Navigating Hip and Knee Replacements: Is Surgery the Path for You?
Exploring Paths: From Pain to Possibility
Many individuals find themselves at a crossroads, wondering if surgery is the right path. Chronic pain, stiffness, and limited mobility can make everyday activities challenging. Conditions such as osteoarthritis, rheumatoid arthritis, and joint injuries often lead people to consider hip or knee replacement surgery. This procedure involves replacing the joint surfaces with artificial components to restore function and alleviate pain. However, before deciding on surgery, exploring conservative management options can also significantly improve quality of life. Everyone’s circumstances and goals are different, so either path can lead to positive results. Making an informed decision involves considering advice from your healthcare team, including our physiotherapists and exercise physiologists, as well as discussions with your doctors.
Conservative Management and Outcomes
Before opting for surgery, many people find that conservative management strategies, including physiotherapy and exercise physiology, can provide significant relief. Research shows that exercise is a first-line treatment for managing arthritis, helping to reduce pain, improve joint function, and enhance overall quality of life.
Conservative Management focuses on:
• Strengthening Muscles: Building the muscles around the joint to provide better support and stability.
• Improving Flexibility: Enhancing the range of motion to alleviate stiffness and improve mobility.
• Pain Management: Employing techniques such as manual therapy to manage discomfort effectively.
Outcomes of Conservative Management can be quite positive. Many individuals experience reduced pain, improved mobility, and a better quality of life without the need for surgery. Our physiotherapists and exercise physiologists will guide you in performing exercises correctly and safely, ensuring you don’t overdo it. This approach not only helps you make a more informed decision about surgery but also enhances recovery and long-term outcomes if surgery is eventually needed.
You’ve Decided on Surgery: How Physiotherapy Can Help
Once you’ve chosen surgery, physiotherapy becomes crucial for both preparing your body and ensuring a smooth recovery. Prehabilitation and post-surgery physiotherapy are essential components in achieving optimal outcomes.
Prehabilitation, or pre-surgery physiotherapy, typically lasts 4-6 weeks and focuses on enhancing strength, flexibility, and cardiovascular fitness. This approach helps set realistic recovery goals and prepares your body for the upcoming surgery.
Post-surgery physiotherapy is essential for a successful recovery. It involves a structured rehabilitation plan designed to support proper healing and restore function. Our physiotherapists will work with you through:
• Week 1-2: Emphasis on gait retraining, increasing range of motion, regaining strength, and managing pain.
• Week 3-6: Continuing to improve range of motion, phasing out mobility devices if needed, building strength, and potentially resuming work or driving depending on your progress.
• Week 7-12: Engaging in lighter exercises like walking, swimming, or cycling initially, then discussing specific goals such as returning to gardening or low-impact sports like golf or dance.
By engaging in a comprehensive physiotherapy program before and after surgery, you can work towards specific goals and activities you enjoy. Our team will support you throughout, helping you regain mobility and enhance your quality of life.
Common Challenges
• Pain and Swelling: Early stages require careful management.
• Adhering to Rehab Protocols: Consistency is key for successful outcomes.
• Emotional and Mental Health: Anxiety and mood changes are normal; support is available.
Conclusion
Choosing hip or knee replacement surgery involves careful consideration of both conservative and surgical options. Our team works together seamlessly to support you throughout this journey. We combine our expertise to enhance your pre-surgery preparation and ensure a smooth recovery, addressing challenges and helping you achieve the best possible outcomes. With our support, you receive comprehensive care that helps you regain mobility, manage pain, and return to the activities you love. We’re here to guide and support you every step of the way, ensuring you enjoy a more active and fulfilling life.
Ready to Take Action? If you’re considering hip or knee replacement, or want to explore conservative management options, our clinic is here to help. Contact us today to begin your path to improved mobility and a healthier, more vibrant lifestyle.
Pregnancy Pilates
Pregnancy is a remarkable journey filled with anticipation, joy, and significant physical changes. As your body adapts to support new life, maintaining your health and well-being becomes essential.
Did you know that Australian health guidelines suggest pregnant women should engage in 2.5 to 5 hours of exercise per week, including cardio, muscle strengthening, and pelvic floor exercises every day? Are you moving your body enough for a healthy pregnancy?
Pilates (studio) offers numerous scientifically-backed benefits and it is a gentle, yet effective method in a safe environment with instructors guiding every step. Pilates exercises can be modified to suit the changing needs and abilities of pregnant women, making it a versatile and adaptable form of exercise tailored to specific trimesters.
Benefits of Pilates for Pregnant Women:
- Increase core strength and stability:
Pilates emphasizes on core strength, which supports the spine, improves posture, alleviates lower back pain, and can also aid in labor and delivery. Strong core muscles also help decrease the progression of abdominal diastasis and can help at the moment of delivery.
Improve pelvic floor function:
Pilates includes exercises targeting the pelvic floor muscles, supporting the bladder, uterus, and bowels. Strengthening these muscles can reduce the risk of urinary incontinence during and after pregnancy.
Improve mobility and balance:
Pregnancy hormones loosen ligaments, increasing susceptibility to injury. Pilates exercises promote flexibility whilst improving stability, thus reducing the risk of strains or injuries and managing changes in posture from the growing abdomen.
Better mental health and breath control:
Engaging in Pilates can have positive effects on psychological well-being by reducing stress, anxiety, and improving mood. It incorporates breathing techniques beneficial during pregnancy and labor, helps managing stress and maintaining oxygen flow to both mother and baby.
While Pilates offers significant benefits, there are important considerations before starting. Particularly if you were sedentary before pregnancy, begin slowly and gradually increase your activity. Consider any risk factors; individual responses to exercise can vary. Consult your healthcare provider before starting any new exercise program, including Pilates. Avoid exercise if you have certain heart or lung diseases, cervical cerclage, placenta previa after 26 weeks, preeclampsia, or severe anemia.
After medical approval for exercise, find a trustworthy instructor and discuss your exercise history, injuries, and any concerns to ensure comfort and safety.
Tips for each Trimester:
First Trimester – Low energy, fatigue, nauseous. Don’t push your limits!
That’s time to educate your movements and breathing techniques, pelvic floor awareness and maintaining your existing fitness levels.
Second Trimester– Most energetic and not many limitations yet.
Your body is changing, but you can still keep your body in movement easily, so it’s time to get stronger! Be aware of balance and alignment as well.
Third Trimester– Tiredness, anxiety and weight gain.
Keep following the current exercise program, but respecting the limitations from the growing belly, tiredness and reduced mobility. Communicate with your instructor about discomforts like back or hip pain.
Postpartum– Follow your health care provider’s advice.
Typically, you can resume exercises around 6 weeks after delivery, but your body takes between 6 months to 1 year to get back to normal.
In conclusion, while Pilates can be safe and effective during pregnancy, it’s crucial to approach it cautiously, seek guidance from a qualified instructor, and ensure it meets your specific health needs and pregnancy status.
Plantar Fasciitis
What is Plantar Fasciitis?
The plantar fascia is a thick, fibrous band of tissue located on the bottom of your foot. It extends from the heel to the base of the toes. This tissue plays a crucial role in stabilising and supporting your foot as you move through daily activities. However, when the plantar fascia becomes overloaded and strained, it can become inflamed and injured, leading to pain and discomfort. This condition is known as plantar fasciitis.
Causes
The primary cause of plantar fasciitis is a change in how you load your foot. Several factors can increase your risk of developing this condition, including:
Overuse and over-training
- Inadequate or worn-out footwear
- Poor strength, mobility, and flexibility in the lower limbs
- Muscle imbalances and dysfunction
- Weight gain and a sedentary lifestyle
- Rigid feet with poor mobility and flexibility, which are inadequate to absorb shock
- Leg length differences
- Abnormal walking and running patterns that place extra stress on the heel bone and ligaments
- Careers and hobbies that involve prolonged periods of standing
- Age; as you get older, your tissues become less elastic
When high loads are repeatedly placed on the heel bone and surrounding soft tissues, they can become fatigued and lose their ability to absorb shock effectively, leading to plantar fasciitis.
Symptoms
Plantar fasciitis typically begins with mild pain at the heel bone, often described as a stone bruise. This pain is usually felt after (not during) exercise. It is most pronounced right after getting up in the morning or after a period of sitting. Without treatment, plantar fasciitis can become a chronic condition, potentially leading to reduced activity levels and further issues with the foot, knee, hip, and back, as the condition can alter your walking pattern.
Treatment
Managing plantar fasciitis involves a combination of exercises, physiotherapy, and massage to alleviate pain and promote healing. Here are some effective treatment methods:
- Stretching Exercises: Regular stretching of the calf muscles and the plantar fascia can help reduce tension and promote flexibility. Try stretching exercises such as calf stretches, towel stretches, and toe stretches.
- Strengthening Exercises: Strengthening the muscles of the foot and lower leg can improve stability and reduce strain on the plantar fascia. Exercises like toe curls, picking up marbles with your toes, and resistance band exercises are beneficial.
- Physiotherapy: A physiotherapist can design a personalised exercise program, taping, and manual therapy to reduce pain and inflammation.
- Massage: Regular massage can help increase blood flow to the affected area, reduce muscle tension, and alleviate pain. Techniques such as deep tissue massage and trigger point therapy are particularly effective.
- Footwear: Wearing supportive shoes with good arch support and cushioning can help alleviate symptoms. In some cases, orthotic inserts may also provide additional support and reduce strain on the plantar fascia.
- Rest and Ice: Resting the affected foot and applying ice can help reduce inflammation and pain. It’s important to avoid activities that exacerbate the condition.
By understanding the causes, recognising the symptoms, and following a comprehensive treatment plan, you can effectively manage plantar fasciitis and maintain your active lifestyle.
Unlock the Mystery of Neck Pain: Your Guide to ReliefStrength x Tension
Tight Muscles Might Actually Be Weak Muscles
There is a common belief that when a muscle is tight, that it needs to be stretched and strengthening that muscle may aggravate the issue. Let’s explore why this isn’t the case and what should be done instead.
What Really Causes Muscle Tightness?
People often think tight muscles mean the muscle is too strong and just needs stretching to loosen up. But sometimes, tightness means the muscle is weak and is trying hard to protect itself and nearby parts—like joints and ligaments—from getting hurt. This protective tightening can happen when there’s a risk of injury, or when an injury has already happened, and the muscle is trying to guard against further harm.
The False Belief: More Stretching, Less Strengthening
There is currently an existing belief that “tight muscle = needs to stretch”, which often leads to neglect in strengthening. While stretching does play a role in maintaining flexibility, it does not address the underlying weakness. Strengthening, on the other hand, teaches the muscle to function correctly through its full range of motion and to tolerate load effectively, which can reduce unnecessary tightness.
Why Strengthening Should Not Be Overlooked
Strengthening weak muscles can:
• Improve Muscle Balance: It takes the burden off overly tight muscles, helping them relax naturally.
• Enhance Flexibility and Range of Motion: Strong muscles can handle greater stretches and activity, improving overall functionality.
• Prevent Injury: Strong muscles support joints and protect the body, reducing the risk of strains, sprains, and other injuries.
Exercises to Consider
Here are a few exercises designed to strengthen muscles through their full range of motion. Remember, the goal is controlled movement, focusing on both strength and flexibility:
• Romanian Deadlifts: Excellent for strengthening the entire posterior chain, including hamstrings and lower back.
• Squats: Full-depth squats promote strength and mobility in the hips, knees, and ankles.
• Lunges: These target multiple muscle groups in the legs and improve hip flexibility.
• Dumbbell Shoulder Press: Enhances shoulder stability and range by strengthening through the full movement.
• Push Ups: Great for building upper body strength and core stability while engaging multiple muscle groups.
Always Consult a Physiotherapist or Exercise Physiologist:
Before starting any exercise program, especially if you have pain, past injuries, or specific health conditions, it’s important to speak with a physiotherapist or exercise physiologist. They’ll assess your needs and ensure your exercise plan is safe and tailored to your individual requirements, including disease management if needed. This step helps prevent injuries and maximizes the benefits of exercise for your overall health.
Conclusion
Tight muscles often need more than just stretching; they need to be strengthened as well so that the muscle will get stronger through a larger range of motion. Understanding and addressing muscle weakness can lead to better flexibility, fewer injuries, and improved overall health. Take the first step towards improving your muscle health today by consulting with one of our physiotherapists or exercise physiologist to develop an exercise plan design for your needs.
Football (“soccer”) injuries
Soccer is a contact sport with loads of sprinting and cutting, jumping and explosive movements such as kicking a ball. Each of these can lead to a different type of injury, from an ankle or knee sprain to a muscle injury or a ligament injury. Aside the goal keepers injuries (hand and wrist), the lower limb is the most affected body part. Hamstring and calf strains are the most common type of muscle injury. Groin pains are usually due to an imbalance between inner thigh muscles strength (adductor) and hip mobility and strength, but it can also be a referred pain from a hip injury (i.e. labral tears or cam injuries). The knee is the most common site of pain, coming from the patellar femoral joint (PFP, i.e chondromalacia), patellar tendon, collateral ligaments, or from internal structures in the knee, such as the meniscus or the ligaments ACL/PCL. Ankle injuries are usually from sprains. Treatment will vary on the site location and severity. When acute injuries such as a cork (contusion in the muscle) or a sprain, physiotherapy would focus primarily in reducing pain and inflammation and restoring movement; when pain is not due to an acute injury, like muscle cramps, or knee pain or patellar or achilles tendinopathy, treatment should focus not only on manual therapy techniques but mainly on exercises to build capacity and reduce recurrences. Regardless of the type of injury, we can help. Understanding the biomechanics of the sport and the most common injuries, a preventive exercise program can be implemented to help reduce the risk of injuries, along with understanding your body’s current capacity and how to build it up.
Fitness Pilates
Discover the power of Pilates for enhancing sports performance and injury prevention.
Pilates offers numerous benefits that can significantly contribute to your athletic journey. Engaging in regular Fitness Pilates workouts can serve as the foundation of a healthy body, enabling you to actively support flexibility, coordination, and core strength. These elements are crucial for improving your performance in any sport.
Elite athletes often turn to Pilates during injury rehabilitation, appreciating its ability to aid recovery and restore functionality. However, Pilates is not solely limited to post-injury care—it also excels as a proactive method of injury prevention.
By practicing precise and controlled Pilates movements, you can strengthen and condition your body, promoting balanced muscles and proper joint alignment. This balance and alignment play a key role in mitigating the risk of overuse injuries and imbalances commonly associated with sports activities.
Moreover, Pilates is renowned among dancers and athletes alike for its ability to improve posture, flexibility, body awareness, and overall strength—essential components in any sport.
Experience the transformative benefits of Fitness Pilates and unlock your athletic potential. Our knowledgeable instructors will guide you through tailored workouts designed to address your specific needs and goals. Elevate your sports performance, prevent injuries, and enhance your overall physical well-being.
Whether you’re a professional athlete, an avid sports enthusiast, or simply looking to improve your fitness level, Fitness Pilates is a powerful tool that can take your performance to new heights.
Join us today to discover the countless advantages that Pilates offers in sports and embrace a holistic approach to reaching your athletic goals.
Contact us now to embark on your Fitness Pilates journey and unlock the true potential of your body.
Fitness Pilates
Discover the power of Pilates for enhancing sports performance and injury prevention.
Pilates offers numerous benefits that can significantly contribute to your athletic journey. Engaging in regular Fitness Pilates workouts can serve as the foundation of a healthy body, enabling you to actively support flexibility, coordination, and core strength. These elements are crucial for improving your performance in any sport.
Elite athletes often turn to Pilates during injury rehabilitation, appreciating its ability to aid recovery and restore functionality. However, Pilates is not solely limited to post-injury care—it also excels as a proactive method of injury prevention.
By practicing precise and controlled Pilates movements, you can strengthen and condition your body, promoting balanced muscles and proper joint alignment. This balance and alignment play a key role in mitigating the risk of overuse injuries and imbalances commonly associated with sports activities.
Moreover, Pilates is renowned among dancers and athletes alike for its ability to improve posture, flexibility, body awareness, and overall strength—essential components in any sport.
Experience the transformative benefits of Fitness Pilates and unlock your athletic potential. Our knowledgeable instructors will guide you through tailored workouts designed to address your specific needs and goals. Elevate your sports performance, prevent injuries, and enhance your overall physical well-being.
Whether you’re a professional athlete, an avid sports enthusiast, or simply looking to improve your fitness level, Fitness Pilates is a powerful tool that can take your performance to new heights.
Join us today to discover the countless advantages that Pilates offers in sports and embrace a holistic approach to reaching your athletic goals.
Contact us now to embark on your Fitness Pilates journey and unlock the true potential of your body.
Running injuries
What to do? Should you stop running? Will everyone benefit from a running assessment?
Despite the odd ankle sprain, the majority of running injuries are due to overload. This is doing more than your current capacity to bear it. Running injuries occur mainly in the leg but low back pain can occur from running. Injuries can vary from a muscle strain to joint pain, to tendinopathy, to a bone stress fracture.
Such injuries occur due to spikes in training loads. Sudden increase in the running routine, are the usual culprit in causing running injuries.
What is load? And what load means in the running context?
This concept is key to manage your running program and run pain free.
Increase in load can be considered, a sudden increase in your pace or doing more speed training, adding hills training, starting to run with a running partner (who runs faster than you, which you make you push your training harder), new shoes, returning from a break with no running such as holidays or if recovering from an injury or illness. To adapt and get stronger, without getting injured, all changes in your running program need to be slow, not sudden.
Previous injuries can increase your risk of getting a new injury, or suffering from the old one again. Do you know that niggle here or there, that you just pretend it does not exist?
This niggle might be a sign that something is off, maybe a muscle compensating from a weakness somewhere else. Our body is really good at adapting when progression is slow, sudden changes might push the body too farther to allow adaptation and injury occurs. An imbalance between training load and recovery will shift the scales towards an injury rather than towards adaptation. Knowing when to add the more intense sessions or when to add rest sessions or light/recovery sessions can be the gold nugget to keep you running pain free.
You decided to go to the physio, what now?
A sports physio will assess your injury, gather the history and perform clinical test to identify what is happening. Strength tests, endurance, mobility, your history of injuries, your training routine, are all key factors to consider. Most running injuries will allow you to keep running even during physio. Some of those can even improve with only a slight change in the running routine, to give your body time to recover and adapt to the intense training load. Load management is key to recovery and to overcome a running injury, which can be long-lasting and recalcitrant.
On the other hand, some injuries can be harder to improve and may require physiotherapy treatment. Treatment will depend on the structure injured and the severity of injury. Bone injuries such as a stress fracture may require some time off running and specific exercises to progressively expose the injured bone back to loading and consequently safely back to running.
Other injuries such as patellar-femoral pain syndrome (PFP), ITB syndrome, gluteal, patellar or Achilles tendinopathy should require no rest, rather resistance exercises to work on weak muscles and biomechanics, and other types of exercises such as jumps and hops. Jumps and hops are important part of return to sport, as they target the springs in your body (tendons) aiming to improve tendon load capacity, required for running.
For most running injuries, treatment will be exercise based. Manual therapy has a role, but only an adjunctive role. Exercises allow the injured structure to get progressive exposure to load and allow adaptation, and therefore, allowing the tendon, muscle, joint and bone to get stronger and more resilient.
For some people, especially novice runners, of for those with a long-lasting injury, a running assessment may be warranted. There are some key things to assess in a running assessment, and potentially change in your running style, to improve efficiency and reduce the risk of injuries.
The road to recovery is not without bumps but we are here to help along the way, to provide you with the best support and guidance through your recovery and return to running pain free.
Our goal is to keep you active while you recover, and to support you in being the best runner you can be.
Portuguese – version (adapted)
Lesões de corrida, e agora, o que fazer? Devo parar de correr pra me recuperar? Uma analise de video da corrida adiciona benefício a todos os corredores?
A maioria das lesões de corrida estão associadas a um “overload”, ou seja “sobrecarga”. Isso signifca, fazer mais do que o corpo consegue aguentar. As lesões de corrida acometem principalmente a região da perna, apesar de algumas vezes podermos termos uma dor lombar associada a corrida; com lesões que variam entre um estiramento muscular, uma dor/inflamação articular (artrite ou sinovite), uma tendinopatia (“tendinite”) a uma lesão óssea pós estress (fratura/reação de estresse).
Estas lesões acontecem na maior parte das vezes, devido a um pico (aumento) na carga de treino (intensidade, frequencia, etc). Um aumento subito na rotina de treinos, geralmente é o principal responsável por lesões de corrida.
Mas afinal, o que é carga? ou sobrecarga? E em que contexto isso se encaixa na corrida?
Entender esse conceito é crucial na organizacao de um programa de treino de corrida, para que você consiga progredir e correr sem dores.
Um aumento da carga de treino é considerado por exemplo, quando feito de forma subita, sem planejamento, exemplo: um aumento do pace, ou começar a fazer treinos mais frequentes de corrida, ou adicionar ladeira. Outro exemplo é começar a correr com um parceiro de treino que corre com um pace maior que o seu, e tentar acompanhar. Mudança de tênis podem tambem ser um fator importante, por exemplo, saindo de um tênis com mais suporte, pra um mais minimalista (ou vice-versa). Sobrecarga pode ser considerada também, o retorno aos treinos, ao mesmo nível que estava acostumado, após um tempo sem correr, por conta de férias, ou se está retomando aos treinos por conta de doença ou lesão.
O seu histórico de lesão, é um fator de risco para novas lesões or para uma reincidiva. Isso pode estar associado a uma lesão que não foi bem tratada, ou a um desequilíbrio muscular associado a essa lesão antiga, que ainda não foi corrigido.
Na mesma tecla, sabe aquele incômodo que você sente durante ou depos da corrida, que você está empurrando com a barriga há algum tempo?
Isso pode ser um sinal de que alguma estrutura (tendão, músculo, a articulção) está sendo sobrecarregada e por estar fraca (de uma lesão antiga) ou que o corpo está tentando se adaptar mas, está criando uma compensação de outra região. Isso mostra a presença de um “ponto fraco” que precisa ser avaliado e corrigido pra evitar virar uma lesão mais seria. Um equilíbrio entre a intensidade de treino e descanso é extremamente importante para que o corpo se adapte ao treino, e fique mais forte. Um desequilíbrio, gera uma lesão. Entendendo quando fazer uma sessão de treino mais intensa, ou quando acrescenta sessões de recuperação/ou mais leves, são o fundamentais para progredir no treino de corrida, sem dor/lesões.
Isso não funcionou, e você se lesionou. Você precisa de fisio. O que esperar da sessão?
Um fisio esportivo vai te avaliar e tentar enteder sua lesão atual. Pra isso, parte da sessão inclui tomar nota do seu histórico de lesões e programa de treino. Na sessão, o fisio vai utilizar de testes clínicos para indentificar o que está acontecendo, quais estruturas estão lesionadas e a severidade da lesão. Testes de força, resistência a fadiga; entender a sua progressão e rotina de treno são todos fatores importantes a serem considerados. A maioria das lesões de corrida, permite que voce continue ativo(a), correndo ou se exercitando de alguma forma. Como um fisio esportivo, a ultima coisa que eu quero dos meus clientes é que eles parem de se exercitar; isso so traz problemas na recuperação e atrasa o retorno ao esporte. Alguma lesões inclusive, melhoram somente com um reajuste no programa de corrida e alguns exercícios específicos pra corrida, focando em mobilidade por exemplo.
Por outro lado, algumas lesões vao precisar de uma redução mais drastica na rotina de treinos, como por exemplo reações/fraturas por estresse. Essas por exemplo podem requerer, parar de correr por um tempo, mas ainda permitem que voce continue fazendo musculação, nadando, pedalando, para manter seu fitness em alto nível e a musculatura forte, o que ajudar a recuperção óssea. Ainda falando sobre as fraturas, o tratamento mais importante e eficiente é exercicio, e repouso relativo. A contração muscular ajuda o osso a se reconstruir e ficar forte, a falta de exercício torna o osso mais frágil e poroso; no entanto, os exercícios são inicialmente leves e precisam respeitar uma progressão controlada para permitir uma recuperação total e o retorno a corrida.
Outras lesões como, dores anterior no joelho (dor patelo-femoral), síndrome da banda ílio-tibial, tendinopatia (tendinite) patellar, de glúteo ou de Achilles, não precisam de repouso; ao contrário, o tratamento é baseado em exercícios. Esses exercícios são focados em corrigir as falhas biomecânicas e desequilíbrios musculares, e introduzir outros tipos de exercícios, como saltos. Exercícios de salto são muito importantes em atletas de corrida, já que eles focam em restaurar a capacidade/performance das molas do nosso corpo (os tendões).
O tratamento da maioria das lesões de corrida, é baseado em exercício. Outras terapias como massagem, taping, etc, tem seu lugar, mas como coadjuvante, não como a principal linha de tratamento. Exercícios permitem explorar as deficiências musculares, articulares, dos tendões e ossos, restaurar a resiliência desses tecidos, os tornando mais fortes e mais adaptados para suportar os treinos e as cargas impostas com a corrida.
Para alguns corredores, especialmente novatos na corrida, uma análise de vido da corrida, pode ser interessante. Com esse tipo de análise, podemos indentificar falhas no movimento que, corrigido, conseguimos melhorar a performance e a mecânica do movimento, e prevenir algumas lesões.
Ninguém falou que o processo de reabilitação seria fácil. Essa fase pode ser demorada e frustante.
Infelizemente muitas decisões erradas, ou o retorno antecipado a corrida, podem atrapalhar e atrasar o retorno ao esporte.
O nosso objetivo é acompanhar o seu processo, e auxiliar seu retorno ao esporte da maneira mais segura e eficiente.
Recovering from COVID-19
We are seeing a number of people in our community recovering from COVID and trying to get back to their normal lives.
Research suggests that between 10 to 30 per cent of people who get COVID-19 may have symptoms that persists beyond four weeks (long COVID).
Even mild Omicron infections have been causing long-term fatigue. So, it’s important not to ‘push through’, pushing yourself too hard too soon can be detrimental to your recovery and can increase the risk of developing long COVID.
Return to sports and physical activities after a break should always be gradual, allowing your body to adapt again. After COVID it’s probably going to be even slower.
Wait at least seven days after you first experience your symptoms to resume any form of exercise.
This might be things like everyday activities, like housework, gardening or gentle walking. You should be able to do tasks such as these while holding a full conversation prior to engage in any other form of exercise.
From there gradually return to your pre-COVID exercise routine. Maybe start with 15 minutes and then increase to up to 30 minutes of light activity before going back to moderate training. A good rule to avoid injury is to increase the exercise intensity by 10% each week, with COVID you might need to stick to 10% every couple weeks until you are back to your pre-COVID levels.
If you have symptoms like fatigue, breathlessness, cough, dizziness, you should see your GP and get assistance getting back to your normal life.
Stay safe!
Clarisse Reis
Director/ Senior Physiotherapist
What is Tendinopathy?
Tendinopathy is a common sport injury that affects the tendon. Highly associated with an excessive cumulative load to the tendon, can cause pain in the tendon, localised swelling and stop. Tendinopathy is an umbrella term that means tendon pain and dysfunction. It is consider tendinopathy, localised pain on the tendon (i.e. Rotator cuff, Achilles, Patellar tendon) and pain during tasks that load or put stress on the tendon such as running, jumping, or throwing a ball.
Research has shown that inflammation does not drive tendon pain or pathology nor is associated with pain, so, old terms like tendinitis or tendinosis are no longer used.
Common symptoms are:
Morning stiffness, localised pain, pain with activities that load the tendon i.e. squatting, lifting the arm, running, jumping, are characteristics of tendinopathy. It is also a common feature the “warm up phenomena”, it hurts at first, but once you warm up, the pain either reduces or disappears, however it can hurt even more afterwards.
Musculoskeletal and Sport Physiotherapists are the first contact “SPECIALIST” health care practitioner you should go to. We specialise in musculoskeletal and sport related injuries and well trained to help you. You do not need a referral to see a physiotherapist. We can accurately diagnose and treat you. Tendinopathy diagnosis is based on patient’s history and clinical examination, and further investigation is rarely necessary, only for differential diagnosis purposes.
What causes tendinopathy?
Tendinopathy is a load related injury, hence referred to as an overloading injury. This means, you can develop tendinopathy when you exceeded your tendon load capacity during a certain activity or sport. Tendons don’t like surprises, or sudden changes in load. When that happens, you can present with tendinopathy symptoms mentioned above.
Overloading can be either cumulative or sudden (Chronic or Acute).
Cumulative overloading: you suddenly increased your training load and at the end of one or two weeks, the cumulative effect was greater than your tendon capacity and its ability to recover between training sessions.
Acute overloading: you exceeded the tissue (tendon) capacity in ONE session of training, ie. Achilles pain after one intense uphill running session, or a Rotator cuff related pain after moving houses, packing and carrying heavy items or after that intense cricket session.
I read this on Instagram and I think it explains the overloading analogy quite well.
“If someone took 3x the recommended dosage of a medication and experienced side effects, the initial intervention would be to simply adjust the dosage”
What is the most effective treatment?
There are a lot of research out there comparing the effectiveness of different treatment for tendinopathy.
Key things we know from research:
– Rest is NOT the answer for tendinopathy. If you rest, your tendon/muscle will become deconditioned and tolerate even less load.
– Ice, heat etcetera don’t seem to work
– Anti-inflammatories such as ibuprofen or corticosteroid injections do not work, with the latter being detrimental to the tendon structure, as there is no inflammation in tendinopathy.
So what does work?
Exercises to progressively build up your tendon load capacity, increase your tendon fitness level and therefore a stronger tendon.
Load management, understanding where and how you over did it and readjust your training load so you tendon can recover and together with the exercises increase the load capacity in the tendon to tolerate this new change in load you now require.
Tendinopathy is a slow recovery injury and can take at least 3-4 months to get better, and even longer for some patients. You should not give up before 3 or so months of progressive exercise program. This does not mean you will have to see your physio 4x a week for 3 months. Your physio will give you advice regarding load management and a home exercise program to do, and you should give enough time to see results. There are NO QUICK FIX treatments. Stay away from “magical”, “new” treatments, they do not work for tendinopathy.
Dry needling, massage, anti-inflammatory and rest, do not resolve tendinopathy. Instead massaging a tendon or dry needling in the tendon can actually aggravate your pain.
With tendinopathy you need an active treatment. YOU, responsible for your recovery, with the guidance from your physio in managing and progressing load accordingly.
The most effective treatment for tendinopathy is a personalised, progressive loading program and advice regarding exercise progression and how to manage flare ups from you physiotherapist.
Your physio can also work alongside your personal trainer, exercise physiologist, training coach, if you have one, or health professional that is helping your fitness and working on other body parts as well.
Taping can also help you during your recovery, in a few cases.
The progression back to your previous level of exercise should be constant and tailored to your needs.
To inject or not to inject?
Doctors used to inject tendinopathy with corticosteroid for years. Today, with science evolving and more research available, we know that corticosteroid can cause more harm than good in your body. Each case is different and in 99% of the cases you should try a progressive exercise program with your physiotherapist before anything else.
Also, research shows that corticosteroid injections for tendinopathy should be avoided at all costs.
If you have any questions, come and talk to your physio. We can help.
Gabriel Fernandes | APAM | CMP |
Titled Certified Mulligan Practitioner (CMP) | Titled Sports Physiotherapist (SONAFE – BRA) | Member of the APA Sports National Group |
| Mphil Candidate at QUT | Accredited Australian and Brazilian Physiotherapist |
Senior MSK & Sports Physiotherapist.