BodyZone

Physiotherapy New Zealand

TREATMENTS WE PROVIDE

Achilles Tendonosis / Rupture

WHAT IS ACHILLES TENDINOSIS OR A RUPTURED ACHILLES TENDON?

The Achilles tendon is a large structure which originates from the calf muscle at the back of your lower leg and inserts into the heel bone. Injury to the Achilles tendon can occur for many reasons including:

  • Overuse (such as a sudden increase in training)
  • Incorrect biomechanics or altered alignment (due to tight or weak leg muscles or the way the foot is positioned)
  • Inadequate footwear (including not enough support during activity)
  • An accident (laceration to the tendon itself).

Achilles tendinosis is usually of gradual onset and results after the tendon is subjected to numerous minute tears which don’t heal fully causing the tendon to thicken and weaken. An Achilles tendon can partially or fully rupture following being overstretched. It commonly occurs with explosive acceleration and most often the tendon tears just above the heel bone.

WHAT SYMPTOMS MAY I EXPERIENCE?

Tendonosis

  • Pain (stiffness/aching/tenderness) in the tendon particularly first thing in the morning or after a period of rest.
  • Improves slightly with initial activity then worsening with increased exercise
  • Tenderness with pinching the sides of the tendon

Rupture

  • Instant snap or pop heard
  • Immediate pain felt at the back of your ankle
  • Impossible to walk
  • Swelling around the heel
  • Unable to rise onto your toes

HOW CAN PHYSIOTHERAPY ASSIST?

Tendonosis

  • Soft tissue massage and/or frictioning to promote healing and optimal alignment of the tendon fibres.
  • Stretching and exercises to progressively lengthen/strengthen muscles.
  • Education regarding correct biomechanicswhile walking/running

Rupture

  • Surgery or managed conservatively and immobilization for 6-8wks.
  • Rehab programme involving:
    • soft tissue massage
    • strengthening exercises
    • progress to sport-specific drills

Ankle Injuries

WHAT IS THIS AND WHY HAS IT OCCURRED?

A sprained ankle or twisted ankle as it is sometimes known, is a common cause of ankle pain. A sprain is stretching and or tearing of ligaments (you sprain a ligament and strain a muscle). The most common is an inversion sprain (or lateral ligament sprain) where the ankle turns over so the sole of the foot faces inwards, damaging the ligaments on the outside of the ankle.

A medial ankle sprain is rare but can occur particularly with a fracture. This happens when the ankle rolls the other way, so the sole of the foot faces outwards, damaging the ligaments on the inside of the ankle.

The most common damage sustained in a sprained ankle is to the anterior talofibular ligament shown towards the front of the image opposite. This ligament, as the name suggests, connects the talus (ankle bone) with the fibula (smaller of the two bones in the lower leg). If the sprain is severe there might also be damage to the calcaneofibular ligament (connects the heel bone to the fibula) which is further back towards the heel. This ligament only becomes injured in more severe injuries due to its increased strength and laxity whilst the toes are pointed (a common position for ankle sprains).

PATIENT INFORMATION AND RESOURCES FOR ANKLE SPRAINS

Ankle anatomy
Ankle Sprain and Instability
Ankle Impingement Problems
Ankle Syndesmosis Injuries
Lower Leg Fractures
Osteoarthritis of the Ankle
Peroneal Tendon Problems
Peroneal Tendon Subluxation
Shin Splints

Back Pain and Sciatica

WHAT IS THIS AND WHY HAS IT OCCURRED?

Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five nerve roots that give rise to the sciatic nerve, or by compression or irritation of the sciatic nerve itself. Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. This point is important, because treatment for sciatica or sciatic symptoms will often be different, depending upon the underlying cause of the symptoms

SIGNS AND SYMPTOMS:

The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In addition to pain,which is sometimes severe, there may be numbness, muscular weakness, and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body.

HOW CAN WE ASSIST?

  • A full assessment to determine the underlying cause of the sciatica
  • Education on the condition, what you should and shouldn’t do at home, postural education, time frames with healing and ways to prevent re-injury.
  • Joint mobilization and/or manipulation to restore full movement of all Lumbar vertebra.
  • Soft tissue massage and electrotherapy modalities for pain relief and to release muscle spasm caused by the sciatic pain.
  • Core stability/strengthening programmes to stabilize the lumbar and abdominal region.
  • Progressive stretching programmes facilitate a return to full mobility.
  • Guidance on gradual return to sport/activities.
  • Postural correction and strategies to prevent recurrence.

Calf Injury

WHAT IS A CALF STRAIN?

A calf strain often occurs following rapid acceleration from a stand still or overstretching the muscle (such as having your heel drop unexpectedly off a step or kerb while running). You will often feel a tearing sensation and sudden pain alerting you to the muscle tear. Typically the injury will occur where the muscle meets the tendon or in the inside muscle belly of your calf.

WHAT SYMPTOMS MAY I EXPERIENCE?

  • Pain: usually quite localized to the area of the muscle tear
  • Pain and/or difficulty rising up onto your toes
  • Swelling or bruising to the calf muscle
  • Pain when palpating the site of the muscle tear

HOW CAN WE ASSIST YOU?

  • Ice and/or electrotherapy modalities, such as TENS, to assist with the reduction of pain and swelling
  • Soft tissue work and gentle stretches to help release any tightness
  • Strengthening exercises involving progressions and sport-specific exercises
  • Extra support such as heel raises to take the strain off the injured muscle

Deep Bruising - Haematoma

WHAT IS IT AND WHAT CAUSES THIS?

A bruise is an area of skin discoloration. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin. A bruise is also referred to as a contusion or hematoma. Bruises are often caused by falls, sports injuries, car accidents, or blows received by other people or objects. If you take a blood thinner, like aspirin or warfarin, you are likely to bruise more easily. The main symptoms are pain, swelling, and skin discoloration. The bruise begins as a pinkish red color that can be very tender to touch. It is often difficult to use the muscle that has been bruised. For example, a deep thigh bruise is painful when you walk or run. Eventually, the bruise changes to a blue color, then to green/yellow and finally returns to the normal skin color as it heals.

WHAT DAMAGE HAS BEEN DONE?

Bruises result from ruptured or damaged blood veins and capillaries in the epidermis, dermal and subcutaneous skin layers. Deep tissue or deep skin bruises damage capillaries in muscle tissue. Red, blue and sometimes purple appearance of bruises is manifested by blood seeping or bleeding into surrounding tissue. As blood coagulates or dries, bruises become darker and commonly fade as tissue fluids flush surrounding bruised areas and as bleeding stops.

HOW CAN WE ASSIST?

  • We can provide appropriate acute management including education, compression and the application of ice
  • We can provide advice for the successful return to sports
  • We can prescribe strengthening, stretching and endurance exercises to assist in the return to sport.
  • We can do soft tissue and manual therapy to release tight muscles and stiff joint structures resulting from deep bruising.
  • Ultrasound is very helpful in alleviating the tissue damage.

Elbow Pain

COMMON CAUSES OF ELBOW PAIN:

  • Lateral epicondylitis (Tennis elbow)
  • Medial epicondyloitis (Golfer’s elbow)

INFORMATION:

Tennis elbow originates from the outside or top of the elbow while golfers elbow originates from the inside or bottom of the elbow (less common). Even though these conditions are in different locations they have similar symptoms and are caused by a similar mechanism. The primary cause of these two conditions are by overuse or repetitive movement; e.g. hammering a nail or typing on the computer. The hand grip also plays a role in elbow pain. A poor hand grip while playing tennis (repetitive movement) may lead to tennis elbow as this places extra load on the tendons in the forearm. Similarly in golfer’s poor wrist control when hitting the ball may increase the stress through the tendons on the inside of the elbow resulting in medial pain (golfer’s elbow).

SIGNS & SYMPTOMS:

  • Pain on the outer part (tennis elbow) or inner part of the elbow (golfer’s elbow)
  • Gripping may be painful e.g. opening doors, jars
  • May find pouring action (e.g. pouring milk) and/or lifting painful
  • Morning stiffness

HOW CAN WE ASSIST YOU?

  • A thorough assessment of the joint and its surrounding structures
  • We use manual therapy including frictions to the tendons, massage and stretches to help relax the muscles and regain full pain free movement
  • We supply forearm braces which help take the load off the tendons which are getting overused
  • We give strengthening programs which improve grip strength and aid the healing of the injured tendons
  • Education on correct techniques and ways to prevent re-occurrence of the injury
  • Acupuncture
  • We also have electro-modalities such as ultrasound to aid in the healing process

Flat Feet / Foot Pronation

WHAT IS THIS AND HOW DOES IT OCCUR?
The pronated foot is one in which the heel bone angles inward and the arch tends to collapse. A “knock-kneed” person has overly pronated feet. This flattens the arch as the foot strikes the ground in order to absorb shock when the heel hits the ground, and to assist in balance during mid-stance. If habits develop, this action can lead to foot pain as well as knee pain, shin splints, achilles tendinosis, posterior tibial tendinosis, and plantar fasciitis. Excess pronation usually causes over-use type injuries, occurring most frequently in runners.When a neutral foot pronates during walking or running, the lower leg, knee and thigh all rotate internally. When an athlete with an overpronated foot runs, this rotation movement is exaggerated.

WHAT DAMAGE HAS HAPPENED?
Excess stress on the inner surface of the foot through over pronation can cause injury and pain in the foot and ankle. Repeated rotational forces through the shin, knee, thigh and pelvis also place additional strain on the muscles, tendons and ligaments of the lower leg. In particular plantar fasciosis is one of the most common foot problems treated in physiotherapy clinics. Biomechanical dysfunction including pronation of the foot is the most common origin of plantar fasciosis

HOW CAN WE ASSIST?

  • We can diagnose the problem
  • We can educate you on why it is occurring and show you how to manage it
  • We can provide stretches for areas which are too tight
  • We can provide strengthening for core areas which are weak and are affecting the alignment of the body
  • We can assist you in footwear and further referral on if required
  • We can do soft tissue therapy to release the tight muscles
  • We can use tape and fit orthotics to unload painful structures and assist in correcting muscle/biomechanical imbalances.

PATIENT INFORMATION AND GUIDEINES FOR FLAT FEET / FOOT PRONATION

Foot Anatomy
Posterior Tibial Tendon Problems
Plantar Fasciitis
Achilles Tendon Problems
Interdigital Neuroma

Foot Pain

WHAT IS THIS AND HOW DOES IT OCCUR?

Bearing the weight of the entire body, the foot is under tremendous stress. In many sports, the foot absorbs tremendous shearing and loading, sometimes reaching over 20 times the person’s body weight. Although foot injuries can occur from a variety of causes, the most common cause is trauma.

Other causes include:

  • rapid or improper warm-up,
  • overuse,
  • intense workouts,
  • improper footwear,
  • playing on hard surfaces.

COMMON CAUSES OF FOOT PAIN – WHAT DAMAGE HAS HAPPENED?

Dislocations of the foot are uncommon but potentially incapacitating injuries. The mechanism of injury may vary from a simple fall to a major motor vehicle accident (MVA). The foot is a complex structure, and injuries often occur in patients who sustain multiple trauma.

Toe fracture: Each toe is made up of several bones. One or more of these bones may be broken (fractured) after an injury to the foot or toes. Approximately 10% of all fractures occur in the 26 bones of the foot.

Turf toe: Is an acute injury that involves forced extension of the first MTP joint (big toe) as the classic mechanism of injury. This results in a sprain of the first MTP joint. Symptoms include pain and stiffness at the big toe joint and difficulty running or changing directions.

Peroneal tendon subluxation/dislocation: Typically present as acute pain and swelling that is centered behind the outer ankle bone. These symptoms can be caused by an ankle sprain. Athletes usually complain of snapping and sudden sharp pain when changing directions or pushing off with the foot.

Overuse injuries: Otherwise known as cumulative trauma disorders, are described as tissue damage that results from repetitive demand over the course of time. The term refers to a vast array of diagnoses, including occupational, recreational, and habitual activities.

Metatarsalgia: Is a common overuse injury described as pain in the forefoot that is associated with increased stress over the metatarsal head region. Stress fracture. Refers to the failure of the skeleton to withstand less than maximal forces over time.

Stress fractures: Are estimated to account for up to 16% of all injuries that are related to athletic participation; running is the cause in most of these cases. Most stress fractures (95%) involve the lower extremities, particularly the metatarsals.

PATIENT INFORMATION AND RESOURCES FOR FOOT PAIN

Accessory Navicular Problems
Achilles Tendon Problems
Foot Anatomy
Interdigital Neuroma
Osteochondritis Dissecans of the Talus
Plantar Fasciitis
Posterior Tibial Tendon Problems
Sesamoid Problems
Tailor
Tarsal Tunnel Syndrome

Gym / Rehab Programmes

WHAT IS A GYM PROGRAMME?

We are able to provide our clients with a “Rehab Pass”for full access to the gym facilities . Here you have access to an extensive range of  the most up to date exercise equipment available. You are able to completely rehabilitate your  injury in a supervised and structured fashion.

We are able to do this FREE of charge to you.

When you suffer an injury you want to return to full health as quickly as possible so that you can return to living normally and doing the things that you wish to do. A gym rehabilitation programme is a personalised programme established by the physiotherapists at BodyZone and designed exclusively for you to regain your full fitness and enable you to live fully again. This may include a weights programme based in the gym.

HOW CAN WE ASSIST YOU TO RECOVER YOUR STRENGTH AND FITNESS FOLLOWING INJURY?

BodyZone will assess your injury, assess what can be done to support the area of injury, reduce the strain on that area and relieve the pressure in your daily life and work. This may involve strengthening, stretching, core stability work, ergonomic and postural advice, work technique and management. BodyZone will advise the gym staff on your injury and what exercises would be of benefit to you and highlight ones that would not. Thus this personalised approach to your health and fitness will assist you in achieving the goals you really wish to achieve…..and as quickly as possible!

Hand and Wrist Injuries

WHAT IS THIS AND WHY HAS IT OCCURRED?

The wrist and hand are frequently injured during sporting activities. Distal radius fractures are the most common fractures seen in emergency departments, and scaphoid fractures are the most common carpal fractures. Injuries to the hand and wrist range from acute traumatic fractures to overuse conditions, which often occur in racquet sports, golf and gymnastics. Finger trauma is common in ball sports. If wrist, hand and finger injuries are not treated appropriately at the time of injury, they can lead to future impairments that can affect both sports and activities of daily living.

COMMON WRIST & HAND INJURIES:

  • Fractured Scaphoid & Distal Radius
  • Carpal Ligamentous Strain/Rupture
  • Abductor pollices Longus Tenosynovitis (De Quervains)
  • Carpal Tunnel Syndrome

Injuries to the wrist often occur as a result of a fall onto an outstretched hand. The most common wrist/hand injuries in athletes are fractures of the distal radius and scaphoid, or damage to an intercarpal ligament. Intercarpal ligament injuries are becoming more frequently recognized and if they are not treated appropriately, may result in long-term disability. De Quervain’s Syndrome is inflammation of the synovium of the abductor pollicis longus and extensor pollicis brevis tendons. These tendons run along the outside of the forearm attaching to the thumb. Before attaching to the thumb they pass around a piece of bone at the end of the forearm where friction can occur resulting in inflammation. This most commonly occurs as a result of repeatedly lifting a weight you are unaccustomed to. Inflammation can also affect the nerve that passes close to these tendons in the wrist. The median nerve may be compressed as it passes through the carpal tunnel along with the wrist, hand and thumb tendons. This is commonly known as Carpal Tunnel Syndrome and is characterised by burning pain, numbness and/or parasthesia.

Headaches

WHAT ARE THEY AND WHAT CAUSES THEM?

Head pain that is referred from the bony structures, nerves or soft tissues of the neck is commonly called “cervicogenic headache.” It often occurs after a head or neck injury but may also occur in the absence of trauma. The features of cervicogenic headache may mimic those commonly associated with other headaches such as tension-type headache or migraine. Although the prevalence of these is low they are much more common in people with chronic headaches (up to 20%). There are many different headache types some of which are not appropriate for physiotherapy management.

WHAT DAMAGE HAS BEEN DONE?

Cervical headache may be due to referred pain caused by irritation of the nerves of the upper neck. This may be due to damage to the upper neck joints or compression of the nerves as they pass through the muscles. Patients with cervicogenic headache will often have poor posture or restricted range of motion of the neck both of which can contribute to symptoms.

HOW CAN WE ASSIST?

  • We can diagnose the problem
  • We can educate you on why it is occurring and show you how to manage it
  • We can provide stretches for areas which are too tight
  • We can provide strengthening for key postural muscles
  • We can perform specific mobilization/ or manipulation to stiff joints
  • We can provide acupuncture
  • We can do soft tissue therapy to release the tight muscles

Hip Pain

WHAT IS THIS AND WHAT CAUSES THIS?

The hip is located on the outside of the buttock, below the pelvis. In adults, three of the bones of the pelvis have fused into the hip bone which forms part of the hip region. The hip joint is the joint between the femur (upper leg bone) and acetabulum (deep socket) of the pelvis and its primary function is to support the weight of the body during walking and standing.

Hip pain is common problem, and it can be confusing because there are many causes. It is important that an accurate diagnosis of the cause of your symptoms is made so that appropriate treatment can be directed at the underlying problem. If you have hip pain, some common causes include:

  • Lumbar Pain – Referred Symptoms Many back and spine problems can cause symptoms around the buttocks and hip. The most common problems that refer pain to the hip region are herniated discs and sciatica.
  • Snapping Hip Syndrome Snapping hip syndrome is a word used to describe three distinct hip problems. The first is when the iliotibial band snaps over the outside of the thigh. The second occurs when the deep hip flexor snaps over the front of the hip joint. Finally, tears of the cartilage, or labrum, around the hip socket can cause a snapping sensation.
  • Muscle Strains Strains of the muscles around the hip and pelvis can cause pain and spasm. The most common strains are groin and hamstring strains.
  • Hip Fracture Hip fractures are most common in elderly patients with osteoporosis. Treatment of broken hips usually requires surgery to either replace the broken portion or repair it with a metal plate and screws.
  • Stress Fracture Stress fractures of the hip are most common in athletes who participate in high-impact sports, such as long distance runners. Successful treatment usually involves avoiding and addressing any biomechanics / Muscle imbalances.
  • Labral tear A hip labral tear involves the ring of soft tissue that follows the outside rim of the socket of your hip joint. This ridge of cartilage, called a labrum, works a little like a suction cup to help hold your hip joint together. Athletes who participate in sports such as soccer, netball, golfing and rugby are at higher risk of developing a hip labral tear. Structural abnormalities of the hip can also lead to a hip labral tear. Signs and symptoms include hip pain or a “catching” sensation in your hip joint. Initial treatment may include pain relievers and physiotherapy.

Knee Pain

WHAT IS KNEE PAIN?

Knee pain can be experienced by any age and is usually related to an injury, old age or sports activity of a repetitive nature. The pain can be anywhere over the knee.

WHY DOES KNEE PAIN OCCUR?

Injury to the knee frequently occurs with activities involving sudden changes in direction or twisting movements. An external force, such as a blow to the side of the knee, can also result in injury to the supporting structures around the knee. The structures commonly damaged can be the ligaments, which run on both sides of the knee and also through the joint itself, and the cartilage – a structure found on the joint surfaces which helps with shock absorption during activity. Alternatively running may cause tracking problems with the knee – see patellofemoral pain information sheet. Age affects the loading joints and Osteoarthritis can affect the knees also.

WHAT SYMPTOMS MAY I EXPERIENCE?

  • Pain and swelling
  • Restricted range of movement
  • Increase in pain with weight-bearing and activities involving directional changes or twisting
  • Feeling the knee giving way on movements

HOW CAN WE ASSIST?

  • Soft tissue massage to help reduce muscular tension and the consequential pain and swelling resulting
  • Acupuncture to help decrease swelling and promote healing during the initial inflammatory stage
  • Manual therapy, such as joint mobilizations to improve range of motion
  • Specific exercises for weak muscles and progressions
  • Stretching of certain groups of tight muscles
  • Recommendations for taping/braces to stabilize the knee joint
  • General exercise programmes for fitness and strengthening

PATIENT INFORMATION AND GUIDELINES FOR KNEE INJURIES

Knee Anatomy
Anterior Cruciate Ligament Injuries
Articular Cartilage Problems of the Knee
Chondromalacia Patella
Collateral Ligament Injuries
Hamstring Tendon Graft Reconstruction of the ACL
Iliotibial Band Syndrome
Meniscal Injuries
Osteoarthritis of the Knee
Osteochondritis Dissecans of the Knee
Patellar Tendonitis
Patellofemoral Problems
Pes Anserine Bursitis of the Knee
Plica Syndrome
Popliteal Cysts
Posterior Cruciate Ligament Injuries
Prepatellar Bursitis
Quadriceps Tendonitis of the Knee

Muscle Imbalance

WHAT IS THIS ?

At BodyZone we see this as a crucial part of our treatment. Treating not just the injury but the cause of it. Most of the conditions and injuries we see, are related to the fact that your body has become weak in an area and strong in another area. This unease in tension can overload a portion of the body putting strain and stress on the area causing injury.

WHY DOES THIS OCCUR?

Most of us have sedentary jobs and work sitting all day, not using our abdominals or gluteals. Then we decide to get out and exercise using those same muscles which have not been utilised so consequently are weak and therefore they are unable to the spine and stabilise the lower limbs. These muscles are called our core stabilisers. We sit with our hips and knees bent most of the day, so that the muscles that cross this area are in a shortened position, as are our hamstrings. When we exercise, we are demanding these muscles to be elongated.

If they are shortened they cannot stretch as well and can tear, or make the muscles that work in opposition to them overwork. So if you run and have tight hamstrings, your hamstrings prevent your knee from straightening and the knee straightener muscles – the quadriceps, have to work much harder. This can overload the quadriceps or the knee cap which is embedded in the quadriceps.

WHAT DAMAGE HAS HAPPENED?

Areas which are overloaded may become inflammed. If an area is sore rest will settle it down but as soon as activity recurs the problem will recur as the condition’s “cause” has not been addressed.

HOW CAN WE ASSIST THIS?

  • We can assess what structures are tight and overloading areas
  • We can also determine which structures are weak and which are strong
  • We can assess your core strength that stabilises your spine and body
  • We can assist you to use your body properly with correct alignment
  • We can improve your posture, your speed and your agility through your ability to use your body properly

Neck pain

WHAT IS IT AND WHAT CAUSES IT?

Most people will experience neck pain at some point in their lives. Neck pain can be acute, meaning it lasts a few hours to a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain. Most causes of neck pain aren’t serious. There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs, and nearby pass the nerves of the neck. A variety of causes of neck pain have been identified including osteoarthritis, disc disorders, trauma, whiplash amongst many others. The cause may not identifiable in a number of patients. This is why your physiotherapist will assess for impaired function of muscle, ligaments and nerve tissue potentially associated with your neck problem.

WHAT DAMAGE HAS BEEN DONE?

In some conditions, particularly those that are degenerative in nature, abnormal findings are not always associated with symptoms. Up to 20% of people without neck pain demonstrate a wide range of abnormalities on imaging studies.

HOW CAN WE ASSIST?

  • We can assist in diagnosing your specific neck problem
  • We can educate you on why it is occurring and show you how to manage it
  • We can provide stretches for areas which are too tight
  • We can provide strengthening and endurance exercises for core areas which are weak and are affecting the alignment of the body
  • We can do soft tissue and manual therapy to release tight muscles and stiff joint structures
  • We can prescribe nerve mobilisation procedures to help reduce the symptoms of neck and arm pain

Manual therapy including manipulation plus exercise has been found to reduce the symptoms of headaches arising from the neck structures and these effects are maintained.

PATIENT INFORMATION AND RESOURCES FOR NECK PAIN

Neck Pain
Cervical Burners and Stingers
Whiplash
Cervical Spine Anatomy
Dropped Head Syndrome
Cervical Spinal Stenosis

Occupational Overuse Syndrome – OOS

WHAT IS THIS AND WHY HAS IT OCCURRED?

Occupational Overuse Syndrome has been known by other names such as Repetitive Strain Injury (RSI). These names are synonymous with working conditions that require repetitive work either at a computer or indeed within manufacturing or detailed work requiring fine hand movement. Usually pain is experienced in the forearms and the wrists. Often the work is carried out intensively with little breaks, poorly designed workspace and excessive loading that takes place on the upper body and arms. With the intensity of the work, the arms get overloaded and the tendons may become inflamed in the forearms and the wrists. Also the intensity can overload the neck and shoulder muscles that “carry” the arms. Neck pain or nerve irritation in the neck is often present due to this. This pain may start gradually and increase over time in intensity

WHAT DAMAGE HAS HAPPENED ?

The forearms may be inflamed within the tendons and the muscles in this area may be in spasm. This places pressure on the nerves in this area and causes pain. The shoulders, shoulder blades, middle of the back and the neck may all become painful due to the postural overloading in the workplace. Pins and needles in the arms may result and continuous aching can be experienced in the arms.

HOW CAN WE ASSIST?

  • We can diagnose the problem and assist you in determining why you have this problem
  • We can address your work load, ergonomics and work station
  • Looking at your posture and the muscular support that you have to support your spine
  • Looking at ways of handling your work load with pertinent exercise programmes of strengthening and stretches to reduce the irritation and assist your posture
  • Educate you in prevention strategies as well as management strategies for repetitive work
  • Releasing the muscles in spasm with Soft Tissue Therapy and Acupuncture
  • Free up the overloaded joints with joint mobilisation and massage

Osteoporosis

WHAT IS OSTEOPOROSIS?

Bone density reduces to some degree in all people as they age, a slow rate of bone loss starts around 40 years in both sexes.
Osteoporosis is a condition where the bones become excessively thin and weak, such that there is a greater risk of fractures. It affects more than 50% of women and about 30% of men over 60 years, as well as a few younger people.
Osteoporosis is often called the ‘silent disease’ as it can develop without any symptoms, until you find you have broken a bone.

HOW DOES BONE GROW?

Bone is a living tissue that grows in a porous mesh-like structure. Throughout life the body breaks down old bone and
rebuilds new bone in a continuous cycle. We gain bone by building more than we lose.
Bones contain the protein collagen and minerals such as calcium and phosphorus, which make the collagen hard and dense.
To maintain bone density, the body needs adequate calcium and other minerals and certain levels of hormones, including oestrogen in women and testosterone in men.
Vitamin D is needed so the body can absorb calcium from food and incorporate it into bones. Physical activity also helps bone become dense.

HOW DOES BONE BECOME THINNER?

Bones grow more and more dense until around the age of 30. After about 40, bone breaks down slightly faster than it is replaced and bones slowly become less dense.
In women, after the menopause, the ovaries stop releasing eggs and the level of oestrogen decreases.
Over many years, a low oestrogen level causes the inner mesh of bones to become thinner, weaker and more brittle. In men, this can happen if there is too little testosterone.

AM I AT RISK FOR OSTEOPOROSIS?

Some people are more at risk than others. The following risk factors are linked to having osteoporosis,
or getting it later on.
The more of these that apply to you, the more important it is to discuss osteoporosis with your doctor:

  • being female
  • previous fracture due to osteoporosis
  • family history of osteoporosis
  • being aged 50 years or older
  • being past the menopause
  • having your ovaries removed or reaching menopause before the age of 45
  • being thin or ‘small boned’
  • White (Caucasian) or Asian ancestry
  • too little calcium in your diet
  • smoking
  • alcohol (more than four standard drinks a day)
  • less than 30 minutes outdoors in sunlight each day
  • less than 30 minutes of physical activity each day
  • long term use of some medications, such as steroids (e.g., cortisone, prednisone) or anticonvulsants.

The last six of these are the risk factors you can modify or have some control over throughout your life to reduce the chances of osteoporosis in old age. For osteoporosis, prevention is far more successful than treatment.

HOW CAN MY DOCTOR HELP?

Your doctor can assess your risk for osteoporosis from your medical history and by asking you about your lifestyle.
Physical signs that you may have weak bones include previous fractures (often of the wrist, hip or spine), a loss of height or stooping, and a curved spine.
Your doctor may suggest you have a bone density scan (a type of x-ray) to check for bone weakness.

HOW CAN WE ASSIST YOU?

Physiotherapists have a role to play in osteoporosis through exercise prescription, therapeutic modalities, specific techniques and education.
In particular physiotherapy may help reduce the risk of falls and subsequent fracture through exercises to improve balance, strengthening exercises and addressing trunk control.

Patella Tendonosis – Jumpers Knee

WHAT IS THIS?

Patella tendonosis or “Jumper’s knee” describes pain over the front of the knee localized to the tendon which sits below the knee cap. The tendon below the knee cap joining the knee cap to the shin bone had been damaged.

WHY DOES THIS PAIN OCCUR?

This pain often occurs as a result of marked loading through the knee with jumping and landing – such as sports like basketball, volleyball, dancing or netball. This overloads the tendon and damage may result.

HOW DO I KNOW IF I HAVE PATELLA TENDONOSIS?

  • You will feel pain on jumping and landing
  • The pain will be localized to an area below the kneecap
  • This painful area will be tender to touch
  • You will only have pain on activity – not rest

HOW CAN WE ASSIST?

  • With patella tendinosis there is a research based programme based on “eccentric strengthening” of the tendon. We are well skilled in delivering this programme.
  • Soft tissue massage to loosen the tight structures around the knee and hip
  • Stretches to increase and maintain muscle length, particularly the quadriceps and hamstrings
  • Exercises to target specific muscles which may be weak
  • Mobilisation of the tendon
  • Taping of the knee cap to help guide and hold it in a correct position
  • Biomechanical correction of gait
  • Biofeedback to the muscles to assist in reactivation

Patellofemoral Pain

WHAT IS PATELLOFEMORAL PAIN?

Patellofemoral pain is a term used to encompass pain in and around the knee cap. If the muscular structures around the knee and hip are not balanced, then the knee cap will pull to one side and thus not move smoothly in the groove in the thigh bone when you move and subsequently cause you pain, as it grates against the sides.

WHAT SYMPTOMS MAY I EXPERIENCE?

  • Pain and aching around and under the knee cap
  • Worsening pain with running downhill and ascending/descending stairs
  • Pain/stiffness after prolonged sitting.

HOW CAN WE ASSIST?

  • Soft tissue massage to loosen the tight structures around the knee and hip
  • Stretches to increase and maintain muscle length
  • Exercises to target specific muscles which may be weak
  • Mobilisation of the patellofemoral joint
  • Taping of the knee cap to help guide and hold it in a correct position
  • Biomechanical correction of gait
  • Biofeedback to the muscles to assist in reactivation

PATIENT INFORMATION AND RESOURCES FOR PATELLOFEMORAL PAIN

Patellofemoral Problems

Post Operative Recovery

WHAT IS THIS?

We see people post operatively for many conditions, mainly Orthopaedic and assist them in their recovery so that they can return to living their life fully again.

WHY DOES IT OCCUR?

Surgery is used to correct and fix problems in our body as a result of injury, age or issues that we inherited genetically.

  • Knee surgery for ligament and reconstruction of joints and joint replacements
  • Shoulder reconstruction following dislocation and tendon repairs
  • Hip Labral tear repairs and hip joint replacement
  • Spinal Surgery
  • Achilles repairs – either surgical or non surgical
  • Foot surgery

WHAT DAMAGE HAS OCCURRED?

Following surgery you are naturally apprehensive that you are doing the right thing and not undoing the damage that has occurred. It is really important that you are guided to do the right thing at the right time and understand your limitations and the time scale it takes to recover from surgery.

HOW CAN WE ASSIST?

  • We will advise you and guide you to what you should be doing at what time periods.
  • Show you how to do home exercises to regain your strength.
  • Assist you to regain your range of motion
  • Advise you on return to recreational, sporting and occupational activity.
  • We will work with you and your surgeon to get the best possible outcome.

Postural Problems

WHAT IS IT AND HOW DOES IT OCCUR?

It is important to understand that posture has a major role in the health of your musculoskeletal system. So, how does poor posture cause pain? A correct posture means that the key body parts stack vertically on top of each other. This positioning should allow the joints to sit in their ‘mid-range’ or middle position. This middle position means that the joints are mildly unstable as no ligaments are tightened in this joint alignment. The small, deep, postural muscles that attach closely to the joint have to work to maintain stability and this correct position. But, what it also means, is that the postural muscles have to be strong and controlled enough for the job. Physiotherapist’s have extensive knowledge and experience in the training of these postural muscles. Modern day life means that we sit for far longer than our ancestors. We sit to work, to play and then, when we are tired, we slouch on the sofa. This slouching encourages our low back to take exactly the opposite to ideal shape. Our lifestyles also encourage us to be physically passive. Our work involves smaller and smaller movements performed under tension.

WHAT DAMAGE HAS OCCURRED?

Sitting is in itself tough on the back but slouching is one of the most damaging strains on our spines in modern life. If we slouch on a regular basis the slouch will feel ‘normal’ to us but human nature is to interpret that feeling as if it is correct.

HOW CAN WE ASSIST?

  • We can diagnose your specific postural problem
  • We can educate you on why it is occurring and show you how to manage it
  • We can provide stretches for areas which are too tight
  • We can provide strengthening for core areas which are weak and are affecting the alignment of the body
  • We can do soft tissue and manual therapy to release the tight muscles

SITTING CORRECTION

To change posture you have to make a change to your shape. The new corrected shape will feel wrong to begin with, and this can be confusing, especially as changing shape can also create ‘change’ pains. Correcting the low back and pelvis position is the first thing. This is the foundation of correct posture. Get this area level and the rest of the posture tends to sit correctly on top. The lower limbs are important to be correctly aligned also. Shoulder girdle and head positioning follow. If you are sitting poorly try this…

Firstly, gently roll your pelvis forward such that you are sitting on top of your “sitting bones”

Secondly, move your thorax slightly upwards and forwards to follow the motion of the pelvis to encourage a slight chest lift.

Lastly, gently and minimally lengthen the back of your neck or imagine that you are nodding.

Sacroiliac Joint Pain

WHAT IS THE SACROILIAC JOINT (SI JOINT)?

The sacroiliac joint is a firm, small joint. The sacroiliac joints are two paired “kidney bean” or L-shaped joints that lie at the junction of the spine and the pelvis. Most often when we think of joints, we think of knees, hips, and shoulders–joints that are made to undergo motion. The sacroiliac joint does not move much, but it is critical to transferring the load of your upper body to your lower body. The SI joint is one source of low back and buttock pain. The SI joint is implicated as a cause of low back pain in at least 13% and perhaps as high as 30% of cases. Women are considered more likely to suffer from sacroiliac pain than men, mostly because of structural and hormonal differences between the sexes.

PREGNANCY

The hormonal changes of menstruation, pregnancy, and lactation can affect the integrity of the ligament support around the SIJ, which is why women often find the days leading up to their period are when the pain is at its worst. During pregnancy, female hormones are released that allow the connective tissues in the body to relax. The relaxation is necessary so that during delivery, the female pelvis can stretch enough to allow birth. This stretching results in changes to the SIJs, making them overly mobile. Over a period of years, these changes can eventually lead to wear-and-tear arthritis. As would be expected, the more pregnancies a woman has, the higher her chances of SI joint problems Trauma, muscle imbalance, and hormonal changes can all lead to SIJ problems.

PHYSIOTHERAPY

Exercise rehabilitation is an integral part of the recovery from SIJ pain. Stretching, massage and joint mobilisation/manipulation are useful in correcting any imbalances that may exist around the SIJ. Sacroiliac belts may be useful in the management of overly mobile sacroiliac joints for example during pregnancy.

Shoulder Injuries

SOFT TISSUE INJURIES OF THE SHOULDER:

  • Rotator cuff syndrome
  • Shoulder dislocation or instability
  • Long head of biceps tear/strain
  • Labral tear
  • Referred pain from the neck

INFORMATION:

The shoulder is one of the most mobile joints in the body and relies heavily on the muscles (rotator cuff) surrounding the joint for stability. The rotator cuff muscles keep the ball of the humerus (arm bone) in the shoulder joint when lifting the arm up. When these muscles are weak/injured or the shoulder is unstable it can cause irritation of the structures surrounding the joint, most commonly the rotator cuff tendons. This is when rotator cuff tears or ruptures may occur. Shoulder instability normally results from dislocation which stretches the joints ligaments and capsule. This allows the shoulder to translate more in the joint irritating the surrounding structures and once again causing shoulder pain. The shoulder is most commonly dislocated playing contact sport when going in for a rugby tackle or from a fall onto an out stretched arm (less common). The long head of the biceps inserts into the top of the shoulder joint and therefore when damaged can also cause shoulder pain. Sometimes shoulder pain can actually be referred pain from the neck. Nerves exit the spinal cord through small holes in the side of the spine and when irritated can cause pain to be felt down the shoulder and arm.

SIGNS AND SYMPTOMS:

  • Pain when lifting the arm
  • Pain when dressing (female – putting on bra)
  • Pain sleeping on the shoulder at night
  • Pain with lifting objects

HOW CAN WE ASSIST YOU?

  • A full assessment including the muscles, joints and ligaments to find out what is causing or contributing to your shoulder pain
  • Help strengthen the muscles to improve the shoulder/shoulder blades biomechanics
  • Help release tight muscles and increase tendon healing using manual therapy
  • Education on the condition, what you should and shouldn’t do at home, time frames with healing and ways to prevent re-injury e.g. taping for sport

Sports Injuries and RICE

WHAT IS THIS AND WHY HAS IT OCCURRED?

Most acute sports injuries affecting muscles, joints, ligaments and tendons will respond well to RICE. Implementation of this will enable the person in most cases to return to sport or daily life quicker. However, medical assessment by a doctor or a physiotherapist is always recommended in initial stages

REST: Rest the injured area and decrease weight bearing on this.

ICE: Apply ice to area for around 10 – 15 minutes initially, depending on injury size. Do this every 4 awake hours for the first 24 hours. Do not apply directly to the skin.

COMPRESSION: Compress the area using stretchable bandage to prevent the accumulation of fluid – this is very important

ELEVATION: Elevate the body part so that gravity can assist in reducing the swelling

WHAT DAMAGE HAS HAPPENED?

RICE components are normally encouraged for 4- 5 days after injury to control the swelling and inflammation which limits your ability to move and load the affected part. RICE assists in decreasing the pain and assists the healing process. In the first 24 hours ice should be applied 4 hourly, however, after 24 hours once to twice a day is often adequate. Compression with a bandage or support and decreasing weight bearing are very effective.

HOW CAN WE ASSIST?

BodyZone can assess the injury and assist you by diagnosing the injury and ensuring you to understand howbest to treat the injury.

Following a thorough assessment and a diagnosis, a treatment plan will be put into place for you to get back to doing all the things you wish to do as quickly as possible!

Strapping

WHY STRAP?

Strapping of a joint is a preventative measure to reduce strain and injury on a joint. Commonly seen in sports such as basketball are knees and ankles. Strapping assists in preventing the athlete from causing further injury to the joint. Strapping is also used in cases such as patella tendinosis to avoid injury strain, by unloading the tendon with the strain placed on the tape, this can be very effective in assisting the athlete to play fully and pain free.

HOW CAN WE ASSIST?

BodyZone Physiotherapists are fully trained in strapping joints and can teach and advise you on how to do this. Strapping tape can be purchased through BodyZone. Strapping tape in some cases may cause a skin allergy and all who utilise tape should be aware that if any itchiness starts to occur the tape should be removed immediately.

Weight Management

Excessive weight can be a major contributing factor in many musculoskeletal injuries: Excess weight results in excess load being placed on joints and soft tissues such as muscles, tendons and ligaments, while undernourishment can be equally detrimental to your body. Sports nutrition is incredibly important for maintaining and improving performance and avoiding injuries. Your body is at its most vulnerable when it doesn’t get the right nutrients, meaning a balanced diet is essential for avoiding injuries and optimising rehabilitation.

WHAT WE CAN DO FOR YOU?

As you work to achieving your weight and fitness goals you may find that your body is placed under new loads. At BodyZone we work alongside your nutritionist and/or trainer in tailoring your fitness programme to ensure that the loads on your body are managed effectively and do not result in excessive stress and injury.

CONTACT BODYZONE

BodyZone are Auckland’s experts for all physiotherapy, acupuncture and podiatry requirements. If you require any of our services, please fill out the form below and we will contact you within 24 hours.