Latest post on physioquestions.com | Back Pain: Part II (Strengthening Exercises)

Continuing from Back Pain: Part I (Stretching/Mobility Exercises), this article will look at some strengthening exercises for the back. 

Much of the latest research on back pain have focused on the importance of two muscles: transverse abdominus and multifidus, and their roles in back pain. This is because both of these muscles lie deep in the spine, forming the functional core of the body. The multifidus muscle stabilises the joints at each segmental level of the spine. Hence you may have heard physiotherapists emphasising the importance of retraining your 'core' stability. 

Research has shown that in people with back pain, these two muscles are weakened, their recruitment patterns are altered and their ability to stabilise the spine is impaired. If these problems are not addressed, evidence suggests that the chances for recurrence of back pain would be increased. 

Strengthening these deep core muscles and retraining their activation patterns during functional activities are two essential components of all back rehabilitation. 

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Back Pain: Part I (Stretching/Mobility Exercises)

Back pain can be a frustrating condition to fight off as it seems to keep coming back without any warning. You may have been careful with posture, didn't do any heavy lifting or strenuous activity, however you wake up with a bit of a niggle that worsens on specific movements or particular activities.

What causes back pain?

There are many causes of back pain. The spine consists of nerves, discs, joints, muscles, tendons and ligaments which can all produce pain. Without going into too much detail on the topic and theories of pain, back pain can be thought to be a result of a chemical or mechanical cause. Chemical pain could be a result of inflammation which irritates nerve endings and causes pain. Mechanical pain could be due to joints that are stiff or hypermobile, muscles that are strained or overactive (spasm), bulging disc with possible nerve impingement (which can also cause radiating pain down extremities), overused tendons/ligaments, etc. 

 

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Research findings on the reliability and accuracy of clinical tests to diagnose ACL tear

Q: With regards to the tests for ACL tear, which is most reliable and/or accurate?

A: The 3 main clinical tests that are usually performed by therapists to diagnose an ACL tear include the Anterior Drawer test, Lachman test and Pivot Shift test. However the reliability and accuracy of these tests have been questioned. Here are the findings from three studies (Ostrowski 2006; Benjaminse et al 2006; Peeler et al 2010) regarding the reliability and accuracy of these tests.

READ MORE on www.physioquestions.com

Do musicians have different brains?

Does musical training reorganise the brain? What are the implications? 

An article published in Psychology Today, June 11, 2010

In the last twenty years, brain imaging studies have revealed that musical training has dramatic effects on the brain. Increases in gray matter (size and number of nerve cells) are seen, for example, in the auditory, motor, and visual spatial areas of the cerebral cortex of musicians.

Latest post on physioquestions.com | Do you get wrist pain from typing or writing?

QUESTION:

"I get pain in my right hand near my wrist after long periods of typing and sometimes the area around my wrist (palm side) gets a bit swollen too. What can I do to help the problem?"

ANSWER:

This sounds like a case of "Occupational Overuse Syndrome" (OOS), or more commonly known as "Repetitive Strain Injury" (RSI). There is usually no discrete pathological cause for RSI - it is rather related to the overuse (and/or improper use) of particular areas of the body resulting in pain and/or other symptom.

Topics covered in this article:

• Common causes of RSI (eg. repetitive movements, sustained/awkward postures, and more)
• Typical symptoms
• Treatment (including advice on exercises, ergonomics, computer & writing equipment, posture care, pain relief)

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Shoulder Complex (Part III) - Anterior/Posterior/Multidirectional Dislocations & Exercise Rehabilitation

Topics covered:

• Anterior Dislocation
• Posterior Dislocation
• Multidirectional Instability
• Exercise Rehabilitation

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Shoulder Complex (Part II) - The Unstable Shoulder

SHOULDER INSTABILITY

Glenohumeral instability is the inability to maintain the humeral head in the glenoid fossa.

• Dislocation = Complete loss of humeral articulation from the glenoid fossa
• Subluxation = Partial loss of humeral articulation within the glenoid
• Laxity = Generalised hypermobility of the glenohumeral joint and other joints; asymptomatic

Topics covered:

• Classification of dislocations (degree, frequency, etiology, direction)
• TUBS vs AMBRI
• Examination of the unstable shoulder

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Intro to the Shoulder (Part I): What makes your shoulder stable?

The shoulder is the most mobile joint in the human body. A normal shoulder precisely constrains the humeral head to the centre of the glenoid cavity throughout most of the arc of movement.  

Shoulder stability is the result of a complex interaction between static and dynamic restraints.

• Static stabilisers (capsule, ligaments, labrum) act as concave structures to deepen the glenoid fossa.
• Dynamic stabilisers include rotator cuff and surrounding larger muscles that provide scapular stability (serratus anterior, lat dorsi, rhomboids, trapezius, pectoralis)

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Review on LARS - An alternative for ligament reconstruction

I was asked about the efficacy of LARS as an alternative surgical option for ACL reconstruction. 

In recent years, the use of LARS ligaments have been increasing with promising clinical results. In fact, these ligaments have been in clinical use for over 15 years. LARS stands for Ligament Augmentation & Reconstruction System, and these artificial ligaments are intended for the intra or extra-articular reconstruction of ruptured ligaments.

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Knee Injury: ACL (Part II)

In follow-up to my previous article on "Knee injury: ACL (Part I)", here is the 2nd half of my discussion to provide an overview of ACL surgery and post-op rehabilitation. 

Who will benefit from surgery?

• Individuals with active lifestyles
• Individuals involved in high-level sporting activities (eg. soccer, basketball, netball, footy, skiing, etc)
• Those with recurrent knee instability due to ACL deficiency
• Those wishing to protect their knee joint and cartilage from future damage
• Individuals who have attempted and failed conservative management with recurrent knee pain and instability

Topics covered in this article: 

• Surgery: What graft is used? What does the procedure involve?
• Rehabilitation: Overview of the aims, goals and duration of each stage in rehab
• Prehabilitation (Preparations prior to surgery)
• Phase 1 - Acute Recovery (0-2 weeks)
• Phase 2 - Muscular Control (2-6 weeks)
• Phase 3 - Balance and Proprioception (6-12 weeks)
• Phase 4 - Sports-Specific Training (3-6 months)
• Phase 5 - Return to Sport (6 months +)

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Knee Injury: ACL (Part I)

My sister-in-law recently ruptured her ACL playing touch footy and will be undergoing surgery in a month. Hence it prompted me to write about the ACL - what it is, what happens with an ACL injury, and provide an overview of surgery and rehabilitation from a physiotherapist's perspective.

What is the ACL?

The Anterior Cruciate Ligament (ACL) is one of the four major stabilising ligaments of the knee. 
The other three are: Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL). The term 'cruciate' is used as the ACL crosses the PCL in a crucifix position.

Topics covered:

• Anatomy including attachments
• Functional anatomy
• What happens in an ACL injury
• Signs and symptoms of a torn ACL
  
• What to do immediately post-injury
• Treatment options: conservative vs surgical
• Returning to sport

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Baby milestones: 7 to 12 months

Understanding the developmental milestones of a baby is a good way for parents to monitor their child's growth. It is of course important to mention that all babies are different and some may achieve certain milestones later than others, and this is nothing to be worried about (unless you notice this delay happening consistently).

Following on from my previous article "Baby milestones: 1 to 6 months", this latest post lists out the major milestones to look out for in your child between 7 to 12 months.

READ MORE on www.physioquestions.com

Latest post on physioquestions.com | Baby milestones: 1 to 6 months

Understanding the developmental milestones of a baby is a good way for parents to monitor their child's growth. It is of course important to mention that all babies are different and some may achieve certain milestones later than others, and this is nothing to be worried about (unless you notice this delay happening consistently).

Tummy time

In this article, I have listed out some of the major milestones to look out for in your child.

READ MORE at www.physioquestions.com 

Latest post on physioquestions.com | Exercises suitable for when sick with the cold/flu

QUESTION RECEIVED 31/8/10:

"What kind of stretches/exercise can you do when you are sick with the flu and a lot of your body hurts? How can you get your blood circulating well without exhausting yourself?"

Good on you for thinking about exercising even when you are sick. It is often so hard to motivate yourself to get up off the bed or couch, or sometimes you just physically are not able to stand up long enough before feeling dizzy or weak.

Here are some gentle exercises that I would recommend for you to do to keep the blood circulating and prevent your body getting stiff (without causing too much exhaustion). Just select a few that you like and try to do them 3 x a day. I have also written down the sets/reps that I would recommend. Of course, the key is not to over-do, so do what your body can handle!

READ MORE on this article at www.physioquestions.com