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Scoliosis: Types, Symptoms and Treatments

July 24,2023 Sharon Tierney Leave a comment

Scoliosis

A side deviation or curvature in your spine is scoliosis. It could be in your neck, mid back and lower back. It can present in more than one area.

The most common area where it develops is mid-back. Cervical and lumber spine are very common when it comes to two curvatures.

Type of scoliosis:

C-shape: This is most common type, there is only one-sided curve. The most common area for C shape to develop is in the thoracic spine and also lumber spine. In this type, scoliosis side leg could be short compared to non-scoliotic side. Sometimes, there are changes in the scapular level. Scoliotic side scapula will be lower than non-scoliotic side.
S- shape: In this type, two curvatures are present in the spine. One curvature is the primary scoliosis and the other curvature develops in compensation of the primary curvature. In this type, the scoliotic sided leg is short and the scapular level is higher than the non-scoliotic side. S-shape will bring other complications such as respiratory issues, cardiovascular issues, etc.

‘S’ Shaped curve and ‘C’ Shaped Curve

Causes of scoliosis:

Usually, the cause of scoliosis is unknown. However, following are a few possible causes mentioned:

Poor Posture habits: People who have habits of not following ergonomics pattern of posture are at risk. One who has the habit of leaning and sitting mostly on their right or left, are also at risk.
Carrying heavy stuff on back: People who have to deal with the delivery of heavy packets and lifting heavy objects are at risk.
Family history: Sometimes, scoliosis runs in family. There are higher chances in these cases.
Congenital limb length discrepancy: Congenital limb length discrepancy needs immediate correction otherwise; it will lead to scoliosis.
Neurological disorder: Neurological disorders like cerebral palsy, multiple sclerosis, Down Syndrome which are progressive diseases have muscular imbalance.

Signs and symptoms:

Limb length discrepancy
Visible deviation of spine to one direction
Uneven shoulder and pelvis height
In anterior view, one sided rib is popping out.
Chronic neck and also lower back pain
Breathing difficulties in severe cases
Recurrent lung conditions like pneumonia, atelectasis, etc.
Pain and numbness
Fatigue due to muscle imbalance

Assessment of scoliosis:

Imaging: X-ray is the gold standard or MRI.

Physiotherapy Assessment: assess in posterior view which means back view with open back.

Therapist will look for visible prominent border of scapula.
with bending forward the scapular border will be seen as well as deviation .
When leaning backward , a visible S shape or C shape will be seen.

Risk factors of scoliosis:

Scoliosis is bony disorientation which is irreversible. The best management is prevention. However, if it not managed well enough , it can lead to many complications.

Lung disorders: Specially, thoracic spine scoliosis has a chance to affect the respiratory system as it disturbs the alignment of the rib cage. Deep breathing becomes limited or difficult and that is why the lower portion of the lungs get less air. As a result of this, atelectasis develops in some areas of the lung.
Limb length discrepancy: Lumber scoliosis has a major effect on pelvis alignment. As scoliosis is irreversible, it leads to permanent muscular imbalance. Thus, there is limb length discrepancy.
Scapular winging: Thoracic scoliosis has drastic effect on scapular orientation. The scapula takes part in shoulder movement. Indirectly, mid back, scapula and the shoulder joint are all affected because of spinal curvature.
Herniated disc in spine: Lumber spine scoliosis has a higher chance to develop a herniated disc. Therefore, you may develop pain in the lower back and down the leg into the thigh, knee or ankle. Please seek immediate attention in this case.

Management of scoliosis:

Scoliosis is a irreversible bony deformity.

Posture: Contact your physiotherapist for a better understanding for well maintained posture at work and home. Correction in pelvis alignment will help in preventing it from getting worse.
Deep breathing exercise: Deep breathing exercise will help in maintaining lung function. Additionally, with breathing exercises, chest mobility exercises will help in maintaining flexibility in the spine and avoid lung conditions like pneumonia, atelectasis, etc.
Spinal mobility exercises: Contact your physiotherapist for proper exercises. Your Physiotherapist can better assess scoliosis and based on that provide spinal mobility exercises to stop it from getting worse.
Orthotics: orthotics adjust leg length discrepancy from scoliosis.
Education: Finally, a physician or physiotherapist can help you to better assess and understand this condition.

Need some help?

Your concerns are best managed by a health care professional. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your issue. If you think you may have scoliosis or are diagnosed with it, book with PhysioNow today for your first assessment and treatment!

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Chronic Ankle Instability Could Cause Your Ankle Not To Heal

July 20,2023 Sharon Tierney Leave a comment

Chronic Ankle Instability

Ankle sprains are one of the most common injuries. Rest, ice, compression and elevation, or the RICE rule, are the go-tos for ankle sprains. In most cases, the ankle will heal between 4-12 weeks. Many people will allow the ankle to heal on its own but a failure to seek treatment and physical rehabilitation for the ankle after just one injury is enough to leave it weaker and more vulnerable to future sprains. Which in turn could result in chronic ankle instability.

What causes ankle instability?

After an ankle injury, there is damage to the ligaments, tendons, and potentially even the ankle joint itself. Ligaments function to limit the normal movement in the ankle, and once they are injured, they may get lax (stretched out). Resulting in the ankle being more unstable. Additionally, the injury results in a loss of strength in the muscles that control the ankle movement, further increasing the instability of the ankle. Finally, it also results in a loss of sensory receptors in the ankle that communicate to our brain where our ankle is in space. This decreased sensation makes it harder to balance and control the ankle which contributes to the ankle instability.

How do I know if I have chronic ankle instability?

Questions to ask yourself include:

Does my ankle ever give out?
Do I avoid walking on uneven surfaces out of fear of falling?
Do I feel like I can’t “trust” the ankle?
Do I try to avoid putting all my weight onto one ankle?

If you said yes to these questions and you have had a severe ankle injury or a history of multiple ankle sprains, you may have chronic ankle instability.

Is it permanent?

Chronic ankle instability is not permanent it can improve with the help of a physical therapist and individualize exercise plan. An untreated ankle injury may be chronic when it is not given sufficient time to heal and is constantly being reaggravated. Thus, the first step to treatment will be a proper rehabilitation program with a health professional.

Who treats ankle instability?

Physical therapists are the first step in conservative management of chronic ankle instability. Your physical therapist will perform an assessment on your ankle range of motion, strength, and balance and will assess for any laxity, or more movement than is normal, within the ankle and ankle ligaments.

After an ankle injury, there is a loss in strength and proprioception (awareness of the position of the body in space). So exercises are given to re-strengthen the muscles, increase ankle stability, balance, and retrain the body awareness of the ankle. Furthermore, a brace and/or taping is recommended to support the stabilization of the ankle, especially for individuals who engage in high-risk activities like sports.

Chronic Ankle Instability Brace and Tapping

Chronic Ankle Instability Exercises

However, not all injuries are capable of recovering with conservative management. Thus, in very severe cases, surgery may be an option to repair the injured ligaments and give the ankle stability.

What happens if its goes untreated?

Without treatment, an individual will continue to have difficulties balancing, walking on uneven terrain, and putting weight onto the ankle. Subsequently, the instability may worsen over time and will have a much greater risk of reoccurring injuries to the ankle. Thus making it more challenging to recover from these injuries. Additionally, it can result in damage to the bones and cartilage within the ankle joint as the muscles weaken and fail to support the joint. Therefore, to avoid severe injury it is highly recommended that individuals seek expert treatment.

If you are having stability problems with your ankle, book with PhysioNow today for an initial assessment and treatment. We have many capable physical therapists that will be able to help your ankle recover!

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Trigger Finger? What can you do about it?

July 20,2023 Sharon Tierney Leave a comment

Trigger finger? What to do

Trigger Finger

Lately you’ve noticed that your finger seems to be clicking, and maybe it also catches or locks into a bent position. Sometimes you may need to use your other hand to help you “unlock” your finger. What is this? We call this condition trigger finger.

Your finger locks in a flexed position. The position it locks in resembles the position of a finger when it is pulling a trigger.

If you have trigger finger, you may also have:

Stiffness and swelling, especially in the mornings.
Painful or painless clicking, catching, locking into the bent position then popping straight.
Loss of full range of motion of the fingers into flexion and extension (bent and straight).
Nodule is felt with other hand.
Pain that radiates to the tip of the finger and/or into the palm.

Why does Trigger Finger happen?

An exact cause is unknown, it develops spontaneously or consequently to another disease, repetitive hand movements during a job, or recent trauma to the hand.

The condition occurs due to inflammation and narrowing in the “pulley” system in the hand. As seen in the image below, the tendons of our muscles must pass through a band of tissue in order to control the fingers. The tendon normally glides through this tunnel without issue but the tissue of the tunnel can thicken and narrow, combined with enlargement of or nodules developing in the tendon itself, resulting in impaired movement and the tissues blocking each other.

Trigger Finger Nodule and Tendon

How to treat trigger finger?

The first line of recommended treatment for any condition is conservative care. A physiotherapist can help you recover your hand function and quality of movement. These treatments
may include:

Soft tissue techniques, joint mobilizations, and stretches to try and increase the mobility in the
area.
Modalities like ice, paraffin wax, and electrical stimulation to help with pain, inflammation, and swelling.
A home exercise program that focuses on increasing range of motion, strength, and gliding of the tendons
Education on wearing a splint (as shown below) which blocks the finger from moving excessively, allowing you to go about your daily life without aggravating the condition. Wear this between 6-10 weeks and your physiotherapist may ask you to wear them at night, during work, or as much as possible during the day.

What options do you have for treatment?

In some cases, this condition may be persistent and medical management with your primary provider. For example, options
may include corticosteroid injections to reduce inflammation and the frequency of the finger locking. Unfortunately, patients may require further intervention when conservative treatment fails, in which case a surgical release of the finger may be indicated. When combined with physical therapy after the surgery, there is usually a rapid and significant improvement in function at relatively low risk. However, there are always increased risks to surgical procedures compared to conservative treatment and where possible, trigger finger should always be treated with non-surgical strategies first and surgery as last resort.

Need some help?

Let us manage your trigger finger. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your issue. If you think you have trigger finger or have been diagnosed with it, book with PhysioNow today for your first assessment and treatment!

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Headaches? See how Physiotherapy can help you!

June 15,2023 Sharon Tierney Leave a comment

How do Headaches occur?

There are many different types of headaches with many different causes. Many people may blame it on the weather, stress, or work, and feel like it is out of their control and that nothing can help their headaches. If this sounds like you, there is treatment available and you do not have to live with your pain. Headaches that stem from your neck or jaw are treatable through physiotherapy and can result in a decreased intensity and frequency or even stop them completely. However, migraines can also be manageable with rehab.

What are headaches from the neck?

Cervicogenic Headache

Headaches that stem from the neck are known as cervicogenic headaches and are a type of referred pain. Referred pain means that the pain actually originates from another part of the body, and not the place where you actually feel the pain. Moreover, the head pain is actually coming from problems in the tissues and/or joints in the neck.

Common symptoms of cervicogenic headaches include:

Firstly, one-sided headaches
Second, neck stiffness
Decreased motion in the neck
Radiating pain to the eyes, shoulder, or arms
Lastly, they are triggered by certain neck positions or movements

What are headaches from the jaw?

Headaches stemming from the jaw result from dysfunction in the jaw joint, anatomically known as the temporomandibular joint (TMJ). This joint connects your lower jaw to the skull and is used in actions such as talking and chewing as it allows the opening and closing of the mouth. Therefore, headaches are one of the common symptoms of jaw dysfunction. Though they are lesser known, it is commonly missed as a source.

Common symptoms of TMJ dysfunction include:

Clicking on the jaw
Pain or tenderness with jaw movements (biting, talking, chewing, etc)
Headaches, especially in the morning (due to grinding and clenching of the jaw during the night)
Also, neck stiffness

How can physiotherapy help?

Your physiotherapist will provide a comprehensive assessment of your neck and jaw to determine a specific treatment plan for you. The evaluation may include observing your resting posture, and the way your jaw and neck move. Also, how much movement is available in your jaw and neck, and more.

Your treatment plan may include strengthening weak muscles, correcting posture and faulty movement patterns, stretching and mobility exercises, manual therapy techniques like soft tissue massage and joint mobilizations to reduce pain and increase range of motion. They may use modalities like heat, electrotherapy and acupuncture as well depending on your condition and goals of treatment. Your physiotherapist will work closely with you to develop an individualized plan of treatment including a home exercise program, and education on self-management of your condition at home. They can also inform you and help you get in contact with other healthcare practitioners that may need to be involved in your care.

If you are experiencing persistent headaches, book with PhysioNow today for your first assessment and treatment!

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Say Goodbye to Knee Pain with Orthopedic Custom Knee Brace!

May 4,2023 Sharon Tierney Leave a comment

Say Goodbye and Beat knee pain with an Orthopedic Custom Knee Brace!

Here at PhysioNow, we can help you recover from your knee pain faster by providing you with a Custom Knee Brace. There are many types of knee braces available for purchase. Therefore, it can be overwhelming to know which brace is best for you so does the type of knee pain. In this article, we will give you an overview of custom knee braces. Also, provide instructions on how to start the process of ordering your custom knee brace.

Who can get a custom knee brace for knee pain?

Custom knee braces are most used for individuals with/after:

Post-operative recovery
Knee instability
Osteoarthritis
Ligament or meniscal injuries

Moreover, the brace is constructed using precise measurements taken from your leg. It is designed to only fit you.

Why get a custom knee brace? Is it worth it for knee pain?

Many patients have found that bracing has returned them to a level of function that they were previously thought to be unattainable after their injury. Some of the benefits of a custom knee brace include:

Firstly, get you back to doing the activities you love.
Second, reduce pain and increase the function of the knee.
Support and prevent further injury while you await imaging, surgery, or after surgery.
Individualized to your needs and level of activity ex. Lifestyle vs performance braces.
Ideal for long-term use.
Lastly, lightweight and can fit underpants for a subtle look.

What types of custom knee braces are there?

The most common type of custom-made knee brace is a rigid knee brace. They are usually made of metal, with a hinge to allow the knee to bend, and are the most supportive type of brace.

They are designed for individuals who need moderate-maximum support. The conditions that require a rigid custom knee brace include moderate to severe osteoarthritis, and athletes that need more support after an injury. Also, pre and post-surgical repair of ACL, MCL, PCL ligaments, or menisci.

Moreover, under the umbrella of rigid knee braces, there are unloader braces for osteoarthritis. These braces provide more support to the painful, arthritic side of the knee to offload it. This can preserve the joint space while reducing knee pain and increasing knee function.

Another category of rigid knee braces is ligament braces for ACL, MCL/LCL, and PCL injuries, including pre and post-surgical repair. These provide knee support to the sides of the knee to prevent any unnatural twisting or movements. However, our PhysioNow team of physiotherapists will be able to determine which brace is best suited to your goals and lifestyle.

How can I get a custom knee brace?

Follow these simple steps below to get one.

Contact us at PhysioNow to book an appointment time for a custom knee brace assessment.
On the day of your appointment, your PhysioNow Brace Specialist will perform a series of tests and ask you questions to determine which type of brace is right for you.
Make sure you tell your Physiotherapist what activities you are currently doing, and any activities that you would like to get back to doing (ex. Golf, running, walking)
Your PhysioNow Brace Specialist will measure and take recordings of your knee, and discuss any considerations like the desired weight of the brace, special features (ex. Straps and clips), materials, colors, etc
Lastly, we will be able to make inquiries to determine whether your custom knee brace can be covered by extended health care coverage. Care plans that include physiotherapy service coverage will usually have coverage for a custom knee brace as well. This process requires a physician’s note, but our clinic will be able to walk you through the process and provide you with the documentation needed to send to your insurance company for inquiry.

Once ordered, delivery will normally take around 7 business days but can be expedited upon request. We will ensure that the brace fits properly and can make adjustments if needed once delivered. So get your own customized brace NOW!

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Sciatica? 10 warning signs

November 28,2022 Sharon Tierney Leave a comment

What is Sciatica?

Sciatica is a pain in the back, neck, or buttock that radiates to the leg or arm. Sciatica is also quite common and affects almost 40% of adults. It travels through the sciatic nerve, which starts in your lower back and extends to run down your leg. A proper diagnosis that confirms and best sciatica treatment is all that you need to lead a pain-free life.

Sciatica pain

10 signs which confirm the diagnosis

Before knowing about sciatica treatment, one needs to understand the nature of pain. The symptoms of sciatica are as follows: –

Calf pain – pain that stretches down the lower leg and back of the knee.
Lower back pain running down the leg. A pull sensation from your lower back to buttocks and thigh, that further extends from calf to the foot.
A pain in your butt or leg that worsens while prolonged sitting.
Numbness in your leg or foot.
Tingling sensation in your extremity (lower body).
Persistent pain on one side of your butt.
Muscle weakness in the distressful leg or foot.
Shooting pain down the leg which makes it tough to stand up or extend the knee.
Pain in one part of the leg while numbness in another part.
Lastly, a sensation of pins and needles only in the toes or feet

Early Symptoms Of Sciatica

Apart from the 10 signs above, sciatica pain often starts in the back. However, occasionally, pain may start at the hip or knee; which may not look like sciatica. Although, you may feel isolated symptoms like feet numbness, knee pain, buttock pain, tingling, etc.

What contributes to Sciatica?

There are many factors that can lead to sciatic pain but the most common ones are listed below,

• Strain and Occupational Stress: People in more physically demanding jobs as a result affect your nerve.

• Obesity and genetic factors: The excess weight in the body put prolonged pressure on the backbone, leading to a slipped disc.

• Accidents and Injuries: Unexpected physical damage from accidents can crack the vertebrae and irritate the nerve.

• Gender: Studies have shown that men are more prone to slipped discs than women.

Treatment options available

Moreover, depending on the severity of the case, sciatica pain can be treated in the following ways:

• First, medication and pain management: Pain can be controlled with various pain relief treatments including medication.

• Second, surgery: In rare cases, the pain doesn’t subside for a prolonged period (6 weeks or more), and surgery can help relieve the pressure on the sciatic nerve endings caused by Sciatica.

• Third, spine rehabilitation:

Effective exercises for Sciatica

There are multiple approaches to physical therapy in spine care and they can stabilize the spine and help patients with disability or restricted physical movement. This helps improve the mechanical functioning of the spine, manages pain, promotes regeneration of the affected tissue and disc, and with functional training, improves strength and flexibility.

• Lastly, even in the case of surgery, follow-up rehabilitation helps sustain and improve the results.

If you are experiencing any such symptoms, our team of qualified physiotherapists at Physio Now will help you diagnose and guide you through your treatment. Book your appointment now!

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DIASTASIS RECTI

June 21,2022 Sharon Tierney Leave a comment

Diastasis Recti is a condition where there is a partial or complete separation due to overstretching of the Rectus abdominis muscles.

Rectus abdominis muscle or the six-pack muscle is a long muscle of the abdominal wall running from the lower rib cage to the pelvic bone, it runs vertically on both sides of the Linea alba.

The function of the muscle is to help in trunk flexion, expiration, and compression of abdominal viscera.

It is commonly seen in

Pregnancy and post-delivery.
Multiparous or multiple pregnancy.
Obesity in male and female.
New born mostly premature due to muscle being not fully developed or connected.

How to identify if you have one.

When you notice a bulge in your stomach while straining or contracting your abdominal muscles.

Lying on your back with knees and hip bend / crook lying, keep your fingers just above your belly button area, lift your head and shoulders up, finger width or more separation between the two muscles does indicate Diastasis recti.

Diastasis recti can lead to

low back pain.
Alters your posture and stability of your trunk.
Pelvic pain.
Pelvic floor dysfunction.
Hernia in extreme cases.

Activities to avoid:

Strenuous exercises involving strong abdominal muscle contraction or loading like crunches, ab twists, planks, certain yoga stretches like arching backwards
Lifting or carrying heavy loads.
Carrying child on one hip.
Coughing without abdominal bracing or support.
Episodes of severe constipation.

A pelvic floor therapist can help you in educating and providing you with service that would help to overcome this situation.

Starting prenatal exercises will help to maintain and control the tone of the abdominal muscles reducing the pressure over the Linea alba.

Postnatally or clients with Diastasis recti have to target the deep abdominal muscles. This includes the transverse abdominis and pelvic floor muscles. Superficial abdominal muscles are not part of this. To get an effective result in helping to tone up the muscle and to reduce the gapping between the muscles to get a better quality of life it is important to get a Physiotherapy Assessment and treatment.

After deep muscle recruitment, the superficial muscle recruitment can be initiated.

Breathing exercises,

postural awareness,

lifting technique, and

abdominal support

are other entities that the therapist can educate on and train you in. This will help to overcome the situation and help in the recovery process

Book with us today PhysioNow

For More information on the topic refer Cleveland Clinic

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Fibromyalgia

January 14,2021 Sharon Tierney Leave a comment

FIBROMYALGIA

Fibromyalgia is a chronic condition. It is often associated with widespread symptoms including fatigue, pain and sleep disturbances.

Causes and Risk Factors

It is unclear as to what causes fibromyalgia. However, there are some causes which might be increasing your risk of getting fibromyalgia:

Genetics-

You could be ay a higher risk for fibromyalgia if it runs in your family

Stress-

Emotional or physical stresses have been known to aggravate or cause this condition

Age-

Women have been found to be at a higher risk

Symptoms of Fibromyalgia:

The symptoms may vary from individual to individual but, following are some of the commonest symptoms-

Fatigue-

One of the commonest symptom is fatigue

Pain-

Pain that lasts > 3 months and widespread pain at several sites in the body

Sleep disturbances-

You could have sleep disturbances or non restorative sleep (sleeping for long but not feeling rested)

Reduced exercise tolerance and morning stiffness.

Other symptoms include trouble with concentration/memory. It is also called ‘fibro fog’ or ‘brain fog’. Headaches and depression are also common. It is common to have fluctuations in the symptoms. You may experience pain that may range from a mild discomfort/ache to an unbearable pain.

Although it may mimic more like an arthritis/ bone related pain, it actually comes from the soft tissues. Fibromyalgia can start at any age. However, mostly it is by early to middle adulthood that people start feeling it.

Diagnosis:

Your doctor will take a detailed history to understand all of your symptoms. There is no definitive test to diagnose this condition. However, the doctors may prescribe you to do other tests like blood work or X-rays to rule out other conditions that show similar symptoms.

How do you treat it?

Drugs-

The treatment is usually focused on relieving the symptoms. For instance, your doctor may prescribe muscle relaxants, pain killers, anti-depressants or sleep medications,

Acupuncture-

To help relieve pain

Fibromyalgia. Acupuncture

Cognitive Behavior Therapy-

Cognitive Behavior Therapy can help to reduce stress. Can be individual or group therapy.

Nutrition-

A healthy balanced diet is good because it helps to keep your body healthy and keep the energy levels high.

Massage therapy-

Helps in relaxing the muscles and relieve pain

Activity pacing-

There may be good and bad days in this condition. Thus, it is important to make sure you prioritize your activities for the day. This is helpful in order to reduce excessive fatigue.

Physiotherapy-

Physiotherapy can help to firstly, reduce your pain. Secondly, they can give guidance on modifying activities and finally, prescribe exercises. In addition, aerobic fitness and strengthening exercises help in this condition.

Physiotherapy for fibromyalgia

How can we help?

Our physiotherapists will take a detailed history followed by a thorough evaluation of all your symptoms and problem areas. Then, they will formulate and discuss a treatment plan for you. Also, we have massage therapists and therapists who do acupuncture. Thus, if you are having fibromyalgia or know anyone who needs help with the same, contact us today at PhysioNow!

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Acute Ankle Sprains

December 2,2018 Sharon Tierney Leave a comment

Acute Ankle Sprains

How do Acute Ankle Sprains happen?

Acute Ankle sprains are common injuries in people of all ages. They can happen in many different circumstances. However, they always involve some type of fall or twisting movement to the ankle. For example:

Going downstairs and missing the last step resulting in twisting the ankle
Landing on the ankle in a twisted position after coming down from a lay-up in basketball or in a Sports Injury
Slipping on an icy street while walking

In all of these situations, the ankle gets a sudden movement and/or trauma that causes it to twist more than its normal range of movement allows.

Acute Ankle Sprains

What structure gets injured with an acute ankle sprain?

The structures that are injured with acute ankle sprains are the ligaments around the ankle joint. Ligaments are soft tissue structures that connect two bones together. Their function is to prevent the bones from moving too far away from each other. Ligaments help maintain normal movement between the bones.

With ankle sprains, the ligaments get over-stretched beyond what they can tolerate which causes tears in their fibres. The ligaments that are involved in acute ankle sprains are present on the outside (lateral), inside (medial), and top of the ankle.

Are there different types of acute ankle sprains?

There are three main types of ankle sprains:

Inversion
Eversion
High Ankle Sprain

The terms relate to the direction of ankle movement that caused the injury to occur.

INVERSION ANKLE SPRAIN

An inversion sprain occurs when the ankle is forcefully turned inwards.
- This type of acute ankle sprain is the most commonly occurring of the three because the ligaments on the outside of the ankle are generally weaker than the rest.
- Another name for an inversion ankle sprain is lateral ankle sprain
- A lateral ankle sprain injures the ligaments on the outside of the ankle.

EVERSION ANKLE SPRAIN

An eversion sprain occurs when the ankle is forcefully turned outwards.
- This type of force injures the ligaments on the inside of the ankle.
- The ligaments on the inside of the ankle are called the deltoid ligament
- An eversion ankle sprain is also called a medial ankle sprain

HIGH ANKLE SPRAIN

A high ankle sprain is the rarest of the three types and it occurs when there is excessive twisting of the shin.
- The ligaments that are injured with this type of injury are located above the ankle.
- The location of the ligaments is why this injury is called a ‘high’ ankle sprain.

Are some people more at risk for Acute Ankle Sprains than others?

There are certain risk factors that may make ankle sprains more likely to happen. However, the research is a little inconclusive on why this is so. Some of these possible factors include:

Poor muscle strength/fitness
Increased weight
Decreased muscle-reaction time
Previous history of ankle sprains resulting in poor balance

Can there be different severities of Acute Ankle Sprains?

The severity of the ankle sprain depends on how much the ligament was overstretched in the process of the injury. Sprains are classified by different grades to explain the severity:

Grade I: mild stretching or tear of the ligament, with little or no instability at the joint
Grade II: incomplete tear of the ligament, with some instability in the joint
A Grade III: ligament is completely torn or ruptured and there is no stability in the ankle

Ligaments affected in Ankle Sprains

What should you do if you think you have sprained your ankle?

In all three types of Acute Ankle Sprains, it is important that you see a health care provider. The health care provider, whether it is a doctor or a Registered Physiotherapist, will first rule out the possibility of fracture. There is always the possibility of a fracture with Acute Ankle Sprains. The ligaments attach onto a bony area and if the twist is severe enough, it can pull off a chunk of the bone. When this happens, it can cause a fracture. Signs and symptoms of a potential fracture include:

Lots of swelling
Increased bruising
Increased tenderness over specific areas of the ankle
Difficulty or inability to put weight through the injured ankle

When the signs and symptoms are suspicious of a fracture, then an X-ray must be completed. If there is no evidence of fracture, then your doctor may send you for an ultrasound. In the end, they should refer you for Physiotherapy treatment. So ask your doctor to send you to Physiotherapy if they don’t think to recommend it themselves.

What will happen during my first Physiotherapy appointment?

During the Physiotherapy assessment, your Registered Physiotherapist will assess everything to do with your Acute Ankle injury, including:

Pain intensity and location
Swelling
Sensation
Range of motion
Ankle stability
Strength
Balance

This will provide some baseline information for your Physiotherapist.

How can Registered Physiotherapy help treat Acute Ankle Sprains?

The treatment for acute ankle sprains depends on the type of sprain as well as the severity of the injury.

Immobilization

Because of their affect on ankle stability, a Grade II or III injury will require some immobilization. This is usually done through a removable walking cast.
The purpose of the immobilization is to protect your injured ligaments from movement and external stressors, so that they can heal.
The period of immobilization will depend on the injury and your health care provider will provide specific instructions.
A grade I sprain will not require any immobilization because the stability of the ankle is still intact. However, your Physiotherapist will recommend activity modification to help with the healing process.

Physiotherapy Treatment in the acute phase?

In the initial phase of the treatment, the Physiotherapist may focus on pain relieving modalities
Electrical modalities like IFC and Ultrasound can help relieve pain and swelling
The Physiotherapist will also prescribe gentle mobility exercises to help improve or maintain movement through the ankle
The length of the acute phase depends on the severity of the sprain

Registered Physiotherapy for Acute Ankle Injuries

Ankle Rotations for movement Recovery

Treatment in the later stages of Acute Ankle Sprains

Once the ligament healing is underway and the patient feels a little better with their pain, the treatment will get more progressive
It will focus on regaining mobility, strength and function through the ankle
Your Physiotherapist will prescribe exercises that are going to help regain the lost range of motion and strength.
Over several weeks, the exercises will be progressed as you improve.
Another important aspect of treating an ankle sprain is including balance re-training in the program.
Balance is very much affected after an ankle sprain and it is something that must be improved with specific exercises. This is very important no matter whether you are returning to Sports or just everyday living! Balance Retraining is key to Falls Prevention!
We use our balance ability on a regular basis with walking on uneven surfaces or when trying to recover from a stumble. Therefore, it is important to improve balance ability to prevent any possible re-injury of the ankle.
If you have had an acute ankle sprain before, and DID NOT attend Physiotherapy, it is likely that you are at increased risk of reinjuring your ankle or falling again!

Physiotherapy Mobilizations

Do I need to get Physiotherapy treatment after Acute Ankle Sprains?

There are some people who have sprained their ankle multiple times and never sought out treatment for the injury. They usually give themselves some time for the pain to get better and then go about their usual activities.

This type of management is not usually recommended because multiple ankle sprains can affect the stability of your ankle. As a result, this may create problems in the future. Also, the reduced stability in your ankle may cause compensations in your knees and hips. This can complicate the picture and make your injury more complex.

It is therefore recommended that you seek out proper Registered Physiotherapy care to address an ankle sprain soon after it occurs. This ensures that your acute ankle sprain heals in a timely manner without added complications. The most important part of treatment is regaining your balance. If you do not do this, another injury in quite likely.

To get started on your Acute Ankle Sprain Treatment, Give PhysioNow a call Today!

Applewood Physionow, Applewood Sports & Physiotherapy Ltd, Custom orthotics, Erin Mills Physionow, Erin Mills PhysioNow, Erin Mills Physiotherapy Ltd., Etobicoke Physiotherapy, General Category, Knee Pain, Long Branch PhysioNow Ltd., Long Branch Physiotherapy, Lorne Park PhysioNow, Lorne Park Sports & Physiotherapy Ltd., PhysioNow, Physiotherapy, Physiotherapy Etobicoke, Registered Physiotherapist Mississauga, Registered Physiotherapy Mississauga, Sports Injuries, Sports Physiotherapy, Sports Taping

Patellofemoral pain syndrome

November 16,2018 Sharon Tierney Leave a comment

Patellofemoral pain syndrome happens when your knee cap does not track properly. The knee joint consist of two joints. The tibiofemoral joint which is between the two long bones in your leg and the second one is the patellofemoral joint. This is between the femoral condyle (end of thigh bone) and the knee cap. The cartilage on the back of the knee cap glides on the cartilage on the front of the condyles of the femur. The knee cap usually sits in a snug groove at the end of the thigh bone.

Knee movements are controlled by a number of muscles connected to the knee cap. Your thigh muscle helps to stabilize the knee cap and enables it to move smoothly in the groove. When this is pulled out of the groove, you can develop Patellofemoral pain syndrome.

Causes of Patellofemoral pain syndrome or Anterior knee pain

Patellofemoral pain syndrome, is one of the most common causes of pain in the knee. Pain is usually felt under the knee cap. This is where it glides on the femur/thigh bone. If you have patellofemoral pain syndrome, it hurts when you bend and straighten your knee . There are a number of factors which can cause the pain.

Common Causes of Patellofemoral pain syndrome

Weakness in the hip and thigh muscles-Weakness in the thigh muscles can cause increased load which may lead to pain. Pain in your knees will further limit the activity of your muscles and over time can cause further weakness. Weakness of the inner thigh muscle will affect the movement of the knee cap as you do your normal activities. Weakness in your hip muscles also can affect activities like climbing stairs and walking.
Excessive loading or rapid increase in the load for muscles around the knee-Depending on your usual activities, your knee will have a level of activity that is tolerated by your joint. Rapid increases in loading of activity may lead to a highly irritable or sensitive joint. This can cause Patellofemoral pain syndrome.
Posture or position of hip, knee and feet-Flat feet or excessive turning in of feet can change movement mechanics further up the leg and cause excessive strain in your knee cap.
Tight muscles around the knee-Tightness in the muscles can reduce the movement of your knee and affect how your joint works . This will lead to excessive loading during activities. The common muscles that become tight are your hamstrings, Quadriceps, Iliotibial band and calf.
Previous injury or dislocation of knee cap
Desk top work, where a lot of sitting can cause pressure on the kneecap.
Irritation of fat pad around the knee
Tendinitis of quadriceps tendon
Bursitis around the knee
Osteoarthritis

When poor biomechanics are repeated with each step of your walking and running it may lead to a highly sensitive joint and Patellofemoral pain syndrome.

Symptoms

The onset of knee cap pain is normally gradual rather than traumatic.
Pain at the front, back and sides of the knee with or without swelling.
Bending and straightening of knee can cause pain.
Pain after prolonged sitting or when you keep the knee bent for longer periods of time.
Clicking or grinding when you bend or straighten your knee.
Pain when you go up and down the stairs, up hill /down hill, squatting, running or jumping.
Poor knee control or stiffness

Physiotherapy Treatment

Physiotherapy is the most effective treatment for short- and long-term management of Patellofemoral pain syndrome. Your Physiotherapist will fully assess you on your first visit to identify your functional limitation. They will also help to set goals and identify contributing factors for the pain. They will provide a customized rehabilitation program.
In the initial phase of rehabilitation, treatment is directed towards reducing the pain, swelling and muscle inhibition. To do this PhysioNow will use electrotherapy modalities, acupuncture, rest, taping, gentle motion or joint mobilization and muscle setting exercises.
Once the pain and swelling reduces, treatment is focused towards modifying the factors that have been identified as a cause for the problem.
Rehabilitation typically emphasizes increasing strength and pain free movements. It also will address postural correction, improving the stability of the pelvis, balance and functional abilities.
Stretching exercises to address the tight muscles and strengthening the weak muscles will improve your load tolerance.
Successful rehabilitation requires adherence to your exercise program .
You will also need to reduce the aggravating movements and slowly build the endurance and strength for those activities over time.
Prior to discharge you will be given a safe progression of exercises and functional activities.
For long term management, your foot and knee control will be assessed by your Physiotherapist.
As a result, you may require custom foot orthotics to correct your foot position.
This will help to improve foot and knee control.
Others might need a hip stabilization program and your Physiotherapist will be happy to discuss with you the long term rehabilitation plans if this is needed.

How long it will take to get better?

We expect to see improvements with Physiotherapy over a 3 to 6-month period. Further improvements continue beyond this period. Adherence to your specific exercise program is important in maintaining the improvement. Most people will get back to their normal function with rehabilitation in the short term. Many patients can continue in their chosen activity during rehabilitation. Some modification of activity may be all that is needed.

If you play sports, you will need to do sports specific exercises to ensure a safe return to sports. It is good to wear proper supporting footwear to help keep your feet in a good position. This will improve alignment of your knees.

How to book an appointment with a Physiotherapist at PhysioNow?

We have four Physiotherapy clinics of which three are located in Mississauga and one is in Etobicoke. You can call 289-724-0448 to book into any of these clinics for an appointment with a Physiotherapist.

Most of the time we can arrange your initial visit on the same day in a location which is nearest to you. Your initial appointment will be a one to one 40-60 minute session with a Physiotherapist which includes treatment as well on the first day.

Your follow up appointments will typically take 40 minutes. Normally, we would recommend 2 to 3 sessions per week depending on the factors identified on initial assessment, treatment plan and your goals. If you have limited funding available, we will be happy to work with you to develop a home exercise program.

Please call today to get started on your treatment for Patellofemoral Pain Syndrome at PhysioNow!