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What is 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.

Categories
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?

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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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COVID-19: Level 3, 4, and 5 restrictions and access to Physiotherapy.

Here are some frequently asked questions and answers.

Q: Can I still attend a physio appointment under level 3, level 4, and even level 5 restrictions or lockdown?

A: Yes, IONA Physiotherapy clinic is open and will remain open under all levels of Covid restrictions, as an essential health service provider.

Q: What precautions are in place for my visit to the clinic?

A: At IONA Physiotherapy, we have put rigorous infection control measures in place to keep you and our staff safe.  The consultation begins with a video call prior to entering, outside the clinic, where you will be asked some screening questions. 

The physiotherapist will be wearing PPE and adhering to strict infection control guidelines.  All staff temperatures are checked every day.  Your temperature will be taken on entry.  You will be given a brand-new medical grade mask for your visit.  The level of protection from a mask is really important, so we use a specific grade that is used in hospital settings (EN 14683:2019.) 

We will open the doors for you, and take payment through your phone to minimise touch points.

Touch-free hand sanitizers are in every room and hallway of the clinic.  Both you and the physiotherapist will use the sanitiser before your appointment begins and again as you exit the building.

We have a one-way system in place, to ensure you do not physically meet any other patients on entry or exit.

We have put enormous effort and planning into our health and safety response to Covid-19.  Our motto is to give each patient the same level of care as we would our own nearest and dearest.  Our in-house Covid safety plan is 80 pages long!  We won’t bore you with the details, but you can get a sense of our level of attention to detail by watching our health and safety video here. 

Q: What if I need physiotherapy but am cocooning, or prefer not to visit the clinic?

A: No problem, we have a video-link appointment option that can ensure you get access to physiotherapy without needing to attend in-clinic.  This is through doxy.me which is really easy to use.  You don’t need to download any software, we just send you an email or text with a link, which you then click on.  Remember to allow your microphone and camera.

Note: Do not attend if you are experiencing symptoms, have been a close contact with a confirmed case, you or anyone of your household are waiting to be tested/ waiting on a test result, or you have been abroad in the last 14 days.  Please phone first.

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Blog

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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Blog

Tips for dealing with 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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What to Expect When You Attend Your Chartered Physiotherapist

 

 

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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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.