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PELVIC FLOOR: POSTURE

PELVIC FLOOR: POSTURE

Pelvic Floor: Posture

PELVIC FLOOR: POSTURE is a very important area if you have issues with urinary incontinence, pelvic pain, etc.  The muscles of the pelvic floor support the abdominal and pelvic viscera.  These muscles are active in standing and sitting. Furthermore, because the abdomen is a fluid-filled cavity, intra-abdominal pressure  is distributed in all directions.  The Pelvic Floor muscles, which form the floor of the abdominal cavity, contribute to its muscle control.

As a result of this contribution to control of intra-abdominal pressure, the muscles of the pelvic floor are likely to contribute to control of the spine and pelvis. The slouched posture places a lot of pressure on our internal organs and pelvic floor. This can cause a worsening of:

  • urinary incontinence,
  • pelvic pain,
  •  symptoms related to prolapse,
  • and rectus diastasis.

Pelvic Floor: Posture, sitting slumped

  • Research has shown that when we sit in a slumped posture, our pelvic floor muscle activity is much less than when we are sitting tall.
  • Pelvic Floor: Posture IS VERY IMPORTANT!
  • slouched sitting postures decrease the activity of your transverse abdominal muscles.
  • A Proper breathing pattern encourages the pelvic floor to move more dynamically.
  • Dysfunctional breathing patterns inhibit this dynamic movement of the pelvic floor.

Pelvic Floor: Posture,  

  • An assessment by a Pelvic Health Physiotherapist includes a thorough postural examination.
  • Your Pelvic Health Physiotherapist will be able to identify your unique postural compensations
  • They can help guide you on the road to improved body posture awareness.

CHECK OUT THIS LINK FOR FURTHER INFORMATION.

At PhysioNow, we have fully trained Pelvic Health Physiotherapists that can help to assess and treat pelvic issues like the following conditions:

  • Constipation
  • Dyspareunia
  • Endometriosis
  • leakage of urine
  • pain with intercourse
  • pelvic organ prolapse
  • pelvic pain
  • urinary incontinence
  • vaginismus
  • erectile dysfunction

If you or someone you know suffers from one of these conditions, give us a call today.  We would be happy to help!

  1. Sapsford, RR. et al (2006) Sitting posture affects pelvic floor muscle activity in parous women: an observation study. Aust L Physiother. 52(3):219-22
  2. Reeve, A., Dilley, A., (2009) Effects of posture on the thickness of Transverse Abdominal Muscle and Pelvic Floor Muscle Exercises for Stress Urinary Incontinence: A Randomized controlled Trial. J Phys Ther Sci. 26(8): 1161-1163.

Peroneal tendinopathy

Peroneal tendinopathy

Peroneal tendinopathy

Peroneal tendinopathy or peroneal tendonitis is characterized by an aching pain and swelling in the perineal tendons. These are located in the lower, outside portion of the ankle. A tendon is soft-tissue that attaches a muscle to a bone. The muscles involved in this condition are the 2 peroneal muscles in the lower leg, called the peroneus longus and the peroneus brevis.

Anatomy

?There are two peroneal tendons that run along the back of the fibula. The first is called the peroneus brevis. The term “brevis” implies short.  It is called this because it has a shorter muscle and starts lower in the leg. It then runs down around the back of the bone called the fibula on the outside of the leg and connects to the side of the foot.  The peroneus longus takes its name because it has a longer course. It starts higher on the leg and runs all the way underneath the foot to connect on the other side of the foot. Both tendons, however, share the major job of turning the ankle to the outside. The tendons are held in a groove behind the back of the fibula bone.

Causes of Peroneal Tendonitis

  • A sudden increase in weight bearing activities, particularly walking, running or jumping
  • Inadequate or unsupportive footwear
  • Muscle imbalances of the lower limb
    Poor lower limb biomechanics
  • Incomplete rehabilitation following an acute ankle injury, such as an ankle sprain

Symptoms of Peroneal Tendinopathy

  • Gradual worsening pain over the outside of the ankle
  • Pain during and/or after weight bearing activities
    Pain with turning the foot in and/or out
  • Instability around the ankle when weight bearing

Diagnosis

A full examination from a physiotherapist can be all thats needed to diagnose peroneal tendonitis
Patients with this condition usually experience pain behind the outside ankle during activities putting stress on the perineal tendons. Pain can also be noticed following these activities or following a rest period. This may be noticed especially upon waking in the morning. There may be swelling when the injury first happens. There will also be pain when testing resisted foot movements.  Stretches into various positions of the foot inversion, and resisted movements can cause pain behind the outside ankle.
Diagnosis may be confirmed with an MRI scan or ultrasound investigation
a diagnostic Ultrasound may be used for detecting all types of peroneal injuries.

What else could it be?:

Symptoms of peroneal tendinopathy mimic various other conditions of the ankle joint. So, before diagnosing peroneal tendinopathy we should rule out other possible injuries by doing the following tests:
Ankle Sprain: ligament testing by the Physiotherapist
Ankle fractures: special tests by the Physiotherapist
Os trigonum syndrome: MRI, physiotherapy testing
Chronical lateral ankle pain with other cause: MRI
Longitudinal peroneal tendon tear: MRI
Peroneal subluxation: ultrasonography, CT, MRI or peroneal tenography
Flexor Hallucis longus tendon injury

Physiotherapy rehabilitation

Treatment for peroneal tendonitis includes a program of stretching, strengthening, mobilisation and manipulation. It also includes proprioceptive exercises, icing, ankle bracing or k-taping during contact sports. If symptoms are severe, a cast or ROM boot immobilization may be worn for 10-20 days. After symptoms resolve, you will begin a progressive rehabilitation programme along with a gradual increase to full activity.

The use of a biomechanical ankle platform (BAPS), deep tissue friction massage, ultrasound electric stimulation can also be included in the physiotherapy
Also, shock wave therapy (ESWT), acupuncture is used to treat tendinopathy. But there is only limited evidence from studies for these treatments.
There is evidence for using manual therapy, specifically the lateral calcaneal glide.

If you have any further queries please call PhysioNow. Our experienced physiotherapists would be happy to help you. Call Today to get started 289-724-0448.!

Hip fracture

Anatomy of Hip
A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is based on the bones and soft tissues affected or on the level of the fracture.
Older people are at a higher risk of hip fracture because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.

? Signs and symptoms of a hip fracture include:
• Inability to move immediately after a fall
• Severe pain in your hip or groin
• Inability to put weight on your leg on the side of your injured hip
• Stiffness, bruising and swelling in and around your hip area
• Shorter leg on the side of your injured hip
• Turning outward of your leg on the side of your injured hip

? Causes of Hip fracture
• falling on a hard surface or from a great height.
• blunt trauma to the hip, such as from a car crash.
• diseases such as osteoporosis, which is a condition that causes a loss of bone tissue.
• obesity, which leads to too much pressure on the hip bones.

? Types of Fractures
In general, there are three different types of hip fractures. The type of fracture depends on what area of the upper femur is involved.
Intracapsular Fracture
These fractures occur at the level of the neck and the head of the femur, and are generally within the capsule. The capsule is the soft-tissue envelope that contains the lubricating and nourishing fluid of the hip joint itself.

Intertrochanteric Fracture

This fracture occurs between the neck of the femur and a lower bony prominence called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. Intertrochanteric fractures generally cross in the area between the lesser trochanter and the greater trochanter. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.

Subtrochanteric Fracture

This fracture occurs below the lesser trochanter, in a region that is between the lesser trochanter and an area approximately 2 1/2 inches below .

In more complicated cases, the amount of breakage of the bone can involve more than one of these zones. This is taken into consideration when surgical repair is considered.

Treatment for hip fracture: usually involves a combination of surgery, rehabilitation and medication.

? Surgery
The type of surgery you have generally depends on the location and severity of the fracture. Are the broken bones properly aligned? (displaced fracture. What is your age? What are your underlying health conditions?

The options include:

• Internal repair using screws. Metal screws are inserted into the bone to hold it together while the fracture heals. Sometimes screws are attached to a metal plate that runs down the upper thigh.

• Partial hip replacement. If the ends of the broken bone are not lined up or damaged, your surgeon may remove the head and neck of the femur and install a metal replacement (prosthesis).

• Total hip replacement. Your upper thigh and your hip socket are replaced with an artificial one (prostheses). Total hip replacement may be a good option if arthritis or a prior injury has damaged your joint. This may have been affecting your hip function even before the fracture.

? Rehabilitation

Rehabilitation is begun as soon as possible after hip fracture surgery, often within a day. The initial goals are to help people retain the level of strength they had before the fracture. You want to keep moving to prevent loss of muscle. You also want to prevent problems that result from bed rest. The ultimate goal is to restore your ability to walk properly without a limp.

Benefits of Rehab

Rehab will help you:

• Restore normal movement in your joint
• Build up strength in the joint and surrounding muscles
• Ease pain and swelling
• Let you get back to your normal activities including walking without a limp
• Help with circulation, particularly right after surgery, so you don’t have problems with blood clots

If you have or someone you know has fractured a hip or had hip replacement surgery, please call PhysioNow. Our experienced physiotherapists would be happy to help with your recovery! Call today to book an appointment!

Trochantric bursitis


Trochanteric bursitis

 

The Trochanteric Bursa is a fluid filled sac near the hip joint. It cushions between the bones and the muscle and acts as a shock absorber. Trochanteric bursitis is the inflammation of the bursa which is at the outside of the hip.

When this bursa is irritated it causes pain on the outside of the hip and thigh.  Sometimes you may feel the pain down to the knee on the same side.  Another symptom is pain which will stop you from lying on your painful side.  It will be painful when you press on a specific spot on the outside of the hip.  The pain gets worse when climbing stairs, getting up from a low chair getting out of a car.  Sitting with crossed legs hurts.  Both  walking and running may also cause increased pain.

Causes of Trochanteric Bursitis

  • Any direct Injury to the outside of the hip like falling, or bumping into an object.
  • Incorrect posture due to muscle imbalance
  • Leg length difference.
  • Stress of soft tissues surrounding the hip due to hip Osteoarthritis
  • Friction of the ITB (Ilio Tibial Band: a muscle along the side of the hip)
  • Overuse injuries like standing for long periods of time
  • Other diseases which affect the hip like Rheumatoid Arthritis
  • Previous surgeries around the hip
  • Very rarely infection of the bursa

Registered Physiotherapy Treatment

Your Registered Physiotherapist can help you to reduce the pain and inflammation.  They will use electrotherapy modalities, taping, or acupuncture.  They will give you  advice on activity limitations in the early stages.

Later the treatment is focussed towards increasing the flexibility and strength in the muscles.  Your Physiotherapist will  increase the hip joint range of movement and correct your hip joint mechanics.

Trochanteric bursitis

Trochanteric bursitisTrochanteric bursitis

Finally the focus is towards preventing it from happening again.

General Advice on prevention

Your Registered Physiotherapist will look at your posture, hip stability, and core strength.  They will look to see if you  need Orthotics to address any problems with your legs or feet.

 Tips for prevention of Trochanteric Bursitis:

  • Whenever you start a new activity, try to take it slow and build up your activity level gradually.
  • Start with  less force or resistance, less repetitions and progress gradually.
  • Avoid or modify repetitive activities if it is putting any stress on the hip joint
  • Your footwear should be comfortable
  • Maintain flexibility and strength in your lower extremity muscles
  • Improve your core muscle strength

If you or someone you know may have Trochanteric bursitis, call PhysioNow Today!  We would be happy to get you started on your treatment and back to enjoying all the things you love to do!

 

Physiotherapy : Total Hip Replacement

Physiotherapy : Total Hip Replacement – Do I really need it?
Physiotherapy: total Hip Replacement

Surgeons often recommend that patients seek out community Physiotherapy

Surgeons often recommend that patients seek out community Physiotherapy : Total Hip Replacement services to continue with your recovery after you have had a total hip replacement (THR). You may wonder how doing extra treatment would help? – isn’t the surgery enough to correct your hip pain?

What is important to remember is that the surgery does take care of the affected joint. However, there is still work to be done to get you back on your feet and back to your desired activities. The surgery involves a cut through the muscles that stabilize the hip. Also, the body has to relearn how to move and function with a new joint.

Normally, the usual process for Physiotherapy: Total Hip Replacement surgery involves:

• Receiving Physiotherapy : Total Hip Replacement as an in-patient for 3-4 days for learning to walk with a walker, using the stairs and initiation of strengthening exercises for the hip
• You also receive education with respect to their precautions and how to ensure you are protecting your new joint and preventing dislocation
• Once you are safe to return home, you will be discharged
• At home, you are usually entitled to receive home care physiotherapy sessions for a few sessions.
During these sessions, the physiotherapist will re-assess your ability to move and progress your exercises as able.

After receiving homecare treatments, it’s then usually up to you to continue with your exercises. This includes progressing your strengthening and conditioning. However, a lot of people have difficulty doing this on their own and need help to further progress. It can be difficult to assess your own strength and safely progress your exercises. Seeking help from a Registered Physiotherapist will help with this process. It will get you back to your optimal function. The physiotherapist can assess where there are still remaining limitations. They will prescribe the necessary treatments to address the issues.
Please check out this link for further information regarding Physiotherapy: Total Hip Replacement.

In addition, we often see patients that have had a Total Hip Replacement, develop Low Back Pain. This happens because the muscles in the hip get very tight after surgery, and tend to tighten up into the Low Back. It is also caused by increased sitting during the recovery process. The good news is that we can help! Registered Physiotherapy and Registered Massage Therapy will help these symptoms to go away.

At PhysioNow, we have well trained Registered Physiotherapists and Registered Massage Therapists available to help you with your recovery. We will help to find the areas that you need in order to walk properly without an aid and get back to all the things you like to do. Call today to get started on your full recovery!