Category: Injuries

A bunion (also referred to as hallux valgus) is often described as a bump on the side of the base of the big toe.
The visible bump is caused by the big toe leaning in towards the second toe, changing the alignment of the joint at the base of the big toe, leading to a visible bump. This condition can be quite painful and make it difficult for shoes to fit. For those with an established bunion, it is important to seek footwear with extra room in the “toe box” area of the shoe to avoid compression of the foot at this spot.

Bunions are usually caused by a variety of biomechanical abnormalities of the foot and are a progressive condition. Poorly fitting footwear is often blamed, but bunions also occur in people whose culture it is not to use footwear. Development of bunions in those who always go barefoot demonstrates the biomechanical nature of the problem. At IONA Physiotherapy, a comprehensive biomechanical assessment will be carried out to determine the cause of your bunion.

Correction of this biomechanical problem with an orthotic can help slow the progression of the bunion and make your foot more comfortable to walk on but it will not get rid of the bunion if it has already started. Surgery is reserved for extreme cases.

This is a general term used to describe pain under the ball of the foot. This usually occurs due to excessive forces occurring through one or more of the metatarsals during walking and running. A comprehensive biomechanical assessment of your lower limb and foot will be carried out before discussing the best treatment option with you. Treatment may include taping, orthotics, advice on footwear and exercises.

If you are making an appointment about a foot problem it is helpful if you bring in the shoes and sports footwear along with you to your first appointment.

Pronation is the way the foot rolls inward when you walk or run. Sometimes this movement of pronation is excessive or too rapid (over pronation.) This is often referred to as “flat feet.”
Overpronation causes excess forces within the foot and further up the lower limb. This can be a contributing factor to developing lower limb injuries such as pain in the arches of the feet, metatarsalgia (pain in the ball of the feet), bunions, plantar fasciitis, Achilles tendonitis and even problems elsewhere in the leg such as shin splints or knee pain (patello-femoral knee pain). Flat feet are not just a cosmetic issue, they can cause pain and cause an inefficient push off during walking and running, slowing down your pace of movement. People with flat feet also often complain of a “tired” or “achey” feeling in their feet by the end of the day, this is particularly problematic for those who walk or stand a lot as part of their occupation.

At IONA Physiotherapy, you will receive a comprehensive lower limb biomechanical assessment and a detailed examination of your foot, both in static positions and during movement. Treatment may include taping, exercises, advice on footwear and orthotics if required.

If you are making an appointment about a foot problem, it is helpful if you bring in your shoes and sports footwear along with you to your first appointment.

Ankle fractures can occur with a twisting or rolling injury to the foot/ankle, a fall and in high impact trauma such as a car accident. The type of fracture .i.e whether it is a stable or unstable fracture will determine your management in hospital i.e. whether you are put in a cast or have surgery. Once your fracture is sufficiently healed, your orthopaedic surgeon will advise you to commence physiotherapy.

At Iona Physiotherapy, we will assess your gait (how you walk), your range of movement, muscle flexibility and strength and proprioception (joint position sense.) Based on your individual assessment, treatment may include manual therapy to restore movement and exercises to improve strength, flexibility, proprioception and function. It is crucial that you regain normal movement (as this can lead to other problems e.g. plantar fasciitis) in addition to normal strength and proprioception (to help prevent further twisting type injuries to the ankle.)

The carpus of the wrist is made up of 8 small bones and these bones are secured together by a complex set of ligaments. Over time, often due to repeated FOOSH in sport, these individual bones can become less securely connected to each other, leading to ligamentous instability. The most common carpal instability is Scapho-Lunate instability, which involves excessive movement between the scaphoid and the lunate bones.

This problem tends to develop slowly over time and can eventually lead to painful gripping, difficulty taking weight through the hand particularly with the wrist in extension (bent back) and painful clicking. Pain and slight swelling is usually noted over the middle of the back of the wrist.

It’s important to diagnose this problem as early as possible as it can lead to long-term wrist problems if it continues unabated. A detailed manual examination will lead to accurate diagnosis of this problem, often earlier than conventional imaging can. Treatment may involve manual therapy, activity advice, exercise and splinting.

A common overuse injury that occurs at the wrist is called deQuervain’s tenosynovitis. It is caused by repetitive activity of the long tendons that control thumb movement and leads to pain and swelling over this tendons at the thumb side of the forearm. Symptoms include pain and swelling over the tendons and maybe even a crunchy sensation over the tendons as the thumb moves (crepitus). Musicians e.g. guitarists, chefs and office workers are all prone to this injury. A thorough assessment is needed to work out why the overuse injury occurred so that training or work practices can be changed to prevent future episodes. Treatment may involve non-steroidal anti-inflammatory medication, icing, manual therapy (massage) and exercise.

The wrist is most commonly fractured by falling on an outstretched hand (FOOSH). You can fracture one of the long forearm bones (most commonly the radius) or one of the smaller wrist bones (carpal bones) such as the scaphoid. If you do sustain a FOOSH and have immediate wrist pain and an inability to put weight through the hand or move the wrist, along with immediate swelling, it’s likely you have fractured your wrist and you should seek medical assessment.
A Colles (radius) fracture is the most common wrist fracture and often displays a ‘dinner fork’ deformity meaning that the back of your wrist resembles a fork turned downwards. This may treated by immobilisation or surgical repair. Physiotherapy will commence after your orthopaedic surgeon has told you that the fracture has united and rehabilitation can begin.

A fracture of the scaphoid bone is less symptomatically severe as a Colles fracture. This bone is found at the base of the thumb. The reason a fracture of this bone is somewhat infamous is because not all scaphoid bones heal well after fracture. The blood supply to this bone can be compromised by fracture, leading to crumbling of the bone over time (avascular necrosis) which leads to longer term problems with the wrist. For this reason, it’s extremely important that this fracture is identified early and treated effectively.

Tendon injury at the Wrist/Hand A common overuse injury that occurs at the wrist is called deQuervain’s tenosynovitis. It is caused by repetitive activity of the long tendons that control thumb movement and leads to pain and swelling over this tendons at the thumb side of the forearm. Symptoms include pain and swelling over the tendons and maybe even a crunchy sensation over the tendons as the thumb moves (crepitus).

Musicians e.g. guitarists, chefs and office workers are all prone to this injury. A thorough assessment is needed to work out why the overuse injury occurred so that training or work practices can be changed to prevent future episodes. Treatment may involve non-steroidal anti-inflammatory medication, icing, manual therapy (massage) and exercise.

This may occur in the shoulder due to significant trauma or more easily, if hypermobility (too much movement) is present as a result of congenital laxity. Physiotherapy is crucial to restoring normal strength and stability in your shoulder to prevent recurrence.

Sometimes surgery is required in cases of repeat dislocation, after which you will need post operative physiotherapy to restore normal movement, strength and function with a progressive rehabilitation programme.

A fracture is the medical term for a broken bone. Trauma to the shoulder (like a fall on an outstretched hand) may cause a fracture, which may or may not require surgery.

Either way, as soon as your orthopaedic consultant deems that you are ready, you will need to start physiotherapy for your shoulder to restore normal movement, strength and function with a progressive programme of rehabilitation.

Also known as Adhesive Capsulitis, this is a painful condition whereby all shoulder movements become increasingly restricted. Thankfully, the natural course of a frozen shoulder is that it does get better with time but often it can take up to 2 years to resolve.
However, physiotherapy is a crucial part of the recovery process- in regaining normal movement and function of the shoulder. An injection in the shoulder can be helpful in the early stages of a frozen shoulder along with a physiotherapy programme.