Author: Michael Ranger

Clinical Case – Subacromial Pain Syndrome

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

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

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

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.

Our fantastic fingers.

Fingers, digits or phalanges, are the organs that we as humans use to manipulate, feel and move the objects that we need to live.

The use of our fingers and thumb set us apart from other primates.

Each finger has 3 bones connected with a complex network of joints and ligaments. Ligament injury and joint dislocation can inhibit function in the short term but if managed well shouldn’t impact long term function.

Other injuries involving the fingers include fracturemallet and trigger fingers. To find out more please visit the ‘Your Body’ page on our website.

Physio Plus Tropical Christmas 2020! 

Qld Christmas party 2020
Physio Plus Tropical Christmas 2020!🎄🌴
We look forward to our QLD team Christmas Party every year! So great to enjoy each other’s company and thank each other for the incredible work we do together.
Who could have predicted 2020? A horrible pandemic – currently at least 53 millions COVID cases and 1.3 million deaths worldwide. Masks became normal attire. Toilet paper sales skyrocketed. The Tiger King brought us together. Zoom became a verb. Telehealth became normal (we’ve been doing it since 2013!). The world has a renewed appreciation of science and health…
We rose to this challenge, we adapted, we innovated and we got through it together. But we’ve done better than just got through it, we’ve grown – our team is bigger and better than ever and we’re doing more than ever to improve #health in our community and across Australia.
What an honour to work with such a fantastic team! Thanks to the wonderful #Makcay and #Whitsunday communities we work in and thanks to the great team at The Dispensary Mackay for hosting our celebration! #Christmas 😀🎄 #Physio #EP #OT #Pilates www.physioplus.com.au🌴🌴 @thedispensarymackay @physioaustralia

Knee injuries

The knee is a particularly important hinge joint that connects our thigh to our lower leg. The bend available at the knee joint allows us to clear our foot and toes from the ground when we are walking and in conjunction with the hip and ankle, flex and extend at complimentary angles for best motion.

Injury to the knee can be debilitating due to it being a weight baring joint required for all upright locomotion.

Patellofemoral joint pain (PFJ) tends to cause significant pain particularly with deep knee flexion positions and walking down stairs and down hill.

Traumatic knee injuries caused by impact, twist and turn mechanisms while working or playing sport include ligament and cartilage injuries. Sports such as football, netball, rugby, lacrosse and hockey are sports that tends to have a high incidence of ACL and other ligament injuries. Cartilage can also be impacted through excessive use and awkward positions under load.

Total knee replacement is the end result if knee osteoarthritis is so significant that discomfort when weight bearing is close to constant. Arthritic changes are graded 1-4 with 1 being minimal and 4 being full loss of chondral surface cartilage.

Self treatment packs

Recently, as part of the ongoing relationship Physio Plus Footscray has with the Maribyrnong City Council (MCC) in providing best practice early intervention programs for all staff, 150 self treatment packs including trigger point therapy balls, self treatment instruction and exercise sheets and tips and tricks on minimising the chance of injury information were put together by the Physio Plus Footscray team. We can’t wait to hear how well all the MCC staff are going treating themselves and their loved ones at the end of their working day.

To be the most functional and effective version of yourself, you need to spend a little bit of time making sure that you are firing on all cylinders. Don’t neglect yourself, you are important!