Essential Tips for Managing a Meniscal Tear

A meniscal tear is a common knee injury that can cause pain, swelling, clicking, locking and limited movement in your knee. Proper management of a meniscal tear is crucial for a successful recovery whether this requires surgery or conserative management. In this blog post, we will provide you with essential tips to help you effectively manage a meniscal tear and aid in your rehabilitation process.

The meniscus is a piece of cartilage located in the knee joint. Each knee has two menisci, one on the inner side of the knee (medial meniscus) and one on the outer side (lateral meniscus). The menisci are C-shaped and act as shock absorbers and stabilizers for the knee. The primary function of the meniscus is shock absorption, joint stability and it provides a protective layer between cartilage surfaces.

How to manage a meniscal tear:

Consult a Medical Professional

The first step in managing a meniscal tear is to consult a medical professional. They will diagnose the severity of your injury and provide you with a personalized treatment plan. Send for an MRI if deemed clinical necessary and the earlier you start the process the better (Do not wait for it to settle down before seeing a physio!)

Rest, Ice, Compression, Elevation, MOVE

Start with this  standard approach to manage many types of injuries. Rest your knee to avoid further damage, apply ice packs for 10-20 minutes every 2-3 hours to reduce swelling, use compression bandages to support the knee, and elevate your leg to minimize fluid accumulation. Start to gently move and activate the muscles surrounding the knee as soon as able.

Rehab Rehab Rehab

Rehabilitation is crucial for meniscal tear recovery. Your Physio will start gentle exercises targetting knee range of motion and quadricep strengthening. This can be progressed as tolerated for conservative management. If there is absence of locking, clicking and catching in the knee and sound conditioning program can restore the knee to normal function.

Surgery or No Surgery? You will need an MRI to help gauge the answer to this question.

1. Surgical Intervention: In some cases, surgery may be necessary to repair or remove the torn meniscus. Arthroscopic surgery is a minimally invasive procedure commonly used for meniscal tear treatment. Your surgeon will determine the best course of action based on the tear’s location, size, knee symptoms, pain levels and activity limitations.
2. Conservative Management: A good rehab program involving restoring good knee mechanics, restoring good strength of surrounding muscles and graded return to activity can be as good as surgery for a meniscus tear. BUT this depends on the levels of symptoms and how the knee tolerates exercise.

Graded return to sport and activities

As with any sport or activity. A graded return to sport and activity is very important and establishing good movement patterns prior to pushing the knee to hard. Prior to any running the knee should have good quads control, no swelling, minimal symptoms and your single leg squat and hop should be symmetrical to the non injured leg.

Managing a meniscal tear requires a comprehensive approach involving medical guidance, rehabilitation, and lifestyle adjustments. By following these essential tips, you can effectively manage your meniscal tear, promote healing, and restore optimal knee function. Remember, every individual’s condition is unique, so it’s crucial to consult your healthcare provider for personalized advice and treatment.

Reach out if you have had a recent knee injury.

Hit us up at info@thephysiodepot.com.au or Book Online Here 

Total Knee Replacement

Total knee replacement (TKR) is a surgical procedure where a damaged or worn out knee joint is replaced with an artificial joint. The purpose of the surgery is to relieve pain and improve mobility in the knee joint. Following a TKR, physiotherapy is an essential component of the rehabilitation process, helping to restore strength, flexibility, and function to the knee.

Criteria for when to have a knee replacement depends on the individual. Generally the patient will have the following.

Marked changes on imaging (x-ray reveals marked osteoarthritic changes).

Reduced ability to do day to day tasks: Sitting, stairs, prolonged standing etc.

Chronic pain varying in intensity. Occasionally bad at night post activity.

Dependance on medications such as NSAID.

The rehabilitation process begins immediately after surgery, with your physiotherapist working with the patient to control pain and swelling and to begin gentle exercises to increase range of motion. As the patient progresses, the exercises become more challenging, with a focus on strengthening the muscles around the knee joint and improving balance and coordination.

The following are some key exercises that may be included in a physiotherapy program following a total knee replacement:

1. Straight leg raises
   This exercise helps to strengthen the quadriceps muscles. The patient lies on their back with their legs straight and lifts one leg off the ground, holding for a few seconds before lowering it back down.
2. Heel slides
   This exercise helps to improve knee flexion and extension. The patient lies on their back with their legs straight and slides their heel towards their buttocks, bending the knee, and then slides it back out again.
3. Terminal knee extension holds.
   This exercise helps to strengthen the quadriceps muscles and improve knee extension. The patient sits on a chair with their feet flat on the ground and a towel rolled up under their knee. They straighten their knee, lifting their foot off the ground and holding for a few seconds before lowering it back down.
4. Step-ups
   This exercise helps to improve balance and coordination. The patient stands facing a step and steps up onto it with their operated leg, holding for a few seconds before stepping back down again.
5. Box squats
   Essentially this mimics a sit to stand movement.
6. Stationary bike
   Cycling on a stationary bike can help to improve range of motion, strength, and cardiovascular fitness. The resistance and duration can be gradually increased as the patient progresses. Once you have greater than 115-120deg this is a great long term option for exercise after sugery.

It is important to note that every patient’s rehabilitation program will be tailored to their individual needs and goals. Your physiotherapist will work closely with the patient to monitor progress and adjust the program accordingly.

A general timeline following total knee replacement as follows:

• Week 0-2
  – Manage acute surgical pain and swelling
  – Keep dressing clean and tidy to prevent infection.
  – Begin gait re-training from day 1 using variety of aids.
  – Start heel slides for knee flexion
  – Start quadricep contraction as soon as possible.
• Week 2-6
  – Wean off all walking aids and slowly build into gentle walks
  – Start standing exercises: Step up, squats, crab walk, mini lunges, wall sit etc
  – Progress knee flexion exercises: Heel slides with a towel, skateboard off the edge of bed or pulling with opposite foot.

• Week 6-12
  – Further progress strength work by adjusting load, reps, sets or volume of training
  – Your knee should start to generally feel a little better now…

• Month 3 to 12 month
  – You will see slow changes in your knee and rehab over the next 6-12 months.
  – Things get easier, bending becomes less painful and the knee starts to ‘mould’ into being a part of you.

In summary, physio is a critical component of the rehabilitation process following a total knee replacement. It can help to reduce pain and swelling, improve range of motion and strength, and restore function to the knee joint.

Written by Pat Lincoln
(Physiotherapist)

Shoulder Dislocation

Anterior shoulder dislocation is a common injury that occurs when the ball of the humerus bone is dislocated from the glenoid fossa of the scapula in the shoulder joint. This is the most common type of shoulder dislocation, accounting for about 95% of all dislocations. In this blog post, we will discuss the causes, symptoms, diagnosis, and treatment of anterior shoulder dislocation.

Anterior shoulder dislocation can occur due to various reasons. The most common cause is a traumatic injury, such as a fall or a blow to the shoulder. Certain medical conditions involving hypermobility such as Ehlers-Danlos syndrome or Marfan syndrome can also increase the risk of anterior shoulder dislocation due to increased joint laxity.

The most common symptom of anterior shoulder dislocation is severe pain in the shoulder joint, which can radiate down the arm. The shoulder may also feel weak and unstable, and there may be a visible deformity in the shoulder joint. In some cases, the person may experience numbness or tingling in the arm, which is a sign of axillary nerve damage.

How to diagnose it?

Diagnosis of anterior shoulder dislocation is usually done by a physical examination, which includes checking the range of motion of the shoulder joint, and assessing the stability of the joint. Imaging tests such as X-rays or MRI scans may also be used to confirm the diagnosis and rule out other injuries.
Generally observation of a shoulder will give you the biggest clue to a shoulder dislocation although can be misdiagnosed for an AC joint or clavicle fracture. The x-ray below shows an acute anterior dislocation in where the shoulder has moved from its normal joint alignment.

How can Physio help?

The treatment for anterior shoulder dislocation depends on the severity of the injury. In most cases, the first line of treatment is to immobilize the shoulder joint using a sling or a brace for a short period of time. This helps to reduce the pain and  prevents further damage to the joint. In most cases, gentle exercises and physical therapy may be recommended to help restore the range of motion of the shoulder joint.

Once initial period of settling symptoms a thorough active rehabiliation including rotator cuff, general shoulder strengthening into full range of motion is imperative to help prevent further dislocations. Any return to sport must only be considered once a specific conditioning program is completed.

If the dislocation is severe or recurrent, surgery may be required. The most common surgical procedure used for anterior shoulder dislocation is the arthroscopic stabilisation repair, which involves reattaching the torn ligaments and cartilage in the shoulder joint.

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Prevention better than cure?

To prevent anterior shoulder dislocation, it is important to maintain good shoulder strength and control. Strengthening exercises for the muscles surrounding the shoulder can also help to improve the stability of the joint and reduce the risk of injury.

In conclusion, anterior shoulder dislocation is a common injury that can cause severe pain and discomfort. It is important to seek prompt medical attention if you experience any symptoms of anterior shoulder dislocation, as early diagnosis and treatment can help to prevent further damage to the joint. With proper care and management, most people with anterior shoulder dislocation can recover fully and regain their normal range of motion and function.

If you need any help with your recent shoulder injury send us an email or book online below.

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Patrick Lincoln

The Physio Depot

Ankle Sprains

Ankle sprains are a common injury that can happen to anyone, regardless of age or activity level. They occur when the ligaments that connect the bones in the ankle joint are stretched or torn. Ankle sprains can range from mild to severe, and can cause significant pain and discomfort. In this blog post, we will discuss the causes, symptoms, and treatment options for ankle sprains

What causes an ankle sprain?

Ankle sprains are often the result of a sudden twisting or turning motion of the ankle. This can occur during everyday activities such as walking, running, or jumping, or during sports or other physical activities. Ankle sprains can also be caused by wearing shoes that do not provide proper support or by walking on uneven surfaces.

Symptoms of Ankle Sprains

• Pain over the outer aspect or front of the ankle.
• Swelling and bruising.
• Difficulty bearing weight on the affected ankle.
• The ankle may feel unstable or the person may experience a popping or snapping sound at the time of injury.

Treatment Options for Ankle Sprains

The treatment for an ankle sprain will depend on the severity of the injury.
Treatment generally will involve:

• Relative rest
• Taping or immobilisation if deemed necessary.
• Ice and compression for swelling management
• Swelling management
• Early gait re-training
• Restore ankle range of motion
• Improve calf muscle strength
• Build balance and proprioception
• End stage sport specific training, conditioning and bracing if needed
• Maintenance exercises to prevent an injury re-occurrence.

Preventing Ankle Sprains

The best way to prevent ankle sprains is to strengthen the muscles in the ankle and work on ankle stability exercises. These need to be built into your training as much as you train the ‘skills’ for your desired sport.

In conclusion, ankle sprains are a common injury that can be caused by a variety of factors. If you experience symptoms of an ankle sprain, it is important to seek medical attention to ensure proper treatment and to prevent further injury.

If you need help with an injury – Send us an email Click here to send an email

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   Tennis elbow

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Written by Pat Lincoln – Physiotherapist

   Managing an MCL injury

The MCL is the acronym for medial collateral ligament, it is the main stabiliser on the inside aspect of the knee. It attaches the thigh and the shin bone with a fibrous band of tissue called a ligament. It’s main job is to support the knee from pressure applied to the outside of the joint causing a ‘widening’ of the inside aspect of the joint. It’s a very common presentation in a sporting context and Physio can help manage it appropriately.

MCL can tear in three different grades. Grade I means less than 10% of fibres have torn and will heal in 3-4 weeks. Grade II is 20-30% fibres torn and can vary in time frames but will generally heal in 6-8 weeks. Grade III is a complete rupture of your MCL and will need surgical intervention to repair the ligament. 

All grades are diagnosed via your health physician depending on the location of symptoms, mechanism of injury and degree of ligament laxity.

How to best manage your MCL injury!

Immobilise it!

Use a brace to immobilise the knee – Aiming to keep the knee from being in a fully ‘straight’ position. This will allow the ligament to sit in a slightly relaxed position to help promote early healing. Using a brace will also help alleviate any side to side movement in the knee which will further aggravate the knee.

Avoid early knee extension (Straightening the knee)!

The MCL is on stretch or pulled tight when the knee is straight. After an acute injury placing the knee in a subtle bend in the first 7-10 days will help promote healing by keeping the ligament in position with more ‘slack’.

Quads Quads Quads!

With immobilisation and altered walking gait comes muscle wasting within the first 72 hours. Completing pain free muscle activation and strengthening of the quadricep muscles as soon as tolerated is very important. Generally simple exercises like mini squats, wall sits and stairs can be tolerated very early on if the knee is kept in a straight position.

Keep it to straight lines!

MCL injuries will hate any lateral or side to side movements. On your journey to returning to exercise it’s best to keep all knee movements in a straight plane. Start with all strength exercises where the knee can maintain a neutral position. Think squats, lunges, wall sits, leg press, bridges where the knee does not have any side to side movement. Straight line running can start in as little as 2 weeks post injury depending on the grade of your tear. Side to side movements begin in the later stages of your rehab when all in clinic testing does not reproduce any symptoms.

Complete sport specific rehab prior to return to sport!

Adding sport specific training prior to return to sport is fundamental. Challenging your knee in cutting, directional movements, contact movements to help restore confidence and proprioception around the joint. This ensures that your knee is back to full stability and your confident returning to sport without risking further injury.

If you have sustained a recent MCL injury – Get in touch!

If you a friend or family member needs our help – Book Here!

Written by Pat Lincoln – Physiotherapist

   Four tips to reduce running injury risk

Beginning of the new year a lot of people have new years resolutions to become more active. One form of exercise most people uptake is running as it is a free and easy option we can enjoy outdoors. However, with any change in physical activity levels injury risk is impossible especially if it is sudden. Our bodies need time to adapt to the demands of exercise. Below are some top tips on how to reduce your risk of a running injury if you are beginning running or even increasing your running.

1. Build your running up slowly & consistently

   Running takes time for our bodies to adapt to so if you do too much to soon you can increase risk of injury. If you are completely new to running, a run/walk programme is often the best way to start. One example is to walk for a minute and run for a minute for about 15-20 minutes. You can then gradually increase the overall running time every 3-4 weeks until you can run continuously. It is also important to gradually increase the number of times you run a week. For example, a recommendation is to start with 3 days a week and gradually increase this frequency over time. Remember you have to have a full rest day

2. Don’t skip strength training day

   Strength training is often neglected by runners. Ideally strength training should be performed 2-3 days/week to reduce injury risk and improve running performance. Strength training doesn’t have to be at the gym but can be performed at home doing body weight exercises such as squats and lunges.

   

3. Mix up your exercise regime

   If you want to exercise daily it is a good idea to mix things up. Instead of running every day you could go for a walk, a cycle or even a swim on your non running days. Mixing your regime will help reduce injury risk and it will also help progress your fitness better as you are regularly changing the type of exercise your body performs. If we perform the same time of exercise all the time our body adapts to this and does not progress well.

   

4. Remember to factor in adequate rest, fuel and recovery

   Rest and recovery are just as important as running and exercise itself. During rest periods this is when our bodies recover and become stronger. If you have decided to increase your exercise remember to factor in rest too. Rest should include 1-2 full days rest a week. Sleep is very important as well in recovery. You should be aiming for 7-8 hours a night of sleep to allow plenty of rest and recovery. Correct fuel and hydration is also important for recovery.

   

If you a struggling with running injuries – Get in touch!

If you a friend or family member needs our help – Book Here!

Megan Tomkins

Shoulder AC Joint Injuries

How do you treat an AC joint injury?

• Early shoulder blade activation and strengthening exercises.
• Restore shoulder range of motion in pain free positions.
• Progress to functional shoulder stability and strength based conditioning.
• If returning to contact sports a support over AC joint and taping is highly recommended.
  

Expect your AC injury to take anywhere from 3-12 weeks for recovery with good management. It’s common for your shoulder to ‘look different’ after this injury but it should function well within normal limits. Long term strategies of increasing the number of pulling based strength exercises versus pushing work. 

Any questions shoot us an email at info@thephysiodepot.com.au

Written by Physiotherapist

Pat Lincoln

Ankle Sprains

Ankle sprains are one of the most common sporting injuries particularly in sports such as netball and soccer. Most people view them as minor injuries that will get better over time because of their quick resolution in symptoms. However, ankle sprains that are not treated correctly can often lead to persistent problems such as laxity and chronic instability.

In fact there is a 70% chance of re-injury to that same ankle if there is no treatment or if it isn’t treated correctly.

The good news is we can prevent the recurrence of ankle sprains!

The term ankle sprains describes an injury to a ligament that has been stretched beyond it’s capability which then results in laxity of that ligament. Thus giving our ankle has more chance of “giving way” during sport, exercise or walking on uneven ground. The muscles around our ankle joint also provide stability of our ankle.

An effective Physiotherapy rehab program can help improve our ankle stability and help prevent recurrent ankle sprains.

How can Physio help manage your Ankle Sprain?

Restore muscle strength around the ankle.

Short term swelling & acute inflammation management.

Balance & proprioception training is an essential part of good rehabilitation post ankle sprain injury.

Restoring normal joint range of motion and tissue length.

Graded return to sport specific training drills.

If you have an unstable ankle or have suffered an acute ankle injury. Be sure to get to your local Physio to get a correct diagnosis and management plan in order. Even a insignificant ankle sprain can progress into a chronic ankle instability and pain.

Any questions shoot us an email at info@thephysiodepot.com.au

Written by Physiotherapist

Megan Tomkins

Is knee pain stopping you from running?

Knee pain during running is a common presentation whether you are an experienced runner or just starting running. One of the main contributing factors to knee pain can come from the joint behind the knee cap known as the patella-femoral joint. We see this all the time in the clinic in the elite and novice running groups and trust me it is a very annoying injury to get on top of.

The Depots 6 Common causes of Runners Knee:

1. Big increases in running distances over a short period of time
   – Did you add in a speed session?
   – Whats your average weekly kilometres look like and has this increased rapidly?
   – Are you running more hills and stairs lately?
2. Non optimal running mechanics and technique
   – Technique can predetermine your injury rate.
   – One BIG thing is stride length & cadence (How many steps you take each minute).
   – This number gives us an idea whether you are over-striding which puts a lot more load through your hips, knees and feet.
3. Footwear
   – Have you changed footwear recently?
   – Changing the support levels or running in old shoes can predispose you to a higher injury rate.
4. Lower limb strength imbalances
   – The legs are your engine when you run.
   – Strong calf complex, hamstring, quads, glutes and core are essential to pain free running.
   – We always advocate for a supplementary strength plan to accompany your running.
5. Poor recovery, sleep and nutrition
   – Are you feeling tired, not great when you run or always injured?
   – Quality sleep, good recovery methods and good food help restore tissue and help reduce injury rates.

Knee pain with running sucks and can sideline you from your running goals!

We have the tools to tailor a program to keep you running and return to your full potential!

Get in touch today if you need some help – Click to Book Here 🙂

Written by Megan Tomkins – The Physio Depot