Do you need help ?
Physios are able to help with a wide range of ailments and physical problems. There are four main areas that they work on: musculoskeletal, neuromuscular, cardiovascular, respiratory. Musculoskeletal refers to the bones, joints and soft tissue in the body. Neuromuscular is the brain and the nervous system, cardiovascular is the heart and blood circulation, and respiratory refers to any part of the body which are used to help you to breathe, such as the windpipe and lungs. Some physio clinics in Thomson are able to help in these areas:
• Mental health
• Intensive care
• Long-term conditions
• Orthopaedics and trauma
• Workplace health
• Elderly care
• Education and health care promotion
• Womens problems
Once the physiotherapist has seen the effects of repeated movements on your pain picture and tested the neurological status of your affected body part they will have a more detailed idea of which structures need more detailed examination to clarify the exact nature of the problem. It is time for the individual muscles, joints and ligaments to be stressed to assess their reaction and add to the understanding of what is going on. The physio may just feel and grip the area firmly first to get an idea of the state of the tissues. Are they very sensitive? Is there muscle spasm, thickened tissues, or pain?
During your physiotherapy session the therapist will often put you on your side and move your spine backwards and forwards as they feel the movement occurring between the individual spinal levels. After this you may be placed on your front as the physiotherapist palpates (prods and pokes) your spinal levels with varying degrees of force but often quite firmly to see if any particular level reacts by bringing on the pain you normally complain of. All the tests for pain in your neck, back, elbow, knee or ankles will help diagnose the issue.
What’s the right price to pay for a physiotherapists help in Thomson?
Cervical spine pain and disability is one of the commonest problems for which people consult a physiotherapist. The first part of the examination is to find out the cause of onset of the pain and how it has behaved since then. The cause of the pain is clear in about half of all cases but the rest can give no good idea why the pain came on. Where the pain is and how it behaves gives indications to the physio about where the underlying pathology might be found and what treatment approach might be
The first investigation of the physiotherapist will be into the location and kind of pain. It is vital to understand if the pain is specific to one spot or whether it also affects other parts of the body. For example, if the pain is intense and specific the physiotherapist would surmise that the cause may be poor posture or a kind of degenerative problem; on the other hand, a referred pain may suggest a pinched nerve or a problem elsewhere.
Because neck pain could be an indicator of various pathologies the physio will ask all the special questions such as general health, past medical history, weight loss, bladder and bowel control, quality of appetite and sleep and medication usage. The objective examination begins by getting the patient to take their upper body clothes off and looking at the posture of the trunk, neck, shoulders and arms. A humped thoracic spine with rounded shoulders and a poking chin are a common postural abnormality which can lead to pain.
Cervical ranges of movement are tested to elicit important information about what is going on in the neck. The response to movement testing will help the physio understand the kind of neck pain problem and how to start treating it. Cervical rotation, flexion, extension, side flexion and retraction are all assessed to try to pinpoint the problem. Muscle strength, sensation and reflexes are tested to ascertain that the nerve conduction to the arms is working well.
Manual therapists such as physiotherapists learn mobilization techniques and to assess the spinal joints manual palpation of the cervical spine is used. Using their thumbs or the heel of the hand, the physio presses down on the spinal processes or side joints of the cervical spine. This allows some specific conclusions to be drawn when the pain symptoms come on at one particular spinal level and not another. Treatment will be aimed at these levels.
Mobilization techniques are a core manual skill for physiotherapists and abnormal joint mechanics, known as dysfunctions, can be identified by palpation of the main spinal and facet joints by the physio. Treatment can use repetitive small movements to relieve pain an encourage normal motion, to more forceful manipulations which take the joints beyond their typical ranges and restore movement. Any increases in movement gained by treatment is maintained by home exercises.
Typical physio treatments are exercise programmes, nerve mobilizing techniques, correction of poor posture, pacing technique, trunk segmental mobilization and strengthening of the deep flexor muscles of the cervical spine. Nerve root compression of a cervical nerve root can cause severe arm pain, loss of sleep and distress from a cervical slipped disc. Cervical traction can decrease the pressure on the affected segment and reduce pain enough to allow recovery to start, either by physio treatment or autotraction from a home traction kit.
"I've Busted my Knee..."
What have I done?...
Acute Knee injuries are one of the most common injuries that are experienced on the sporting field. There are many structures that can be damaged, including the ligaments (both collateral and cruciate), the meniscus and the patella. Normally the knee will be injured by forcibly twisting when the foot is kept planted. The amount of force required to cause injury sometimes does not have to be very large. Usually the knee will swell considerably, become very painful, and range of motion will become restricted.'Clicking', 'giving way' and 'locking' are common symptoms. To determine the exact area of damage, your Physiotherapist will perform a number of specific special tests on your knee. However, for an accurate diagnosis, the swelling and pain may have to subside somewhat first, as too many false positives (where everything hurts!) may occur early on. If severe, it may be appropriate to undergo an MRI scan to determine the exact cause of the injury and the most appropriate action. A referral by your doctor to an orthopaedic surgeon is necessary prior to having an MRI scan.
So what does my Diagnosis actually mean?
The Cruciates: Anterior & Posterior Cruciate Ligaments The basis for treatment depends mainly upon what structure has been damaged. If the Anterior Cruciate Ligament (or ACL) is torn, as many footballers and netballers suffer, then surgical reconstruction of the ligament will likely result in the best outcome. This to some extent depends on your goals for recovery, your age and how physically active you are now and intend on being in the future. The Posterior Cruciate Ligament (or PCL) is less of a concern as the quadriceps muscle is perfectly positioned to compensate for any injury to the PCL. Rarely is surgery required and with 6 weeks of progressive rehabilitation, an athlete can expect to be back to near full fitness. The Meniscus Meniscal Injuries involving the cartilage discs within your knee are the most common injury and their treatment depends on how severe the injury is. If not severe, then there is a good chance that your symptoms will respond to conservative management under the guidance of your Physiotherapist. Strengthening and dynamic control work is essential.
What Do I Need to Do?
STAGE 1: ACUTE MANAGEMENT (1- 3 DAYS)
Rest: Try not to take too much weight through the knee initially. For severe cases, crutches may be required.
Ice: Early & Often for 24 hours; 15-20 minutes every 2-4 hours. Compression: Bandage or taping to control swelling for 48 hours.
Elevation: Above waist height to assist in oedema control. Seek treatment. Correct diagnosis and EARLY management will often be the difference between an optimum and a poor recovery. Avoid alcohol, heat or heavy massage.
STAGE 2: SUB-ACUTE MANAGEMENT (3-14 DAYS)
Where range of motion begins to return, strength training begins and walking becomes easier. Progress off crutches as advised by your Physiotherapist. This stage will see the Physiotherapist use their manual therapy skills, with a primary goal to return Range of Motion. The Physiotherapist will prescribe exercises aimed at maintaining the strength of your muscles in different areas - and if appropriate, begin strength training about the knee.
STAGE 3: RETURN TO FUNCTION (14 DAYS - 21 DAYS)
Range of motion is restored, strength training progresses, walking returns to normal. The patient now becomes more of a driver of the treatment, with a strong emphasis on exercise rehabilitation to ensure optimal return to function. However, it will be important to ensure that the rehabilitation program is closely monitored, so as not to aggravate the knee. At this stage, it is also important to ensure that muscle balance of the lower limb is maintained to ensure that secondary complications are avoided.
STAGE 4: RETURN TO SPORT (3-6 WEEKS)
A return to sport will be partly dictated by the extent and nature of the injury. Your knee will be required to pass certain 'fitness' tests, much the same as what footballers do, before being allowed to resume training. Your Physiotherapist will guide you through this process and specify when and what you can do at training. Returning before your knee is capable of withstanding the demands of sport can be disastrous.
A Final Word...
Remember, each individual is different. Almost all patients will progress at different paces, and will have different end goals, meaning that rehabilitation programmes will differ substantially between individuals. Each stage will have certain goals that your Physiotherapist will look for you to achieve before moving onto the next stage. Working together with your Physiotherapist, you will achieve the best outcome for your injury. If you have any queries about the rehabilitation programme that you are given, please discuss this with your treating Physiotherapist.