Physiotherapy Column Archives

Old injuries coming back to bite you

Old injuries and Accumulative Strain

Remember that incident from years and years back? The one has completely healed and doesn’t give you any pain, but it was a pretty big deal at the time? It may not seem related to a pain you are currently experiencing, and maybe it isn’t, but no matter where or what the injury was, it DID cause load and strain on the body. This load and strain causes other muscles and nerve pathways to fire differently – initially, it might be for a protective response, but over time, those adaptations to avoid pain can become your new ‘normal’ leading to tight muscles, irritated nerves and restricted movements. Pushing into these limits over and over can lead to pain in a seemingly new area.

Example

If we take an example of a surfing incident and hitting the waves hard, the breath may have been knocked out of you, nothing was broken, but your body had been very sore and it took a week or so to be moving normal again. Your body will have been moving very differently as taking a breath was hurting you. Your breathing becomes shallow, you limit your turning and arm movements because it hurts and this continues without you realizing even after the initial pain is gone.

Fast forward to now, you are back at the gym, back at work, and your shoulder starts getting sore over a period of a couple weeks.

You come to us, we assess and treat. We draw your accumulative strain graph on the board and we work with you to find out how your body has come to this point:

Accumulative strain

What we are looking at is how the body has been dealing with strain up until that surfing incident. The other points of discussion are what else causes strain:

Poor sleep
Stress at work, financially, or with relationships/family
Poor or changed nutrition
Energy levels

Other injuries also go onto this list:

Rolled ankles
Car accidents
Neck pain

Each time your body takes on one of these events, you may never get back into the optimal zone or a low level of strain. These events can layer on each other and our body becomes less tolerant and more likely to be triggered into a pain event.

Why

Strain builds up and our body handles it, but at the expense of something else: a different muscle pattern is now required or that last bit of movement is coming from the joints above or below that injury. You start using these postures in everyday life, and so those muscles now are working harder and harder. Eventually, you keep pushing and pushing, and for your body to tell you to stop, you get pain.

When you come to us, our Barefoot Approach will bring us to the full body check, so we can discover if some of these old injuries are holding you back from feeling great! Book online or call to chat to one of our physios to discuss any new pains that could be stemming from older injuries!

Rib pain and physiotherapy treatment

in Physiotherapy Column

Our rib cage is an essential for protection of our organs, having a strong trunk and is involved in our everyday movements, like breathing or turning our bodies. Our rib cage rises and falls with each breath using the muscles between the ribs and our diaphragm. Just like any other joint and muscle, these areas can be loaded and irritated. Rib pain is frustrating and can be treated with Physiotherapy.

Symptoms

Sometimes rib pain is hard to describe because there is not a specific place where it occurs. Often, we hear comments like:

“When I take a deep breath, it hurts”
“I have a burning or achiness at the middle of my back”
“There is a pain under my shoulder blade that I cannot reach with a trigger ball or roller”
“I have pain that starts in my back but wraps around my side”

Other times, it is more obvious as to why there may be pain in the ribs or around the ribs, and clients may come in already with a diagnosis from their GP or another physiotherapist, including:

Rib fractures – this may be diagnosed with an x-ray, but small fractures are sometimes hard to pick up even with a scan
Rib pain in pregnancy – as the belly expands, then rib cage also has to make space accordingly
Costochondritis syndrome – inflammation of the area where the rib is attaching to the sternum at the front of the chest
Thoracic outlet syndrome – an issue with blood flow that may be associated with compression from the upper ribs of the blood vessels branching out to the arms
Rib spasm – a reactive response of the muscles between the ribs called intercostals
It may also stem from restrictive clothes such as tight bra and binder

Treatment

Our holistic approach at Barefoot Physiotherapy will help to determine the underling causes and triggers related to your rib pain. We implement a specific rib technique that treats the rib cage as a ring, called Thoracic Rings (developed and taught by LJ Lee, a Canadian physio). This approach looks at each ring and how they may be interacting with each other, therefore, causing load and muscle pull in your area of pain. This understanding is termed Connect Therapy (LJ Lee).

Our treatment techniques involve rib joint mobilizations, manual therapy rib and ring corrections, muscle release for the intercostals (between rib muscles) and surrounding areas like the back and shoulders, individually tailored motor control activation, and maintenance exercises.

Rib pain is not always straightforward, and we are here to help you understand where it is coming from so that you are able to return to your everyday life without having to worry about it. We will develop a treatment plan based on your specific presentation and create self-management strategies to maintain being pain free.

If you or someone you know is experiencing rib, trunk, or chest pain, please contact us. We can determine if it is a musculoskeletal issue before having to see a GP. We are open 5 days a week and a couple Saturdays a month. We have early and late appointments available. Please call us at 1300 842 850 or click here to book an appointment.

What is nerve pain?

in Physiotherapy Column

Nerve pain is a common contributing factor to a person’s overall pain presentation. It can cause tight muscles, stiff joints and restricted movements. Sometimes this pain is harder to describe and localize making it a difficult condition to understand. Nerve pain can be also be described as nerve irritation or nerve inflammation. When specific branch of a nerve is involved, it will often be named after that nerve.

Here are some common examples:

Piriformis syndrome – involving the sciatic nerve as it runs through the piriformis muscle
Sciatica – pain from the sciatic nerve that may start near the back/buttock and travel down the back of the leg
Carpal tunnel syndrome – involving the median nerve at the inner wrist

Other terms used to describe nerve issues include:

Radiculopathy – a nerve entrapment at the nerve root when it exits from the spinal cord through the spinal joints, sensation changes, weakness, or pain can present anywhere along the path of the nerve
Peripheral neuropathy – usually associated with other health conditions, such as diabetes, peripheral vascular disease, or other neurological conditions, often felt as sensation changes or weakness in the hands or feet

Symptoms of nerve pain, nerve inflammation and nerve irritation can include:

Burning
Tingling
Pins and needles sensation
Weakness
Heaviness
Change in skin sensation
Feeling of tight muscles and stretching does NOT help
Achiness in a muscle or joint

A scan or imaging is NOT always required for nerve pain. Our physiotherapists will ask you specific questions and can perform specific tests regarding your pain to determine if a scan is required. If so, we will discuss this with you and your GP. Sometimes nerve pain medication prescribed may not make a difference in the pain you are experiencing.

Most nerve pain and nerve irritation can be treated by a musculoskeletal physiotherapist. At Barefoot Physio, we have specific and sensitive tests that will give us the information to guide our treatment. Our treatment is called Neural Tissue Management which involves joint mobilizations to neck or back joints. It can also include muscle treatment along the path of the irritated nerve. This will reduce the sensitivity of the nerves to allow them to be restored to their full gliding movements within the muscles and joints.

With our individualized and specific treatment approach, we can teach you ways to continue to keep your body happy and pain free. We will teach you muscle releases, motor control and exercises to ensure that nerve pain in the future is prevented.

If you or someone you know is experiencing nerve pain, whether it be a day, a week, or years, please contact us. We are open 2 days a week with early and late appointments, along with a couple Saturdays a month to accommodate your schedule. Please call us at 1300 842 850 or click here to book an appointment. All our physiotherapists are trained in nerve pain assessment and treatment.