This problem often has a gradual onset and can result from repetitive activities such as squatting and stair climbing as well as being the result of poor footwear. A reduction in activity as well as an increase in activity may lead to the onset of this knee pain. If you suspect that you have a problem such as this it is important to get an early diagnosis so that treatment can be started early and the problem can be quickly resolved. The tibio-femoral joint or your actual knee joint is the one that is most commonly replaced in a Total Knee Replacement. Physiotherapy can help at all of the 4 stages –Diagnosis, Preventing surgery, Prehabilitation (before surgery) and Rehabilitation (post-surgery)

1. Diagnosis – The First step is to determine where the majority of symptoms are coming from. It is important to get assessed early after or even before the onset of symptoms.

2. Prevention – prescribe appropriate exercises for you, based on your symptoms and presentation, to reduce pain and swelling, improve range, and strengthen the surrounding muscles to prolong or prevent the need for surgery. Studies have shown that appropriate, body weight exercises will reduce your pain and improve function. Many of our patients have been able to completely avoid Total Knee Replacement.

3. Prehabilitation – if you require surgery, Physiotherapists can help ensure you are in the best shape to maximise your recovery and reduce your time in hospital. Your Physiotherapist will teach you exercises to do in preparation, and begin practicing the exercises you will need after surgery. You will also practice using crutches or other aids that you will need initially post-surgery

4. Rehabilitation – your Physiotherapist will assist your recovery greatly. They can use many different techniques to manage pain and swelling, increase your range, and strengthen the leg muscles.

The Physiotherapist can advise on footwear and also assist in when and how to walk without your walking aid.

If you think this may apply to you, or you are seeking the treatment of related issues, we are only a call away to securing your appointment with our experienced Physiotherapists!
Relieve your pain – call now: 35116352

Often when people get buttock pain, they consult Doctor Google or even traditional musculoskeletal medicine textbooks and immediately lay blame on poor piriformis. ‘Piriformis Syndrome’ has been the popular diagnosis for some decades now but is not quite as common as once thought. Piriformis can have different structures in different people and the relationship of the Sciatic nerve to Piriformis is thought to change the likelihood of symptoms. In a small percentage of people, the Sciatic nerve does pass right through the middle of Piriformis (about 10% have variations). Sciatic nerve involvement may produce pins and needles or numbness due to irritation or compression of the Sciatic nerve if it passes through the Piriformis muscle.

There are many pain producing structures through the buttocks. Some of the other muscles in that region include the Gemelli, the Obturator muscles, Quadratus Femoris, Gluteus Medius, Minimus and Maximus. Many of these muscles originate from the Sacrum and/or the Iliac crest of the pelvis. Buttock pain can also be a result of referred pain from the Thoraco-lumbar junction, Lumbar spine and Sacroiliac joint. It is not unusual for multiple anatomical sources of buttock pain.

Gluteus Medius has complex anatomy that changes function according to hip position and is a more common cause of buttock pain as well as lateral hip pain.

Management normally involves local treatment to settle symptoms and working on improving the way the muscles around the pelvis interact with their complex biomechanics. Weakness on one side will often cause symptoms on the other. A graduated return to increased load / exercise is important.

If you experience buttock pain start your Physio management as soon as you can, so you can moderate your exercise rather than needing to stop. 

Osteoarthritis (OA) commonly occurs with degenerative changes in the hip and knee joints. Having a previous
knee or hip injury puts you at higher risk for developing these changes within your joints later in life.

How will I know if my symptoms are due to osteoarthritis?
Pain due to OA may start without any injury. Joints may become painful, hot, swollen or begin to creak and
crack. Joint pain is often worse in the morning and can gradually increase over time.

Will I need a knee or hip replacement?
Knee and hip replacements are often sought after too early by those with osteoarthritis. Physiotherapy has
been proven to increase joint function and reduce pain and stiffness in those with osteoarthritis. Settling
symptoms can help delay or prevent the need for a knee or hip replacement.

Did you know?

• You have an increased chance of developing knee OA after 45 years of age
• Women are more likely to have OA than men due to hormonal changes during menopause
• Excess weight can increase the chance of knee osteoarthritis

How can a Physiotherapist help?

Physiotherapists are experts in assessments of body movement and function. A Physio will assess your
strength and movement to design a personally tailored exercise program that fits your lifestyle. Hands on
manual treatment by Physiotherapists of the joint and muscles help to release surrounding muscles and
increase the nutrition of your joints. Movement feeds the joint surface.

A combination of these treatments and careful exercise planning will help
you discover and maintain the full capacity of your body.

What can you do?

Health and good habits become more important as you age. Don’t let achy joints, sore knees and feet stop you
from doing the things you love. Get on top of your symptoms with a full assessment from booking an
appointment with one of our Physios will help you overcome the barriers to your exercise.

December is a common time for DIY projects around the house but DIY Home Renovations are responsible for a vast number of injuries.

Some of the presentations include tennis elbow from painting, neck pain from reaching, knee pain from flooring and ladders, low back pain from lifting and shoulder injuries from power tools.

• Consider your home renovation like a sport – warm up prior and do your stretches.
• Have a clear ‘playing field’ to reduce your chance of injury.
• Rest regularly and seek help early for small injuries before they affect your ability to complete the task.
• Consider ergonomic options for your tools.
• Try to reduce the amount of over shoulder and overhead load.
• Make sure ladders are securely placed.
• Sustained vibration from power tools such as jack hammers can increase injury risk.
• Make sure you are wearing suitable footwear. Safety boots may be appropriate.

• Your computer monitor should be about arms length away & you eyes should be level with the top of the screen.
• You may need to raise or adjust your monitor.
• Your keyboard should be in front of you so you are straight onto it.
• It is recommended that you use a document holder if you type a lot from other documents. This reduces neck strain so that you are not constantly twisting or holding your neck in unusual positions, a bookstand may also assist.
• Make sure your lighting at the computer is adequate and there isn’t glare off the screen. Try to use shortcut keys wherever possible to try and reduce the use of the mouse, but also make you quicker in the use of your computer.
• Make sure you take regular breaks from sitting at the computer and include a neck exercise regime regularly. If you start to tighten up over the shoulder and neck, it may be useful to see a physiotherapist before the onset of neck pain and headaches.

Plantar fasciitis is the most common cause of heel pain, although, there are other causes. Another common cause is Fat Pad syndrome (‘bruised heel’ or ‘stone bruise’). This is usually caused by a fall onto the heels from a height, or excessive heel strike when walking/running. Other less common causes include stress fractures and nerve entrapment.

There are many factors that contribute to Heel Pain including:

• Poor ankle range of movement/tight calves
• Foot posture, motion & function (eg. pes planus or extreme pes cavus)
• Prolonged standing
• Training changes
• Poor footwear
• Age, height and weight

Both Physiotherapists & Podiatrists can help to treat this condition.

Physiotherapy;

A Physiotherapist can give advice on what changes in activity are needed, and also help treat any calf and plantar fascia tightness or ankle and foot joint stiffness, tape the foot to alter its biomechanics, and prescribe exercises to manage the problem.

Podiatry;

A Podiatrist can give footwear advice to help alleviate the problem, and can also assist by prescribing orthoses if poor foot posture appears to be the main problem.  Orthoses are particularly useful in chronic or resistant cases of Plantar Fasciitis, as long term cases tend to be caused through poor biomechanics.

Some Fractures require a period of immobilisation while the bone heals but it is not always good to be completely immobilised as the fracture ends need some very small movement to stimulate healing. Immobilisation could be using a fibreglass cast or plaster-cast which might be applied at a hospital emergency room or there are other methods of immobilisation that can be done at Paddington Physiotherapy. Other options may include a sling, a boot, an ankle brace, wrist brace or a soft-cast. A soft-cast looks like a fibreglass cast but is lighter weight and can be used in more temporary situations. Taping and a good shoe can sometimes be used effectively for feet.

There are some fractures that do not show up on an early X-Ray Clear X-Ray doesn’t equal no problem!!

Sometimes a Ligament or Tendon pulls the bony attachment off. This is called an Avulsion fracture. Many avulsion fractures can be treated by Physiotherapy in a similar way to a ligament sprain may be treated. Avulsion fractures at the Ankle will very commonly be treated the same as a severe ankle sprain.

Other fractures are due to reduced bone density, which can be called osteopenia, or in the more advanced form, osteoporosis. More information on osteoporosis can be found at our blog Maintaining Healthy Bones – Preventing Osteoporosis

One of the most common causes of heel pain in children or adolescents is a condition called Sever’s Disease, often also referred to as growing pains.

Sever’s disease is an insertional apophysitis which is a tendon condition where the Achilles tendon meets the calcaneum or heel bone. When children have a growth spurt, often the bone grows faster than the muscle/tendon complex and pulls at the insertion. The Achilles complex is a long functional unit starting from above the knee and terminating at the end of the first metatarsal. It involves many different types of structures including muscle, tendon, fascia and bone.

Some of the risk factors contributing to Sever’s in children include:

• Growth spurt
• Tight calves and hamstrings
• Football boots
• Poor school footwear or joggers
• Poor lacing of shoes
• Thongs and flip flops
• History of ankle injury that reduces ankle range
• Poor balance

Often our Physios can get the parents to assist in the treatment of Sever’s to allow the child to continue to play sport whilst recovering. Other causes of heel pain in children include a fat pad bruise, bursitis, Achilles strain, impingement and plantar fasciopathy. Many of these conditions share risk factors.

At Paddington Physiotherapy we attempt to fix the footwear and the individual biomechanics prior to considering Orthotics as often the child will be in a high growth phase. If addressed early, the child or adolescent can recover faster and develop good habits to prevent further occurrences.

Ladies, do you feel like there is a pebble under the ball of your foot when you walk? Chances are your suffering from Morton’s Neuroma or sometimes called interdigital Neuroma.

Morton’s neuroma is more common in woman than it is in men. The exact aetiology is unknown but we know it is caused by the formation of excessive tissue, which surrounds a nerve in your foot which supplies sensations to your toes. The tissue forms as a reaction to increased pressure and friction or trauma, when the relevant nerve is compressed it causes the nerves to swell and tissue to form as a protective response.

Morton’s neuromas commonly occur in the interdigital spaces of the lesser digits. The location of it is one of the main reasons why it can be very painful and more difficult to treat.

Risk factors include inappropriate footwear, prolonged use of high heels, tight footwear or even reduction in the size of the fat pad in the feet.

If you feel affected by the above symptoms don’t hesitate to come and see your Podiatrist and get Morton’s neuroma treated.

What constitutes the first ray?

The first ray includes the first metatarsal and first cuneiform bones. The big toe joint, the first metatarsophalangeal joint behaves as a spring and is in charge of propulsion. A compromised or inefficient gait due to a shortened metatarsal leads to a reduced range of motion which compromises the spring effect of the first ray. This inefficiency coaxes the other relevant structures involved in gait to work a lot harder. Other adaptions may include increased pressure in the first metatarsophalangeal joint or a shift in pressure to the lesser metatarsals which are not designed to take increased pressures. This could lead to other pathologies such as Morton’s neuroma, bursitis, the formation of painful callosities or even other soft tissue injuries.

If you think you have an abnormal first ray length, check in with your podiatrist to prevent further pathological progression.