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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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Lifestyle Overhaul?

Do you have a niggling feeling that your lifestyle needs an overhaul? Do you know what the signs and symptoms are that you need to make some changes? Find out about Metabolic Syndrome and if it could apply to you…….

Metabolic syndrome is not a disease in itself.  It is actually a group of risk factors which can increase the risk of heart disease, stroke, and diabetes.

The five different risk factors that make up Metabolic Syndrome are:

1: Excess visceral (belly) fat

2: Increased blood pressure

3: High blood sugar level (insulin resistance)

4: High triglycerides (“bad cholesterol”- measured by a blood test)

5: Low level of HDL (“good cholesterol”)

Metabolic Syndrome is diagnosed if a person has excess fat around the waist in addition to any two of the above risk factors.

 

Signs and Symptoms

There are various ways of measuring visceral (belly) fat. One simple tool, is waist to height ratio. Ideally your waist measurement should be less than half your height.  

Excess thirst and / or an increase in the number of times you urinate may indicate high blood sugars (warrants an appointment with your GP.) 

In lots of cases though, the signs and symptoms are not very obvious to people.  In fact, it is estimated that between 25% and 43% of the world’s population may have MetS, with a significant number unaware of this.

 

Implications of having MetS

Metabolic syndrome can have a significant effect on your overall health.  The syndrome can give rise to Type 2 Diabetes and heart and blood vessel disease.  These complications can be chronic and can often take a lot of effort and medication to effectively manage and treat them.

Why is too much belly fat considered a problem?

Adipose tissue (fat), does not quietly sit in the background, in fact, it is metabolically active. This means that it is causing cellular changes within your body.  Adipocyte (fat cells) can get enlarged and stimulated to produce excess amounts of adipocytokines (messenger molecules.)  One of these adipocytokines are called Free Fatty Acids (FFA).

These FFA’s in turn inhibit the uptake of glucose into healthy muscle tissue.  This means that there is excess glucose circulating in your blood, and optimal muscle contraction and repair is impaired.  The result is sub-maximal muscle performance, increasing risk of injury and pain.  The metabolic disturbance can also affect the quality of your tendons (achilles tendon for example) by way of overproducing Type III collagen in the tendon.  Type III collagen is stiffer and less elastic and can be a factor in achilles tendon pain.

Sub-par muscle performance, can indirectly impact on your joints, such as the knee or hip, increasing the risk of pain and pathology in the joint.   

In addition to creating extra load on joints, excess body fat leads to widespread low grade inflammation throughout the body.  This can contribute to a feeling of “aches and pains all over” and make local joint problems feel more painful.

Management of MetS

So that’s the science.   In practice we often find that this patient group can feel really stuck!  They may know that they need to overhaul their lifestyle and increase their exercise but have a problem such as back/hip/knee/foot pain that makes it difficult to get started.  This is where your chartered physiotherapist can help, though a combination of treating the problem that is making exercise difficult and prescribing a tailored exercise programme to help you become more active without aggravating your current injury.  A combination of positive diet and exercise changes can reduce the risks (associated with MetS) of developing cardiovascular disease significantly.

If this resonates with you, and you’d like an appointment, please click here

 

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Rotator Cuff Related Shoulder Pain

What is Rotator Cuff Related Shoulder Pain?

“Rotator Cuff Related Shoulder Pain”

The rotator cuff is made up of a group of muscles that help keep the head of the humerus bone (‘the ball’) in the shoulder socket.  The rotator cuff muscles are also involved in moving your arm up and out to the side and rotating the shoulder.

“Rotator cuff related shoulder pain” is commonly seen with people who perform repetitive overhead activities such as painters, swimmers, tennis players etc. “Rotator cuff related shoulder pain” can also develop after a one-off event such as a fall or a quick jolt.

People who have “rotator cuff related shoulder” pain may have pain on the outside of the upper arm that is usually made worse when lifting the arm overhead.  It can also be painful to lie on the affected side.  In more severe cases, the pain may be constant, rather than only on specific movements. 

Types of Rotator Cuff injuries

Injuries to the rotator cuff muscles and/or tendons are quite common.  Anytime we use our hands and arms for any day to day task or sport, we are simultaneously using our shoulder muscles.  Injuries to the rotator cuff can occur at any age.  As well as the rotator cuff muscle and tendon complex, there are other structures in the shoulder that can cause pain.  Here are three of the more common causes of “rotator cuff related shoulder pain”.

1: Rotator Cuff tendinopathy

Tendinopathy can be acute (recent occurance) or chronic (lasting for weeks or months).  It is where there is degeneration or inflammation of the tendons, which causes pain.  This may be caused in some cases by repetitive overhead activities, a recent increase in shoulder exercise, or even a return to previous levels of activity, after a long period of inactivity.

2: Rotator Cuff tear, partial or full-thickness

This is where one of the rotator cuff muscles or tendons tear partially or fully.  This can happen due to a trauma, degeneration, or indeed from repeated microtraumas.  

3: Bursitis / sub acromial pain / impingement

You may hear the above terms in relation to shoulder pain.  Sometimes in reports such as an MRI report, bursitis may be reported, or sub-acromial impingement.  A recently published International Consensus Paper (Requejo-Salinas, Lewis et al, 2022) recommended that the above three terms were not clinically useful and that the term “Rotator Cuff Related Shoulder Pain” be an overarching term to include ‘bursitis’ and ‘impingement’.

Can Physio help?

Yes! We will start with a comprehensive assessment.  This is important so that we determine the reason for your shoulder pain, and start you on the right path to recovery.

Rehabilitation for “rotator cuff related shoulder pain” often involves a combination of manual therapy, and a graduated programme of strengthening exercises.  The exercises will be sepecific to you, depending on your contributing factors.  The exercise programme is not a ‘one-size fits all’ approach.

We will also investigate lifestyle factors specific to you (ergonomics, sports technique, posture, sleep etc.), so that your rehabilitation programme is tailor made, giving you the best possible results.

Start your recovery today, book online at: www.ionaphysio.com 

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What is a ‘Sports Physio?’

Do I need a 'Sports Physio?'

 

DO I NEED TO SEE A ‘SPORTS PHYSIO’?

The term ‘sports physio’ is used a lot, and you if you are involved in sport and get injured, you may be advised to seek out a ‘sports physio’. 

So, what is a ‘Sports Physio’?

Sports Physiotherapy’ (or sports physio) is a specialist area of physiotherapy that involves assessment, treatment and rehabilitation of sporting related injuries.

Chartered physiotherapists that specialise in musculoskeletal injuries are experts in treatment of all sporting injuries and for all age groups.

At IONA Physiotherapy clinic in Drumcondra, our team is made up of clinical specialists and senior musculoskeletal Physiotherapists.  Our physiotherapists have previously worked in professional sport and performance with Leinster Rugby and Riverdance among others.

If you are looking for a ‘sports physio’, then please contact our experienced team for a thorough assessment and rehabilitation program.

     

     

 

 

 

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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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Hamstring Muscle Injuries

Hamstring Muscle Injuries

If you are involved in sport, at any level, you will know someone who has had a hamstring injury, or you may have even had a hamstring injury in the past yourself.

 

What are the hamstrings?

They are a group of muscles located at the back of your thigh. Their primary function is to flex (bend) the knee and extend (straighten) the hip. They also have other functions, such as stabilising the knee joint and the pelvis.

They are named Bicep Femoris, Semitendinosus, and Semimembranosus.

There is also a 4th muscle that blends with the hamstrings called Adductor Magnus

How do they get injured?

There are a few ways in which a hamstring can get injured, but typically the mechanism of injury may be:

  • Running / sprinting

  • Kicking

  • Bending over from the hip

 

 

Rehabilitation

Adequate rehabilitation is essential, and your chartered physiotherapist will guide you through this process. The length of time from injury to a safe return to your chosen activity will largely depend on the severity of the muscle injury.

Muscle injuries are graded either: Grade I, Grade II, or Grade III.

Grade I muscle injury: A mild muscle strain

Grade II muscle injury: A partial muscle strain

Grade III muscle injury: A complete muscle tear or rupture

Thankfully the most common injuries are the Grade I and Grade II strains.

 

Rehabilitation Process

The overall aim of the rehabilitation period will be to strengthen your hamstring back to its pre-injury level and stronger.

Your physiotherapist will structure your rehabilitation into phases. Initially the goal will be to eliminate pain from walking and day to day activities. Once that landmark is achieved you can start loading (strengthening) your hamstring.

As the primary functions of the hamstring muscle group include flexing the knee and extending the hip, the strengthening exercises prescribed will reflect this.

Your program may include the following exercises:

  • Bridge

  • Squat

  • Split Squat

  • Deadlift

As well as strengthening exercises your physiotherapist will aim to include running as early as possible into your program. As you progress and get closer to full fitness some plyometric exercises will be added as well as some running drills.

 

Return to sport

You will set specific goals around return to sport with your physiotherapist. Your physiotherapist will explain and set out the specific criteria that you must meet in order to achieve these goals. This will help you understand your progress and achieve a successful outcome.

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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