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Lower Limb Injuries In The Adolescent Athlete

22nd September 2017 | By Mark Scholes

When their pain is more than just “growing pains”. Lower limb injuries in the adolescent athlete. Due to the complex architecture of the growing skeleton, children and adolescent athletes are at risk of a number of injuries that we adults are not. Young athletes can be prone to both acute injuries and chronic overload due to the any combination of the following: The presence of open growth plates (physes) The presence of unfused apophyses (tendon or ligament attachment sites that are yet to fuse with the main structure of the bone) Rapid growth spurts which can affect muscle length, strength and coordination High training volumes – from my clinical experience it is not uncommon for young athletes to be training 6-7 times a week across different sports – something we would never expect our elite adult athletes to survive! When combined with their rapidly changing body, these high training volumes experienced by young athletes can lead to overloading of particular [ more ]

General News
Top tips

6 Quick Tips For Healthy Nutrition

22nd August 2017 | By Chris Ross

6 Quick Tips For Healthy Nutrition Nutrition is an aspect of Health and Fitness that is largely overlooked and misunderstood. In many cases individuals believe that just because they exercise regularly, they can eat whatever they want. What people fail to realise is that eating healthy and having sound nutrition can help you achieve your goals whether it be getting stronger, feeling better or losing fat. We as a society do not think twice about what we put in our mouths. Obesity is running rampant all over the world and even with such negative notoriety, people still seem to opt for the quick, easy and unhealthy choice. Featured below are 6 quick tips for healthy nutrition: 1. Eat a Balanced Diet This means you should eat a mixture of carbs, protein and yes – FAT. My ideas on nutrition are those that portray balance. People love the quick fix, the wonder pill and the celebrity fad but these options are short lived. [ more ]

General News

Clinical Pilates – moving beyond “core stability” for low back pain

27th June 2017 | By David Thwaites

For many years, Clinical Pilates has been the popular vessel of Physiotherapists to prescribe “core stability” programs for people with low back pain.  Historically, these core stability programs have encouraged clients to engage core muscles and maintain this contraction while they perform a series of movements. Recently, there is a growing mass of research showing that this approach is not as beneficial as we once thought.  A recent systematic review of the literature suggested that in people with low back pain, core stability programs are no more effective than general exercise (Smith, Littlewood & May, 2014).  It is even hypothesised that encouraging these heightened contractions and rigid postures can breed unhealthy beliefs around pain and movement, and perpetuate symptoms (Nijs et al., 2013).  Given this shift in thinking, it is imperative that Physiotherapy, and in particular Clinical Pilates evolves. Thankfully, Clinical Pilates has the capacity to move beyond this stability approach. Clinical Pilates can be used as a platform to [ more ]

Chronic pain
Diagnosis
General News
Pathology
Rehabilitation
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So let’s talk about the finesse of shoulder rehab

16th May 2017 | By Meagan Davis

Shoulder pain is a very common complaint as the joint inherently lacks stability so that we have increased mobility and range. Most shoulder pain arises from weakness and poor positioning of the stabiliser muscles. Due to the multidirectional nature of the shoulder, painful activities can vary. However, activities like getting your wallet out of your back pocket, doing your seat belt up and driving can be quite painful. A common cue I will hear, when people talk about shoulder rehab will involve setting the shoulder in a ‘back and down’ position before commencing the exercises. So, why is this exacerbating the problem? Naturally the scapula (shoulder blade) upwardly rotates as the arm moves away from the body. If we drag the shoulder blade down and puff the chest out while trying to move our arm up, we won’t then have the freedom of mobility, which the shoulder demands. Why is finesse and patience so important with shoulder rehabilitation? Corrective exercise [ more ]

Chronic pain
Diagnosis
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Rehabilitation
Running
strike patterns
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Benefits Of A Jog:Walk Program

18th April 2017 | By Matthew Kenny

Many of the running injuries we see are when a patient has performed a sharp increase in activity (running), especially after a long period of rest. A thorough assessment usually finds a strength deficit combined with less than optimal biomechanics. In our treatment we provide rehabilitation exercises and cues to correct their biomechanics. But the big question from the patient remains…. ‘When can I start running?’  My short answer is very soon. Factor in a day or two to let the injury settle then patients can start not long after. Most of my patients start back with a Jog:Walk program. Now depending on the severity of the injury, fitness of the patient and upcoming goals. We start with: 1 min jog: 1 min walk There are a few reasons why this is a fantastic way of getting back into running: The walk interval gives your tissue a chance to ‘rest’. Reducing the constant load that continuous jogging can give. Allows [ more ]

Chronic pain
Diagnosis
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knee cap pain
patellofermoral pain
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Running
strike patterns
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The Obsession With Strike Pattern Continues: But Be Careful

20th March 2017 | By Dr Christian Barton

Recently I read with interest a paper by Roper et al (2016) which looked at whether changing the strike pattern of runners with patellofemoral pain (i.e. knee cap pain) from a heel to a forefoot strike would be effective. They made the change over 2 weeks and followed runners up a month later as well. 16 runners with patellofemoral pain were randomised to either change to a forefoot strike pattern or continue with the same heel strike they normally ran with. Although there were only 8 runners in each group, the findings were interesting.  Roper et al’s conclusion was clear: “Findings suggest running with a forefoot strike pattern leads to reduced knee pain, and should be considered a possible strategy for management of patellofemoral pain in recreational runners.” This conclusion is appropriate but I recommend caution. Firstly we know from previous reviews I have completed with my team at La Trobe that changing strike pattern reduces load on the knee. [ more ]

Chronic pain
Diagnosis
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Pathology
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Gluteal Tendinopathy – A Pain In The… Hip

27th February 2017 | By Ben Janson

Gluteal tendinopathy is a common condition that causes pain on the outside of the hip and often the upper thigh. Like Peter said in the previous blog, often pain arises due to a reduction in tolerance of the tendon to perform certain activities. This often includes going up or down stairs, walking, sitting with crossed legs, lying on your side or even standing on one leg. Why then does the gluteal tendon become less tolerant to certain loading, well there are a few risk factors. Risk factors for developing gluteal tendinopathy    Female (especially post-menopausal) Middle aged Increased body weight (obesity) Back pain Certain biomechanics and strength deficiencies   Often we find that gluteal tendinopathy evolves in certain at risk people who are then overdoing things when it comes to activity, such as excessive walking, or, in those people who have suddenly changed/increased activity levels. Once pain evolves, it can be difficult to manage and can have significant activity limitations. [ more ]

Chronic pain
Diagnosis
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You Can Manage Your Tendon Pain Better Than Any Doctor

24th January 2017 | By Dr Peter Malliaras

Tendinopathy is a painful conditions affecting many tendons such as the Achilles, lateral elbow, lateral hip and rotator cuff tendons. The more I practice and specialise in tendons, the more I realise that all I am doing is guiding you, the patient during your recovery. In fact, I do almost nothing else to get patients better these days. Maybe I’m just getting lazy, but it seems to work! Here are some top tips to empower you (the patient) to get yourself better. Understand Your Condition: Understanding what is going on in your body will make the condition much less scary and will help unravel some of the unnecessary worrying. You will also learn that there is only one person who can really get you better – you. The following questions with appropriate simple answers will help you understand your condition; Why does it hurt? Simplest answer is the threshold for your body to signal pain has reduced. The pain does [ more ]

Diagnosis
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Imaging
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What happened to Osteitis Pubis? Classifying groin pain for better rehab outcomes.

14th December 2016 | By Mark Scholes

It didn’t seem too long ago that professional and amateur sportspeople alike were spending lengthy periods on the sidelines with the dreaded diagnosis of osteitis pubis. Associated strongly with field sports that required fast paced agility running and kicking, osteitis pubis was a common diagnosis that often meant prolonged rehabilitation and time away from competition. What were the issues with calling groin pain “osteitis pubis”? Inconsistent imaging findings for a similar presentation of “osteitis pubis” The lack of inflammation associated with the pubic symphysis dysfunction (Holmich, 2007; Weir, 2014). True osteitis pubis is a gynaecological condition commonly seen in the post-operative period. While irritation to the pubic symphysis can occur in athletes and be a source of pain, unlike in post-partum women it is less likely to be the primary source of a pain. Instead, pubic symphysis pain is often the result of muscle imbalances and altered biomechanics secondary to one of the other three groin pain entities described below, [ more ]

Chronic pain
Diagnosis
Imaging
Pathology
Rehabilitation

“Doc, should I get my back scanned?” – 2 reasons to think twice

3rd November 2016 | By David Thwaites

Low back pain is extremely common. Three quarters of people will report at least one episode of back pain in their life time.  Back pain is often excruciating, leading to withdrawal from activity, time off work and decreased productivity while at work.  So given this, it would make sense to get an X-ray, CT or MRI to work out the cause of your back pain, right? Actually, for most people this is not the case.                                                Key Points: Most results seen on scans do not  relate to pain and symptoms and are likely to be part of normal aging Scan results can create more anxiety about your pain – it may make it more likely that you will have surgery In rare circumstances, scans are still important, but your practitioner can help assist you on this decision.   [ more ]