Lateral Epicondylitis (Tennis Elbow)

What is it?

Lateral epicondylitis or more commonly known as tennis elbow. Tennis elbow is an over use injury of the muscles on the outside of your forearm, known as the wrist extensor muscles, which leads to pain and decreases your ability to use that arm.

Tennis elbow affects 1-3% of the population and is most commonly seen in people between the ages of 30 and 50, although it can present in anyone. Also contrary to popular belief you do not have to play tennis to get tennis elbow! It is more common in tennis players due to the nature of swinging a tennis racquet but any person can develop this injury from continued activities most commonly linked with work.

Overall 90-95% of patients recover fully after conservative treatment with only the small remainder possibly requiring surgery.

Signs & Symptoms can include:

• Pain on the back of the forearm on the outside part of the elbow (lateral epicondyle)
• Pain in the wrist extensor muscles when trying to lift or twist objects
• Tightness of the wrist extensor muscles
• Pain in the wrist extensor muscles when doing repetitive tasks at work
• Pain in the wrist extensor muscles when trying to move the wrist backwards

Treatment can include:

• Decreasing pain through ice and massage
• Improving function in the short term with the use of strapping or bracing
• Strengthening exercises to rehabilitate the tendons and muscles
• Stretching exercises to decreases the tightness in the forearm

Lateral Epicondylitis (Tennis Elbow)

What is it?

Lateral epicondylitis or more commonly known as tennis elbow. Tennis elbow is an over use injury of the muscles on the outside of your forearm, known as the wrist extensor muscles, which leads to pain and decreases your ability to use that arm.

Tennis elbow affects 1-3% of the population and is most commonly seen in people between the ages of 30 and 50, although it can present in anyone. Also contrary to popular belief you do not have to play tennis to get tennis elbow! It is more common in tennis players due to the nature of swinging a tennis racquet but any person can develop this injury from continued activities most commonly linked with work.

Overall 90-95% of patients recover fully after conservative treatment with only the small remainder possibly requiring surgery.

Signs & Symptoms can include:

• Pain on the back of the forearm on the outside part of the elbow (lateral epicondyle)
• Pain in the wrist extensor muscles when trying to lift or twist objects
• Tightness of the wrist extensor muscles
• Pain in the wrist extensor muscles when doing repetitive tasks at work
• Pain in the wrist extensor muscles when trying to move the wrist backwards

Treatment can include:

• Decreasing pain through ice and massage
• Improving function in the short term with the use of strapping or bracing
• Strengthening exercises to rehabilitate the tendons and muscles
• Stretching exercises to decreases the tightness in the forearm

Chronic lower back pain

What is it?

Chronic lower back pain is defined as back pain that has been ongoing for greater than 7-12 weeks. According to the Australian Bureau of Statistics 3 million Australians, that’s 13.6% of the population, have back problems. It is also estimated that between 70-90% of people will suffer from some form of lower back pain at some point in their lives.

Common factors that can increase your risk of getting lower back pain can include poor posture, increasing age, being unfit, smoking, being overweight and the stress that your job places on your back.

Signs & Symptoms can include:

• Pain in lower back that has been present for greater than 7-12 weeks
• Reduced range of motion at the lumbar spine e.g. bending forwards, backwards and side to side
• Stiffness of the lower back
• Tight lower back muscles

Treatment can include:

• The use of heat packs and massage to reduce pain and release tight muscles
• Core strengthening exercises
• Flexibility exercises
• Manual therapy

Winged Scapula (shoulder blades)

Winged scapula commonly seen as one or both of your shoulder blades at odd angles in your back is often caused by muscle weakness in your back, especially of the trapezius muscle. This weakness leads to your scapula (shoulder blade) not sitting in its correct position which may lead to shoulder pain and problems later on.

Fortunately winged scapula can be fixed with a range of strengthening and stretching exercises provided by your physiotherapist.

Anterior Cruciate Ligament (ACL) Injuries

What is the ACL?

The ACL is a ligament in your knee that prevents your femur (thigh bone) from sliding forward and over the tibia (shin bone) and also prevents rotation at the knee when you are walking, running or jumping. It is no surprise then that when a person pushes the knee past it limits causing the joint to hyperextend or twist too far that the ACL can be damaged. The damage can range from a minor sprain to a full rupture of the ligament. Depending on the severity of the injury will determine the symptoms experienced and the treatment needed.

Signs & Symptoms can include:

• Pain around the knee joint
• Large amounts of knee swelling
• An audible pop or crack may be heard when the injury occurs
• Knee giving way possibly causing the patient to fall over
• Loss of range of motion and inability to walk, run or jump

Treatment can include:

Treatment for an ACL injury determines how badly the ligament has been damaged. Physiotherapy assessment along with other investigations such as an MRI may be necessary to determine the severity of the injury. For minor or moderate strains physiotherapy treatment including exercises, bracing and education are important to return full function to the knee as quickly as possible. For complete ACL ruptures, surgery may be indicated by the discretion of your doctor and surgeon in order for the best outcome to be achieved.

Sever’s Disease

What is it?

Sever’s Disease is a common condition causing heel pain that affects active children most commonly around the time of their growth spurt. As the child grows there can be a mismatch between the growth of the gastrocnemius (calf muscle) and the tibia (shin bone) this then causes the calf to become tight and pull on the junction between the Achilles tendon and the heel around the growth plate. The connecting site between the Achilles tendon and heel can then become inflamed and very painful.

Signs & Symptoms can include:

• Heel pain around the Achilles tendon
• Heel pain after exercise e.g. running and jumping
• Calf muscle tightness and stiffness
• Limping
• Walking on tip toes

Treatment can include:

• Rest
• Icing
• Pain relief e.g. Neurofen or Paracetamol
• Protective heel cups
• Stretching exercises
• Gradual strengthening to re-train walking/running gait once initial symptoms have resolved

Achilles Tendon Injuries

What is it?

The Achilles tendon is the large tendon at the back of your ankle that connects your calf muscles to your heel and allows you to push off when running or walking. Injuries to the Achilles tendon can range from minor strains to complete ruptures of the tendon.

Risk factors for Achilles tendon injuries:

• Sudden increase in activity levels
• Wearing poor footwear
• Running on hard or uneven surfaces
• Tight or weak calf muscles
• Inadequate warm up, stretch or cool down with sports/exercise

Treatment for Achilles tendon injuries:

• For immediate injuries RICER (Rest, Ice, Compression, Elevation and Referral)
• Exercises to gradually strengthen the tendon
• Stretching exercises to decrease muscle tightness
• For complete ruptures surgery or immobilisation in plaster/CAM boot may be necessary

Achilles Tendon Injuries

What is it?

The Achilles tendon is the large tendon at the back of your ankle that connects your calf muscles to your heel and allows you to push off when running or walking. Injuries to the Achilles tendon can range from minor strains to complete ruptures of the tendon.

Risk factors for Achilles tendon injuries:

• Sudden increase in activity levels
• Wearing poor footwear
• Running on hard or uneven surfaces
• Tight or weak calf muscles
• Inadequate warm up, stretch or cool down with sports/exercise

Treatment for Achilles tendon injuries:

• For immediate injuries RICER (Rest, Ice, Compression, Elevation and Referral)
• Exercises to gradually strengthen the tendon
• Stretching exercises to decrease muscle tightness
• For complete ruptures surgery or immobilisation in plaster/CAM boot may be necessary

Sever’s Disease

What is it?

Sever’s Disease is a common condition causing heel pain that affects active children most commonly around the time of their growth spurt. As the child grows there can be a mismatch between the growth of the gastrocnemius (calf muscle) and the tibia (shin bone) this then causes the calf to become tight and pull on the junction between the Achilles tendon and the heel around the growth plate. The connecting site between the Achilles tendon and heel can then become inflamed and very painful.

Signs & Symptoms can include:

• Heel pain around the Achilles tendon
• Heel pain after exercise e.g. running and jumping
• Calf muscle tightness and stiffness
• Limping
• Walking on tip toes

Treatment can include:

• Rest
• Icing
• Pain relief e.g. Neurofen or Paracetamol
• Protective heel cups
• Stretching exercises
• Gradual strengthening to re-train walking/running gait once initial symptoms have resolved

Ankle Sprains

What are they?

Ankle sprains are one of the most common sports injuries. A sprained ankle occurs when your ligaments are overstretched. There are different levels of severity with ankle sprains from a minor sprain to complete ligament ruptures.

How can you avoid an ankle sprain?

• Try to take care when running on uneven surfaces
• Work on sport specific skills (e.g. speed and agility)
• Strengthen your ankle and calf muscles
• Work on your proprioception and balance
• Wear appropriate good fitting footwear during activity
• See a health professional for injury protection and prevention

Signs & Symptoms can include:

• Pain in your ankle when walking or using the ankle
• Ankle instability
• Unable to run or participate in sport due to pain, weakness or loss of balance
• Loss of balance and/or strength

Treatment can include:

• RICE (Rest, Ice, Compression and Elevation)
• Strengthening exercises
• Stretching exercises
• Balance exercises
• Manual therapy to decrease pain and improve movement at the joint

Soft tissues injuries include strained muscles, sprained ligaments and bruises, for example rolling your ankle or pulling your hamstring.

What should you do? RICER!

R– rest
I– ice for 20 minutes every 2 hours
C– compression, wrap a bandage firmly but not too tight around the injured area
E– elevate the injured area preferable above the heart
R– referral to your doctor or physiotherapist for comprehensive treatment

RICER should be done for 2-3 days after the injury in order to manage swelling, pain and help recovery.

What to avoid? HARM!

H– heat to the injured area
A– alcohol
R– running or activity
M– massage