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Achilles Tendonitis INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Achilles Tendonitis WHAT’S IN A NAME Tendonitis - tendinitis - tendonosis The suffix ‘itis’ means inflammation; therefore, tendonitis literally means inflammation of the tendon. At some point, people started to use tendinitis as well, which is exactly the same, only with a different spelling. With tendonitis or tendinitis, the tendon is overloaded due to an acute injury causing pain and swelling from tears in the injured tissue. TENDONOSIS Sometimes also referred to as tendinosis - occurs from failed healing or repetitive trauma to a tendon. This microtrauma leads to a loss of collagen continuity with micro tears in the tendon. As a result, there is a loss of strength and further injury will happen when continuing to (over)use the tissue. However, inflammation is generally NOT present with tendonosis (or tendinosis), whatever writing you prefer. In rare cases, chronic degeneration with or without pain may result in a rupture of the tendon. CAUSES "Active people and athletes are at a higher risk for developing disorders of the achilles tendon." A sudden increase in training (too much too soon) is a classic example where individuals will put too much stress on their ankles and feet. Foot position also has an impact on this tendon, such as people with a flat foot or overpronation. Due to the greater demands placed on the tendon when walking and running, there is a higher chance of getting tendonitis or tendonosis. SYMPTOMS The most common symptoms are an achy pain, stiffness or soreness along the tendon or just below the calf muscle. Often the pain is worse in the morning or after periods of rest and then improves with movement but later worsens with increased activity. TREATMENT "Tendonitis or tendinitis, where inflammation is present is best treated with the simple RICE principle (rest, ice, compression and elevation) to reduce the inflammation and to allow healing." Physiotherapy is very helpful at this stage as well; with specific hands-on treatment and guided exercises. The tendonitis should heal in about 6 weeks and can also benefit from anti-inflammatory medicine and sometimes with a cortisone injection. With Tendonosis, (no inflammation present at this stage) anti-inflammatory medication and cortisone injections are not appropriate, because they inhibit collagen repair. Tendonosis healing time is normally between 3 and 6 months once it becomes chronic. Studies show that it takes up to 100 days to rebuild collagen. The primary treatment plan for tendonosis is to break the injury cycle and to reduce the stress on the tendon with relative rest (or altered physical activity), proper ergonomics/biomechanics and physiotherapy. Our physiotherapist will first determine what has caused the condition to arise, as mentioned ‘too much too soon’ is typical of tendinosis, so the first step is adjusting your training load if you're an athlete or your employment load. We can set manageable loads of work through your week with modifications to your tasks that will provide the tendon with relative rest. Upon settling the episode of pain in the tendon we will gradually build the tolerance within the tendon using specific exercises to strengthen the tendon whilst not triggering a relapse in the condition. DOES DRY NEEDLING HELP WITH ACHILLES TENDONITIS? It sure can. As mentioned before, there is too much stress on the tendon due to various reasons. The muscle can be too tight and cause the tendon to get thicker or inflame. Releasing the muscle will reduce the pulling on the Achilles tendon and therefore reduce the pain or inflammation. Dry needling is a great way to release muscle tightness fast and effectively. To learn more about dry needling, click here .

Sprains, Strains And Tears INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Sprains, Strains And Tears Sprains, strains and tears are a hot topic in the physiotherapy world As physiotherapists we come across these types of injuries daily, but what does that mean for you? Keep reading to find out what the differences are between each of these, the physiotherapy treatment involved, and even how to avoid them recurring (or happening at all!) Ligament vs tendon vs muscle Let’s start with muscles. So what are they? Muscles are soft tissues. Many stretchy fibers make up your muscles. You have more than 600 muscles in your body. Different types of muscles have different jobs. Some muscles help you run or jump, others perform delicate tasks like threading a needle. Ligaments and tendons on the other hand, are quite different from muscles and even from each other! Tendons serve the purpose of attaching our muscles to our bones. They act like an anchor for the muscle to the bone. Ligaments attach bone to bone. Now you may think that ligaments are kind of the outlier in this situation. However the example of the calf complex sums it up perfectly! From the outside it looks as though the foot is just attached to the lower leg which naturally becomes the calf. While this is not wrong, what's going on underneath is much more interesting! The Achilles tendon, at the back of your heel, attaches the calf muscles to the calcaneus (heel bone), while a ligament holds the shin and foot bones (tibia and fibula with the talus) together at the ankle joint. So now that we know what’s involved, what happens when something goes wrong? You may often hear people and professionals speak of sprains and tears, but how do we distinguish between them? Sprain VS tear A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints. The most common location for a sprain is in your ankle. Initial treatment includes rest, ice, compression and elevation. Strains and tears can be grouped together. This is because a severe strain is referred to as a tear. Take a look at the table below to see how we can classify these injuries. Grade 1- The signs may not be present until after the activity is over. There may be a sensation of muscle cramp/tightness and a slight feeling of pain when the muscles are stretched or contracted. Grade 2- Immediate pain which is more severe than that of grade 1. It is confirmed by pain on stretch and contraction of the muscle and is usually sore to touch. Grade 3- Quite a serious injury. There is an immediate burning/stabbing pain and the individual is unable to walk without pain. The muscle is completely torn and there may be a large lump of muscle tissue above a depression where the tear is. Bruising will appear below the injury site. Treatment Treatment of strains and sprains should begin as soon as possible. Many people are familiar with the “RICE” protocol of R est, I ce, C ompression and E levation. Research now suggests that we can do a lot more in the early stages of Injury. See the infographic below for the most effective acute injury management protocol - “Peace & Love”. Your physiotherapist will guide you through a detailed and comprehensive rehabilitation programme individualized to your injury and personal goals. This kind of injury can take time to heal and may change the dynamics of the joint. The degree of sprain will determine the steps you will need to take in the recovery process. As physios, we will work with you to regain strength and mobility in your joint. We will teach you exercises, as well as give you a home exercise program, to prevent the injured joint from becoming stiff. Exercises to build strength and balance (in ankle and knee sprains) will be increased over time until you are back at a pre-injury level of activity. Your physio therapy can help with a return to exercise, sports programs and get the affected joint or muscle even stronger than it was to begin with. If you have suffered repeated sprains or strains (such as an ankle sprain or hamstring strain) or were immobilised for a while as the area healed (like in a boot or cast), physiotherapy will be strongly recommended to reduce the chance of getting injured again. Using an injured muscle or tendon can make your injury heal faster, as long as it's within the parameters set out by our physiotherapists. Exercising strained muscles and tendons may seem counterintuitive but a specific program of gradual strength training actually heals tendons faster. As your body repairs damaged tendons, it lays down fibres of collagen to form a scar, by exposing the scar to mechanical load (resistance exercise) the collagen aligns itself appropriately. Resting completely and avoiding any loading of the damaged tissue causes a phenomenon called ‘collagen disarray’. This essentially means the scar that the body has laid down to repair the tendon is not efficient at transmitting force through the tendon and can increase risk of re-injury, prolonged pain and inflammation. Our physiotherapists will guide you through your muscle or tendon strain rehabilitation with graded exposure to resistance exercise and functional activities to facilitate optimal healing and a return to your best level of function. Prevention Though sprains and strains can happen to anyone, there are a few ways you can reduce the risk of a sprain. These tips include: Avoid exercising or playing sports when tired or in pain. Maintain a healthy weight and well-balanced diet to keep muscles strong. Wear shoes that fit properly and be sure any sports equipment is also fitting well. Practice safety measures to prevent falls. Do stretching exercises daily or prior physiotherapy exercises to maintain strength and balance. Warm up and stretch before doing any physical activity. If you ever are questioning if you have a muscle/tendon strain/tear or a ligament sprain, always consult your physiotherapist. It’s usually a good idea to make sure it’s only a sprain or strain and not a more severe injury. You can also get a treatment plan that will get you up and moving again.

Disc Bulges, Herniated Discs And Sciatica INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Disc Bulges, Herniated Discs And Sciatica A spinal disc is the natural shock absorber and also allows movement of the spine. A bulging disc is actually a very common condition in our spine. It is natural wear and tear, the older we become, the more discs can bulge. DIFFERENCE BULGING DISC AND HERNIATED DISC The spinal disc consists of 2 parts: the inner nucleus: is a jelly-like structure, a bit comparable with the liquid part inside a chocolate cake. The outer annulus fibrosus: the more dense part of the cartilage. When a disc is moving out as a whole, it’s called a disc bulge. When the outer ring (annulus) is damaged and the inner nucleus is escaping from within the disc, it’s called a herniated disc. CAUSES Spinal degeneration (wear and tear) Repetitive trauma such as shocks from work or sports, or poor posture can lead to degeneration of the discs. An acute injury with heavy lifting or in an accident (although most disc problems due to an acute injury already had some kind of degeneration) Initial bulging or herniation might be symptom free. A bit more chronic condition will usually give a broad ache in the area, often accompanied with muscle tightness. When the disc is heading towards the nerve root (beginning of the nerve), it can cause inflammation of that nerve. Sciatica is a condition where the nerve gets irritated and refers into the leg. The further down the leg you feel the sensations, the more the nerve will be irritated. Early stage nerve irritation will only give different sensations (numbness, pins and needles), more inflammation or nerve compression can result in loss of strength of the limb. DISC BULGE TREATMENT SCIATICA TREATMENT "At Physio K, we will determine the best course of treatment for you. It is important to know exactly what you have, before moving on to a solution." We will provide a thorough assessment to determine what specifically is causing your problems. Treatment is predominantly determined by the stage of your healing as more chronic pains will require longer and different treatment than more acute ones. We are very experienced in the treatment of all kinds of low back pain and neck pain and will provide you with the best outcome in order to get you moving well again. HOW CAN DRY NEEDLING HELP WITH NERVE PAIN /SCIATICA? When certain muscles are tight or overactive, they can cause pressure on the spine and therefore directly or indirectly cause irritation of the nerve root (which is the beginning of the nerve when it's exiting the spine). Sometimes these muscles can be overactive or underactive, and via dry needling, we can normalize the tone. Underactive muscles can be stimulated and overactive muscles will get released. As a result, the irritation around your nerve should disappear and therefore, your symptoms as well! To learn more about dry needling, click here . In the bellow video, Kenny from Physio K is showing an exercise program for people with lower back pain, tailored for people who have disc issues or sciatic nerve problems. Numbness in the bum or further down the leg or the feeling of pins and needles could be an indication of this problem. Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you. Watch the video with lower back pain exercises for people with disc problems or sciatic nerve issues. 1. Cat cow exercise. On your hands and knees, in all four position, making sure that your hips are above your knees and your hands are underneath your shoulders. Try to tilt your pelvis forward and backwards. We're going to focus on the lower back, imagining tucking a tail in between your legs and then putting your tail up in the air. The curved up position is a bit like how a cat is rounding its back and the opposite, curved down position, is similar to the position of a cow. Make sure you stay mid range, don’t push all the way up or down if you have disc issues or sciatic nerve irritation. Do this for about a minute: 20 to 30 times and if possible multiple times a day. 2. McKenzie extension exercise Laying on your tummy on a mat on the floor and putting your elbows underneath your shoulders (sphinx pose). Try to extend your lower back and look up with your head. You'll have a little bit of compression in the lower back which is great for your disc and you can also feel a little bit of stretch in the front so that's why you have to look up to have the maximum amount of stretch in the front. Stay in that position for 20 - 25 seconds and go down again. Do that four to five times in a row. If this is too easy for you then you can go to the next step, which is trying to extend your elbows. Put your hands underneath your shoulders, extend your elbows totally and try to relax in your back and look up. 3. Stretch of the Piriformis Laying on your back on a mat, pull up one leg and grab your knee with one hand and grab your heel with your other hand. The purpose is to try and pull your knee towards your opposite shoulder and make sure you leave your head relaxed on the table. You should feel a deep stretch under your glutes. The piriformis is a muscle that's laying in the pelvis, underneath your glutes. That's a very important muscle for your nerve health. If you have any kind of nerve issues make sure you do that stretch. Hold this position for 20 to 25 seconds, relax, do that four or five times in a row. Make sure you have a straight angle in your knee which is 90 degrees and pull across 4. Nerve glider Laying on your back on a mat with your knees bent and feet flat on the floor. If the problem is on the right side, then you'll do the exercise with your right leg. Put your right knee on top of your left knee and then, in this position, relax your foot and try to extend your right knee up and down. Don't hold, don't try to stretch, we're trying to get a glide in the nerve. This is a good stand alone exercise, or could be used as a warm up. The next step is the same thing but at the same time, pull your toes towards your nose while you extend the knee and then go down again, leaving your knee on top of the other one. Try to do 20 to 30 repetitions each, a few times per day.

Learn more about our dedicated team of expert physiotherapists in Bondi Junction, specialising in sports rehabilitation and more. MEET OUR TEAM Josh Sharpe JOSH SHARPE | PHYSIOTHERAPIST | DRY NEEDLING | SPORTS INJURY REHABILITATION | WORK AND LIFESTYLE INJURY REHABILITATION Read More Radi Zinger RADI ZINGER | REMEDIAL MASSAGE THERAPIST | DIPLOMA OF REMEDIAL MASSAGE, TAFE NSW | AQUA EXERCISE INSTRUCTOR, AT Read More Josefina Canepa Bustos JOSEFINA CÀNEPA BUSTOS | PHYSIOTHERAPIST | OVERUSE INJURY REHABILITATION | MUSCULOSKELETAL & SPORTS PHYSIOTHERAPY FOR YOUNG ATHLETES | MANUAL THERAPY | DRY NEEDLING Read More Kenny Merlevede KENNY MERLEVEDE | SENIOR PHYSIOTHERAPIST | FOUNDER AND DIRECTOR OF PHYSIO K | PASSIONATE AND DRIVEN PHYSIOTHERAPIST WITH OVER 13 YEARS OF EXPERIENCE AS AN INDEPENDENT PRACTITIONER ACROSS PHYSIOTHERAPY, MANUAL THERAPY AND SPORTS REHABILITATION. Read More