Femoral Acetabulum Impingement (FAI) is a condition where the bones of the hip are abnormally shaped causing too much friction. The ball (head of the femur) and the socket (acetabulum) move abnormally with one another which may cause damage to the articular cartilage or labrum (fibrous rim around the socket)

FAI usually occurs in two types forms – Cam and Pincer. In the Cam impingement, the head of the femur is not round and cannot rotate inside the acetabulum. A bump forms on the edge of the femoral head that may grind the articular cartilage. Pincer impingement occurs because of extra bone extending around the rim of the socket, causing the acetabulum to be deeper than normal. The labrum may be damaged due to the prominent ring of the acetabulum. Cam and Pincer type impingment may occur simultaneously.

What Causes FAI?

The exact cause of femoral acetabulum impingement is yet to be found however, it is believed to be a combination of genetic and environmental factors. During puberty, abnormal hip bone growth may contribute to being more at risk of developing FAI. Athletically active people may work their hip more vigorously and move the joint into more extreme ranges of movement, and so may start to experience pain than those who are less active; however exercise does not cause FAI.

 Symptoms of Femoral Acetabulum Impingement:

• Pain in the groin area, or towards the outside of the hip and restricted range of movement
• Sharp stabbing pain occur with certain movements – turning, twisting, squatting
• Low back pain
• Gluteal pain
• Referred pain into leg
• Movement restricted in high flexion or trying to cross legs – pain may be provoked by these movements

How is FAI treated?

Non-operative management is possible however it involves a change to a less active lifestyle, and long-term commitment to maintaining hip strength. Conservative management will not change the underlying hip biomechanics and the resulting damage of the cartilage, but it may help manage the pain. Non-steroidal inflammatory medicine may be prescribed to reduce pain and inflammation.

Operative management may be recommended by your doctor if your pain is not relieved by non-surgical treatment and tests have found joint damage caused by FAI. Hip arthroscopy is usually used in surgical management. During hip arthroscopy, the surgeon may clean or remove any damaged labrum or cartilage. FAI may be corrected by trimming the bony rim around the acetabulum or shaving down the bump on the femoral head. Although physiotherapy cannot change the biomechanics of the hip joint itself, it may help to reduce inflammation, improve core stability, improve range of movement and help avoid pain being provoked by certain movements. To discuss what our physiotherapists can do for you, please call your nearest clinic.

Osteoporosis is a condition in which the bones become fragile and brittle, leading to a higher risk of fractures (breaks or cracks) than in normal bone. Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone mass or density). As a result, bones become thinner and less dense, so that even a minor bump or accident can cause serious fractures. Fractures due to osteoporosis (osteoporotic fractures) can lead to changes in posture (e.g. developing a stoop or Dowager’s hump in your back), muscle weakness, loss of height and bone deformity of the spine.

How can osteoporosis be prevented?

Regular physical activity on a long term basis has an important role in maintaining healthy bones. Exercise can maintain and increase bone strength by increasing bone mass or by slowing age related bone loss. Regular activity can also improve muscle strength, which is important in supporting joints and helping to reduce the risk of falls. Exercise has also been shown to improve co-ordination and balance, which helps to prevent falls and to improve general physical health and well being.

Be aware that any positive gains in bone strength are lost when you stop exercising, so that it is important that your exercise is regular and ongoing.

Exercises for bone health

There are two main types of exercises that are beneficial to bone health:

Weight bearing exercise

Your bones become stronger when they bear weight during exercise and when some amount of impact or strain is placed on those bones. The best strain is from activities that may be new to your body, which means your bones are getting a variety of forces and loads on them.  Examples of weight bearing activities are jogging, walking, golf, netball and basketball.

Higher impact activities, such as aerobics, running and jumping, have a greater effect on bone strength than low impact activities and everyday activities, such as normal walking, are not considered to be especially bone building because they produce a strain that is normal for the body.

High impact activities may not be suitable for everyone, especially for those with joint problems or other medical conditions. If you are unfit or inactive, lower intensity exercise is a good starting point as you are able to progress to more moderate intensive exercise over time.

Resistance exercises (lifting weights with your arms or legs)

Resistance exercises, better known as strength training, can have a good effect on bone health and have been shown to reduce the number of falls in the older population. The  muscle contractions required to move a heavy weight place stress or ‘strain’ on the bone that the muscles are attached to. When bone is ‘strained’ repeatedly (as in regular exercise training) it responds by increasing bone mass to become stronger.

Everyday activities do not produce enough ‘strain’ to change bone mass, so resistance exercises need to be increased as the body adapts to each new level. Targeting muscle groups around the hip, spine and arms with weight lifting is also beneficial.

If you have been diagnosed with osteoporosis, there are also some important lifestyle changes, medications and fall prevention measures that you can adopt to reduce the risk of osteoporosis having a further impact on your health.  If you would like to know more on how you can change your lifestyle and begin fall prevention aspects to improve your health, please call a physiotherapist to arrange a time at your nearest clinic.

Come and help us celebrate on Saturday 24th March 9am-1pm at our open day and receive

* Free pilates classes every hour

* Free physiotherapy treatments

* Free breakfast

* Get advice from myotherapists, naturopaths and other health professionals

* Raffle prize and more!

Bookings required for pilates classes and treatments

Address: Casey Corporate Centre, Suite 1 Floor 2. 58-60 Victor Crescent, Narre Warren 3805.

The rotator cuff comprises four muscles (and their respective tendons) that help to stabilise the shoulder and assist in its movement. These muscles are the supraspinatus, infraspinatus and teres minor and major. The shoulder joint is a ball and socket joint and can be injured as a result of overuse, wear and tear or excessive force. While sports/ athletics might result in overuse injuries and injuries related to excessive forces, aging accounts for wear and tear problems in the shoulder. When the rotator cuff becomes injured, everyday activities such as raising your arm (above your head and out to the side), grooming, personal hygeine become increasingly difficult or impossible.

Physiotherapy for rotator cuff injuries

Physiotherapy intervention is usually successful in the majority of cases. Your physiotherapist will begin with a thorough assessment of your condition, paying particular attention to your muscle strength, range of movement and ability to do everyday activities. Your treatment will focus on strength exercises (for the injured rotator cuff muscles) and stretching exercises. You may be asked to purchase some resistant bands (theraband) to use for your strengthening exercises. Your physiotherapist will progress your exercises as needed and indicated.

Surgery for rotator cuff injuries

In the event that your shoulder does not respond to physiotherapy, you may require surgical intervention. Upon consultation with your surgeon, arthroscopic surgery to repair frayed and torn tendons and remove bone spurs and inflammed tissues around the shoulder can be organised. This procedure has a high success rate, however, it is important to note that you will still require intensive physiotherapy post operatively to help restore range of motion and strength. Usually this will also involve hydrotherapy.

To make an appointment to see a Physiotherapist about your ankle injury, please contact your nearest clinic.

The Team

Integrated Health

An ankle sprain is the injury to the ligaments of the ankle. It is very common, especially in the sporting population. It often happens during activities that involve rapid changes in direction, running on uneven surfaces, jumping and landing awkwardly or even on another person’s foot. The lateral ligaments (outside of the ankle) are the most commonly injured because they are weaker than those of the inside ankle. The severity of injury can vary and aside from ligament damage there may be fractures tendon injuries sustained.

Signs and Symptoms

• Audible (“hearing”) snap.
• Pain on inside or outside of the foot.
• Swelling (usually rapid onset).
• Difficulty weight bearing.
• Instability.

Treatment

The Physiotherapist will provide a thorough assessment to determine the extent of the injury and decide upon the best course of action. Treatments aimed at decreasing swelling, improving strength and balance, increasing ankle range of motion and in meeting the lifestyle goals of clients may include the following:

• Oedema (swelling) massage.
• Soft tissue massage.
• Joint mobilization.
• Education and advice.
• Taping.
• Electrotherapy.
• Strengthening.
• Stretching.
• Hydrotherapy.

To make an appointment to see a Physiotherapist about your ankle injury, please contact your nearest clinic.

Osteoarthritis is a common condition within the community. Symptoms of persistent joint stiffness, swelling and pain are the typical signs of an arthritic joint. Common sites of arthritis are the hands, feet, hips and knees, with the spine also commonly affected. Arthritis usually affects the group 50 years and over, with a gender preference to the aged female population. The damage to the joint surface caused by the effects of osteoarthritis can often be painful, limit mobility and effect quality of life and is particular worsened by the effects of aging.

What causes Osteoarthritis?

The exact cause of Osteoarthritis has yet to be found, although a link between previous injury or repeated stress on a joint through lifetime activity has been put forward. There appears to be a high prevalence of Osteoarthritis in individuals who have completed jobs with physical labour and within the sporting population. Genetic factors and a family history of osteoarthritis have also been thought to increase the risk of developing the
disease.

How can Physiotherapy help?

Physiotherapists are highly skilled in the diagnosis, treatment and education of clients with osteoarthritis. Our therapists are trained to provide the best information in lifestyle or task modification and pain control as a means of managing the lifelong disease. In addition treatments to alleviate joint stiffness, strengthen muscles and restore mobility have been shown through research to lead to both symptomatic and lifestyle improvements in this population. Your Physiotherapist will provide a thorough assessment of joint function,
strength and pain. More importantly, the therapist will investigate the impact of the disease on lifestyle and mobility.

Treatment of Osteoarthritis

While there is no cure for Osteoarthritis, some relief from symptoms may be achieved. Treatments aimed at improving the overall quality of life and in meeting the
lifestyle goals of clients may include the following:
• Manual therapy including massage and gentle joint mobilisation.
• Postural advice.
• Lifestyle advice and education to prevent or slow disease progression.
• Pain management strategies.
• How to exercise effectively and safely with osteoarthritis.
• Proper and safe use of home and walking aids.
• Hydrotherapy.
• Heat and cold treatments.
• Electrotherapy.

To make an appointment, please contact your nearest clinic.

What is Plantar fasciitis?

Plantar fasciitis is the most common cause of rear foot pain. Commonly seen in runners, it is associated with poor foot biomechanics, in particular excessive supination (causing high arches) and pronation (causing flat feet).

The plantar fascia is a thick layer of connective tissue that sits under your foot. It connects from the heel bone to the toes. It consists of 3 segments, the central component being the largest and most prominent. The plantar fascia forms the longitudinal arch of the foot and acts to maintain this arch in weight bearing, whilst also providing dynamic support for absorption during walking and running activities. When the plantar fascia becomes irritated or inflamed, the condition is called plantar fasciitis.

 Symptoms of Plantar Fasciitis:

• Insidious onset of pain
• Pain worse in the morning, but improves with exercise
• As condition worsens pain will get worse with activity and weight bearing
• Pain at the bottom of the heel bone
• Heel spurs – a small bony calcification coming off the heel bone. It is a common side effect of plantar fasciitis

Causes of Plantar Fasciitis:

• Pes planus (flat feet) or pes cavus (high arches)
• Excessive walking in inappropriate footwear
• Obesity
• Work related factors, ie. prolonged standing

Accurate diagnosis is important to ensure the correct treatment is applied for this potential chronic and debilitating condition. Physiotherapy is a key element in managing the injury and helping with rehabilitation.

Treatment for Plantar Fasciitis:

• Massage
• Strengthening exercises
• Taping techniques
• Stretches of the calf and plantar fascia
• Avoiding the aggravating factor
• Icing the foot post activity
• Non steroidal anti-inflammatory drugs
• Surgery and injections may be an option

To make an appointment, please contact your nearest Integrated Health clinic.

The ACL (anterior cruciate ligament) is one of four ligaments that are responsible for providing stability at the knee joint. An injury to this ligament can vary from a small tear to a complete tear. It is a relative common injury in sports but can also occur in motor vehicle accidents, falls or work related injuries. Around 80% of ACL injuries occur in non contact situations, rather than coming into contact with another player it may occur, or in combination, from landing after a jump, pivoting, hyperextending the knee or suddenly stopping. It is common for the injury to be a result of performing an action repeatedly in an athlete’s career or from a simple manoeuvre.

An ACL injury may occur in isolation or in combination with other injuries particularly the other structures that are closely related to the ligament. Other structures that may be involved are meniscus, articular cartilage or the MCL (medial collateral ligament). Women are more likely to have an ACL injury than men, due to the differences in body shape (hip to leg angle).

Signs and Symptoms:

• Audible ‘pop’ or ‘crack’ or feeling ‘something going out and then going back’ during the accident.
• A feeling of instability.
• Lack of confidence in the knee.
• Pain – complete tears can be extremely painful.
• Swelling at the knee but in some cases can be delayed.
• Initially unable to continue to participate in the activity which can be due to pain or swelling.

Treatment:

Our expert team of Physiotherapists can help by assessing your injury to ensure an accurate diagnosis to determine the extent of your injury and the best treatment to suit your needs. Initially after the injury, physiotherapy helps to improve swelling range of movement, strength balance and to reduce pain. In more severe injuries, surgery will need to be considered. Physiotherapy plays are large role in rehabilitation after surgery to strengthen the knee to prevent future injuries and to help return to sports or any lifestyle goals of the individual. These techniques maybe include:

• Electrotherapy.
• Soft tissue massage.
• Joint mobilisaton.
• Strengthening.
• Stretching.
• Hydrotherapy.
• Oedema (swelling massage).
• Education and advice.
• Return to sport / work.

To make an appointment, please contact your nearest Integrated Health clinic.

Also referred to as adhesive capsulitis, Frozen Shoulder affects approximately 2% of the general population. It is a disorder in which there is thickening and contraction of the soft tissues surrounding the shoulder joint (the joint capsule and synovium). This greatly restricts range of motion and causes chronic pain.

Adhesive capsulitis is generally described as a condition of three stages; the painful stage, the freezing stage, and the thawing stage.

The ‘painful’ stage describes the gradual onset of shoulder pain. It is not generally  accompanied by a restriction in movement, and usually lasts around 2-3 months.

The ‘freezing’ stage is characterised by significant loss of movement in the affected shoulder. During this stage pain may or may not subside partially or completely. This stage generally lasts around 4-6 months.

In the ‘thawing’ stage there is a gradual reduction in pain and normalisation of movement of the affected shoulder. It is currently unknown what causes the spontaneous recovery experienced during this stage of a frozen shoulder. The thawing process typically takes 6 to 12 months.

What causes a ‘Frozen Shoulder’?

The cause of adhesive capsulitis is largely unknown, however there are some risk factors which increase a person’s likelihood of developing the condition. These risk factors include diabetes, chronic inflammatory arthritis of the shoulder, previous chest or breast surgery, and any previous shoulder injury such as tendonitis, bursitis or rotator cuff injury. Other factors such as a family history of adhesive capsulitis and an individual having already had a frozen shoulder in the past contribute to a person’s risk of developing the condition.

What are the signs of a frozen shoulder?

• Restricted active and passive range of motion
• Tightness of shoulder structures
• Minimal findings in a patient’s history or xrays

What are the symptoms of a frozen shoulder?

• Slow onset of shoulder pain (usually dull, aching)
• Pain usually worst at night
• May experience a burning pain into the arm but usually not passed the elbow
• Difficulty with activities such as brushing hair, putting on shirts/bras

How can a physiotherapist help you?

Physiotherapists are experts in musculoskeletal conditions such as adhesive capsulitis. They can assist you by performing treatment options such as soft tissue and deep tissue massage to help release tightened structures, and joint mobilisation. Our Physiotherapists can also offer advice on other treatment options such as hydrodilatation or surgery if conservative treatment techniques are not successful.

Additionally, our Physiotherapists can provide you with information regarding exercises to do at home to help with the recovery of your frozen shoulder. Such exercises may be aimed at strengthening shoulder muscles by using bands or weights, or improving shoulder movement with stretches, pulleys and hydrotherapy.

To make an appointment, please contact your nearest Integrated Health clinic.