Month: December 2020

Clinical Case – Subacromial Pain Syndrome

Posted on December 23, 2020 by - Category One

Subacromial Pain Syndrome is an umbrella term for non-traumatic, usually unilateral, shoulder problems that produce antero-lateral shoulder pain often worsening during or after lifting the arm.

This term encompasses pain involving one or more structures within the subacromial space. It is thought to represent between 45-65% of all complaints of shoulder pain.

This comprises conditions such as:

  • Subacromial bursitis
  • Rotator cuff tendinopathy or rotator cuff tears
  • Biceps tendinopathy or
  • Rotator cuff tendinosis

Three main mechanisms are thought to be involved in the pathogenesis of subacromial pain syndrome:

  • Reduced scapular control
  • Reduced humeral head control
  • Change to the actual size of structures within the subacromial space (rotator cuff tendons, subacromial bursa etc).

Patients will usually present with:

  • Weakness (particularly external rotation)
  • Limited range of motion (flexion and abduction primarily)
  • Pain that radiates down the upper arm (stopping above the elbow)
  • Pain worse at night with difficulty sleeping on the affected side.

Three useful tests in clinic to aid in the diagnose subacromial pain syndrome are as follows:

  • Hawkins Kennedy
    • Taking the patient into internal rotation passively with the arm in 90 abduction and 90 degrees elbow flexion
  • Painful arc
    • Pain with shoulder abduction from 60 – 120 degrees. Pain should ease towards the top however if it reappears at 170-180 degrees this may indicated ACJ involvement.
  • Resisted external rotation in neutral
    • Pain +/- weakness with resisted contraction either during or on release.

Initial conservative management would comprise of:

  • Relative rest and limitation of aggravating activities
  • Strengthening and mobility program to address relevant deficits over an 8-12-week period.
  • NSAIDs to help with pain and inflammation
  • A cortisone injection is unlikely to be needed as first line management unless pain is severe and preventing the patient from participating in rehabilitation.

Surgical management is usually only considered after a failure of conservative management after 3-6 months.

 

Matt Delaney – Physio Plus Footscray

HAPPY CHRISTMAS

Posted on December 16, 2020 by - Category One

Happy Christmas to the Physio Plus family and support crews.

We look forward to looking after each and every one of you in the closing days of 2020 and are excited about a great 2021.

Opening hours have now been updated on each of the practice google info pages.

HAPPY CHRISTMAS!

Injury prevention program

Posted on December 9, 2020 by - Category One

Before shift start this morning for the Mackay Ring Road Northern Access project team of Plant Operators, Labourers, Concreters, Carpenters, Steel fixers and Form workers, Tom and Jess ran an information session on occupational health and risk minimisation techniques.

The session included stretches and strengthening exercises for the team to complete before starting their physical work day in the hope that they can reduce risk of workplace injury and best management of their most important tools, their body.

Thanks to our partners on the Mackay Ring Road project for their continued support of preventative occupational health and injury prevention measures.

Athlete Across the Lifespan Symposium

Posted on December 2, 2020 by - Category One

A couple of weekends ago, Mike and Mick completed the APA run Athlete Across the Lifespan Symposium. It was a particularly informative day that allowed Mike and Mick to build on their current knowledge of athletes from a variety of sports and from all age brackets.

The Sports and Exercise Symposium was designed specifically for experienced physiotherapists, bringing together an impressive group of renowned sports and exercise practitioners.
The program featured complex case presentations focusing on diagnostic clinical patterns, aetiology and research-informed management of challenging athletic presentations across the lifespan.
Brought to you by the Australian College of Physiotherapists and Physio Educations, the program included:
  • The younger athlete: Physiological developmental considerations of muscle, tendon and bone in the younger athlete – APA Musculoskeletal and Sports and Exercise Physiotherapist Dr Dave Spurrier
  • Lumbar stress fractures in developmental cricketers – APA Musculoskeletal Physiotherapist Dr Kevin Sims, FACP;
  • An adolescent knee presentation – APA Sports and Exercise Physiotherapist Dr Loretta O’Sullivan Pippia, FACP;
  • Growth plate injuries in young gymnasts – APA Sports and Exercise Physiotherapist Mr Phil Cossens, FACP;
  • Hip and groin pain in young athlete – APA Sports and Exercise Physiotherapist Dr Andrea Mosler, FACP;
  • An elite athlete with boney stress injury: Critical clinical decision-making – APA Sports and Exercise Physiotherapist Mr Dave Battersby, FACP;
  • Physiological considerations for the older athlete – Professor Robin Daly;
  • Shoulder dislocation presentations across the lifespan – APA Musculoskeletal and Sports and Exercise Physiotherapist Dr Mary Magarey, FACP;
  • The post-menopausal athlete – APA Sports and Exercise Physiotherapist Ms Keren Faulkner, FACP;
  • How similar injury aetiology presents and is managed differently in younger and older athletes – Expert panel hosted by APA Musculoskeletal and Sports and Exercise Physiotherapist Jane Rooney, FACP.