Archive for the ‘Joint pain’ Category

Flexibility: why it is important

exercise-improves-flexibilityFlexibility is important in day-to-day activities and sports. It allows for greater comfort and ability  – and reduces your risk of injury.

To initiate movement, your muscles contract (shorten).  How well they contract will depend on the initial resting length of the muscle.

And, for any movement, there is an optimum resting length to gain the optimum contraction your muscles.

For example …

Turning your head

Turning your head while driving is something we do regularly. This requires optimum resting length in your neck muscles and a muscle contraction.   If the resting length of your neck muscles is less than optimum (shortened) , you won’t be able to turn your head to the desired range.

When you can’t turn your head it means some muscles are too tight and the optimum tension is not correct.

Bending over

Think about bending over to touch your toes. If you can’t bend over like you used to, your hamstrings may be too tight and need lengthening.

What is flexibility?

Flexibility refers to the mobility of your muscles and is defined as the Range Of Motion (ROM) of your joints or the ability of your joints to move through different planes.

There is a balance between the initial resting length of a muscle and the contraction of a muscle to build the right tension to move your joints.  This impacts on the joint range of motion.

  • If the resting length of a muscle is too long, or too short, it will affect the ability of the muscle to contract.

Why is flexibility important

Improves skill level

Good muscle and joint flexibility allow your joints to accommodate all the different angles required for everyday movements or sport-specific movements.

Decreases risk of injury

A balance between the length versus the tension of muscles reduces your risk of injury, particularly muscle tears or sprains.

There are several groups of muscles that show a tendency towards tightness.

These include the:

  • hamstrings
  • calf muscles
  • pectoral muscles and some
  • back muscles.

These muscles are often implicated in musculoskeletal pain, especially back pain and are prone to strains.

Increases efficiency

When muscle length and muscle contraction are optimised, you can obtain maximum muscle power and efficiency for your chosen sport or activity.

For example, when running …

If you have optimal length and tension in hamstrings, quads, hip flexors and gluteal muscles when you are running, this allows for:

  • an increase in speed
  • less fatigue over longer distances
  • overall enhancement of your running enjoyment due to less pain in your legs and lower back

Flexibility can be limited by …

High muscle tone

High muscle tone occurs when the muscle is overworked or tense. Nerves supplying the muscle continue to provide a low-level discharge. This means the muscle cannot fully relax so the resting length is altered. This limits the full range of movement of the joint to which the muscle is attached.

Stretch reflex

As a muscle is rapidly stretched there is an automatic neuromuscular response – the ‘stretch reflex’ which limits overstretching to prevent injury. Where the length and tension relationship of a muscle is reduced, this reflex can start earlier, limiting the joint’s range of motion.

Change in muscle and connective tissue

As we age, muscle fibres are gradually replaced with fibrous connective tissue which is less elastic. This increases the stiffness of the joint, limiting the range of motion of the joint, particularly in highly mobile joints such as the shoulder and hips.

Bony change

Bony changes in the joints due to ageing or injury can affect how the surfaces of the joints line up decreasing flexibility and decreasing joint range of motion.

Poor posture

Poor posture can reduce the optimum length and tension relationship of skeletal muscle leading to stiffness in the joints as they are prevented from moving through their full ROM.

Try this activity and see if you notice the difference in your arm’s range of motion.

  1. Sit in a slumped position and raise your arms up over your head.
  2. Now sit on your sit bones, stack your spine up long and now raise your arms up overhead.
  3. Do you notice the difference?

Previous injuries

Injuries to muscles and connective tissue can lead to a thickening (fibrosing) of the soft tissue. Fibrous tissue is less elastic and can lead to decreased resting length of the muscle and reduced range of movement (ROM) in the affected joint.

 

 

The rotator cuff and shoulder pain

rotator-cuffMuscles in the rotator cuff allow the should to rotate

The rotator cuff is a group of tendons and muscles in the shoulder, connecting the upper arm (humerus) to the shoulder blade (scapula).

They include:

• Supraspinaturs
• Infraspinatus
• Teres Minor
• Subscapularis

The rotator cuff tendon attaches the muscles to the head of the arm bone (humerus).  It provides stability to the shoulder joint. When either the muscles and/or tendon is damaged, it can cause shoulder pain.  The pain may limit your ability to  lift your arm up overhead, making everyday movements difficult to do.

 

Common Rotator Cuff Conditions

Rotator cuff tear:  an injury that tears a rotator cuff tendon usually already weakened by age or wear and tear. Symptoms include weakness in the affected arm and pain when sleeping on the affected shoulder.

Rotator cuff tendinopathy: repetitive overhead use of the affected arm (such as painting or throwing) causes swelling and cellular changes in the tendon, leading to pain at rest, on movement and at night.

Rotator cuff impingement:  the tendons of the rotator cuff are squeezed between the humerus and a bone called the acromion. Symptoms and treatment of impingement are similar to rotator cuff tendinopathy but there are many different causes of impingement.   Rotator cuff tendonopathy often leads to impingement.

Subacromial bursitis: inflammation of the small sac of fluid (bursa) that cushions the rotator cuff tendons from a nearby bone (the acromion).

Managing rotator cuff shoulder pain?

  • Relative rest from the aggravating movement and applying ice locally will help reduce acute shoulder pain levels.
  • Physiotherapy will reduce pain levels further and improve shoulder range of motion.  Treatment includes soft tissue therapy, joint mobilisation, dry needling, taping and posture correction.
  • Exercise therapy, especially rotator cuff strengthening exercises, will help prevent further irritation.

Prevention is key

To manage and prevent ongoing episodes it is important to correct the faulty biomechanics of the shoulder through targeted shoulder exercises.

This is where physiotherapy can help!

At Strive Physiotherapy Drummoyne, we can correctly diagnose the cause of your shoulder pain, ensuring the appropriate exercises are prescribed to get you back to the things you love to do.

Call us on 9819 6151 for an appointment.

Sprains and Strains

sprains-and-strainsSprains and strains are injuries to the muscles, ligaments and tendons or ‘soft tissue’ of the body.

They usually occur during sports and exercise activities, but sometimes simple everyday activities can lead to a soft tissue injury.

Sprains

A sprain is a stretch and/or tear of a ligament, (connective tissue that passes from one end of the bone to another) and/or the joint capsule. Ligaments stabilize joints and limit unwanted movements.

The areas of your body that are most vulnerable to sprains are your:

• ankles
• knees and
• wrists

A sprained ankle can occur when your foot turns inward, placing extreme tension on the ligaments of your outer ankle. A sprained knee can be the result of a sudden twist, and a wrist sprain can occur when falling on an outstretched hand.

Strains

A strain is an injury to a muscle and/or tendons.

Tendons are fibrous cords of tissue that attach muscles to the bone. During movement, muscles contract to perform an action. Excessive pressure or load on the muscles during these movements can damage muscle fibres and/or the tendons resulting in local bleeding, bruising, and pain.

Strains often occur in your:

• lower leg (calf muscles)
• upper leg (typically the hamstring)
• groin or
• back

Degrees of severity of a sprain or strain

Soft tissue injuries are graded according to their severity and include:

Grade I – some fibres are torn and the site is moderately painful and swollen, but function and strength are mostly unaffected.

Grade II – many fibres are torn and the site is painful and swollen, with some loss of function and strength. If a ligament is sprained there is usually some instability in the joint.

Grade III– the soft tissue is totally torn, with considerable loss of function and strength. If a ligament sprain there is usually significant instability in the joint. Grade III injuries often need surgical repair.

Symptoms of sprains and strains

While the intensity varies symptoms of sprains and strains include:

• Pain
• Bruising
• Swelling
• Inflammation
• Weakness of muscles or tendon
• Instability around the affected joint

Treatment for sprains and strains

Most soft tissue injuries will take 3-6 weeks to heal properly.

It is important to get the correct treatment as soon after the injury as possible to help recovery and reduce the risk of further injury. This is where physiotherapy can get you back to moving well again.

In the first 24 hours after injury:
• RICE (Rest, Ice, Compression, Elevation)
• Avoid exercise, alcohol and massage which can increase swelling.
• If symptoms become worse in the first 24 hours seek medical attention.

Mild to moderate sprains and strains
Treatments such as mobilisation and soft tissue therapy; bracing and electrotherapy can help you recover quicker. Exercise therapy to restore full strength and flexibility is an important part your treatment, particularly if you are returning to sport.

Severe sprains and strains
May require surgery. You will need a review and advice from a Sports Physician and/or Orthopaedic surgeon.

Does cold weather increase joint pain and stiffness?

There are plenty of people who report an increase in joint pain and stiffness in cold weather.

But is this fact or fiction?

Results of scientific studies to date are mixed.

From clinical observations I definitely see an increase in people presenting with joint pain during the colder months.

So what may be some of the contributing factors?

1. A Decrease in Barometric Pressure

Barometric pressure is the force exerted by the weight of the atmosphere. Some researchers have proposed that a drop in barometric pressure (which tends to accompany cooler, damper weather) could allow tissues in joints to swell and put pressure on nerves that control pain signals.

But other researchers suggest that this minor drop in barometric pressure in winter is unlikely to be significant enough to cause joint pain. It does seem to be possible at extremes of barometric pressure, like going to mountain tops or deep sea diving.

2. Amplification of pain signals from the joint

One theory with more scientific evidence behind it is the notion the cooler weather can amplify pain signals from affected joints to the brain.

So, for people with existing joint pain like arthritis, nerve signals travelling from the joint have been found to be amplified in the brain by signals carried on separate nerves called sympathetic nerves.

Sympathetic nerves are part of the body’s system for automatically maintaining its internal functioning. When it’s cold, these nerves constrict blood vessels in the limbs, to minimise heat loss and help keep the vital organs of the body warm.

However, the increased activation of these nerves around joints in response to cold weather might also lead to an increase in the pain a person feels.

3. A decrease in mobility

There are some factors that we can do something about – and mobility is one of them.

Shorter days and cooler temperatures make us less inclined to be as active as we are during the summer months. This increased immobility tends to make joint pain worse.

Why?

Being less mobile decreases nutrients and oxygen to the joints increasing the feeling of ‘stiffness’.

Similarly a decrease in movement, shorter amount of daylight and a bout of cold and/or flu can lead to a low mood which we know is linked to a higher level of perceived pain.

The best solution for joint pain is to get moving.

Not only does it increase much needed oxygen and nutrients to the joints, it also helps overcome the winter blues!

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