Andrew Preston

Corked Thigh

Corked Thigh – Ouch!

A ‘corked thigh’ in the medical world is referred to as a quadriceps contusion. This occurs when a direct force (usually a knee) makes contact with someones thigh. As a result of the direct blow, localized bleeding occurs intermuscular (between muscles) or intramuscular (confined to one muscle). Significant bruising, swelling and restriction of range of motion is commonly evident.

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In some cases, the bleeding and resultant hematoma can calcify and cause a painful condition called ‘myositis ossificans’. In this instance, the body mistakenly lays down osteoblasts (bone cells) into the thigh! Ouch! Luckily, the bone stops growing after a few weeks and the body reabsorbs the bone.

Physiotherapy is very useful in speeding up the recovery process. Early mobilisation through massage, stretching and exercise is vital to ensure a quick and safe return to play.

Heel Spurs

Heel Spurs – A side effect of Plantar Fasciitis?

Do you have pain in the arch of your foot when you first put your foot down to walk in the morning?

You may well be suffering from a condition called plantar fasciitis (‘plantar fasciopathy’). The plantar fascia is designed to provide shock absorption for the arch of the foot and if overused, can become painful and interfere with daily and recreational activities.

A ‘heel spur’ is a bony growth that forms on the heel as a result from prolonged or excessive pulling of the plantar fascia from its attachment on the bone. Activities such as prolonged walking, running and dancing are the common causes.

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A heel spur may or may not be present with plantar fasciopathy, therefore, an X-ray is not needed when determining a diagnosis. In addition, a heel spur may even worsen on X-ray once symptoms have completely resolved.

The take home message… If you have been told you have a heel spur, or a heel spur is present on an X-ray, don’t stress, it may not mean anything! It’s best to go and get your condition properly assessed from a physio.

Gluteal Tendinopathy

Lateral Hip Pain – Don’t Stretch It!

Did you know 1 in 4 women over the age of 50 suffer from gluteal tendinopathy at some point in their life?

And women are 4 times more likely to suffer than men?

What is Gluteal Tendinopathy?

The most common cause of lateral (outer) hip pain is change within the gluteal tendons (tendinopathy) due to persistent overload. This commonly results in secondary inflammation of a fluid filled sac known as a ‘bursa’, due to compression or friction of the Illiotibial band (ITB). It is now understood that gluteal tendinopathy is the primary driver of pain, rather than inflammation of the bursa.

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Gluteal tendinopathy can be caused by:

  • A recent increase in exercise (walking, running, step machines) especially in females 40-60 years
  • Prolonged sitting, or sitting with legs crossed
  • Compression forces due to side-lying
  • Standing with more weight on one leg, such as carrying a child on your hip
  • Decreased muscle strength of the gluteal muscles resulting in a positive ‘Trendelenburg’ sign

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A positive Trendelenburg sign results when a drop of hip height on the opposite side to the weight bearing leg is observed.

Why are women more susceptible than men?

Women are more likely to suffer from gluteal tendinopathy due to decreased gluteal muscle tone (especially post menopause), and wider hips also influence the amount of compression.

Treatment – Should we stretch our glutes?

Compression is thought to be a key factor in tendinopathy and placing your glutes on stretch will increase compression on the gluteal tendons, therefore, stretching is not recommended. Treatment should involve correcting postural abnormalities (you may not even know that you’re aggravating your pain) and increasing pelvic stability through tailored strengthening exercises by your physio or clinical pilates instructor.

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Remember.. DON’T stretch it and if you’re unsure… Come and see us at either our Sydney CBD physiotherapy clinics or our new Chatswood Physiotherapy clinic.

Golfer’s Elbow

Golfer’s Elbow

Golfer’s Elbow, aka Medial Epicondylitis, is a niggly condition that affects not only the everyday golfer taking a swing, but those involved in racquet sports, (e.g tennis/squash), throwing, and activities that involve gripping (e.g driving). This may be due to repetitive stress or excessive loading which can build up around the tendons and muscles on the inside of the elbow and forearm.

For some people, you may not see this coming. Over time, what may begin as a low level irritation can soon turn into a pattern of pain and discomfort from the stressed structures, which can lead to pain with grip, weakness in grip and sensitivity to touch. If this is your dominant arm then this can be quite limiting in day to day activities.

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But alas! All is not lost! It may just be that your grip technique is off, and this in turn has put low level undue stress to the inside elbow. For example, a lot of amateur golfers can have poor swing mechanics at impact, which can lead to excessive load on the forearm muscles. Simple swing modifications may be all that you need to become pain free. For sports that require a lot of throwing (e.g Cricket or baseball), technique needs to address the power exerted from the ground up through the body. Rest from your aggravating activity, and icing around the elbow may be advised in the first instance to allow any inflammation to settle and structures affected to begin their repair process. A graded and progressive strength programme for the muscles of the shoulder, arm and forearm may also be required.

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