Injuries

The lumbar spine is commonly known as your lower back. Some causes for lumbar pain include muscle strain, ligament sprain, disc bulge, joint dysfunction, incorrect lifting technique, weak core, weak surrounding muscles (e.g. glutes) and normal degenerative changes (e.g. joint space narrowing).

Symptoms:
– Pain in the low back, pain may also be in the hips/legs
– Pins and needles in the legs/toes
– Muscle tightness
– Reduced movement in the low back
– Inability to remain in one position for long periods of time
What can physiotherapy do?
– Reduce pain
– Restore movement in the lower back
– Correct posture and strengthen core to prevent future injury
– Suggest modifications to your workplace to prevent future injury, specifically those who work at a desk or who do lifting

The knee has 4 major ligaments to provide support. These ligaments can be stretched or torn if the knee is twisted or directly hit, particularly in sporting activities. You can sprain a single ligament, or multiple ligaments may be involved. Depending on the ligaments involved and the severity of the sprain, treatment options include braces, physiotherapy or surgery.

Symptoms:
– Pain in the knee
– Swelling in the knee may be seen initially
– Feeling of instability, or the knee “giving way”
– An audible ‘pop’ at the time of injury
– Unable to walk, may have a limp
What can physiotherapy do?
– Reduce the pain and swelling in the knee
– Improve strength of the knee muscles to provide support
– Improve movement in the knee
– Improve balance
– If surgery is required, your physiotherapy will work with your surgeon to facilitate healing of the ligaments, and return function to the knee
– Suggest use of, and fit, a brace or crutches if required

The hamstrings are a group of muscles at the back of your thigh, between your pelvis and knee joint. Injury to this group of muscles is common in sport, but can also occur in everyday life. A muscle strain occurs when one or more of the hamstring muscles are stretched or torn. There are 3 categories of muscle strains;
– Grade 1 strain: stretching of the muscle fibres
– Grade 2 strain: less than half of the muscle fibres are torn
– Grade 3 strain: tear of half to all of the muscle fibres
Hamstring tears can occur for many reasons including weakness in the muscle, poor pelvic or lumbar spine control, improper warm up, overloading the muscle, muscle fatigue and a previous hamstring strain.

Symptoms – vary depending on the grade of the strain
– Initially, intense pain in the hamstring, and possibly a “pop” sound.
– Pain or discomfort in the hamstrings when walking or straightening the leg
– May notice swelling and bruising in the area for the first 1-2 days with a grade 2-3 tear
– Inability to walk with a grade 3 tear, limping with a grade 2 tear
– Weakness in the hamstrings
– Pins and needles in the foot are possible if the sciatic nerve is affected
What can physiotherapy do?
– Reduce pain
– Facilitate healing of the muscle
– Prescribe exercises to strengthen and lengthen the muscle, and strengthen the muscles of the leg (glutes, calves, quads)
– Address any underlying factors to prevent future strains
– Facilitate return to sport and improve techniques e.g. running, landing, jumping
– Improve balance, agility and proprioception (i.e. knowing where your limbs are in space)
– Improve the way your sciatic nerve moves through the hamstring muscle to ensure scar tissue does not inhibit this

Golfers elbow is an overuse injury. The muscles that attach to the inside of your elbow joint are damaged and therefore painful. Some causes include incorrect golf technique, manual jobs such as factory work or carpentry, or throwing activities.

Symptoms:
– Pain in the elbow with gripping tasks
– Pain may extend into the elbow
– Tightness or tenderness along the muscles inside the forearm
– Often have full range of elbow movement
What can physiotherapy do?
– Reduce your pain
– Facilitate muscle healing
– Strengthen the muscles, especially for gripping
– Return to work and sport

Tennis elbow is an injury to the tendons on the outside of your elbow joint. It is commonly an overuse injury after frequent hand use (e.g painting, lifting heavy objects frequently, excessive gripping or wringing activities).

Symptoms:
– Pain in the elbow with gripping or turning tasks
– Pain may also extend into the forearm
– Tightness or tenderness along the forearm muscles
– Often have full range of elbow movement
– May experience tingling or numbness in the fingers/forearm
What can physiotherapy do?
– Reduce your pain
– Facilitate muscle healing
– Strengthen the muscles, especially for gripping
– Return to work and sport

Tendons are the thick fibrous band that connects muscle to bone. Tendons are very strong, and transfer the power of a muscle contraction to the bone to be moved. Tendons exist all throughout your body. Some common ones include the rotator cuff tendons, quadriceps tendons, and the Achilles tendon. Tendons are normally damaged as a result of overuse.

Tendinopathy is a term used to describe any disorder, damage or condition affecting a tendon in the body. This can include swelling, tearing, chronic damage or “wear and tear”. Some symptoms include pain. Swelling in the area, weakness, crunching sounds, pain worse with activity, stiffness or pain in the morning.

Tendonitis is used to purely describe swelling of a tendon. Some symptoms include pain, swelling/enlarged size, heat or redness in the area.

Achilles tendinopathy is damage to the thick ropy part behind your ankle. It is commonly caused by overuse such as sports involving repetitive running/jumping, poorly supportive shoes, regularly wearing high heels, or jobs with repetitive squatting on the ground. If left too long, or with sudden acute injuries, the Achilles tendon can rupture completely, which requires surgery.

Symptoms:
– Pain
– Stiffness, particularly in the morning
– Weakness of the ankle/calf
– Red and warm around the Achilles tendon if there is swelling
– “crunching” when moving the ankle

What can physiotherapy do?
– Suggest appropriate rest to relieve the tendon of excessive strains
– Guide slow progression back to previous activities – increasing the load on the tendons too quickly can further inflame the tendon and slow healing
– Strengthen the muscles surrounding the foot – particularly calf muscle and the ankle stabilisers
– Improve foot biomechanics and stability – including footwear
– Improve balance, power, agility and speed to return to sport/work

Hip and knee replacements are common orthopaedic surgeries for joint arthritis, some traumatic fractures and avascular necrosis ( death of bone). Physiotherapy is important both before and after your surgery. It is important to maximise your strength, range and mobility before surgery, as this will improve your recovery.

Symptoms:
– Pain in and around the joint
– Reduced strength
– Stiffness, particularly in the morning or after long periods of sitting
– Reduced range
– Reduced mobility
– Swelling (knee more than hip)

What can physiotherapy do – Pre-Op Rehabilitation?
– Maximise available range prior to surgery
– Strengthen the muscles surrounding the hip and knee
– Practice the exercises that will be important immediately after surgery
– Practice using mobility aids (crutches, walker) that may be used after surgery

What can physiotherapy do Post -Op Rehabilitation?
– Assist with initial mobility post-surgery
– Improve strength and movement of the hip/knee
– Give exercises to continue post discharge from hospital
– Long term return to work, sport or hobbies

The rotator cuff is made of 4 muscles that surround the shoulder blade and stabilise the shoulder while moving. An injury to any one of these muscles causes pain and limited movement of the shoulder. The rotator cuff can be torn through trauma (i.e. fall, lifting/catching heavy weight) or through micro-trauma (small tears that build up over weeks/months through overuse). Surgery is performed to repair the damaged muscles/tendons. Initially, the arm will be immobilised in a sling, then movement and strength exercises can gradually begin, as directed by the surgeon.

Symptoms:
– Pain in the shoulder that can extend to the neck or elbow
– Reduced movement and strength of the shoulder
– Reduced function
– A click may be present when moving the shoulder up
– Reduced ability to sleep, particularly when lying on the injured arm
– Note, that full tears may present as less painful as the nerve fibres have been torn, but will be weak and have poor movement

What can physiotherapy do?
– Assist with fitting of the sling
– Guide some pain management strategies
– Prescribe appropriate exercises to improve range and strength
– Guide your return to work, sport or hobbies

ACL injuries are common in sports such that involve pivoting, sudden turning, landing from a jump or twisting e.g. soccer, netball, gymnastics, rugby etc. The ACL, or anterior cruciate ligament, is one of the four ligaments in the knee that keeps it stable. One or more of the other ligaments may also be injured with the ACL. An MRI may be required to diagnose an ACL injury. Surgery is indicated if you experience instability, ongoing pain, or have a job/sport that requires a functional ACL.

Symptoms:
– Significant pain and swelling of the knee. Note, complete ACL tears can present with minimal pain
– Audible pop
– Knee gives way
– Feeling of instability when walking

What can physiotherapy do?
– An intense physiotherapy rehabilitation post reconstruction is extremely important to maximise recovery, prevent re-injury and have the best return to sport/work.
– Reduce swelling
– Improve range of the knee
– Progress mobility aids as appropriate
– Improve balance and proprioception (how the brain knows what the leg is doing)
– Gradual return to sport or work
– Prescribe exercises to prevent re-injury