strong around the hips (abs, glutes, hamstrings, adductors) the knee (quads) and ankle (calf) is important for a footballer. There are many useful bodyweight exercises that can be completed at home or at training to make sure you are increasing your strength.

4 – Movement Skill and landing technique

Practicing good landing technique is an essential part injury prevention. Its also a great to include in the warm up process. The FIFA11+ warm up protocol is a great introductory program to ensure that athletes are performing appropriate movements in their warm up. It is also important to practice landing in difficult situations – ie. turning in the air, contacting another player in the air, after heading a ball, different speeds and directions – this way you can prepare for what typically occurs during a game.

If you want to find out the areas that you can improve to reduce your risk of injury, an RHP Physiotherapist can perform a thorough screening and a tailored plan can be made to ensure that you perform well and reduce your risk of injury during this football season.

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RHP Physiotherapy by Office Manager - 5M ago

Post by Sam Donaldson, Sports and Exercise Physiotherapist

What can you do?

Thank you for following on through these blogs on knee osteoarthritis (OA). Hopefully, some of this information has been helpful and the same goes for what follows.

Many of us start the new year by getting more active. Unfortunately, sometimes this means we start doing something that we aren’t prepared for. This often leads to overuse injuries, but what we are seeing more and more in our population is osteoarthritis, a condition which can affect our ability to start activity and remain active.

The previous blog was a brief overview of some of the issues leading to knee OA, which have been grumbling along for quite a few years (or decades) in most cases. We saw that the cartilage within the knee is not as tolerant over the activities it is asked to undertake and due to some of the normal bodily processes this can a) cause pain, and b) influence further change in the tissue.

So how is it best managed?

Total knee replacement? WRONG!

Well… sure, eventually, if conservative management has not been successful and the pain is significantly impacting on daily function, health and life, then surgery is a reasonable option.

But before then, and even included as part of your treatment if surgery is required , every person with knee OA should be addressing the lifestyle factors that they can control.

This may require losing weight or attending to diet. Exercise is a must, and good guidance on this is paramount. Better movement patterns will often help as well. Physiotherapy, including massage and joint mobilisation, has been shown to help with reported function.

Some people will benefit from pharmaceuticals (drugs) prescribed by their doctor, and perhaps trialling orthotics or specialised braces may help. This is likely to be more effective when daily function is being regularly impacted upon due to the knee pain, however it is not effective for everyone.

Of greatest importance here is the emphasis on diet and exercise. Having a good understanding of the issue in your knee will help, and this will be slightly different from person to person.

Understanding what to do about exercise and what to do about diet will also help, but actioning this is the most important thing.

To get some guidance on this there are a number of options, from group sessions to private therapy. If you believe you could benefit from some help in this area, get in touch on 07 3856 5566. If physiotherapy isn’t your best option, we will help you find a great exercise physiologist or dietitian!

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RHP Physiotherapy by Keeley Wells - 6M ago

Post by Sam Donaldson, Sports and Exercise Physiotherapist

Knee osteoarthritis (OA), is a leading cause of pain and loss of physical function in the knee. Unfortunately, knee OA is an increasing problem in our society, closely linked to our ageing and increasingly overweight population. OA in general is the sixth-ranked most common condition presenting to our GPs.

Knee OA is characterised by joint pain, stiffness and some swelling. It can occur at any age, however it is most common later in life, with some international bodies requiring patients be over 45 in order to be clinically diagnosed.

Often the GP or other health professionals (physios included) may request an X-ray to look at the joint space and congruency of bone surfaces to determine the diagnosis or perhaps the extent of osteoarthritic change.

But what is really going on in there?

Imaging often shows a reduced amount of space between the femur (thigh bone) and tibia (shin bone). There can be other features on the scan as well and some people may say things like, “Oh, that’s bone on bone,” or, “Jeez, there is no space left in there.” This may be correct if we just look at the scan, but it doesn’t necessarily mean you have a problem – or that this problem needs to limit your life plans and goals.

X-ray comparison of normal (left) and osteoarthritic (right) knees

Traditionally, this ‘wear and tear’ of the joint has been considered a very structural and biomechanical problem. This would mean that if you walk or run awkwardly, you are destined to have issues. But more recent research suggests that it’s not that simple.

With increasing weight, there is increasing prevalence of hand OA. Unless people are putting on weight and deciding to walk on their hands, the simple biomechanical explanation for knee OA doesn’t quite fit anymore.

The current explanation involves a more complex combination of normal body processes that involves turnover of our bone and cartilage cells, inflammatory responses, genetics and hormones, as well as our biomechanics.

As we age, the DNA and systems that create new cells when others have exceeded their life-span will create a code that is not as pure as it was in our adolescence and early adulthood. This results in the cartilage and bone gradually become less resilient and durable to new things (like starting to run 5km without prior training = overload).

Being overweight increases a systemic (read: “whole of body”) inflammatory response, which, once it has started in the knee, may continue to occur with this higher systemic state. It may have started with an ACL or Meniscal injury at the age of 15, or simply some boom-bust episodes of exercising over the years, or perhaps your genetic make-up is not as resilient. In any case, attending to this is important.

Finally, there is no ‘perfect movement pattern’, but there are more and less efficient ones and this can be different for everyone. How a person moves determines how forces are distributed around their body – some people naturally move and distribute force well, whereas others unintentionally direct too much force to certain areas of their body. When this excessive force is absorbed by the knee, the result is a structural change of the cartilage within the knee. This feeds into an inflammatory response and causes pain and altered movement or reduced activity, which then results in inconsistent exercise loads and may lead to putting on weight… vicious cycle ensuing…

But it doesn’t need to be a problem that you can’t deal with. As yet, we can’t be sure that the structures can return to normal, but those sources of pain within the knee can absolutely become more resilient and you can get back to living a fulfilling and active lifestyle!

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Post by Sam Donaldson, Sports and Exercise Physiotherapist

It’s the start of a fantastic new year! Bring on 2019! Bring on the resolutions and the commitment to a better me!

Did you also make a commitment to doing more exercise? Maybe it’s to get into the gym more, maybe you’ve bought a bike, maybe you have downloaded the Couch to 5k app and have hit the ground running…

Great work if you have, we’re all for it at RHP Physiotherapy. Part of our vision is to provide real solutions and life-changing benefits to active people of all ages. Because exercise is medicine and we support that!

But have you hit a road block already? “Knee pain!” you say.

There is a myriad of reasons you might have started to get a sore knee with these new exercise ventures. Maybe you just had a good festive season, are familiar with exercise, but having just started again you are getting sore. Often it can be some morning stiffness, pain when going up or down stairs, and this may warm up with some exercise but will get sore again after some amount of that activity (note: not every one of these features are the same for everyone).

So, what could be happening?

Depending on your history of injuries around the knee, how your lifestyle has been to this point and what your age and activity history is, there are some common issues in this scenario. Each of them relates to the relative lack of consistency or gradual progression in exercise load.

If you’re in your teens, perhaps it is Patella Tendinopathy or “Osgood Schlatter” syndrome. For females under 40, it could be Patellar-Femoral Pain syndrome. In the over-45 bracket, maybe some lifestyle choices could have been better and/or you hurt your knee when you were younger, leading to Knee Osteoarthritis. Please note that age groups, gender and other features are not always as described above.

Our next blogs will be covering some more information about Knee Osteoarthritis, so stay tuned. But if this sounds like you, perhaps a quick call in with us at RHP Physiotherapy might be in order – 07 3856 5566. We will help with identifying why your knee hurts, why it has come about and what you can now be doing about it to keep on top of that New Year’s Resolution!

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RHP Physiotherapy by Julia Danilova - 8M ago

Post by Michael Thiel-Paul, Remedial Massage Therapist

We ALL fail to do things that we know will be good for us. This phenomenon is no different in the physiotherapy and massage realm. Most days we are told by a client that they haven’t done their prescribed exercises/mobility work and we get it. We completely understand, we’re humans too.

Here, I’d like to offer two very simple methods to help maximise the chances of patients completing the physical maintenance required. The trick is to ‘automise’ it as much as possible.

Tip 1. Use that thing in your pocket!

Smart phones all have ‘alarm’ functions that allow the user to set dozens of alerts at once. If you can put aside 2 minutes to set multiple alerts, you can set numerous reminders each day at times when you know you’re most likely to be able to complete your prescribed tasks. “I forgot” becomes redundant.

Tip 2. Piggy back your exercises!

We all have daily habits that we do get done every day. Piggy backing your physio exercises onto these daily habits is very effective way of getting them done.

Examples for you:

  • hang your stretchy band near your toothbrush and each time you brush your teeth do your exercises
  • take your massage ball when you sit down to watch some TV
  • leave a note near your kettle and do an exercise while making the cuppa.

You’ll you find these tips are easy to implement and effective. Get into it!

Michael. Massage maestro.

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Post by Daniel Miller BAppSc (Physiotherapy)

Being able to move through the water with less resistance (drag) will improve your speed without having to stroke harder or faster.

So how do we do that? Well, one key component is improving your streamline position in the water. A good streamline position requires adequate mobility, flexibility, and stability to be in that efficient position.

The below picture demonstrates what areas of the body we require to have adequate mobility and flexibility, to maintain a good streamline.

The following pictures demonstrate exercises you should be performed regularly, especially prior to entering the pool, to gain a good streamline.

If you have any concerns or would like more information, come see one of our physiotherapists!

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RHP Physiotherapy by Office Manager - 9M ago

Post by Kerry Staples (MPhysio (Sports) BPhysio (Hons) B HMS (Ex Sci) Sports Physiotherapist APAM)

Have you ever heard some-one say, “Oh, it is just an ankle sprain..”, or even thought that yourself?  Yes it may be an ankle sprain, but they may not be as simple as they appear.

Lateral ankle sprain is the most prevalent musculoskeletal injury in physically active populations as well as a common condition in the general population.  Up to 70% of the general population report having incurred an ankle injury during their lifetime.  It is the most common sports injury across all sports.  Interestingly, many people do not seek treatment at all.

Lateral ankle sprain injuries have a very high re-injury rate.   Individuals who incur an acute lateral ankle sprain injury have a twofold increased risk of re-injury in the year following their initial injury.  Many people still report symptoms up to 1 year after ankle sprain.

Re-injury can lead to a number of sequelae including:

  • Pain
  • Persistent swelling
  • Feelings of ankle joint instability
  • Ankle joint ‘giving-way’,
  • Reduced functional capacity

Injury recurrence rates following lateral ankle sprain are high, leading to a large percentage of patients developing chronic ankle instability (up to 40%).  High re-injury rates might be due to inadequate rehabilitation, and/or premature return to sport and activity.  Chronic ankle instability and recurrent ankle sprains have been linked to early onset ankle osteoarthritis, and this is occurring much earlier in life than you might expect.

Physiotherapists in the management of lateral ankle sprain will

  • Help you to manage the early immediate symptoms
  • Identify the type and severity of the sprain clinically
  • Refer you for appropriate investigation if required
  • Use an activity and function based progression for rehabilitation rather than just simple time based progressions, while simultaneously allowing for optimal tissue restoration.
  • Assess your level of function and provide advice for return to activity
  • Provide options and strategies for the prevention of re-injury. There are a number of tests and outcome measures that can be performed with your physiotherapist to minimise risk of injury recurrence when returning to activity and sport.

References

Delahunt E, Bleakley CM, Bossard DS, et al.  Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium. Br J Sports Med 2018;52:1304-1310. Accessed online at http://dx.doi.org/10.1136/bjsports-2017-098885

Gribble PA, Bleakley CM, Caulfield BM, et al.  2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 2016;50:1493-1495. Accessed online at http://dx.doi.org/10.1136/bjsports-2016-096188

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