Month: July 2014

Fracture at the Elbow

There are three bones involved in making up the elbow joint: the ulna, radius and humerus. Fracture of any one of these bones near or within the elbow joint causes problems in how the elbow joint functions.
Your orthopaedic surgeon will tell you when you need to commence physiotherapy, after your fracture has united.

This varies greatly depending on the location, type and management (surgery versus conservative) of the fracture at your elbow. Often people think of the elbow just in terms of bending (flexion) and straightening (extension), but in fact the elbow joint is also involved in allowing you to turn your forearm/ hand over and back. Physiotherapy is crucial to restoring this normal movement and function of the elbow joint.

At Iona Physiotherapy, you can expect a thorough assessment of not just your elbow, but the whole upper limb, including your shoulder and wrist/hand as these can sometimes be injured in the trauma or become stiff if you have been wearing a sling. Treatment may include massage, manual therapy and exercise to restore normal movement and function.

Top Tips for Fracture at the Elbow:

While you are waiting to start physiotherapy for your elbow, it is very important that you move your hand/ fingers by making a full fist and then stretching your fingers out several times a day. It is not enough to just wiggle your fingers!
The same applies to your shoulder; you need to move your shoulder through its full overhead range of motion every day.
The above will really save you a lot of problems and reduce the amount of physiotherapy needed at a later stage. At Iona Physiotherapy we can give you the appropriate exercise programme, in the very first few days after your fracture in order to prevent such complications and allow your subsequent rehabilitation to be as straightforward as possible.

Injuries

Golfer’s elbow

Pain on the inside of the elbow (common flexor tendon) that is associated with manual tasks is known as golfer’s elbow. This is less common than tennis elbow.
Pain may also occur on the inside of the elbow if there is a problem at the neck, which causes referred pain down to the inside of the elbow, or if activities such as throwing place strain on the structures on the inside of the elbow.

At IONA Physiotherapy, you can expect a thorough assessment of your entire upper limb and neck, in order to determine what the problem is and formulate an appropriate treatment plan. This may include manual therapy, exercise and an analysis of you sport/ work environment.

Injuries

Tennis elbow

Most people who get tennis elbow don’t play tennis, in fact the term now used is Lateral Epicondylalgia (or LE for short!). Symptoms include pain on the outside of the elbow with gripping and sometimes even with bending and straightening of the elbow.
In recent years there has been some exciting research in this area confirming the effectiveness of physiotherapy in managing this condition.

Contrary to what was popularly believed in the past, inflammation is not present in the tendons around the elbow, which explains why anti-inflammatory medications may not help. While the pain from a tennis elbow is located at the tendons on the outside of the elbow (common extensor tendon), a significant proportion of people with tennis elbow also have a problem with their neck that is a contributing factor.

At IONA Physiotherapy you will receive a thorough assessment of your elbow, shoulder and neck to determine the reason for your elbow pain and importantly, why it developed. Treatment will include manual therapy to your elbow and/ or neck and a specific exercise programme which has been shown in research to speed up recovery and prevent recurrence of tennis elbow.

A research paper published in the British Medical Journal (2006), compared physiotherapy to corticosteroid injection for tennis elbow and reported that physiotherapy achieved the best long term results.

Treatments

Ergonomics Interventions

Ergonomics is the science that studies the relationship between how we work and the environment we work in. Good ergonomics allows a person to work in an environment that causes minimal physical strain on the body and is a crucial part of injury prevention. This is important for all of us- no matter what we work at! For example:

For a person with a desk based job: having the screen, chair or computer mouse at the incorrect height, or in the incorrect place, may predispose someone to developing a neck or upper limb problem.
For a chef: given the repetitive nature of food preparation and the demand to be standing, having the work surface https://www.osha.gov/SLTC/etools/computerworkstations/checklist_purchasing_guide.html

at the incorrect height could be a contributing factor in developing low back pain.
For a musician: poor technique, posture and an incorrectly sized instrument could predispose to neck or shoulder pain and even overuse injuries at the wrist.

At IONA Physiotherapy, we have a particular interest in ergonomics and work place assessments as we see this as an important part of a comprehensive rehabilitation programme and in injury prevention. Making our work environments a pleasant and productive place is of interest to employees and employers alike. Ergonomic and work placed assessments can be arranged on an individual basis or a workshop can be carried out in a group setting.

If you use a computer at work or home, run through this self-assessment checklist from the Occupational Safety and Health Administration (OSHA) in the US, to assess and improve your setup.

https://www.osha.gov/SLTC/etools/computerworkstations/checklist_purchasing_guide.html

Treatments

Taping and Strapping

There are many different types of taping materials and techniques and chartered physiotherapists are experts at selecting the type of tape and technique that is most appropriate for you:

Rigid Strapping Tape (sometimes referred to as sports tape) can be used to stabilise or support a ligament injury, relieve pain by unloading the painful tissues or facilitate normal movement.
Elastic strapping tape can be used when less support or rigidity is required for example, supporting a muscle strain.
Kinesiology tape is a type of elastic tape that assists how muscles function during movement.

At IONA Physiotherapy we offer many types of taping and strapping materials and techniques for foot strapping, ankle strapping, knee strapping, shoulder strapping , wrist/hand/ thumb strapping, hamstring muscle strapping, calf muscle strapping etc. Taping can be a useful adjunct to your rehab from injury, including allowing return to sport while protecting an injury but the exact diagnosis and extent of your injury are the major determinants of return to sport. Following a thorough musculoskeletal assessment, we will discuss with you whether or not taping will be helpful for your problem and which type of tape and taping technique is most appropriate.

Treatments

Orthotics

You rely on your feet to propel you for almost every physical activity you do. The foot is a complex structure that moves in 3-D motion. For optimum function and comfortable feet, the biomechanics need to be finely tuned and working efficiently.

A problem with the biomechanics of your feet (e.g. over pronation, supination etc.) can cause a feeling of “tired feet” or pain in the feet, knees, hips and spine. Orthotics (a special type of insole in your shoe) work to optimize the biomechanics of the feet, leading to less strain on your feet, lower limbs and spine. The range of orthotics available is comprehensive; ranging from a simple off the shelf device to a device that is custom made (from a mold of your foot) in a laboratory for your individual foot.

We can customize your orthotic depending on your foot mechanics, your weight, sport, level of activity and type of shoes that you wear. Of course, like glasses, not everyone needs orthotics and sometimes advice regarding the most appropriate footwear for your foot type is sufficient. The best treatment option will be discussed with you after a comprehensive biomechanical assessment.

Treatments

Sports Physiotherapy

As Clinical Specialists in Musculoskeletal Physiotherapy, we are specialised in the diagnosis and management of problems of the musculoskeletal system (i.e. muscles, tendons, joints, ligaments, nerves, connective tissue etc), including sports injuries. Sports injuries can result from mechanical trauma (acute injuries e.g. ligament sprain) or repetitive overload to the musculoskeletal tissues (overuse injuries e.g. tendinopathy or stress fracture).

At IONA Physiotherapy, we see people from all types of sport, including dance performance. There are only so many ways to injure the musculoskeletal system but each sport carries with it various physical demands and risks of injury. Rehabilitation following injury must vary accordingly which is why, with the same injury e.g. an ankle sprain; the rugby player will be rehabbed differently to the teenage gymnast, ensuring a safe return to sport.

Sports physiotherapy encompasses this difference in focus and also includes injury prevention. Pre-season screening is available for all sports people and performers and will form the foundation of an individualised exercise programme aimed at minimising the risk of injury throughout the season.

Treatments Uncategorized

Manual Therapy

manual-therapy

Manual Therapy

Manual therapy is the umbrella term used to describe manual treatment techniques applied to the soft tissues and joints of the musculoskeletal system. Manual therapy includes soft tissue massage (such as Swedish Remedial Massage or trigger point compression), joint mobilisations (such as Maitland’s low velocity joint movements) and joint manipulations (high velocity thrust techniques).

Manual therapy may also include active techniques, meaning that the patient applies their own force to assist with the mobilisation technique, such as Muscle Energy Techniques or Mulligan’s Mobilisations with Movement.

Research has shown that manual therapy can provide significant short to medium term improvements in pain, movement and function and has a much better effect overall, when combined with exercise therapy. This means that, for example, for low back pain, manual therapy will significantly help reduce pain and regain movement and facilitate a patient making more permanent progress with prescribed exercise.

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