Rehabilitation | City Physio Adelaide City

Groin Pain and Injury Treatment | City Physio Adelaide

Posted on August 8, 2024August 8, 2024 by Tucker Creative

Physiotherapy Treatment for Groin Pain and Strain

Experiencing groin soreness and pain can be frustrating and disruptive to your daily routine. While rest, ice-therapy, and anti-inflammatory medication can assist in the reduction of inflammation and pain related to groin strains, these alone are often not enough to fully recover from a groin injury.

Our physiotherapists will work with you to develop a personalised treatment plan that addresses the underlying cause of the problem.

By incorporating specific exercises and stretches into your routine, you can gradually regain mobility, strengthen the supporting muscles, and reduce the risk of re-injury. Our goal is to empower you to take an active role in your recovery and achieve long-term relief from groin pain.

At City Physio Adelaide, our physiotherapists design programs that focus on the specifics of your body and lifestyle. While everyone is different, if you are suffering from acute or even chronic groin pain you are likely to benefit from:

Increased Mobility: Groin injuries can significantly restrict your range of motion. Our exercises target the muscles and joints around your hips, including the often-overlooked adductors muscles. By increasing overall flexibility and ease of movement, we reduce any unnecessary stress put on your groin muscles.
Increased Strength and Stability: A strong core and hip musculature are crucial for supporting your groin and preventing re-injury. Our programs focus on strengthening key muscle groups, such as the glutes, abdominals, and adductors. By targeting these areas, we enhance stability, reduce strain on the groin, and improve overall performance.
Correction of Muscle Imbalances: Groin pain often stems from imbalances between different muscle groups. Our physiotherapists identify these imbalances and prescribe specific exercises able to address them. For example, strengthening the external rotators can help counteract the excessive tension in the adductors, reducing the risk of groin strain.

By combining these elements, our exercise programs help you regain full function, reduce pain, and ease recovery from injury.

Remember, consistency is key. Our physiotherapists are here to support you, ensuring you’re empowered to perform these exercises correctly and safely.

Groin Injury Recovery and Prevention

While many groin injuries can heal on their own with proper care, it’s important to seek guidance to avoid complications and prolonged recovery.

What might seem like a minor strain initially can develop into a more complex issue over time. When a significant groin injury occurs, other structures in the groin area can also be affected, prolonging your recovery. Incorrect management can lead to weakened muscles and increased susceptibility to re-injury.

Groin injuries can be frustrating or even debilitating. They impact your ability to play sports, work comfortably, or even complete daily activities. At City Physio Adelaide, we understand the challenges you’re facing and are committed to helping you recover fully and prevent future injuries.

Understanding Your Injury:

The first step to recovery is understanding the nature of your groin injury. While most groin injuries involve muscle strains or tears, some may be more complex, such as avulsion fractures or tendon damage. Our experienced physiotherapists will conduct a thorough assessment to accurately diagnose your aches and pains.

Supporting Your Recovery:

Our rehabilitation programs focus on the factors that contributed to your injury and the root cause of any associated pain. Our goal is to ensure a smooth, relatively painless recovery that gets you back to doing what you love as quickly and safely as possible.

Preventing Future Injuries:

Knowing the contributing factors to your injury not only allows us to ensure a safe and smooth recovery. It also helps us provide you with the mental and physical ability to avoid groin injuries occurring again in the future.

Biomechanical Assessment: We analyse your movement patterns to identify any imbalances or weaknesses that may have contributed to your injury. This information helps us tailor your treatment plan to your specific needs.
Hands-on Therapy: Our physiotherapists use techniques like manual therapy to reduce pain, improve flexibility, and restore normal movement in your hip joint.
Targeted Exercises: We prescribe specific exercises to strengthen the muscles around your groin, improve core stability, and enhance your overall athletic performance.
Load Management: We work with you to gradually increase your activity level, ensuring a smooth transition back to your sport or daily activities.
Returning to Sport and Activity: Our goal is to get you back to doing what you love as quickly and safely as possible.
Education and Prevention: Our physiotherapists will provide you with valuable information about groin injuries, including how to prevent future occurrences and manage your condition effectively.

What Causes Groin Pain and Injuries

Groin pain is a common complaint that can affect people of all ages and activity levels. While often associated with athletes, it can also occur in individuals who participate in minimal physical activity.

The groin region is a complex area comprised of muscles, tendons, and ligaments that work together to support movement. Overuse, injury, or underlying conditions can disrupt the normal function of these tissues, leading to pain and discomfort.

Common causes of groin pain include:

Muscle strains: Overstretching or tearing of the groin muscles is a common cause of groin pain.
Soft tissue injuries: Contusions or bruising of the soft tissues in the groin area can also lead to pain and discomfort.
Joint-related issues: Conditions such as hip arthritis or pelvic instability can contribute to groin pain.
Overuse injuries: Repetitive movements, especially in sports involving running, jumping, or kicking, can increase the risk of groin pain.
Referred pain: Pain originating from the lower back or abdomen can sometimes be felt in the groin area.

Understanding the underlying cause of your groin pain is crucial for effective treatment. At City Physio Adelaide, our experienced physiotherapists will conduct a thorough assessment to accurately diagnose your condition.

Muscle Strain in the Groin and Pelvis

Groin strains around your pelvis are fairly common in these muscles. Falling, sprinting, changing direction too quickly, kicking, or doing the splits accidentally, can result in groin strains. This can cause pain within your groin that radiates down your thigh.

Usually, the injury is to your muscle or tendon attachment and involves a strain of your muscle fibres. Your groin muscles can be repaired, however, they may become weakened or become susceptible to repeated injury.

Sometimes, the muscles may tear away from their bony attachments. These injuries are called avulsion fractures. If these avulsion fractures include severe displacement, surgical repair may be required.

Thankfully, most strains and tears can be helped with good physiotherapy treatment. Treatment may consist of rest, ice, compression, specific stretching and strengthening exercises, and a gradual return to activities.

Injuries to groin muscle-tendon units

Muscle-tendon units are commonly strained and injured in football. The muscles most commonly injured and strained are those in your abdomen and your largest groin muscle, your adductor longus.

A rectus abdominis strain is an injury that could cause acute or chronic groin pain. This strain involves injury to the rectus muscle of the abdominal wall, which attaches to the pubis. This injury can take a long time to recover from.

Adductor origin strain or tendinopathy

Adductor tendinopathy may occur after a specific incident (strain or tear) during activity, or it can appear gradually over time. You will notice symptoms of local tenderness over the adductor muscle and your pubic bone, pain on stretching your groin and on any resisted hip movement. It is believed that stretching of the groin muscles too early after an injury can lead to tendinopathy developing.

Adductor tendinopathy causes groin pain ‘high up’ near the pelvis, which tends to worsen with increasing activity. If adductor tendinopathy is left untreated, your pain can persist during activity and it may transfer either to the other side or to your pelvis and lower stomach area.

Treatment of adductor tendinopathy includes rest, physiotherapy treatment, remedial massage therapy, and eccentric strengthening exercises. Eccentric strengthening exercises are specific exercises designed for your condition by your physiotherapist to help strengthen your groin and prevent a recurrence of injury.

Experienced a Groin Injury? Book an appointment with City Physio!

Don’t let groin pain hold you back.

At City Physio Adelaide, we’re committed to helping you overcome groin pain and regain your full mobility. Our experienced physiotherapists will work with you to develop a personalised treatment plan tailored to your specific needs.

Adelaide Sports Injury Rehabilitation | City Physiotherapy

Posted on June 21, 2024June 24, 2024 by Tucker Creative

How does physiotherapy help a sports injury?

At City Physiotherapy and Sports Injury Clinic, our musculoskeletal and sports physiotherapists are dedicated to supporting you throughout your recovery from sports-related injuries. Our treatments are tailored to promote healing and ease injury-related pain. They also enhance your strength, flexibility, and mobility – ensuring you can return to the sports you love confidently and injury-free.

Whether you’re dealing with sprains, strains, tears, fractures, or anything in between, we’re here to provide you with a personalised treatment plan for sports injury rehabilitation.

Adelaide sports injury treatment and rehabilitation

Our team at City Physio is equipped to help you recover from a wide range of sports injuries. Common injuries we treat include:

Ligament sprains: These are especially common in sports that involve sharp changes in direction. Ligament sprains occur when the bone’s connective tissue is stretched or torn. We can help manage pain, swelling, and instability to promote healing and a safe return to your sport.
Muscle strains: Overexertion or trauma can cause strains or even tears in your muscles. Tears or strains are almost always accompanied by some combination of pain, weakness, bruising and swelling in the affected area.
Meniscus injuries: The meniscus is a piece of cartilage in the knee that acts as a shock absorber, cushioning your knee during movement. Unfortunately, meniscus tears are a relatively common sports injury, often caused by sudden twisting or pivoting motions.
Overuse injuries: Repetitive stress can lead to overuse injuries such as shin splints or shoulder impingement. These types of injuries occur when you overload a muscle, tendon, or joint over time, causing micro-tears and inflammation.
Post-surgical rehabilitation: Following surgery for a sports injury, physiotherapy is crucial for regaining strength, flexibility, and range of motion.

Physiotherapy treatments for sports injury recovery

Sports injuries can be frustrating, but that doesn’t mean you have to be sidelined for long. At City Physio, we offer a comprehensive range of treatments focused on facilitating a smooth recovery from an injury, so you can get back to playing your sport as quickly and safely as possible.

Remedial massage for sports injuries

Our remedial massage treatment goes beyond relieving everyday aches and pains. It offers targeted benefits to support your recovery from injuries. By identifying problem areas and providing hands on treatment, remedial massage can significantly speed up your healing process and ease pain.

How remedial massage helps in sports injury recovery

Improved sleep and reduced stress: Lowers cortisol levels and promotes better sleep, which is vital for healing and muscle repair. As an added benefit, better quality of sleep contributes to positive mood and improved pain management.
Enhanced blood flow: Increasing the blood flow to the injured area helps deliver oxygen and essential nutrients for healing.
Reduced inflammation: Flushing out inflammatory byproducts promotes reducing swelling, pain, and stiffness.
Faster healing and tissue repair: Removing cellular debris and inflammatory mediators creates an optimal environment for tissue repair.
Reduced muscle tension and spasms: Techniques like kneading and stroking relax tight muscles. This improves blood flow and reduces muscle spasm frequency and intensity, allowing comfortable movement and faster recovery.
Promotes relaxation and overall wellbeing: Easing muscle tension and reducing pain signals helps manage the stress associated with recovery and promotes a positive mindset for returning to sport.

Exercise programs while recovering from an injury

Sports injuries can limit your range of motion and hinder your ability to perform at your best. Our experienced physiotherapists offer personalised experience programs designed to help you regain strength, flexibility, and full functionality following an injury.

Strength training

Strength training is a crucial component of any sports injury rehabilitation program. It helps build stronger muscles that support your joints, reducing your risk of re-injury. Strong muscles also help maintain balance between opposing muscle groups. This is essential for proper movement that avoids aggravating your injury.

Muscle stability training

Your core and lower back muscles play a central role in maintaining stability and efficient movement throughout your body, especially in your lower limbs. Strengthening these core muscles helps your body transfer force more effectively during activities, reducing the risk of soft tissue injuries like hamstring strains. We also offer Pilates based exercise programmes to assist with your recovery. Pilates is a great way to improve core activation, control, and endurance, leading to better overall stability and a lower risk of injury.

Flexibility training

Maintaining good flexibility is essential for athletes of all levels. It allows you to move through a wider range of motion, which can improve your performance and reduce your risk of injury. This is especially important for sports that involve explosive movements, such as netball, soccer, or football. Stretching improves the elasticity of your tendons, making them more resilient to the demands of high-intensity sports activities.

Sports taping for injury recovery

Sports taping, sometimes called sports strapping or athletic taping, can be a valuable asset to ensure a smooth and safe recovery. This technique involves applying specialised tape to injured or vulnerable areas of the body to provide support, reduce pain, and enhance stability.

The benefits of sports taping for sports injury recovery:

Minimises pain and inflammation: Taping can help stabilise the injured area, reducing swelling and inflammation, especially in the early stages of recovery.
Improves stability: By limiting unwanted movement around a joint, taping can provide support and promote healing as the injured tissues mend.
Enhances body awareness: Taping can improve proprioception, which is your body’s awareness of its position in space. This can help prevent making the injury worse, as it helps you become more attuned to how your body moves post-injury.
Reduces unwanted movement: This helps protect the injured area and promotes healing.
Supports weakened areas of the body: Taping can provide support for muscles or joints that are weakened by injury.

What are the benefits of physiotherapy for athletes?

Engaging in sports, regardless of your skill level, often means pushing your body to its limits. While striving for peak performance is admirable, it also increases the risk of injuries. This is where physiotherapy steps in, offering benefits beyond just rehabilitation.

Setbacks can be frustrating, hindering your training and sidelining you from the game. Our experienced physios help perform at your best while reducing your risk of injury.

We create tailored programs designed to meet your specific needs and the demands of your sport. These focus on all aspects of your sport, including:

strength and flexibility training to prepare for competition
effective warm-up routines
posture and ergonomics during play
essential cooling down techniques

With our support, you can make game winning moves with far less risk of injury.

Reduce your risk of injury

Biomechanical assessment: Our physiotherapists will assess your movement patterns and identify any imbalances or weaknesses that could lead to injury. We can then design a personalised program to address these issues and improve your overall biomechanics.
Building strong foundations: We focus on improving key physical attributes essential for athletic performance, such as strength, flexibility, coordination, speed, and power. This well-rounded approach helps your body withstand the demands of your sport.
Corrective exercises and hands-on techniques: We’ll provide specific exercises to target any muscle imbalances or weaknesses identified in the assessment. Additionally, hands-on techniques like manual therapy can help improve mobility, flexibility, and tissue health.
Training load management and recovery strategies: By managing your training load effectively, we can help you to avoid overuse injuries. We’ll also develop personalised recovery plans that incorporate strategies like stretching, core strengthening, and proper sleep hygiene to optimise recovery after playing or training for a sport.

Improve your athletic performance

Insight and education: We’ll educate you on proper movement patterns, injury prevention strategies, and ergonomics specific to your sport. This empowers you to take an active role in your well-being.
Targeted exercises: Our exercise programs focus on strengthening the muscles, tendons, and soft tissues affected by an injury. We’ll also incorporate exercises to improve mobility, balance, and overall physical function, allowing you to return to your sport safely and confidently.
Remedial massage therapy: Massage therapy can promote healing, reduce muscle tension and pain, and improve blood circulation, all of which contribute to faster recovery.
Posture correction: Proper posture is crucial for optimal performance and injury prevention. City Physio can help you identify and correct any postural imbalances that may be putting stress on your body.

Book an appointment with City Physio Today

At City Physio, we understand the challenges associated with recovering from an injury.

Our team of experienced physiotherapists is dedicated to helping you get back to the sports you love as quickly and safely as possible. We offer a comprehensive range of physiotherapy treatments, including personalised exercise programs, remedial massage, and sports taping, all designed to address your specific injury and promote a speedy recovery.

For more severe sports injuries, we can refer you for imaging tests like X-rays, MRIs, or CT scans.

If you have experienced a sporting injury, schedule an appointment with City Physiotherapy today and start your journey towards recovery.

Injury in Winter Sports

Posted on April 14, 2022June 24, 2024 by Tucker Creative

Injury Prevention for Winter Sports in Australia

In Australia, sports are as big a part of our culture as eating, breathing, or sleeping; we love sports, and winter sports in Australia have players and spectators alike out in full force. Around 5.2 million Australians are injured in sport each year, these injuries are most common in May, June, and July. The most common injuries, in order of the rate of occurrence, are to the knee, ankle, foot, back, and shoulder. Many of these injuries arise from the very popular winter sports we play, so injury prevention is critical.

Why do injuries happen so much in winter sports in Australia?

As mentioned above, injuries peak in May, June and July. This is right in the middle of the winter sports season, so playing winter sports in Australia is a contributing factor to these injuries. There are three main reasons why injuries can happen so much in winter sports in Australia.

Winter Sports in Australia Contain Injury-Prone Movements

Most of the sports occurring in the winter season contain a lot of running, jumping, and quick changes of direction; these activities reflect the higher rate of knee, ankle, and foot injuries. In some of our most popular sports like rugby and AFL injuries can occur due to their high-contact nature, this reflects the higher rate of back and shoulder injuries with tackling and scrums.

Cold Weather’s Effects on the Body and Chance of Injury

These injuries are worsened by the cold weather. As your body tries to maintain your body temperature, blood flow moves away from the muscles; the lack of blood flow leads to the muscles producing less power, losing flexibility, and overworking. As muscles are working harder and are less flexible, they become more susceptible to strains, sprains, tears, and other types of injury. Read about the differences between strains and sprains.

Here is why some muscle groups are more at risk of injury in the cold.

Knees: The muscles that connect to the knee become stiffer in the cold, as such the knee ligaments become more vulnerable to tears and strains. This is the reason ACL injuries occur so much in winter sports in Australia.
Shoulders: A shoulder joint that hasn’t been warmed up properly will be limited in its range of motion, therefore putting stress on the surrounding muscles, tendons, and ligaments, possibly straining or tearing them.
Hips: Your hips bear the most amount of weight out of all the joints in the body. Excessive tightness or stiffness in the hip from the cold and an improper warm-up can damage ligaments.

Overuse and Lack of Recovery Leads to Injury

Many people who play winter sports in Australia may not play sports in summer or are not used to the intensity or amount of exercise, therefore increasing the risk of injury due to sufficient recovery strategies not being performed as well as your body being potentially overworked.

This is where City Physio comes in. We can provide you with strategies to improve recovery and help you when you’re overworked from lots of training and games.

Some other common complications from winter sports include:

Stress fractures
Knee injuries
Shin splints
Ankle sprains
ACL injuries
Muscle soreness
Shoulder injuries
Hamstring strains

City Physiotherapy can help prevent injuries

Here at City Physiotherapy, our philosophy is to address the factors that could lead to injury before an injury occurs. While this may not always be possible, this is where our injury prevention strategies come into play.

Muscle Imbalance Assessment

City Physio’s first line of defense against injuries is a muscle imbalance assessment. In this assessment, our experienced physios will look for weaknesses in certain muscle groups and how they can be strengthened in ways relevant to your sport.

Tailor-Made Program

Our physios can also develop with you a program that includes recommendations for warm-ups, stretching, and functional strength training. These will be specific to you and your sport, helping to address weaknesses, reduce the chance of injury and improve your performance in sport. For more information about sports physiotherapy, click here.

Recovery Strategies

For those involved in winter sports, recovery can be more than just effective warm-ups, stretching, and addressing muscle imbalances, our remedial massage therapy, and hands-on physiotherapy is just these types of extra recovery. Remedial massage is good for the release of pain and soreness that follows strenuous exercise.

Your hands-on physio session may include:

Soft tissue, trigger point & deep tissue treatment
Stretching and muscle release
Dry needling
Joint mobilisation & manipulation

All these treatments help the body recover from the damage and potential overuse caused by your sport or unique body mechanics.

Sports Taping and Strapping

If you’ve ever watched professional sports you would have seen the many different types of tape athletes use, taping and strapping in these sports limits and restricts the range of movement of an injured body region, usually around joints, helping to reduce or to control the pain of an injured or affected body part.

Prevent Injury This Winter Sports Season With City Physiotherapy

It’s the beginning of the season for winter sports in Australia, which means it’s more important now than ever to look after your body. Whatever winter sport you play, injuries can leave you sidelined, whether it’s Netball, AFL, Soccer, Basketball, Hockey, or Rugby injury prevention is key.

How To Treat A Pulled Hammy And Strained Quad

Posted on January 21, 2022August 22, 2024 by Linda Shacklock

A muscle strain, or pulled muscle, occurs when your muscle is overstretched or torn. This usually occurs as a result of fatigue, overuse, or improper use of a muscle.

Muscle strains are categorised as Grade I, II, or III. A small strain is classified as a Grade I tear, whereas a complete rupture or tear, is classified as a Grade III tear. Grade II tears are partial ruptures or tears. Severe Grade II and Grade III tears will cause loss of normal muscle function and you will probably see bruising around the area of your injury.

Grade I Strain

After a Grade I strain, it is possible to continue use of the affected muscle or muscle group. Grade I injuries tend to be mild and they mostly fully heal. With appropriate rest and physiotherapy rehabilitation, you can reduce the healing time of your strain.

Grade II and III Strains

A Grade II or III strain will cause you severe pain and thus all activity of the muscle should be ceased to limit pain and further injury; most likely you will not be able to move the affected muscles. Grade II tears can heal with physiotherapy rehabilitation, although your healing time is going to be longer. In the case of a Grade III tear, most likely a gap has formed in the muscle fibers of the quadriceps or hamstrings, you may not be able to bend or straighten your knee. Grade III tears usually require surgery and physiotherapy rehabilitation for full recovery.

Quadriceps strain information

A thigh strain or quadriceps strain is essentially a small tear in one of the four quadriceps muscles located the front of your thigh. Muscle strains can feel like a mild ache up to a severe pain or even result in the inability to run or walk, constricting movement of the affected muscles. A quadriceps strain can also be called a pulled quad muscle or a strained thigh.

What are the signs and symptoms that indicate one has a pulled quad muscle?

You will feel a sudden, sharp pain at the front part of your thigh
You will feel swelling and a bruise may form on your thigh indicating inflammation from the strain.
You may also feel a lump or muscle spasms in your thigh

Hamstring strain information

Hamstring muscle injuries — such as a “pulled hamstring” — occur frequently in athletes. A pulled hamstring or strain is an injury to one or more of the muscles at the back of the thigh. A hamstring strain can be a pull, a partial tear, or a complete tear. Most hamstring injuries occur in the thick, central part of the muscle called the muscle belly, or where the muscle fibers join tendon fibers.

In the most severe hamstring injuries, the tendon tears completely away from the bone. The tendon may even pull a piece of bone away with it as it separates.

What are the signs and symptoms that indicate one has a hamstring strain?

You will notice a sudden, sharp pain in the back of your thigh.
You will feel swelling in the first few hours after injury.
Bruising and discolouration may also form on the back of the leg, below the knee over the first few days.
Weakness can also persist in your hamstring for weeks.

In the case of a Grade III tear, most likely a gap has formed in the muscle fibers of the quadriceps or hamstrings, you may not be able to bend or straighten your knee.

Common causes for quad strain and hamstring strain

A quadriceps strain or hamstring strain are common during running or jumping movements, especially during sudden movements or if you are starting and stopping quite suddenly, which can occur in some sports. However, you could just as easily pull your quadriceps or hamstrings while weightlifting, working out in your garden or falling over into a hole.

What will increase your risk of straining your quadriceps muscle or hamstring muscles?

You will increase your risk of straining any muscle by not warming up adequately before you run or exercise

Hip flexor or quadriceps muscle tightness can increase your risk of muscle strain. Poor muscle recruitment and activation or weakness in your gluteal or buttock muscle will overload your quadriceps predisposing you to injury.

In the case of hamstring strains, muscle imbalance from an overdeveloped quadriceps muscle leads to a faster rate of fatigue and higher chance of injury. Muscle overload is the largest cause of hamstrings strains, so weak and poorly developed ones will buckle under the stress of the stronger quadriceps. Focus on stretching and strengthening the hamstrings to reduce risk of injury.

Pushing yourself too quickly, e.g. running too fast when you haven’t trained for the activity or intensity; performing exercises that your quadriceps muscles are not used to or haven’t performed previously; overtraining and not allowing proper time for rest and healing.

Contact us today to enquire about an appointment. Call 8212 4886 or book online for an assessment from one of our qualified and highly experienced physios.

Understanding Running Related Injuries

Posted on May 6, 2020September 13, 2024 by Linda Shacklock

Running-related injuries – let’s break it down

Running has been shown to provide numerous health benefits and research has continued to encourage running as a safe and effective form of exercise. With the recent coronavirus pandemic, more people are be looking to running as their primary form of exercise. Despite the numerous physiological and psychological benefits of running, there are some associated lower limb injury risks. The fact is that over 50% of runners experience a running-related injury each year, this might lead you to wonder if the risk is worth the reward. In this blog, I hope to guide people on how to get the best out of running while reducing your risk of injury.

Running related injuries are most commonly attributed to the following:

Anatomical factors – This refers to our physical appearance prior to running. Factors such as body composition, height and resting posture may have an effect on load distribution during running. There is little evidence that these factors are responsible for running-related injuries and I believe injuries are often incorrectly attributed to anatomical factors. The theory is that the physical appearance of the body usually develops over a long period of time. That means the body has time to adapt to the changes in load. Unless there has been a sudden change in your physical appearance this is not something to be too concerned about.

Biomechanical factors – This refers to the way we move, particularly our running form or gait. Assessing running form and biomechanics is a complex task and often it is difficult to change. There are some minor changes that have been agreed upon to elicit positive change, such as increasing a runners cadence (more steps per minute). This can improve running efficiency, which is generally associated with reducing running-related injuries.

Training error – This refers to errors in the training regime, which may include the type of training, the intensity, the frequency and the duration of training. In my experience, the majority of injuries can be traced back to a training error. Here are some tips on what to record and how to progress your training effectively while reducing your injury risk:

1. Track how you feel

One of the easiest methods to track your training is using a training diary. This will contain basic information such as distance, time, pace and perceived level of exertion (PE). The latter is particularly important in gauging how much a particular run has stressed the body. The PE score is usually out of 20, indicating how hard or tough the training session felt to the runner. The runner keeps track of their running and reviews the diary on a weekly or monthly basis. This can help the runner identify when they might be overtraining or progressing the training too fast. Other indications of overtraining include increased muscle soreness after training, persistent fatigue (tiredness), poor sleep and general irritability.

2. Take at least one rest day a week

Resting is when the body recovers from the stress of exercise. This is when tissues rebuild and the body adapts to make us fitter and stronger. It is essential to take resting seriously and try to minimise any additional stress to the body (this includes everyday stressors such as physical work). When starting out as a runner I would recommend having a rest day in between every training day.

3. Make sure the training is progressive

It is well known that improvements in fitness will only occur if we push our bodies further or faster over time. This should be done very gradually and over a sufficient period of time to allow the body to adapt. Rapid progression can lead to overuse or excessive tissue stress. The key is to progress slowly, a recommended guideline may be to increase by 5-10% every second week.

If running is something you or a family member would like to take up, try using a progressive training program and keeping a training diary to monitor your progress. I hope this will assist you in getting the best results and help you stay injury-free. If you are suffering from a running-related injury come in for a physio assessment and treatment and let City Physio get you back up and running.

Happy Running.

References:

Napier, C. and Lewis, A., n.d. Science Of Running. New York: DK Publishing.
Bramah, C., Preece, S., Gill, N. and Herrington, L., 2019. A 10% Increase in Step-Rate Improves Running Kinematics and Clinical Outcomes in Runners With Patellofemoral Pain at 4 Weeks and 3 Months. The American Journal of Sports Medicine, 47(14), pp.3406-3413.

Tracking Your Injury Recovery Progress

Posted on November 3, 2019August 23, 2024 by Linda Shacklock

Recovering from an injury takes time and tracking your injury recovery progress can be a challenging time for you. Your recovery process can be influenced by a large number of factors all influencing the time taken for you to fully recover. Depending on the severity, nature and duration of your injury, it can take longer to improve than initially expected. Tracking your recovery progress during this process is important for both you the patient and your physiotherapist. There are two key outcomes to consider when we are tracking your recovery, namely your pain and function. These include your pain levels, the severity and nature of your pain and the frequency of your pain to name a few. Your function includes things like the quality of your movement, stiffness or range of movement and your strength and endurance capacity.

Patients and some physiotherapists often only track the reduction in pain intensity without further investigation into changes in pain behaviour or changes in your overall function. Below are examples of questions that we may ask you when tracking your recovery from injury progress:

Pain

How much activity takes place before experiencing pain?

Are you experiencing pain less often throughout the day?

Does it take longer to provoke pain and does it settle down easier?

How has your pain changed during activities of daily function and sleep?

Do you find yourself less distracted by your pain?

Has the nature, area or associated symptoms of your pain changed? (Less sharp or duller? More isolated to a single area? Less associated pins and needles, numbness or swelling?)

If your pain has increased, what activities have you undertaken that may have contributed to this occurring? ie did some gardening, shifted some furniture, did an exercise class at the gym you thought would be ok but stirred up your symptoms etc.

Function

Have you seen an improved range of motion and quality of movement in the injured area?

Do you experience improved strength, endurance and power?

Have you gained the ability to perform previously challenging tasks?

Are you able to perform more of your everyday tasks with less difficulty?

Have you seen improvement in the quality of your sleep?

Do you experience less fatigue towards the end of the day?

During the recovery process, it is important for us to ask you these kinds of questions. It can be demotivating and frustrating when progress becomes stagnant and reaches a plateau. However, it may only seem stagnant due to the focus only being on the overall reduction in pain intensity. Being more aware of the wider range of improvements during your recovery process is a great source of motivation and optimism for your overall recovery process.

At City Physiotherapy our highly skilled Physiotherapists are constantly tracking the progress of your injury recovery in order to tailor a bespoke rehabilitation and treatment plan for you. We do this by asking you the types of questions above and also by using our hands to palpate your muscles, joints, soft tissues, tendons, ligaments or nerves. We are skilled in feeling the quality of your tissues and can track changes in areas of your body such as your joint range of movement, your muscle pliability, regions or areas of tension or adhesions, muscle length, fascial or nerve tension, scar tissue pliability, amount or region of swelling or haematoma ( bruising ). Another way we can track your progress is to watch the way you move. This can be as simple as observing the way you walk, get out of a chair, sit, lie down, bend over to take off your shoes or remove items of clothing to more specific movements that relate to your particular injury and recovery such as squatting, running, hopping, lifting, gripping, lifting arms above head etc. We are observing how easy or difficult it is for you to perform these types of movements and all of this information assists us in determining how we progress your treatment and recovery process.

Sprained Ankle in Runners

Posted on September 30, 2019August 22, 2024 by Linda Shacklock

It’s true that most of us don’t want to stop running when we are in injured. How often have you heard someone say their ankle injury was just a twisted ankle? As Physiotherapists in a busy sports injury clinic, we hear this quite a bit, but unfortunately, it is often well after someone sprains their ankle. Sometimes it is months down that track that help is sought by patients as the sprain has not healed and may still be causing pain or there is difficulty getting back to preinjury running form. This article discusses the sprained ankle in runners and highlights that there is often more going on than simply a twisted ankle.

Ankle Sprains can be divided into three categories. A Grade I is a minor sprain or twist. Ankle ligaments are overstretched, but there is usually no other damage. Grade II is a more severe sprain with marked ligament tearing and Grade III involves a major rupture of the ligament away from the bony attachment that may need surgery to repair it.

A severely sprained ankle in runners sometimes involve small fractures of the foot or ankle bones and it is imperative for future health of your foot and or ankle joint that if a fracture is present, that the appropriate treatment is provided. At City Physiotherapy your physiotherapist is qualified to refer you directly for an X-ray or MRI if we feel it is required.

A simple rule to remember is if you can’t put weight through your ankle then you must get an X-ray, especially if your pain is felt near-certain foot bones. If you hear a popping or cracking sound or your ankle swells up rapidly and you have a lot of bruising or discolouration of your skin then these are also signs that you should get an X-ray to check for any signs of a fracture.

There have been many research studies performed over the past 20-30 years on ankle sprains and the evidence all points to receiving professional assessment and rehabilitation as the key to a successful recovery. Even for a Grade II sprained ankle in runners, failure to rehabilitate could delay return to full activity by several months.

One research study from 1999, undertaken by Barbara Braun of Health System in Minnesota, examined 467 sprained ankle patients. The study revealed that most of the participants still had pain and weakness in the ankle and foot from six to eighteen months post-injury. Approximately one-quarter of these participants couldn’t even walk for 1.5kms without pain, and almost twenty per cent of the participants had managed to re-sprain the same ankle, some people did this more than once!

With the right kind of rehabilitation, most ankle sprains can be helped. Luckily for runner’s and athletes alike, rehab involves getting back to weight-bearing activity as soon as your ankle will tolerate it. This doesn’t mean getting back to running straight away though.

What we do know is that the quicker you begin your ankle rehabilitation, the more quickly you can get back to your preinjury condition and running. At City Physiotherapy your physiotherapist your treatment may consist of hands-on treatment, soft tissue and joint mobilisation, dry needling, taping and support and rehab exercises.

We no longer use RICE or PRICE as current research has shown us this is not as helpful as we used to think it was and some aspects of this may actually delay healing. Nowadays the initial treatment follows the new acronyms of PEACE and LOVE. PEACE is to Protect, Elevate, Avoid Anti-Inflammatories, Compression, Education and then after the first few days we apply LOVE which is Loading, Optimism, Vascularisation and Exercises. For more information on current treatment and management of soft tissue injuries using PEACE and LOVE read our blog article by clicking on the link : https://cityphysiotherapy.com.au/rice-soft-tissue-injury-treatment/

Some of the well-known exercises such as drawing the alphabet in the air with your ankle and using theraband (elastic bands) to strengthen your ankle muscles are still good ankle rehab exercises. Don’t forget to stretch your Achilles tendon and calf muscles as these can tighten up quickly with a sprained ankle. Further down the track, we start with some basic weight-bearing exercises, like leaning against a wall whilst squatting. At City Physiotherapy your physiotherapist will guide you with which exercises are right for you and when to progress them.

This is the point where most runners stop rehab and treatment but it is important to follow through from here as simply getting back to running can lead to recurrent ankle sprains or weakness in your ankle muscles.

In order to stop yourself from spraining your ankles repeatedly, also called chronic ankle instability, you will need to perform specific strength rehab exercises.

Your peroneal muscles, which are situated on the outer side of your lower leg, need to remain strong and with good reflex action as these can stop your ankle from rolling. Your foot muscles also need to be strengthened as running is actually a single leg activity – think about how you propel yourself forward whilst one foot takes the impact the other foot is in the air.

In order to have good reflex action, your muscles need to have good proprioception. Proprioception is your body’s internal sense of its position and ensures you can balance. When you sprain your ankle, you not only get weaker muscles from the injury, but you interrupt the nerves that provide you with good proprioception. Both of these factors together can lead to your balance remaining poor, which in turn can lead to chronic ankle instability and recurrent ankle sprains. There are loads of balance exercises we can undertake. One of the more common balance exercises is to try and stand one foot with your leg slightly bent. Your physiotherapist will guide you as to which balance exercises are best for you and how to progress your ankle rehabilitation. It is important to be patient as your proprioceptive ability can take quite a few months to recover. If you persist then you will improve your proprioception, balance and foot strength. Now you are ready to get back to running safely.

If you feel your ankle sprain recovery isn’t progressing quickly enough, you might have bruised a bone, developed chronic ankle instability from repeated sprains or developed a stress fracture, which can show itself with the same symptoms as a strain or sprain. If your ankle ligaments have been overstretched one too many times your recovery will be slow you should seek the assistance of your physiotherapist if you haven’t already done so by this stage. They will devise a personalised strategy and treatment plan to improve your ankle instability and get you back to running pain-free.

Give City Physiotherapy a call on 8212 4886 Monday – Friday between 8am -6pm and Saturdays from 8.30am- 2pm or book online 24/7 at https://healthengine.com.au/book/46470

RICE | Should we still be using this treatment for soft tissue injury?

Posted on July 15, 2019August 22, 2024 by Linda Shacklock

It’s time for an alternative to RICE (Rest, Ice, Compression, and Elevation). It’s Time for PEACE and LOVE for soft tissue injury instead.

RICE is the most commonly advised treatment for acute soft tissue injuries. It is so common that it very rarely needs repeating. Anyone that has taken part in any sport or a form of structured exercise, would have come across this acronym. However, despite its popularity and relative success, science might be pressing us for an alternative.[1]

Karl Meiring, Musculoskeletal & Sports Physiotherapist at City Physiotherapy gives us the latest evidence & advice for the best management of soft tissue injuries.

Here is the problem.

RICE is mainly focused on the immediate care following injury, without giving attention to the injury as it progresses through the stages of healing.[2] There is no convincing evidence that implementing the RICE strategy will do any harm, however, there might be different strategies that offer more benefits when recovering from injury.[2] The rest component would be an obvious initial treatment, but how much rest is enough? Too much rest might be leading us down a path of avoidance behavior when it might be time to return to graded activity. Too much-unwarranted rest can lead to deconditioning and a reduced ability to manage the physical demands of exercise. The second component (ice) can certainly numb the pain for short term pain relief but is this the best course of action. There may be some evidence suggesting adverse effects in the long term from removing pain and swelling too quickly.[3]

Lastly, the overall view of inflammation has changed significantly in the last few years. We are now starting to understand the benefit of inflammation in acute injuries. Our obsession with removing all pain and swelling associated with inflammation might be detrimental.[4] Removing some pain is often necessary, but pain can be a useful guide and it allows us to know when to rest and when to move. Swelling can be similarly useful in stabilizing an area during the healing process. Inflammation is an integral part of the healing process, removing it may disrupt this and delay recovery.[4]

An alternative acronym for acute/immediate management is PEACE.

[1] P (Protect) – This would replace rest as protection can still occur while being active. E (Elevate) – Unchanged. A (Avoid anti-inflammatories) – Respecting the acute inflammatory process. C (Compression) – Unchanged. E (Education) – Talking to your Physiotherapist about your injury and what exercise might be safe to take part in. Understanding your injury can also help with pain management. [7]

After the first few days following an injury, the acronym LOVE can then be applied.

[1] L (Load) – Early loading can be very beneficial. It can stimulate tissue healing and recovery. [6] O (Optimism) – A positive mental state can certainly help you through the recovery process. [7] V (Vascularisation) – Moving more, loading early if appropriate and exercise can all improve blood flow to the injured area. [5] E (Exercise) – Has a wide variety of benefits and if the injury is something that might take time to heal it’s important to find out how you can continue enjoying these benefits. [5,6]

In summary, I believe poor early management can often lead to chronic pain and long-term dysfunction. It is important for you to address injuries early and appropriately. If you’ve suffered an acute injury or struggling with recovery, make an appointment with City Physio to help guide you through the healing process.

1) Dubois, B. and Esculier, J. (2019). Soft tissue injuries simply need PEACE & LOVE | BJSM blog – social media’s leading SEM voice. [online] BJSM blog – social media’s leading SEM voice. Available at: https://blogs.bmj.com/bjsm/2019/04/26/soft-tissue-injuries-simply-need-peace-love/ [Accessed 25 Jun. 2019].

2) van den Bekerom MPJ, Struijs PAA, Blankevoort L, et al. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults. J Athl Train2012;47: 435-43.

3) Singh DP, Barani Lonbani Z, Woodruff MA, et al. Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Front Physiol2017;8: 93.

4) Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle sprains: Update of an evidence-based clinical guideline. Br J Sports Med2018;52: 956.

5) Bleakley CM, O’Connor SR, Tully MA, et al. Effect of accelerated rehabilitation on function after ankle sprain: Randomised controlled trial. BMJ2010;340: c1964.

6) Khan KM, Scott A. Mechanotherapy: How physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med2009;43: 247-52.

7) Lin I, Wiles L, Waller R, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: Systematic review. Br J Sports Med2019; Epub ahead of print

Common Weight Training Injuries

Posted on February 5, 2018September 29, 2024 by Linda Shacklock

WEIGHT TRAINING INJURIES

Improper weight-training techniques can lead to weight training injuries. The most common areas to be injured are the back, shoulders, and knees.

Back Injuries

Back sprains and strains most commonly result from improper lifting technique when performing exercises such as bench presses, deadlifts, and rows. Sprains involve stretching of ligaments while strains involve stretching of muscles or tendons. Initial treatment involves the R.I.C.E. method (i.e. Rest, Ice, Compression, and Elevation). Assessment and treatment by your physiotherapist at www.cityphysiotherapy.com.au are also valuable. At City Physio your Physiotherapist can help you minimise the risk of obtaining weight training injuries.

Training Tip: The risk of back injuries can be reduced by maintaining a neutral spine and avoiding flexing or extending the lower back under heavy load.

Shoulder injuries

Lifting weights overhead incorrectly can lead to injuries such as shoulder impingement syndrome and rotator cuff damage. Shoulder impingement syndrome is when swelling and inflammation of structures in, and around the shoulder results in pain in the front and side of the shoulder/upper arm. Rotator cuff damage causes pain and weakness of shoulder movement. Treatment for these conditions may include physiotherapy and anti-inflammatory medication in minor cases; and cortisone injections and potentially surgery in more serious cases.

Training Tip: The risk of shoulder injuries increases with excessive repetitions. Ensure you also train other body parts to give your shoulders adequate recovery time between training sessions.

Knee Injuries

Repetitive knee exercises such as squats, lunges, deep knee bends, jumps, knee extension and leg lifts can cause pain at the front of the knee. Injury to the patellar tendon (the tendon that connects the kneecap to the shin bone) can occur with overuse. Small tears develop in the tendon leading to pain just below the kneecap. Treatment in the form of physiotherapy and a patellar tendon strap often helps to reduce symptoms and your doctor may also recommend anti-inflammatory medications.

Training Tip: Ensure that your kneecap tracks correctly (i.e. over the outside of the foot) during squat and lunge exercises.

If you feel pain from weight lifting in the gym seek treatment and corrective strategies from us at City Physiotherapy (www.cityphysiotherapy.com.au). The longer you keep training with an injury or small niggles that can turn into bigger injuries, the longer your recovery time will be. Seek help early and keep yourself in the gym – there is no need to suffer from weight training injuries.

REFERENCES:

Aasa U, Svartholm I, Andersson F, et al. Injuries among weightlifters and powerlifters: a systematic review. Br J Sports Med 2017; 51:211-220.
Kerr ZY, Collins CL, Comstock RD. Epidemiology of weight training-related injuries presenting to United States emergency departments, 1990 to 2007. Am J Sports Med 2010; 38(4): 765-71.
Mazur LJ, Yetman RJ, Risser WL. Weight-training injuries. Common injuries and preventative methods. Sports Med 1993; 16(1): 57-63.
Siewe J et al. Injuries and Overuse Syndromes in Competitive and Elite Bodybuilding. Int J Sports Med 2014; 35: 943-948.
Siewe J et al. Injuries and Overuse Syndromes in Powerlifting. Int J Sports Med 2011; 32: 703-711.
Weisenthal BM, Beck CA et al. Injury Rate and Patterns Among CrossFit Athletes. The Orthopaedic Journal of Sports Medicine 2014; 2(4): 1-7.

To Ice or Not to Ice After Injury?

Posted on June 16, 2017August 22, 2024 by physioadmin

Ice can be very effective if applied immediately after an injury, to limit the extent of the injury, or during the recovery phase to help reduce pain and swelling.

Excessive inflammation and swelling from an acute sports injury can lead to a secondary injury occurring. Ice is a relatively safe way of limiting any secondary injury you may suffer after an acute injury, while not impeding your bodies healing process.

Ice works by decreasing our body’s inflammatory response. However we also know that the inflammatory response is very important during the first few days of the healing process and you could argue that you might hinder your healing process by using ice. Read further to find out why.

Some studies have found that taking anti-inflammatory drugs (NSAIDS and corticosteroids) can interfere with our bodies healing process. These drugs stay in our system for 6 hours or longer whereas the cooling effect of ice only lasts a few minutes.

Anti-inflammatory drugs have a direct effect on how the inflammatory chemicals work in our tissues, whist ice mainly affects swelling through decreasing circulation of our blood to the injured area. Don’t take anti inflammatory drugs in the first few days after an injury as these drugs also have an anti- coagulant effect which means they increase bleeding – definitely not what you want to do after an injury!

Immediately after an injury

Ice should be used immediately after sustaining an injury to decrease the amount of bleeding and swelling. This is important since both excessive bleeding and excessive swelling will cause an increase in the pressure on the tissues and cells adjacent to the injury.
This increased pressure can cut off the blood and oxygen supply to the adjacent, undamaged cells causing them to die. This is referred to as a secondary injury because it wasn’t caused by the same incident that caused the first injury.
Excessive swelling or bleeding will cause an injury to be more severe and take longer time frame to heal.

How to apply Ice

Always have a wet towel or cloth between your skin and the ice to prevent it from burning your skin.
Apply the ice for 10 minutes with gentle compression over the injured area. I use regular cling film to wrap around the body part. It keeps the ice in place and also provides compression to help stop bleeding.
Do not leave the ice on for more than 10 minutes or use strong compression as this can have the opposite effect.
It also helps to stop the bleeding if you can have the body part elevated in a supported position above the level of your heart.

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