Research studies, using randomized control trials, reveal that treatments consisting of manual therapy, using joint mobilizations, and specific prescribed Physiotherapy exercises are most effective for recovery versus strengthening exercises alone.[3,5,6]Treatments are aimed towards restoring joint alignment and mobility by breaking up joint capsule restrictions (scar tissue) and correcting muscle imbalances and kinesthetic & proprioceptive awareness.[5,6] Activity modification can also aid in the management of or / and further prevention of the pathology from occurring.
The use of non-corticosteroid medication & corticosteroid injections has a role in the treatment of inflammation and pain control.
When conservative treatment fails and the shoulder impingement is causing considerable pain & dysfunction, arthroscopic surgery followed by manual therapy and exercise has shown to be effective.
For more information about shoulder impingement or shoulder injuries please contact InSync Physio.Contact Us
Have you ever woken up with a sore or stiff neck because you slept on it funny? Have you ever done a prolonged activity such as driving, being on the computer or playing sports where you felt stiff or soreness in your neck afterwards? These kinds of injuries are usually non-traumatic in nature. It is commonly known as wry-neck or also referred to as “torticollis”, and is a condition in which muscle spasms occur from soreness and stiffness in the neck causing it to be out of alignment.
Wry neck can occur due to the prolonged or sudden stretch of the neck for a few possible reasons. The shock absorbing cushion called the meniscoid structures within the zygoapophyseal joint of the neck vertebra can become blocked and jammed in its rest position, swelling and thickening of ligaments / capsules and the surround soft tissue around the joint(s), or a slow shift of the disc in the neck vertebra can all cause muscle spasms. Moreover, old injuries causing unstable joints, constant “self adjustments”, and hyperflexibility can all be contributing factors to developing wry neck.
As well, it can also occur following an upper respiratory tract infection (mainly affecting children), which causes the lymph gland under the neck muscle to swell; this is known as “Grisel’s Syndrome”. Non-activity related causes of torticollis include neurological disorders or tumors.
There is usually a limitation of movement toward one side and the posture is slightly flexed away from the painful side. You can wake up with pain on one side initially which can then occur on both sides. Initially the pain can be localized but may later radiate to other areas in the neck, shoulders, arms, hands or fingers. As well, you may experience a headache.
Using ice and resting your neck for the first 48 to 72 hours is the recommended first step. Swelling, pain and having the neck vertebra out of alignment can cause the joints to lose its normal range of motion. More over, the altered function of the neck causes imbalances such as muscle weakness and tightness to develop. Physiotherapy, through the use of manual therapy and specific exercises, has been shown to help in the restoration of the movement of the neck joints and the optimal functioning of the muscle imbalances that can occur.[2,3,4] The use of Intramuscular Stimulation (IMS) has also been shown to be beneficial in these types of neck injuries5. Overall, successful management of wry neck includes regaining joint mobility, muscle strength and flexibility, as well as retraining the coordinated movements.[2,3,4]
For more information about neck injuries please contact InSync Physio.Contact Us
Whiplash “Whiplash Associated Disorder (WAD)” occurs when a certain force is transmitted to the neck or “cervical spine”. Motor vehicle accidents, any sudden forceful movements of the neck, a fall causing impact on the head, or sports involving impact to the head can result in injury. Any acceleration and deceleration forces absorbed can cause damage to structures of the neck.
A small amount of force can sometimes cause more significant injury than large amounts of sudden force. Reasons for this is largely due to the fact that the degree of damage depends on the amount of force involved as well as the direction of the force.
Signs and Symptoms can occur immediately after impact or may take a day or two to develop.
Here is a scale to help you understand how whiplash signs and symptoms can be classified and how to grade its severity:
|Grade||Signs and Symptoms|
|0||No complaints about the neck|
|1||Stiffness, pain or tenderness only|
|2||Stiffness, pain, increased soreness, loss in mobility|
|3||Stiffness, pain soreness, loss in mobility, Neurological Signs of weakness in shoulder, arm or hand(s), pain or loss in sensation in shoulder, arm, hand(s)|
|4||Stiffness, pain soreness, loss in mobility, Neurological Signs of weakness in shoulder, arm or hand(s), pain or loss in sensation in shoulder, arm, hand(s), AND Fracture or dislocation|
|Note||Symptoms and disorders that can occur in all grades, but are not limited to: deafness, dizziness, ringing in ears, memory loss, difficulty with swallowing, and jaw pain (TMJ)|
*** If you are experiencing symptoms that are similar to either grade 3 or grade 4 whiplash it is highly recommended that you see a doctor immediately. Radiology must confirm grade 4 classifications WAD.
For grades 1-3 whiplash, immediately following your injury apply ice for 10 to 15 minutes every hour for the first 3 days. Early physiotherapy intervention using manual therapy to guide soft tissue and joint movements, therapeutic ultrasound, electrical stimulation, and specific home exercises are very effective.[2,4,5] Dry Needling intramuscular stimulation (IMS) is also effective in controlling pain and reducing muscle spasms and promoting therapeutic increase in mobility. After the first few days and beyond if your function in activities and perhaps even sport participation increases it is important to continue to achieve functional mobility and strength of injured segments.[2,3,4,5] Progressive techniques using manual therapy, massage and specific home exercises and postural education is very effective to achieve this.[2,4] Dry needling (IMS) can also help to progress with your recovery.
Full functional recovery from Whiplash can take anywhere from 6 weeks up to 12 weeks or longer depending on the severity and nature of the injury. As you begin to recover and resume certain activities, and even participation in sports within the first 2- 3 weeks, your joints, ligaments, and muscles are still healing.[1,4] By regaining joint mobility, strengthening muscles and retraining the coordinated movements of injured areas you will get back “InSync” to your active lifestyle.
For more information about neck injuries please contact InSync Physio.Contact Us
The primary function of the ACL is to provide stability in the knee and restrain anterior displacement of the tibia relative to the femur. It also acts to restrain internal-external rotation and varus-valgus angulations and combinations of. Therefore an injury to the ACL causes a loss in stability in the knee joint.
Proper treatment can only be applied when a correct diagnosis can be made. A clinical examination will help to assist this.
Research studies reveals that ALC tears are problematic because of functional instability, which results in meniscal injuries, secondary instabilities, and early onset osteoarthritis. Incidence of meniscal tear in ACL deficient knee is 40% at year one, 60% at year five, 80% at year ten. Osteoarthritis occurs in 60%-90% by year 10-15. Surgical intervention may be an option depending on the your current situation.
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The strongest tendon in the body conjoins the gastrocnemius and soleus muscles to the heel bone (calcaneous). The average length is about 15 cm and does not have a true synovial sheath covering and protecting it but rather a single cell layer of fatty areolar tissue called a paratenon. Blood supply is evident in three locations, being most vascular proximally where it attached to the muscles and least in the mid section of the tendon.
Achilles tendon disorders are reported in a wide variety of sports. Seen amongst a variety of athletics it is more symptomatic during training as opposed to during competition. It accounts for up to 9% in recreational & competitive runners. People who are less active are not immune to this either. Although there is an increased prevalence of Achilles injuries as age increases, the mean age for Achilles disorders is reported to be between 30-50 years of age.
Likely that both ultrasound and MRI imaging will play an important role in verifying tendon structure to augment clinical decision-making.
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