Author: Michael Earley

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Exercises for managing Knee Osteoarthritis

Knee osteoarthritis (OA) can be a challenging condition, impacting mobility and reducing the quality of life for many people. 

Did you know that a chartered Physiotherapist can play an important role in managing knee OA?

Understanding Knee Osteoarthritis

Before exploring the benefits of physiotherapy, it is important to have a basic understanding what osteoarthritis is. 

OA is a degenerative disease that can affect the bone and cartilage in joints, making them stiff and painful. 

There are many factors that can contribute to the development of OA, such as ageing, injuries, and even genetics.

The role of Physiotherapy

1: Pain management:  Your Physiotherapist can employ various techniques to alleviate pain associated with knee OA.  This may include manual therapy, such as joint mobilisations, to reduce stiffness and enhance flexibility.

2: Exercise prescription: Specific exercise programs are a cornerstone of management for knee OA. Strengthening exercises to target the muscles groups that support the knee will help provide stability and support.

3: Education and self-management: Your physiotherapist will educate you on correct ergonomic advice, howe to protect the joint, and any lifestyle modifications that may be deemed appropriate.  This can empower you to actively self-manage the condition.

4: Weight management: Excess weight can often put additional stress on joints, and as such, weight management strategies may form part of the overall holistic approach to managing OA.

5: Gait training: Abnormal gait patterns can exacerbate joint pain.  Your physiotherapist can advise you should you need any assistance devices to limit any unnecessary exacerbations.

What's Next?

Physiotherapy is an important part of managing knee OA. Through a multi-faceted approach, encompassing pain management, exercise prescription, education, and lifestyle modifications, your Chartered Physiotherapist will empower you to take an active role in managing your condition.

If you have been diagnosed with osteoarthritis, please book an appointment with us by booking online here or calling us on 01 -797 9545

 

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Blog

Physio for Headache

Physiotherapy and headaches

Did you know that many headaches originate from the neck?  These headaches are known as Cervicogenic Headaches (CGH), and they occur due to some dysfunction in the upper 3 segments of the spine.  Thankfully, physiotherapy can help with the treatment and management of a CGH.

What causes Cervicogenic Headaches?

A mechanism known as “Convergence” means that pain coming from your neck can be perceived by your brain as a pain in your head.

This occurs because the nerves from the upper part of the neck converge (meet at the same point) with a sensory nerve in the head called the Trigeminal nerve.  If there is dysfunction in the neck, when these two signals converge, the brain mistakes the dysfunctional message as coming from the head and causes the headache.  It is simply referred pain from the neck.

“Convergence” also explains why sometimes people with gallbladder problems can feel the pain into the tip of their right shoulder. The body is pretty amazing!

 

How can a physiotherapist help?

As physiotherapists, we can help alleviate your symptoms through guided exercise prescription, advice, and manual therapy.

If you think you may be suffering from cervicogenic headaches, please book an appointment with us for an assessment.

*Please note that there are numerous causes for a headache, and numerous different types of headaches.  This article is only related to cervicogenic headaches.  If you have a headache with any of the following symptoms, please seek urgent medical care: Sudden onset, worsening in nature, blurred vision, dizziness, loss of balance, slurred speech, blind spots, fever, nausea or vomiting, shortness of breath, confusion, a headache after a fall or a concussion, stiff neck with a rash.

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Back pain and working from home

For many of our patients at IONA Physiotherapy in Drumcondra,  ever-increasing computer usage can be associated with neck, shoulder and even arm pain.  Often, if the computer workstation is not set up well, this neck and shoulder pain gets worse, the longer you spend at your computer.   Sound familiar?   The good news is, is that there is lots you can do to optimize your workstation and minimize discomfort!  Neck and shoulder pain is one of the most common complaints that we see at IONA Physiotherapy in Drumcondra, and an analysis of the workstation is an important part of the assessment.  Based on the most common mistakes that we see, here are our top tips!

Top tips for Improving your computer Workstation

  • If you use a laptop, make sure that you can separate the keyboard from the screen. An old keyboard that you can plug into your laptop will do the trick, allowing you to move the screen away from you to the correct position.
  • The top of your screen should be level with your eyes, and should be placed directly in front of you.
  • If you need glasses for the computer, wear them!  Otherwise, you are likely to lean your head excessively forward to read the text, causing strain which can lead to neck and shoulder pain.
  • Ensure that there is enough cord attached to your keyboard to allow you to place your keyboard close to you. Your arms should not need to reach forward to use the keyboard.
  • Similarly, you should be able to easily reach the mouse with your arm comfortably by your side. Consider a shorter keyboard if you don’t frequently use the number’s keys on you keyboard.
  • Your feet should be flat on the floor, if your feet don’t reach the floor while sitting back into your seat, use a foot rest.
  • The chair should be firm but covered with soft padding.  Ideally it should have a lumbar support to support the natural hollow in your lower back.  The backrest should recline roughly 15 degrees, and lock into position, allowing you to rest back into your seat.
  • If the chair has arm rests, they should slide under the desk, allowing you to get close enough to your keyboard.
  • Use a document holder between your keyboard and screen if your work combines computer and paper work.

 

 

What next?

The above are some examples of the most common mistakes that we see at IONA Physiotherapy in Drumcondra.  This does not take the place of a thorough assessment by a physiotherapist, but it’s a good start!  For further information regarding the set up of your work station, click on the following link:

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

 

We hope that the above helps, however if you continue to have ongoing pain or discomfort, then we recommend that you make an appointment at the clinic for an assessment.  Please phone 01 7979545 for appointments.

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Blog Injuries

Ankle pain and how to treat it

What causes ankle pain?

There are many reasons someone may suffer from ankle pain. For the purpose of this article, we will
focus on one of the most common ankle injuries, namely a lateral ankle sprain.
Injury to one or more of the lateral ankle ligaments typically happen when you ‘roll your ankle’. This is
when the foot rolls inwards suddenly, maybe over a curb or from an uneven surface. This can sprain or
tear the supportive ligaments on the outer ankle and cause pain, swelling and difficulty walking.

Ankle Pain

How to treat ankle pain?

If your ankle is swollen then it is recommended to adopt the PRICE protocol for the first 48 hours.
PRICE stands for: Protect, Rest, Ice, Compression, and Elevation. This can be done by wearing a
bandage or an ankle sleeve, applying ice to the region for 10 minutes 3-5 times a day, resting, and
elevating your foot while resting. This should help speed up healing and reduce your ankle pain over the
first few days. In fact if you do this, you are likely to not only get better faster but also need less
physiotherapy sessions!

What can my physio do?
The good news is that most ankle sprains are not serious, however, they do require rehabilitation. Your
physiotherapist will guide your ankle rehab. Exercises and therapy will focus on restoring full normal
range of motion to your ankle, ankle strengthening and balance training.
A guided rehabilitation program, prescribed to you by your chartered physiotherapist, will enable you to
return to your chosen activities and greatly reduce your risk of recurrence.

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Blog Uncategorised

What’s Behind Our Name?

Physio-in-Glasnevin

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So many people have asked us down through the years how we came up with the name ‘IONA Physiotherapy’. 

Firstly, it’s not a misspelled version of “I own a physiotherapy practice”. Secondly, we do not have any links to the Iona Institute! 

Historical Roots

Many of the streets in the surrounding area of Glasnevin are called after Iona, an island off the coast of Scotland. And so, the name actually stretches way back to monastic Ireland as Iona had links to Saint Mobhí, an abbot of Glasnevin monastery in the 6th Century.

As we are deeply rooted in the community, we thought it appropriate to use the local placename in Glasnevin for our physiotherapy practice. IONA Physiotherapy has been providing private physiotherapy to the surrounding areas of Glasnevin and Drumcondra since 2001. 

All of our physiotherapists have a Masters Qualification meaning that we can provide an expert level of service, so that you get the best possible care. If you’re looking for a physio in Glasnevin, Drumcondra or the surrounding areas of Dublin 9, we would be delighted to help.  Bookings can be made online here, or by phoning the clinic here.

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Blog

Tips for dealing with Tennis Elbow

Tennis Elbow
Tennis Elbow

 

If you’ve ever had pain on the outside of your elbow with gripping objects or lifting, you’ll understand just how annoying it can be not to be able to use your arm properly. 

 

Tennis elbow, known as “lateral epicondylalgia” in medical circles, is very common, affecting roughly 3% of the population.   It is more common in manual workers and tennis players, but lots of people who do neither of these activities also develop this condition.   The pain is typically felt on the outside of the elbow, with activities such as gripping and lifting, particularly with the elbow straight and the palm of the hand facing down.  When severe, people may also complain of pain at rest, without moving the arm, or pain with just bending and straightening the elbow.

 

MRI or ultrasound of the tendons on the outside of the elbow may show some degenerative changes (wear and tear.)  However, radiological imaging is not particularly helpful in most cases, as research has shown that these kinds of changes are seen just as frequently in those without symptoms. 

Tennis elbow diagram showing a detail of the damaged tendon tissue.


The research in this area has been really fascinating over the last few years.  Research has shown that there are widespread changes in the sensory system, in those with tennis elbow.  Simply put, if you press on the shins of someone with tennis elbow, they will register pain quicker than those without!  They are more sensitive to pain all over.  The muscles of the whole upper limb also change, showing a reduction in grip strength and a failure of the muscles around the wrist to be able to hold the wrist in a good position during functional activities.  So, it seems that with tennis elbow, it is not as simple as the problem being confined to the tendons on the outside of the elbow.  Often the trigger is excess load or more load than the person is used to, causing pain in these tendons on the outside of the elbow.  This then is associated with widespread changes to the sensory and muscle system at and beyond the elbow.

 

This research may sound complex, but it has given us as physiotherapists a much better understanding of what is happening at the elbow, meaning that physiotherapy is now a very effective treatment for tennis elbow.  In fact, physiotherapy is now considered the gold standard of treatment, and any possible new treatments need to be benchmarked against that.  Injection and shock wave therapy have been shown in research to be ineffective treatments, with worse outcomes medium to long term (than controls) for those who receive an injection for tennis elbow, which cannot be reversed by physiotherapy.   Your physiotherapist will also assess your neck, as this can be an underlying factor causing some elbow pain, and needs to be addressed in order to achieve a good outcome.

 

Some tips

  • Don’t rub, or let anyone else rub/massage/friction the tendons on the outside of your elbow.  Remember there are changes in the sensory system with tennis elbow and “pushing on the sore bit”, because of increased sensitivity, just tends to make the pain worse.
  • Don’t have any injection for tennis elbow, without trying a good rehabilitation programme first.
  • If there are any factors which could be causing strain on your neck, address those e.g poor ergonomics, sleeping on your tummy at night etc.  Ongoing neck pain/stiffness is a risk factor for developing tennis elbow and other types of referred elbow pain. 

IONA Physiotherapy is a Clinical Specialist Practice.  All of our physiotherapists are chartered and have a Masters Qualification.  For appointments or further information, phone: 01 7979545

 

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Blog

What to Expect When You Attend Your Chartered Physiotherapist

physio-first-time

 

 

Your first Physiotherapy Session 
Your first visit with a Physiotherapist will involve us asking you some questions and listening to your story regarding the history of your injury or condition.  We will also take a detailed medical history. This allows your Physiotherapist to gain a better understanding of you and your problem and helps direct the physio assessment.  This is the cornerstone of being able to make an accurate diagnosis, which will direct your physiotherapy treatment plan and optimise your recovery.  So, forgive all the questions, but it is so important that we get to the bottom of what is wrong!


Do I need a GP referral for Physiotherapy?

It’s not necessary to have a GP referral to attend IONA Physiotherapy but if you already have a letter from your GP, consultant or other health professional as well as any written reports from any scans and investigations related to your problem, do take them with you so  that your Physiotherapist can understand the background of your issue better. 

 
What should I wear to Physiotherapy?

Wear loose, comfortable clothes that you can move well in and that you feel comfortable in. This also allows your Physiotherapist to assess your injured area or condition better, e.g. shorts for a knee, ankle or foot problem; a vest/loose top for back, shoulder or arm problem. 

 

If you have an injury or pain in your feet, please bring a selection of the shoes that you wear most often.  We may need to look at your footwear to see if it is contributing to the problem.  Also, if you need orthotics, it is helpful if you have the shoes that you wear most often with you on the day of your appointment.

 
Do I need to bring anything?


If you are attending as a result of a sporting injury, it can be useful to bring in your usual sporting equipment, e.g. for runners, bringing in your usual pair of runner shoes; for a tennis player, your tennis shoes and racket, etc. It can also be of benefit to take a video of yourself in action, playing your sport, so that we can have a look at your usual technique and biomechanics.  Remember, when taking the video, do what you usually do for the camera and not what you think you should do! Seeing you in action gives us a wealth of information about your biomechanics, movement patterns and technique which may be contributing to your injury.

 
Arrive early!


If this is your first visit, it is helpful if you can arrive 5-10 minutes before your appointment time, so that you can fill in any necessary paper work before you are called in for your appointment. 








IONA Physiotherapy is a Clinical Specialist Practice.  All of our physiotherapists are chartered and have a Masters Qualification.  For appointments or further information, phone: 01 7979545.  www.ionaphysio.com – Online booking coming very soon
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Blog

Basketball Injuries and Lateral Ankle Sprains

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Basketball is a non-contact sport, but this doesn’t make it a non-physical sport! As a sport, it involves complex movements including jumping, abrupt turns, changes of direction and deceleration, moderate- to full-speed running, side-stepping and back-peddling. Several research studies published looking at injuries in basketball have shown that the body parts that are most injured are the ankle and the knee (Andreoli et al., 2018; Clifton et al., 2018; Cumps et al., 2007; Zuckerman et al., 2018). The main focus for this blog will be ankle injuries, specifically lateral ankle sprains.

Lateral ankles sprains (LAS) occur on a sudden turning in of the ankle and foot (inversion) causing stress to the lateral structures of the ankle joint as bodyweight is put through it. This can happen if you jump in the air and land awkwardly, land on another player’s foot, or on sharp changes of direction. The most common ligament to injury in this way is the Anterior Talo-Fibular Ligament (ATFL) but other lateral ligaments and muscles groups, including the peroneal muscles tracking down the side of your shin and ankle, can be affected as well. ATFL attaches to the joint capsule of the ankle so swelling and bruising, is almost immediate for a lateral ankle sprain.

What should you do if this happens to you? As the rule goes, if in doubt, get it checked out! Ankle fractures happen in roughly 10-12% of lateral ankle sprains (Kerkhoffs et al., 2012). However, if there is bony tenderness at your ankle joint and/or at the smaller bones of the foot and you’re also not able to walk more than four steps, an X-ray is advisable. This is the recommendation from clinical guidelines called the Ottawa Ankle Rules regarding ankle X-rays following injury (see below).

 

 

 

 

 

 

 

 

 

 

 

On the other hand, if you’re able to put some weight through your ankle after you have “rolled” it but aren’t able to continue to train or play, it’s best to follow the POLICE principles (Bleakley et al, 2012):

P = Protection 
In this instance, protection means sitting out of training or a game to “protect” your ankle from further injury. You may also require ankle taping carried, an ankle brace or support bandage, or even crutches. However, these, protection strategies should not be long-term.

O = Optimal  L = Loading
Optimal Loading is not the same as rest. It is based on the evidence that “early activity encourages early recovery.” All this means is that you gradually start to move and weight-bear through your injured ankle as much as you can tolerate, early and often. If you only stick to “rest”, you run the risk of the ankle joint stiffening up, the muscles that help the ankle move may become deconditioned and your balance and ability to run/land/jump may be detrimentally affected, resulting in return to playing at a lower level than before you were injured. This in itself is a risk factor for further lateral ankle sprains.

I Ice
Ice helps your ankle sprain by promoting a pain-relieving, numbing effect to the injured area, and although somewhat controversial, is thought to reduce swelling.  Avoid putting ice directly onto your skin – wrap it in a dampened towel or a dampened spare sock. If there is any numbness to your ankle post-injury or there is an open wound, do not apply ice.

C Compression
A simple tubigrip or elasticated support bandage may be useful at the acute and chronic stages of your ankle sprain to help with pain and possibly with swelling – it should be tight but comfortably so. Taping also comes under this category.

E Elevation
This is useful for swelling and pain management – and it’s a perfect time to do your rehabilitation exercises of gentle active ankle movements!

Usually minor to moderate ankle sprains take between 4 weeks and 2-6 months to fully recover. To prevent further ankle sprains, and to also prevent them occurring in the first place, balance and strength work for your ankles and lower limbs is crucial. This should include landing mechanics and multi-directional work.  All of this rehabilitation is crucial so that the sensory nerve endings in your ankle and lower limb, feedback accurate and timely information to your central nervous system (including your brain), that the brain integrates this information well, so that the right message is sent to the correct muscles, at the correct time, and that your muscles are strong enough to act.  This pretty impressive system is called sensorimotor control and is crucial to preventing re injury. Prophylactic taping and bracing of the ankle is also useful but should be used to complement your balance and strength work for the ankle, not replace it.

If you are returning to basketball, or any other sport, after an ankle sprain or need some advice regarding assessment and management of your current injury, contact us here at IONA Physiotherapy.

 

References

  • Andreoli, C.V., Chiaramonti, B.C., Buriel, E., Pochini, A.C., Einisman, V., Cohen, M. (2018) Epidemiology of sports injuries in basketball: integrative systematic review. BMJ Open Sport and Exercise Medicine, 27;4(1):e000468. doi: 10.1136/bmjsem-2018-000468. eCollection 2018.

  • Bleakley, C.M., Glasgow, P., MacAuley, D. C., 2012. PRICE needs updating, should we call the POLICE? BJSM, 2012; 46(4): 220-221.
  • Clifton, D.R., Hertel, J. et al. (2018) The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls’ Basketball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women’s Basketball (2004-2005 Through 2013-2014). Journal of Athletic Training, 53(11):1037-1048. doi: 10.4085/1062-6050-150-17.
  • Cumps, E., Verhagen, E and Meeusen, R. (2007) Prospective Epidemiological Study of Basketball Injuries During One Competitive Season: Ankle Sprains and Overuse Knee Injuries. Journal of Sports Science Medicine, 6(2): 204-211. Published online 2007 June 1.
  • Kerkhoffs, G.M. et al. (2012) Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. BJSM, 46:854–860. doi:10.1136/bjsports-2011-090490
  • Taylor, J.B., Ford, K.R., Nguyen, A.D., Terry, L.M., Hegedus, E.J. (2015) Prevention of Lower Extremity Injuries in Basketball: A Systematic Review and Meta-Analysis. Sports Health, 7(5):392-8. doi: 10.1177/1941738115593441. Epub 2015 Jun 26.
  • Zuckerman, S.L., Wegner, A.M., Roos, K.G., Djoko, A., Dompier, T.P., Kerr, Z.Y. (2018) Injuries sustained in National Collegiate Athletic Association men’s and women’s basketball, 2009/2010-2014/2015. BJSM, 52(4):261-268. doi: 10.1136/bjsports-2016-096005. Epub 2016 Jun 30.
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Blog

VHI Women’s Mini Marathon for newbies

 

Even though it’s early February, many of you out there are already planning to do the VHI Women’s Mini Marathon in June as a running newbie. You may have already started on a Couch-to-5k programme, you’re following your own training programme from a running magazine or website or have taken those tentative first strides at your local park run. Here are a few helpful nuggets to help you on your way to the starting line on June 2nd.

Everyone’s training goals and reasons for doing an event are all different but one thing should be the same: train smart and keep it consistent. Start off slowly and build up your mileage sensibly with no big spikes or troughs in your training. Think of the “10% rule”:  increase your mileage 10% each week. Aim to do a dynamic warm-up before you head out the door: high knees, stride outs, heel raises, trunk rotations, heel kicks and if you’re really stuck for time, do a few jumping jacks! Also remember to factor in a recovery day or two each week. Recovery is vital to any training in every sport and should include good sleeping habits and good nutrition/hydration strategies. Keeping a training log is a great way to track your progress. It’s also really helpful to jot in a few lines about how you felt on each run because, realistically, some runs feel epic while others feel like you’re treading through mud. It’s also a useful way to spot illness or injury early.

Stretching and foam rolling are good ways to keep your body supple and to manage feelings of muscle tightness post-run. However, one of the best ways to keep you on the road is actually doing some supplementary strength training. This is not about getting bulked up and you don’t need to go to a gym for strength work either: all you need to do is a few simple body weight exercises to ensure that as you up your mileage, your muscles maintain their capacity to allow you to run further and to help minimise injury.

Some suggestions to start with are:

  • Squats
  • Double and single leg bridges
  • Double and single leg heel raises with the knees straight and with the knees bent slightly
  • Forward lunges

And of course Good Luck!