Injury blog: Muscle strain

Have you ever gone to reach your leg out for a ball just that little bit too far, or tried to suddenly sprint off from a standing still position and felt a painful tug, pull or tearing sensation in your leg? If you have, there is every chance you have been the recipient of a strained muscle. Muscle strains (aka ‘tears’) are up there as one of the most common conditions we treat in the clinic. A strain can theoretically occur anywhere in the body where there is muscle tissue (which is almost everywhere in the body!), but some muscles are more susceptible to straining than others. Interested to know more? Read on…

What is a muscle strain?

Our muscles are essentially made up of a combination of contractile and non-contractile tissues. So, parts that actively move and contract, and parts that do not actively move and contract, respectively. Throw in some protein, fat, water, a whole heap of intertwining membranes all arranged in long fibres, and bingo… you have a muscle (it’s a bit more complex than that, but you get the gist!). Simplistically, at the end of each muscle is a tendon, which attaches it to a bone. When the muscle contracts, it pulls on the bones and movement of the body occurs.

Proteins within the muscle fibres are responsible for creating the force required to move a body part. When the force is too great for the muscle to handle (for example when we stretch or load it beyond its limit), the whole system fails and a strain or tearing of the muscle fibres (and possibly it’s associated tendon) occurs.

The most strained muscles of the body are the hamstrings, calf and quadriceps muscles. These are large leg muscles that are exposed to the highest amounts of force in the body.

Grades of a strain

Strains are graded based on the severity of the injury:

  • Grade 1: Only a few fibres are torn
  • Grade 2: A greater proportion of fibres are torn, but not all of them
  • Grade 3: A complete tear of all fibres

A grade three strain has the largest amount of damage to the muscle and so has the longest recovery time. It is important to note that there is no hard and fast rule with recovery though, as similar graded strains between different people can take varying amounts of time to recover (meaning it’s not just about physical damage when it comes to recovery!).

Signs and symptoms

Signs and symptoms of a muscle strain include:

  • Pain (due to irritation of nerve endings during the tearing process)
  • Bruising (due to damage to small blood vessels within the muscle)
  • Swelling
  • Loss of strength and function in the affected body part

Treatment

Initial treatment for a muscle strain focusses on reducing the immediate symptoms of pain, swelling and loss of movement, as well as limiting the amount of scar tissue formation that occurs during the recovery process. Expect us to ask you to continue moving! Movement is key to muscle recovery, but at the same time it is important not to continually damage the recovering muscle fibres, so we’ll advise you to steer clear of over-stretching the area and keeping any movements slow and within a pain-free range.

Ice and compression may be used early on to control and reduce swelling and pain. We may also help this process using our hands by gently massaging the areas around the site of the tear (but not directly on it).

Once the initial symptoms have subsided, it will be time to progressively ramp up the movement and exercise. We will also be able to get more hands-on around the area, whilst always ensuring the areas distant from the injury are staying pain free and functioning well too. Remember, a tear in your calf will have a direct effect on your upper leg, pelvis and low back. We’ll keep your body in check!

Focus can start to switch to faster and more powerful exercises. When a muscle tears, it loses strength, and you feel that with reduced ability to perform a normal everyday task. Strength needs to be built back up so the muscle can start to withstand and transmit greater forces passing through it again. There are a few different elements to strength training that can be quite confusing to get your head around, but do not worry. We know how your muscle should work and will continually assess you and progress you as appropriate.

The ultimate aim is to achieve a return to your pre-injury level of fitness so you can return to playing, working and living as you were before the injury occurred. Although having some extra fitness in the tank is always a good thing, so if we work you extra hard with the exercises, it’s so you return fitter than you were before being injured. This greatly reduces your chance of injuring the same body part again in the future.

Have you strained a muscle and are ready to say goodbye pain? Look no further than your trusty osteo! Call us today on 9078 2455 to book your appointment and get ready to wave hello to us… and goodbye to that muscle strain!

Why Osteopathy?

We regularly get asked the question, “Why osteopathy?”. Why not go to see a physio or a massage therapist? The most important thing to point out here is that we will not be spending this blog trying to talk down other therapies, but rather explain osteopathy. There are many different therapies out there, and there are some highly skilled therapists within each profession. It comes down to a matter of preference and finding a therapist that works for you. Having said that, we believe in osteopathy and here are some reasons why we think our profession is awesome:

University education

Your osteopath has been put through their paces. Depending on the country of study, it takes 4-5 years of university degree-level education to become an osteopath. In that time a budding osteopathic student is grilled on all areas of the human body, the principles behind osteopathic thinking and treatment, hands-on techniques and how to help someone obtain health, and keep it. Each osteopathic student goes through a wide range of spoken, written and practical assessments each year which help to prepare them to take on the important role of a health practitioner. So, rest assured you’ll be in good hands when you see your osteopath.

Anatomical knowledge

An osteopath’s knowledge of human anatomy is second to none. We study every inch of the body from head to toe… it is our bread and butter. If we don’t know anatomy, we cannot treat osteopathically. We have extensive knowledge on how the different systems of the body relate to and work with each other to keep the human form ticking over and functioning well. An osteo looks much further than just the muscles, ligaments, and bones. We consider the whole body when we treat, which makes us extremely well-rounded practitioners who can provide treatment and advice for a wide range of conditions.

Hands-on skills

If you’ve been to see an osteo before, you’ve probably been amazed at the number of techniques they seem to know and perform on you across your time seeing them for treatment. The human body is very complex and requires an osteo to be tooled up to cope with any given situation. We are expert hands-on therapists who can call upon many different types of treatment techniques, including massage, mobilisation, manipulation (i.e. cracking) and many others. How we handle your body will leave you feeling confident in our ability to make a positive change for you.

Holistic approach

Osteopathy is a complete approach to treating the body. One of the number one reasons people come to see us is to help them get rid of pain. But osteopathy is much more than that. When you see us, you get the whole package. Yes, we will absolutely help you get rid of pain to the best of our ability. Pain is a complex phenomenon and there are always many reasons behind why someone feels the pain they experience. We can help you to work out what those reasons are and give you the tools to reverse the negative effects they are having on you. And with the best will in the world, keep that pain away forever too. We can help with our hands, but osteopaths are also skilled at giving great lifestyle, diet and exercise advice.

We care

Osteopaths are naturally caring people. We live to help others in need. When you consult with an osteopath for the first time (and any time after that for that matter) you will notice what a great manner they have. Always a keen listener, they will allow you to tell your story and always be there for you when you need them. Osteos will always do our best to get you the help you need, even if it means referring you to a different practitioner for specialised treatment. If you come to us with a problem that is out of our scope of practice, we won’t just turn you away. We will liaise with doctors and other medical specialists to ensure you get the care you need, when you need it.

 We hope this has opened the book on osteopathy and given you a good reason to choose us here at Inner West Health Clinic the next time you need a helping hand. If you’re still not convinced, then give us a call on 9078 2455 today, and we will be happy to twist your arm (in a totally caring and gentle way) to show you what we’re made of.

Gait – walking you through it

Walking would appear to anyone as being a simple action carried out by many people, every second of every day across the globe. For the average Joe, walking is simple. We learn to walk from a very young age, and then we don’t really have to think about doing it after that… Until something goes wrong with the body. Read on to find out more about the wonderful phenomena that gets us humans around from A to B.

What is gait?

The manner or pattern in which we walk or run is referred to as ‘gait’. Although it seems a very simple thing to do, and indeed most of us are able to carry out this task with incredible ease, it is possible only through a combination of extremely complex bodily movements. It is something many of us take for granted, unless you have experienced not being able to walk properly, or at all. You can think of gait as a repetitive, controlled fall with a forward movement in a straight line.

Phases

It is useful to think about gait as a cycle of movements. The human gait cycle starts when the heel of one foot touches the ground and ends when the same heel touches the ground again. The whole cycle can be broken up into two main phases:

  • Stance or support phase: This begins with the heel of one foot hitting the ground, moving through to the whole foot (as it keeps contact with the ground) and ending with the heel lifting off before moving into the…
  • Swing phase: This begins when the toes of the same foot lift off the ground, swinging the leg forward before the heel hits the ground again to begin a new cycle.

While one leg moves through the stance phase, the other leg is moving through the swing phase. The whole cycle takes approximately one second in the average adult and results in the forward movement of the body. It gets you from your bed to the toilet first thing in the morning, then to the kitchen, your workplace and finally back to bed again.

Functions of gait

It might seem silly, because the main function of gait is to allow us to move our bodies. But, when broken down, gait comes with many benefits:

  1. It provides support to the head, trunk and arms as we move
  2. It helps us to keep an upright, balanced posture
  3. It allows us to control foot movements, so we can dodge obstacles in our path
  4. It creates energy through muscle contraction to begin, maintain and speed up movement
  5. The action of the muscles involved provide shock absorption to the many forces acting on the body as we move

What can go wrong?

Our gait can be affected in many ways. Some effects can be serious and devastating, resulting in permanent change to the way you move. A person who experiences a stroke may end up losing function in the muscles that control ankle movement, leading to a ‘drop foot’. This causes the toes to catch the ground as they swing their leg through which can easily lead to a person falling. The neuro-degenerative condition, Parkinson’s Disease, can result in a person having a ‘shuffling gait’, where the feet essentially stay in contact with the ground permanently and the person moves by shuffling or dragging their feet along the ground. This issue, like many other problems that can lead to significant changes in the gait cycle movements, is a huge risk factor for a person falling, and potentially experiencing a life altering injury (i.e. a serious head strike or hip fracture).

Other effects may be less severe and reversible following correct rehabilitation of the problem. A simple knee injury is a good example here. You twist your knee playing basketball and that knee becomes painful. The pain causes you to shift your weight to and favour the other leg, leading to excessive strain on that side of the body. The body will compensate well to keep you moving, even if not in the usual smooth manner. Eventually the knee injury heals, but it is quite possible you will be left with unresolved strains and tensions running up the injured and uninjured sides of the body. And this is why you should always get us on board from the word go!

We can help

Osteopaths are experts in human movement. We know how you should move. We are trained to recognise when things are not quite working properly. And we know how to get you back to your true self. Don’t take a chance on it. A simple injury that is not treated correctly from the beginning can lead to bigger problems down the line. Be smart, seek help from professionals (i.e. us!) and enjoy the fact you can walk unaided or unhindered for years into your future.

Do you have an injury or condition affecting your ability to walk normally? Call us today on 90782455 to book an appointment.

References

  1. Chila, AG. 2011. Foundations of Osteopathic Medicine. 3rd ed. Philadelphia: Lippincott Williams & Wilkins
  2. Magee, DJ. 2008. Orthopedic Physical Assessment. 5th ed. Edmonton, Canada: Saunders Elsevier
  3. Solberg, G. 2008. Postural Disorders & Musculoskeletal Dysfunction. 2nd ed. Edinburgh: Churchill Livingstone

Human posture and why it’s important we look after it

Posture, posture! Remember when you were a kid and your parents used to tell you to “Stop slouching!” and “Sit up straight!”? Well, however annoying that may have been at the time, your parents had your best interests at heart. They were looking ahead to the future and trying to save you the woes of having developed poor posture, and the effects that can have on you as an individual.

What is posture?

Posture is described as the position a person holds their body at any one time. Humans evolved to adopt an upright bipedal (i.e. two-feet on the ground) stance. A person’s ability to adopt and maintain an upright posture is a balance between gravity acting on the body, and the strength a person has to withstand the constant barrage of that force. Because our bodies are so versatile in movement, it is possible for a human to take up many different postures. Standing and sitting are examples most people are familiar with.

Advantages and disadvantages

So why did humans evolve into an upright posture? What are the advantages of this position? Are there any disadvantages?

Advantages of an upright posture include:

  • It allows the arms to move freely
  • It allows the hands to be free to be used to carry out important tasks
  • It allows the eyes to be higher off the ground so that we can see further into the distance

We couldn’t play tennis, walk and talk on the phone at the same time, play guitar on stage, or see danger coming from a distance if we took up a permanent ‘all fours’ position. So whilst this posture allows humans to do wonderful things with their bodies, it does actually come with some disadvantages:

Disadvantages of an upright posture include:

  • It places greater loads on the spine, pelvis and legs
  • It is a less stable position than an ‘all fours’ or quadruped posture
  • It makes the heart work harder to pump blood to the brain

As osteopaths, we are particularly interested in this first example. Increased or excessive loads on certain joints of the body over time is a big risk factor for the breakdown of these body parts. Osteoarthritis classically affects the joints that take the most load through them throughout a person’s life. Common joints affected by this include the lower segments of the spine, hips and knees.

However, the body is resilient, and if looked after throughout life with good nutrition, good movement and regular servicing by an expert osteo, you can be sure the body will see you through life quite well.

When a person comes to see us for treatment of a problem, we always take posture into account. A person’s genetic make-up, age, gender, environment, emotions and level of physical activity can all play a role in how posture develops and is maintained. All things considered, a plan can be put in place to ensure your posture keeps you upright, moving well and looking into the future, as well as avoiding any nasty postural dysfunctions that can heavily impact your quality of life.

Having trouble being upright on your feet without pain? Call us today on 9078 2455

References

  1. Chila, AG. 2011. Foundations of Osteopathic Medicine. 3rd ed. Philadelphia: Lippincott Williams & Wilkins
  2. Magee, DJ. 2008. Orthopedic Physical Assessment. 5th ed. Edmonton, Canada: Saunders Elsevier
  3. Solberg, G. 2008. Postural Disorders & Musculoskeletal Dysfunction. 2nd ed. Edinburgh: Churchill Livingstone

Flat footed? Read on…

Have you ever been told you have flat feet? Or have you noticed that the arches in your feet are not quite the same as others? Although we are all a part of the same species, many of us have variations in our anatomy that make us unique. Look at a crowd of people and you’ll notice many different shapes and sizes. Our feet are the same. Some people have very developed arches in their feet, others have under-developed arches and have an almost ‘flat’ look to their feet. This phenomenon is known as ‘pes planus’.

Feet of woman doing exercises with rubber ball in clinic

Why does it occur?

There are two main reasons a person may develop flat feet. They are:

  • Congenital: A person is born with it and the feet fail to develop an arch through childhood into adulthood. A small percentage of the population have a connective tissue disorder which can leave the joints in the body less stable and more mobile. These conditions (namely Ehlers-Danlos and Marfans Syndromes) are also associated with having flat feet.
  • Acquired: A person develops flat feet as a result of trauma, tendon degeneration, or through muscular or joint disease.

Most babies will have a flat foot at birth, but usually by the age of 10, a strong and supportive arch has developed. For some people, the arch simply does not develop, and this may or may not lead to problems down the line.

Signs and symptoms

The obvious sign to look for is a flattened arch of the foot. If you look at someone from the front or slightly to the side, you may notice that the majority or whole of the inside border of the foot is touching the ground, as opposed to there being a clear space between the heel and ball of the foot.

What effect can this have on the body? It is quite possible and very common, for someone to have flat feet and have no symptoms at all. This is known as being ‘asymptomatic’. It may surprise you to know that only 10% of people with flat feet experience symptoms. These people are known as ‘symptomatic’.

People who do experience pain as a result of this condition do so because the lack of arch supporting the inside region of the foot has a knock-on effect to the mechanics of the rest of the limb. This then affects how the pelvis and spine function too. Pain in the middle part of the foot, heel, knee, hip and lower back are all common complaints. It is also not uncommon for someone with flat feet to experience recurrent ankle sprains, where they regularly ‘roll  the ankle.

Treatment

Do I need treatment if I have flat feet?” If you have no symptoms and having flat feet does not affect your life in any way, the answer is simply ‘no’.

If you have pain caused by this problem, then this is where we (and other professionals) come in. Pes planus is a great example of how a problem in one part of the body may lead to pain and dysfunction in a completely different part of the body. It’s an osteo’s dream! Not your pain, of course… However, we are experts at recognising the root cause of a problem and putting a plan in place to get it resolved fast.

Techniques we use may include soft tissue massage, joint mobilisation of the foot, ankle, knee, hip or spine and strengthening exercises. Exercises will aim to strengthen the arch itself, but may focus up the chain to the thigh, glutes and trunk as well. A large part of our job here is to also educate a patient on which footwear to use and whether or not they require the help of orthotics (these are special insoles for your footwear). Some children and adults may need some extra support inside their shoes to help reduce the effect of mechanical change up the limb. We may decide that you will benefit from seeing a podiatrist or other foot specialist who is able to design and supply you with insoles that are unique to you and the shape of your foot. Being obese can also increase the load on the lower limbs, therefore increasing the effects of pes planus in the process. In these cases, we can help to advise on how you go about losing weight through changes to your diet and exercise regimes.

For the majority of cases, a combination of these treatments above will result in improved mechanics and reduced pain, allowing the patient to continue doing the things they love. For the very few people who do not respond to treatment, an orthopaedic specialist’s opinion may be required for long term management. This is always a last resort.

Check out your feet. Do you have a flattened arch when you stand up and weight bear? Is there any associated pain? If so, call us today on 9078 2455 and we’ll tell you what needs to be done to beat the pain! Arch you glad you read this now?! 😉

References:

  1. Radiopedia. 2020. Pes planus. [Online]. Available from: https://radiopaedia.org/articles/pes-planus. [Accessed 08 May 2020].
  2. Raj, MA. et al. 2020. Pes Planus. Stat Pearls. [Online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430802/. [Accessed 08 May 2020].

Pandemic posture

Hey readers, it’s your favourite osteo checking in to see how you are going! I ha’s been, and continues to be, uncertain times for many of us as the virus pandemic continues to sweep across the globe. Lockdown has meant many of us have had to batten down the hatches and re-discover what it means to be ‘at home’. We ask you the question “how is your body being affected.

Let us take you on a scan of the body, focus on some potentially problematic areas, and give you some advice to avoid any long-term issues.

Head and neck

Handsome young man sitting on sofa at home. Incorrect posture concept

First stop is the very top! For all of you that normally head out to the office every day, the pandemic might mean you’ve had to start working from home. Not having your usual desk set up can place a great deal of stress on the neck region. Are you now working on a laptop instead of a desktop computer? Are you sitting on the sofa instead of an adjustable chair? Close your eyes for 30 seconds and hone your thoughts in to your neck. Move it around… How does it feel? Is it tight, restricted or does your head feel heavier than usual? It could be that your new ‘desk’ set up’ is causing some strain in places it doesn’t usually. Think about the effect of having your head looking down at a laptop for 8 hours a day compared to straight up at a monitor set to the ideal height… Your poor muscles must be feeling the strain too.

We recommend trying to recreate your office space as close as possible to the real thing. If you don’t have a desk at home, a dining table may be more suitable than sitting on a sofa or armchair. You also need to ensure you are moving your neck and shoulders more regularly to avoid them being in a strained position for too long. Take a break every 30 minutes and move into a different position.

Spine

Our spine sits at the core of the body, and we need good function throughout to ensure our limbs can also function with minimal effort and maximum efficiency. Are you used to an active job and now you find yourself homeschooling the children, or trying to break the day up with a bit of reading, gaming, TV or doing a crossword? Life is suddenly much more sedentary for most of us, so it’s important to avoid getting stiff. Sitting with poor spinal posture for extended periods, day after day can wreak havoc. Our spines curve ‘out  in the mid-back and ‘in ’ in the lower back. If we don’t look after those curves carefully by protecting our posture from excessive strains, then we leave ourselves open to sore backs and poor functioning limbs as a result.

We recommend avoiding long periods of sitting or lying down. Save it for bedtime! Try some standing spinal twists or bends (gently, of course), go for a walk around the garden, or do a session of yoga, Pilates or simple stretching through the day to mobilise your spine. If you have kids, get them to do it with you. They will enjoy a break from their school work, no doubt.

Hips

Anyone who works in a seated position knows what effect this can have on the hips. Having your hips in a ‘flexed’ or in a seated position for long periods of time can leave your hip flexor muscles tight and short. This decreases your ability to open the body out into a fully straight position, reducing flow of fluids through the central part of your body and leaving the back chain of muscles in a lengthened state, which can eventually result in the weakening of the chain.

We recommend lots of upright exercises for this one. Counteract the time spent seated  working or binge watching a TV series with some standing-based exercise. Jumps, skipping, walking, running or bridging is a nice way to open those hips and get the blood flowing.

Our underlying message through all of this is to move, move, move! You are a movement machine, so regularly start the ignition and go for a spin. Look after yourselves and please get in touch today on [insert clinic number] if you need help keeping your pandemic posture in check!

References

  1. Office of Industrial Relations. 2012.  Ergonomic guide to computer based workstations. [Online]. Available from: https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0006/83067/guide-ergo-comp-workstations.pdf. [Accessed 04 May 2020]

Injury blog: Spondylolisthesis

Hello readers! Our blog this month focuses on a spinal condition that in the sports world most commonly affects cricketers and gymnasts, but in reality, can affect anyone! The condition is known as spondylolisthesis (pronounced ‘spon-di-lo-lice-thee-sis’) and most commonly affects the lowest segments of the lower spine region.

Spondylolisthesis is the slipping forward of one vertebra on another. This most commonly occurs at the L5 segment (the lowest vertebrae in the lumbar spine), which slips forward on the S1 segment of the sacral bone. The runner up? L4, which is also a commonly affected area.

What is spondylolisthesis? 

There are a few different causes of this condition, and so it has been classified into different types. There are five categories of spondylolisthesis. These are:

  1. Degenerative: Occurs due to degenerative changes to the spinal facet joints and discs
  2. Isthmic: Occurs due to a bone defect in a part of the vertebrae known as the ‘pars interarticularis’
  3. Traumatic: Occurs following a trauma that results in a fracture of either the spinal facet joints or pars interarticularis
  4. Dysplastic: Occurs due to a developmental defect of the vertebrae which alters the direction of the spinal facet joints, leaving the segment(s) open to slippage in the area where they are partially held in place by the facet joints.
  5. Pathologic: Occurs secondary to a medical problem such as infection or cancer

In theory, any process that leads to the weakening of the supportive structures of the spinal segments (i.e. the bones, ligaments, discs, muscles) can lead to abnormal movement of the spine.

Grades of spondylolisthesis

Spondylolisthesis is further classified based on the amount of slippage that has occurred:

  • Grade 1: Between 0-25% of the vertebral body has slipped forward on the vertebrae below
  • Grade 2: Between 25-50% has slipped forward
  • Grade 3: Between 50-75% has slipped forward
  • Grade 4: Over 75% of the vertebral body has slipped forward

The most commonly reported grade of this condition is grade one, accounting for approximately 75% of all cases.

Signs and symptoms

These vary depending on the cause, but can include any or all of the following:

  • Low back pain, including pain in the buttocks
  • Pain along the back of the thigh which rarely goes lower than the knee
  • Tight hamstring muscles
  • Changes in walking pattern
  • Pins and needles and/or numbness down the legs
  • Bowel and bladder dysfunction (in more severe cases)

If you come to us with low back and/or leg pain, we are trained to work out exactly what is going on based on your symptoms and medical history. We will ask you lots of questions to begin with to dwindle our list of potential diagnoses to just one or two. Then we’ll get you to move and through a thorough movement assessment, will be able to come to a specific diagnosis that we will work with you to treat.

Sometimes we may require the help of imaging to rule in or out spondylolisthesis, depending on the severity of symptoms and how much it is impacting your life. In these cases, we will send you off for an x-ray which can detect this issue.

Treatment

Most cases of spondylolisthesis can be managed conservatively, meaning non-surgical options are chosen over a surgical one. When this injury occurs, the instability of the particular spinal segment can lead to many of the signs and symptoms mentioned above. One of the main goals of treatment is to increase stability around the affected area and offload the forces that are acting on the injured area.

We will spend time educating you on the mechanics of the spine. If you understand what is happening to your spine, you will know how to protect it, without adding unnecessary stress to the area. We will also advise on appropriate footwear, as well as standing, seated and sleeping postures. Being obese or overweight is also a risk factor for developing, as well as maintaining this problem. If you need to lose weight, we can help you formulate a plan to get there.

Exercise to increase core stability, as well as flexibility of tight muscles is a very important part of therapy as this will reduce the need for external supports such as braces in the long term. And of course, not forgetting our wonderful hands which will get to work on your muscles and joints to reduce tension and tightness, while increasing range of motion.

All of the above treatments will help you to manage pain, increase function and get you back to work or sport or gardening… Whatever your goal is! Call us today on 9078 2455 if you have low back pain, or even if you already have a diagnosis of spondylolisthesis, and we can help you formulate a recovery plan to get you on the road to better health.

Osteoarthritis

Knee pain in the middle to late decades of life is a common complaint amongst patients presenting to osteopathic clinics across the globe. Osteoarthritis (OA) is a common cause of knee pain in this age group of people. Research suggests approximately 654 million people aged 40 years and over were living with knee OA in 2020 around the world. This comes at an incredible cost to healthcare services worldwide, with figures in the billions of dollars! 

What is osteoarthritis?

Osteoarthritis is just one of a number of forms of arthritis… Essentially a disease which affects the joints in our body. OA is the most common form of arthritis, with Rheumatoid Arthritis (RA) being the second most common form. This blog will focus on OA, a potentially debilitating disease that most commonly affects the weight-bearing joints of the body (i.e. the knees, hips and lumbar spine), but can affect any joint in the body where the joint surfaces are covered in cartilage.

The characteristics of OA include loss of the cartilage that covers the ends of bones that come together to form joints. The underlying and surrounding bone, as well as other joint structures (including joint capsules and other tissues) are also susceptible to degenerative changes that ultimately lead to poor functioning of a joint. The process usually occurs over a long period of time, often starting early in life (interestingly with little to no symptoms at all) and progressing into the latter years. The severity of the disease varies from person to person with some people only experiencing mild symptoms throughout their life. Other people experience more severe symptoms and may require joint replacement surgery as a last port of call to ensure they can continue to live their life as pain-free as possible.

Osteoarthritis of the knee can affect either of the two main joint components of the knee… The joint between the ends of the thighbone and the shin-bone (called the tibiofemoral joint), and the joint between the thigh-bone and the knee-cap (called the patella-femoral joint).

Risk factors

There are certain factors associated with higher rates of knee OA. These include:

  • Age: Rates of knee OA increase in the elderly
  • Obesity: Rates of knee OA increase with higher levels of obesity
  • Gender: Females slightly out-do the males with this one, being approximately 1.5 times more likely to develop it
  • Trauma: A trauma to the knee can increase your likelihood of developing knee OA
  • Smoking: Smoking is associated with higher rates of knee OA

Signs and symptoms

The signs and symptoms of knee OA include:

  • Pain
  • Stiffness
  • Swelling
  • Reduced range of motion
  • Difficulty performing functional movements including squatting and kneeling

Pain associated with tibiofemoral OA commonly affects the inside region of the knee first, where the two bones meet at the joint line. Patella-femoral related pain is often felt deep behind the kneecap. Pain will vary from one person to another, and the severity of pain does not necessarily relate to the severity of degeneration. Although if you speak to a person who is about to have a joint replacement surgery (i.e. their joint has degenerated to the point of needing a surgical intervention to keep the person functioning well), they will likely tell you that the pain is extremely debilitating.

Pain and stiffness are regularly felt first thing in the morning and late at night. OA tends to respond well to movement of the joints, and so people often find their pain and stiffness improves once they are up and moving, for it to return once their day has finished and they are relaxing at night.

Treatment

So, you’ve been diagnosed with knee OA. What to do? Call your osteo… Ta-dah!!!! Given we are experts in how the human body moves (we study human biomechanics at uni), we’re good at picking up how the body should and shouldn’t move. There are no magic pills for treating OA of the knee, and no practitioner can claim to treat the disease itself, as there is unfortunately no cure for OA. It is a progressive, degenerative disease, but there are ways of stunting the progression of this condition if the risk factors leading to its presence are attacked head on.

Poor movement resulting from daily postural repetitive strain, or an old injury that wasn’t treated to resolution is a big factor in the maintenance and development of OA in the knee. Poor movement or dysfunction occurring in the low back, hip or ankle can all lead to excessive load being placed through the knee joints, which can exacerbate the disease process. This is where we come in. We can watch you move during an assessment and work out what is causing the excessive loads through the knee and put a plan in place to improve range of motion and flexibility, strengthen muscles and return you to (hopefully) pain-free daily activities. We will use a combination of soft tissue manipulation, joint mobilisation and progressive exercise programs to restore life to your body. Returning to efficient movement patterns after years of neglect, poor movement and a de-conditioned body part will take time, but with determination from both you and your practitioner, it can happen.

As previously mentioned, some cases of knee OA can end up requiring surgical intervention to replace either part of or the whole joint. The good news is, if you do have to go through this process, we have your back (well… in this case, your knee) and can help you through rehab and recovery. Many people who have a knee replacement return to full daily activities and live a long and pain-free life.

Knee pain? What are you waiting for? Call us today on 9078 2455 and we’ll help you book your appointment today, or you can always click on our ONLINE BOOKINGS to book your own appointments too.



References
1. Cui, A. et al. 2020. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 100587. 29-30. Available from: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2820%2930331-X

2.  Arthritis Australia. 2016. Counting the cost. [Online]. Available from: https://arthritisaustralia.com.au/wordpress/wp-content/uploads/2017/09/Final-Counting-the-Costs_Part1_MAY2016.pdf. [Accessed 09 February 2021]

3. Centres for Disease Control and Prevention. 2020. Cost statistics: The cost of arthritis in US adults. [Online]. Available from: https://www.cdc.gov/arthritis/data_statistics/cost.htm. [Accessed 09 February 2021]

Getting to the bottom of stress

Are you a stressed individual? Do you find it difficult to cope with the load of life, and regularly find yourself freaking out when it all gets a bit much? You are not alone. Coping with stress is something we all have to do and some of us are better at dealing with it than others. Some of us even thrive off that stress. If you want to get to the bottom of controlling stress in your life, it is first useful to understand what stress is.

First and foremost, stress is not always bad. It can actually be very good for us and have an incredibly positive effect on our lives. Other times it can have the opposite effect. The things in our lives that ultimately lead us to feeling stressed are called ‘stressors’. A stressor is anything that places a demand on us. The feeling or reaction we get from that stressor, be it physical or emotional, is the stress so many of us talk about.

Types of stress

When that demand has a positive effect on us, it falls under the category of ‘eustress’ (pronounced ‘you-stress’). These types of stressors promote feelings of motivation, excitement and generally drive us to be more productive and happier. Examples of eustress may include getting a new job, getting married, buying your first home or going on holiday.

When the demand has a negative effect on us, we call this ‘distress’. Feelings of distress include anxiety, worry and concern, which generally lead us to become less productive in our lives. Examples of distress include losing a job, getting divorced, selling your long-term family home or injuring yourself.

Coping with stress

If you are finding yourself living a life of constant ‘distress’ and things are getting too much, then it’s useful to know some techniques / things to try to offload the stress. A barrage of negatively stressful situations over a long period of time can have a negative effect on your mental and physical health. It’s good news however, that some of the most effective treatments for stress management are simple and easy to implement into your life with a little bit of planning.

Examples of stress management techniques include:

  • Breathing: This sounds simple, but you’d be surprised how poorly some people breathe. Time spent going through some deep breathing exercises, learning to use your diaphragm and abdomen, can really calm the system when you’re feeling stressed.
  • Exercise: One of the best things you can do to flip stress on its ugly head is to get out and move. Walk, jog, run, cycle, go to the gym, kayak, rollerblade, play basketball or football, anything… Literally anything that can take you out of the stressful situation and allow you to focus your mind elsewhere can have a profound effect on helping you control those distressful feelings and reactions. Having a regular hobby is something we strongly recommend you consider bringing into your life. Break up the rat-race!
  • Planning: If life is hectic, and that stresses you out in a bad way, try planning your life a bit more. Have a schedule you can easily stick to. Maybe some order in your life is just what you need. Disorder is most definitely one of those ‘distressors’ for many people. You can plan meals, have a bedtime schedule for the kids, an exercise schedule for you and your partner, or a work schedule which allows you to plan some down-time during the day to unwind a little bit before it all kicks off for the afternoon.
  • Drink water, eat healthily: If you are good at hitting your water, fruit and vegetable targets each day, and steering clear of the indulgent foods, you’ll know how good you can feel from that alone. Having a poor diet and leaving yourself dehydrated each day is itself a negative stressor for your body. You’ll likely feel sluggish, tired, irritable and demotivated. How are you then meant to deal with all the other demanding tasks being thrown at you day-to-day? Give yourself a healthy baseline and your bucket may not overfill quite so quickly.
  • Talk: A great way to deal with stress is to talk it out with a loved one, close friend, or a professional. Being stressed can leave you feeling helpless and unable to organise your thoughts and feelings into something that makes sense to you. Why not have a little help? A doctor, psychologist, life coach or counsellor may be just what you are looking for. They can teach you ways to organise your mind, calm your life and leave you feeling ready for each day.

If you would like to learn more about stress, the effect it can have on your body, and ways in which to deal with it, please speak to us next time you are in. Osteopaths are full of wise, helpful lifestyle advice that can help you to start leading the life you want. We can also help put you in touch with the right professionals, should you want to go down that path.

References

  1. Healthline. 2019. Eustress vs. Distress: When Your Stress Might Actually Be Doing You Good. [Online]. Available from: https://www.healthline.com/health/how-to-harness-eustress. [Accessed 08 February 2021]
  2. Li, CT. et al. 2016. Eustress or distress: an empirical study of perceived stress in everyday college life. [Online]. Available from: https://www.researchgate.net/publication/308043050_Eustress_or_distress_an_empirical_study_of_perceived_stress_in_everyday_college_life. [Accessed 08 February 2021]

Connective tissue disease

Welcome readers! The human body is made up of trillions of cells. Recent findings suggest as many as 30 trillion cells combine to form the human body at any one time. That’s pretty much impossible to comprehend. But combine they do, and what beautiful forms we are! Have you ever thought how all those cells stay together so well? Well… Our intricate and amazing bodies contain special tissues (made up of proteins) known as ‘connective tissues’ (CTs), which act as a glue to hold everything together. Without connective tissue, we may just exist as one big blobby puddle on the floor!

As well as their glue-like property, CTs allow the tissues of the body to stretch and recoil… A little bit like an elastic band. Some common examples of proteins that make up the CTs in the body include ‘collagen’  and ‘elastin’  (you may have heard of these before). It is possible for a person to have a disease which directly affects the CTs of the body. Collectively these are known as connective tissues diseases (CTDs), or diseases of connective tissue. As connective tissue is found all over the body, nearly all of the body can be affected. CTDs may affect the skin, blood vessels, blood, muscles, fat, bones, cartilage, tendons, ligaments and other joint-related tissues. Even the eye can be affected!

Types of CTD

There are two main types of CTD… Genetic and autoimmune. We’ll explain what these mean:

  • Genetic: These types of diseases are inherited. This is usually because of a single mutated gene that is passed on from your parents to you.
  • Autoimmune: These types of diseases occur because your body’s defence system (aka the immune system) views the CTs as foreign and attacks them. This results in a painful, inflammation-driven condition where a person regularly experiences redness, heat, swelling and pain in specific parts of their body.

Genetic CTDs

Examples of genetic diseases of CT (with a little description of each) include:

  • Ehlers-Danlos syndrome: Affects the collagen in our body, resulting in excessively stretchy skin, hyper-mobile joints and abnormal scar tissue formation. There are over ten forms of this condition.
  • Marfans syndrome: Affects fibrillin (a protein) in the body, resulting in longer bones and thin and long fingers and toes. People with Marfans are usually very tall and slender.
  • Osteogenesis Imperfecta: Another condition that affects collagen, resulting in brittle bones, weak and thin skin, loose ligaments and a lower than average muscle mass.

Autoimmune CTDs

Examples of autoimmune diseases of CT include:

  • Rheumatoid arthritis (RA): The body attacks the membranes that hold the joints together resulting in pain, stiffness, degeneration and destruction of joints throughout the body. RA typically affects the small joints of the hands and feet.
  • Sjogrens syndrome: A disease which typically leaves a person with an excessively dry mouth and eyes. People also regularly experience joint pain.
  • Systemic Lupus Erythematosis (SLE): A condition that causes inflammation of the skin, internal organs and joints. Other symptoms include mouth ulcers, heart, lung and kidney problems, hair loss and mental health issues.

It is useful to point out there are many other CTDs. Having one CTD means you are more likely to have other CTDs as well.

Treatment

So where does my osteo come into the equation? Being the holistic practitioners we are, we can help in many ways. People with CTDs regularly need help with joint range of motion, as well as an exercise program to help strengthen the body. Treatment and exercise need to be carefully planned out with CTDs, so having someone with experience to help you manage a potentially difficult condition is always handy. We can also help to educate you on what the diseases are, and how they affect you to ensure you have the correct self-help strategies in place.

Have you been diagnosed with a CTD? If so, get in touch today for an appointment. We’d love to be a part of your team!

References
1. Healthline. 2018. Diseases of connective tissue, from genetic to autoimmune. [Online]. Available from: https://www.healthline.com/health/connective-tissue-disease#types. [Accessed 16 Dec 2020]

2. Genetic and rare diseases information centre. 2014. Mixed connective tissue disease. [Online]. Available from: https://rarediseases.info.nih.gov/diseases/7051/mixed-connective-tissue-disease. [Accessed 16 Dec 2020]

3. Science Direct. 2019. Connective tissue disease. [Online]. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/connective-tissue-disease. [Accessed 16 Dec 2020]

4. Healthline. 2018. How many cells are in the human body? Fast facts. [Online]. Available from: https://www.healthline.com/health/number-of-cells-in-body. [Accessed 16 Dec 2020]