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Ankle & foot physiotherapy

Ligament tear (sprained ankle)

The ligaments of the ankle hold the ankle bones and joint in position, and therefore help to stabilise the ankle joint. They protect the ankle joint from abnormal movements-especially twisting, turning, and rolling of the foot.

A sprained ankle is a common cause of ankle pain. A sprain is stretching and or tearing of ligaments. The most common is an inversion sprain where the ankle turns over so the sole of the foot faces inwards, damaging the ligaments on the outside of the ankle.

The risk of an ankle sprain is greatest during activities that involve explosive side-to-side motion, such as tennis/ basketball/netball.

Symptoms include:

  • Swelling around the ankle
  • Bruising around the ankle (which can extend along the outside of the foot)
  • Pain around entire ankle joint
  • Pain on weightbearing

Syndesmosis (high ankle sprain)

A high ankle sprain is an injury to the large ligaments (called the syndesmosis) above the ankle that join together the two long bones of the lower leg. High ankle sprains commonly occur from a sudden and forceful outward twisting of the foot, which commonly occurs in contact and cutting sports such as soccer, rugby union and rugby league. The ligament can also be an associated injury with more common low ankle sprains, and even ankle fractures.

A high ankle sprain causes symptoms similar to other ankle sprains, but patients often complain of pain when the ankle is turned outwards or when the calf is squeezed.

Symptoms include:

  • Pain around the front of the ankle
  • Pain when foot is turned outwards
  • Pain when calf is squeezed

Stress fractures

A stress fracture is generally an overuse injury. It occurs when muscles become fatigued or overloaded and can not absorb the stress and shock and repeated impact. Fatigued muscles transfer that stress to the nearby bone and the result is a small crack or fracture, in the bone.

Symptoms include:

  • High levels of very localized pain
  • Increased pain when doing specific loaded activity

Knee physiotherapy

Anterior Cruciate ligament tear (common in soccer, rugby, skiing)

Injuries of the ACL range from mild such as small tears to severe when the ligament is completely torn. There are many ways the ACL can be torn; the most prevalent is when the knee is bent too much toward the back and when it goes too far to the side. Tears in the anterior cruciate ligament often take place when the knee receives a direct impact from the front while the leg is in a stable position. Torn ACL’s are most often related to high impact sports or when the knee is forced to make sharp changes in movement and during abrupt stops from high speed. Continued athletic activity on a knee with an ACL injury can have devastating consequences, resulting in massive cartilage damage, leading to an increased risk of developing osteoarthritis later in life.

Symptoms include:

  • Hearing a popping sound whilst changing direction
  • Swelling
  • Instability
  • Pain at the back of the knee

Meniscal tears

Tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. Can be referred to as “torn cartilage” . Menisci can be torn during innocuous activities such as walking or squatting. They can also be torn by traumatic force encountered in sports or other forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In older adults, the meniscus can be damaged following prolonged ‘wear and tear’ called a degenerativetear.

Symptoms include:

  • Inability to fully straighten or bend the knee
  • Clicking
  • Pain going up or down stairs
  • Swelling around knee

Patello-femoral joint issues

Patello-femoral issues relate to the correct ‘fit’ or tracking on the patella within the knee joint. This can be affected by the position and structure of the patella itself, muscle strength or tight tissues.

Symptoms  include :

Pain in knee which worsens with going up or down stairs or when bended for a prolonged period.

Shoulder physiotherapy

Swimmers’ shoulder

Swimmer’s Shoulder, or painful arc/rotator cuff tendonitis (or tendinopathy), is a repetitive stress injurywhere tendons in the shoulder have been damaged. The body mechanics of the freestyle stroke can cause inflammation of the shoulder tendons during both the pull through and recovery phases of the stroke.

Symptoms include:

  • Pain is felt during the overhead motion of the freestyle stroke
  • Weakness at this point of the stroke is also an indication
  • Weakness may also indicate a tear in the tendon

Impingement

Is a clinical syndrome which occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through a space underneath the end of the collarbone and shoulder blade. This can result in pain, weakness and loss of movement at the shoulder.

Symptoms include:

  • Pain into the shoulder or arm with overhead activities

Instability (esp. in rugby)

Shoulder instability is a problem that occurs when the structures that surround the glenohumeral (shoulder) joint do not work to maintain the ball within its socket. If the joint is too loose, is may slide partially out of place, a condition called shoulder subluxation. If the joint comes completely out of place, this is called a shoulder dislocation.

Symptoms include:

  • Feeling of shoulder instability when the arm is put into certain movements

Rotator cuff tears

The rotator cuff is a group of four muscles  (infraspinatus, supraspinatus, teres minor, subscapularis) which are responsible for both movement and stability of the shoulder / arm complex. Rotator cuff tears are tears of one or more of these four tendons and can include any type of irritation or damage to the rotator cuff muscles or tendons. These can be caused by sudden injury or long-term degeneration.

Symptoms include:

  • Pain or weakness in the muscles supporting the arm and shoulder
  • Pain when lying on the affected side
  • Pain with overhead actions

Sciatica physiotherapy

Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five spinal nerve roots that form the sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body.

Although sciatica is a relatively common form of low back and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain.

Symptoms include:

  • A cramping sensation of the thigh
  • Shooting pains from the buttock, down the leg
  • Tingling, or pins-and-needles sensations in the legs and thighs
  • A burning sensation in the thigh

Vertebral instability

Vertebral Instability is abnormal movement between a bone in the spine and the one next to it. As a disc degenerates it loses tension which allows the disc to bulge and permits increasing movements to take place between the vertebrae. The loss of disc height causes the joints in the back to displace and override beyond their correct normal alignment. This overriding and abnormal slipping of the joints causes increased wear and tear and the production of bone spurs around the joint.

Symptoms include:

  • Catching pain when standing from sitting position
  • Sudden pain when bending forward or backwards
  • Pain on lifting
  • Spasm in back muscles

Spondylolysis

Spondylolysis is a defect of a vertebra. It is typically caused by stress fracture of the bone, and is especially common in adolescents who overtrain in activities such as rowing, tennis, diving, martial arts and gymnastics.

Symptoms include:

  • Lower back pain that is worsened with activity
  • Lower back pain that is worsened with bending back of the spine

Trapped nerve physiotherapy

A pinched nerve is caused when a nerve is somehow damaged or injured by direct pressure orcompression and is unable to properly conduct its signal. There are many potential causes for a pinched nerve, depending on the location of the nerve.

Symptoms include:

  • Tight neck muscles
  • Sharp pain

Burning / tingling in the neck, shoulder or into the arm

Wry neck

A stiff neck associated with muscle spasm, is often caused by sharp movements or prolonged episodes of bad posture

Symptoms include:

  • Lack of movement in the head and neck
  • Tight muscles
  • Sharp pain

Headache

Headaches where the pain originates in the cervical spine, neck and upper shoulders are often referred to as a cervicogenic headache. These headaches can be a byproduct of whiplash, neck injury or muscle trauma due to poor prolonged posture or severe stress.

Symptoms include:

  • Pain which centers across the forehead/behind the eyes/ up the back of the skull
  • Tight muscles which can extend from the shoulder to the top of the neck

Poor ergonomics

Poor postural alignment can place increased stress on the structural and nerve components in the neck, leading to increased pain and discomfort in the neck, shoulder and head region.

Symptoms include:

  • Dull aching pain in the neck and shoulder without trauma
  • Tightness in the neck/shoulder region

Neck physiotherapy

Pinched nerve

A pinched nerve is caused when a nerve is somehow damaged or injured by direct pressure orcompression and is unable to properly conduct its signal. There are many potential causes for a pinched nerve, depending on the location of the nerve.

Symptoms include:

  • Tight neck muscles
  • Sharp pain

Burning / tingling in the neck, shoulder or into the arm

Wry neck

A stiff neck associated with muscle spasm, is often caused by sharp movements or prolonged episodes of bad posture

Symptoms include:

  • Lack of movement in the head and neck
  • Tight muscles
  • Sharp pain

Headache

Headaches where the pain originates in the cervical spine, neck and upper shoulders are often referred to as a cervicogenic headache. These headaches can be a byproduct of whiplash, neck injury or muscle trauma due to poor prolonged posture or severe stress.

Symptoms include:

  • Pain which centers across the forehead/behind the eyes/ up the back of the skull
  • Tight muscles which can extend from the shoulder to the top of the neck

Poor ergonomics

Poor postural alignment can place increased stress on the structural and nerve components in the neck, leading to increased pain and discomfort in the neck, shoulder and head region.

Symptoms include:

  • Dull aching pain in the neck and shoulder without trauma
  • Tightness in the neck/shoulder region

 

Lower back physiotherapy

Sciatica

Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five spinal nerve roots that form the sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body.

Although sciatica is a relatively common form of low back and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain.

Symptoms include:

  • A cramping sensation of the thigh
  • Shooting pains from the buttock, down the leg
  • Tingling, or pins-and-needles sensations in the legs and thighs
  • A burning sensation in the thigh

Vertebral instability

Vertebral Instability is abnormal movement between a bone in the spine and the one next to it. As a disc degenerates it loses tension which allows the disc to bulge and permits increasing movements to take place between the vertebrae. The loss of disc height causes the joints in the back to displace and override beyond their correct normal alignment. This overriding and abnormal slipping of the joints causes increased wear and tear and the production of bone spurs around the joint.

Symptoms include:

  • Catching pain when standing from sitting position
  • Sudden pain when bending forward or backwards
  • Pain on lifting
  • Spasm in back muscles

Spondylolysis

Spondylolysis is a defect of a vertebra. It is typically caused by stress fracture of the bone, and is especially common in adolescents who overtrain in activities such as rowing, tennis, diving, martial arts and gymnastics.

Symptoms include:

  • Lower back pain that is worsened with activity
  • Lower back pain that is worsened with bending back of the spine