Spinal Stenosis - Physio Direct NZ

Spinal Stenosis

What is spinal stenosis?

The spinal cord, nerves and arteries are housed by the spine, which acts as a hard electrical casing to support and protect these vulnerable structures. The spine has a hollow column that allows the spinal cord to run from the brain to the rest of the body. At each spinal segment, nerves exit the spine and supply the tissues of the body. There is also an intricate network of small veins and arteries that provide blood to the spinal cord and vertebrae, providing them with the nutrients needed to operate.

Spinal stenosis is characterized by a narrowing of the spaces that house the spinal cord, nerves and blood supply. A variety of factors can cause spinal stenosis, however overwhelmingly it is caused by degenerative changes to the spine as we age. Many people over the age of 60 will have spinal stenosis; however, not all will have pain. Clinically, spinal stenosis is used to describe the painful symptoms of this condition rather than just the narrowing itself.

What are the symptoms?

Pain with walking or standing that radiates into the hips, thighs and even feet is the hallmark of spinal stenosis. Usually, this pain will be reduced with rest and forward movements of the spine. Spinal stenosis is a progressive condition and symptoms will gradually increase over time. The pain is often described as a deep radiating ache and can be associated with fatigue, heaviness, weakness and numbness. It can affect just one leg, however more often will be felt in both legs.  There will often be associated back pain; however, leg pain is usually the most severe complaint.

How can physiotherapy help?

There are many conditions that need to be excluded before a diagnosis can be made. Your physiotherapist is able to conduct a thorough examination and accurately diagnose this condition. In some cases, imaging may be requested. As mentioned earlier, many people have stenotic spinal changes without symptoms. Surgery to decompress the restricted nerves and stabilize the spine are used in very severe cases. 

For mild to moderate cases of spinal stenosis, physiotherapy can be extremely beneficial.  Your physiotherapist can help you manage your pain through hands-on techniques and by providing a targeted exercise program based on biomechanical assessment. They are also able to help you to understand and manage your day in a way that helps to reduce flare-ups and maintain muscle strength.

If surgery is the right choice for you, your physiotherapist is able to guide you through this treatment pathway, helping you to prepare and recover from surgery to get the best outcome possible. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your condition.

Tips For Exercising When You Have Pain - Physio Direct NZ

Tips For Exercising When You Have Pain

One of the most challenging aspects of living with an injury or chronic pain is how it can quickly impact your exercise routine. If you have been working towards a fitness or weight goal, this can be extremely demoralizing. Here are a few tips that can help to keep you on track while you recover. Staying as active as possible during this time can mean you’re in the best position to reach your goals again once your injury has healed.

1. Try a new activity.

When injury strikes, it can be tempting to stop exercising altogether and rest while you recover.  An injury can be frustrating, but it can also be an opportunity to try out a different sport. If you’re a runner with an ankle injury, you can keep up your fitness by swimming instead. Cycling can be an excellent option for people for dealing with knee pain, and if you’re a swimmer with shoulder pain, maybe switch to running for a while. Check with your physiotherapist for some ideas to keep you moving. 

2.  Exercise within your limits.

If you’re getting pain at 5km, this doesn’t always mean you should give up running altogether. Your physiotherapist can help you monitor your symptoms carefully and plan an exercise routine that keeps your fitness up while reducing symptom flare-ups. Staying as active as possible throughout your recovery can also mean that you a better placed to get back to your best performance once symptoms reside.

3.  Take the opportunity to improve your footwear and equipment.

Injury and pain can be a great prompt to look at your equipment and technique. For example, with hip and knee pain, the type of shoes you wear can have a significant difference. Often pain has more than once cause, with technique and equipment more often than not having a substantial impact on the stress placed on your body. Your physiotherapist is an excellent source of advice in this area, don’t hesitate to ask for an assessment.

4. Take to the water

Hydrotherapy has long been used to help patients with joint pain or muscle weakness exercise. The water helps reduce joint stress and provide extra sensory input that can reduce pain. Exercising in water can be especially helpful for sufferers of chronic pain or those who have pain with weight-bearing.   Speak to your physio for a hydrotherapy program if you’re not sure how to approach exercise in water.

Our physiotherapists are happy to discuss your condition with you and share their tips to help you stay pain-free.  None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your condition. 

Pumpkin and Parmesan Risotto - Physio Direct NZ

Pumpkin and Parmesan Risotto

Pumpkin and Parmesan Risotto

Ingredients:

½ Small Pumpkin

2 cups Arborio Rice

½ Small Red Onion

2 Tbsp. Olive Oil

1 handful Fresh Basil

2 Clove of Garlic

2 cups Vegetable Stock

½ Cup White Wine

100g Fresh Parmesan

Salt and Pepper

  1. Chop pumpkin into small cubes, roughly 1-2cm cubes and place in pot of salted boiling water. Cook for 10-15 minutes or until soft. Strain excess water and set aside. In a large frying pan, add salt and pepper, diced red onion, crushed garlic clove and olive oil. Heat to medium temperature and add Arborio rice, stir until completely coated in oil.
  2. Add cooked pumpkin pieces to the frying pan and stir gently for 2-3 minutes. Gradually add vegetable stock, one tablespoon at a time, stirring slowly. Once all the vegetable stock has been added, stir through white wine.
  3. Cover risotto and reduce to low heat. Stir occasionally and add extra water if necessary. Once risotto is soft, add grated Parmesan cheese and serve immediately.

Garnish with basil and balsamic glaze. Serves 4

Wrist Sprains - Physio Direct NZ

Wrist Sprains

Wrist sprains are a general term used to describe any injury to the wrist that doesn’t include a fracture. While this can indicate that they are not serious injuries, wrist sprains can be complicated injuries that require supervision and treatment to recover fully.

The wrist refers to the area where the bones of the forearm, the radius and ulna, meet and join the bones of the hand. The wrist is able to twist on itself and allows the hand to move to face palm up (supination) or palm down (pronation). The hand is also able to move up and down (flexion/extension) and side to side (abduction/adduction). To allow such complicated movements, the joint surfaces of the wrist are held together by a series of ligaments. When a wrist is sprained, it is usually these ligaments that have been damaged.

What are the symptoms?

The primary symptom of a sprained wrist is pain with movement of the joint or when taking load, such as when holding a heavy object.

Ligament injuries are given a grading scale to indicate their severity, which can help to guide treatment. Grade I tears refers to a stretching or laxity of the ligament fibers and injuries of this grade usually heal with rest within 2-3 weeks. A grade II classification signifies that there has been a partial tear of the ligament fibers and will often need more time and treatment for recovery. Grade III tears refer to a full thickness rupture of a ligament and may require splinting or even surgery.

The most common cause of a wrist sprain is a fall onto an outstretched hand. Ligament injuries can also happen gradually through over use, although this is less common.

What is the treatment?

Your physiotherapist is able to help diagnosis a wrist sprain and can help to rule out a fracture. An X-ray might be required and your physiotherapist will perform special tests to help identify exactly which structure has been injured, giving the injury a grade, to help guide treatment.

How can physio help?

The key to effective recovery for a wrist sprain is often in ensuring that the right treatment protocols are in place for your injury. Grade I sprains will recover best with gentle exercises and early strengthening while Grade II to III injuries may require splinting or even a surgical consult for repair.

If surgery is the right course for you, your physiotherapist is able to guide you through this treatment pathway, helping you to prepare and recover from surgery to get the best outcome possible.

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. 

How To Make The Most Of Your Physiotherapy Treatment - Physio Direct NZ

How To Make The Most Of Your Physiotherapy Treatment

Physiotherapy treatment can be life changing, helping you recover from traumatic injuries, chronic pain and get you on the road to your best performance levels. Here are a few tips to make sure you get the most out of your physiotherapy treatment.

1. Ask your therapist questions about your injury

Understanding your condition and how to best manage it is one of the most important factors for a successful recovery. Effective therapists allow time for you to ask questions in a non-judgmental environment. There are no stupid questions, if you don’t understand what is happening in your own body it is harder to follow advice and stick to protocols. This can also help you to cope with pain and feel less helpless in your recovery.

2.  Follow your therapist’s advice and do your exercises

Home exercises are a key part of your recovery, especially when treatment times are limited. Try to stick to your exercise program as seriously as you would a medicine schedule. It is also important to ensure that you are doing your exercises correctly at home. Don’t be afraid to double and triple check your technique before leaving your appointment.

Your therapist will also provide you with advice regarding activities to avoid, how to stretch, when to rest and how to avoid further injury. If you’re not sure about something, ask your therapist to write it down for you.

3.  Notice your improvements

Nothing can be more disheartening than feeling like the appointments and exercises you’re dilliegently attending to are making no difference. As thereapists, we make regular measurements to track your improvement and know that while  your symptoms might  be staying constant, you are  actually moving more and increasing stress on your body as you recover. Set your own measurements to help you track your recovery. This can help you stick to treatment and feel more positive as you complete your recovery journey.

4. Set goals and work with your physio to meet these.

The goals of recovery are different for everyone. Some of us want to be able to reach peak performance, such as running a marathon. For others, just getting through the day with a little less pain would be a huge success. Know your own goals and take the time to discuss this with your therapist, who will guide your treatment to help you meet these milestones.

Our physiotherapists are happy to discuss your condition with you and share their tips to help you stay pain-free. 

Osteoarthritis of the Knee - Physio Direct NZ

Osteoarthritis of the Knee

What is it?

Osteoarthritis (OA) is a common degenerative joint disease that affects almost all the joints of the body. The knees are some of the most commonly affected joints, with many people experiencing at least a small degree of osteoarthritis over the age of 40. The disease is characterized by degradation of the cartilage that lines the surfaces of the joint, growth of osteophytes or bony spurs, pain, stiffness and swelling.

What are the symptoms?

Stiffness in the morning that lasts less than 20 minutes and pain with movement, clicking, crepitus, swelling and a generalized reduction in joint range of motion are all common symptoms of osteoarthritis. As OA is a progressive disease, the condition is categorized into stages to help describe symptoms and guide treatment. Early stages of OA may have only mild symptoms, however as the disease progresses, a joint replacement may be required.

What causes it?

While aging is the most significant risk factor for the development of OA, it’s not an inevitable outcome of growing older. Other factors that may predict the development of OA are obesity, family history, previous joint injury, high impact sporting activities and peripheral neuropathy. It is thought that abnormal wear and tear or stress on the joint is the primary cause of OA. It is also important to note that many people will have changes on X-Ray that show OA, however, will have no symptoms – which indicates that simply having OA is not a sentence for having pain.

What is the treatment?

Your physiotherapist is first able to help diagnosis and differentiate OA from other conditions that may have similar symptoms. An X-Ray can confirm the diagnosis and can be helpful in determining the best course of treatment to follow.

While OA is a progressive disorder, there is often a significant improvement that can be made simply by addressing lifestyle factors and any biomechanical factors that may be contributing to pain.

How can physio help?

Your physiotherapist is able to guide you with strengthening exercises to support the joint, advice for adapting your exercise routine and can even help you to lose weight, all of which have been shown to have a positive impact on the symptoms of OA.

If surgery is the right course for you, your physiotherapist is able to guide you through this treatment pathway, helping you to prepare and recover from surgery to get the best outcome possible.

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. 

Four Tips For Reducing Knee Pain - Physio Direct NZ

Four Tips For Reducing Knee Pain

Knee pain comes in many forms with many different causes. While treatment for every person and condition will be different in each case, here are a few tips that may help to reduce knee pain throughout the day.

1. Choose supportive footwear

One of the biggest culprits for ongoing knee pain is wearing unsupportive or high-heeled shoes to work. High heels often lead to tight calves and altered gait patterns, while unsupportive shoes can allow rolling in of the ankles, which can, in turn, place extra stress on the knee joints. Having an assessment with your physiotherapist to see how your shoes might be affecting your knee pain is a worthwhile investment.

2.  Adjust your sleeping position

While most of the time, our knees get a well-deserved rest during the nighttime hours, there are a few sleeping positions that can place additional stress on the knees. Lying on your side with bent knees can place tension on the outer thigh muscles and also the knee joint itself. Try to keep your knees straightened to at least 30 degrees and if you sleep on your side, place a pillow underneath the top knee to reduce stress on the joint.

Alternatively, if you sleep on your back it may be helpful to place a pillow under your knees so that they rest in a slightly bent position, to unload the joint.  Try experimenting with different pillow arrangements to see which combination works best for you.

3.  Avoid sitting or resting too much

When knee pain strikes, your first instinct is probably to get off your feet and stop exercising. The truth is that our knees, like all our joints, are designed for movement and regular exercise helps to keep them healthy. If you are having pain with high impact activities such as running, try switching to swimming and cycling before stopping exercise altogether. Resting in a sitting position for prolonged periods can also place excess stress over the knee cap and knee joint. When sitting for long periods, try to stretch your legs out ahead of you and avoid crossing your legs.

4.  Seek physiotherapy treatment

Many of us see putting up with pain as a sign of strength however, a small niggle that is easily treatable can turn into a larger problem if left over time. This may seem like an obvious point, yet the first step to recovery is often just seeking treatment.

Our physiotherapists are happy to discuss your condition with you and share their tips to help you stay pain-free. 

Adductor Tendinopathy - Physio Direct NZ

Adductor Tendinopathy

What is it?

The adductor muscles are a group of five muscles located on the inside of the thigh that act to move the hip inwards or control hip movements outwards. These muscles also provide stability to the pelvis while standing, walking and running. The muscles attach to the pelvis via the adductor tendon, at the base of the pubic bone. Adductor tendinopathy is a condition affecting the adductor tendon and is used to refer to the typical pattern of pain and stiffness in the groin and inner thigh that accompany this injury.

What are the symptoms?

The hallmark of this condition is pain in the groin region with movements of the adductor muscles. There may be a feeling of stiffness, weakness and pain when pressing over the adductor tendon. The pain usually begins gradually and progresses over time. It may build up over a few months and may not go away on its own. In severe cases, the pain may impact day-to-day activities, with pain being present when walking or going up and down stairs. Tendon tears may occur suddenly, however tendinopathy is often already present when this happens.

What causes it?

Adductor tendinopathy usually occurs due to chronic overuse, particularly for runners and athletes whose sports involve regular changing of directions. Overstretching of the tendon or an increase in training intensity or type often precede the development of adductor tendinopathies. It is thought that excess forces over an extended period of time cause the tendon tissues to degenerate, becoming painful and more prone to tearing.

What is the treatment?

As many different conditions mimic adductor tendinopathy, accurate diagnosis by a health professional is essential. Certain conditions such as stress fractures of the hip, nerve entrapment or pathologies of the hip should first be ruled out. 

Adductor tendinopathy is treated by first identifying factors that may have led to the development of the condition. Your physiotherapist may recommend a period of rest and suggest that you stop stretching. Common contributing factors are running technique, muscle tightness and/or weakness and training frequency.

Your physiotherapist is able to help you maintain your training program to the highest level without aggravating your symptoms and help support tendon healing. They are also able to provide support to unload the tendon along with manual therapy and an exercise program, particularly with eccentric exercises, which have been shown to stimulate tendon regeneration.

In most cases, conservative or non-surgical treatment is attempted as the first line of treatment. If this is unsuccessful, cortisone injections are often used to reduce symptoms. In severe cases where the pain persists despite all other attempts at treatment, other medical interventions can be attempted. Once the pain has subsided your physiotherapist is also able to help prevent any further recurrence.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. 

When Physiotherapy Treatment Doesn’t Work - Physio Direct NZ

When Physiotherapy Treatment Doesn’t Work

We often hear from patients that they have put off seeking treatment following an injury because they have previously tried physiotherapy and found that it didn’t work. Understandably, this can lead to a reluctance to invest time and money into future treatments. While there are never any guarantees in healthcare, in this article we highlight a few reasons why your treatment may not have worked in the past and why it may be worth trying again.

1. You couldn’t commit to your exercise program.

With our busy modern lives, finding time to make an appointment with your physiotherapist can be hard enough, let alone making time to complete the exercises they prescribe. The tasks set for you at a home by your therapist are often actually more important than the treatment time and are highly targeted for your individual circumstances. Ensuring you are performing your exercises correctly as well as frequently enough are other factors that might leave you seeing little to no improvement.

2. You weren’t able to continue physiotherapy for long enough.

While very occasionally, an issue can be resolved in 1-2 visits, most conditions will require at least 5-6 visits for a significant change to be made. Chronic pain and injuries often need much longer still to make an impact. There are many reasons for not being able to return for treatment, however this is one of the most common reasons physiotherapy fails, there’s simply not enough of it to be successful. It is important to discuss with your physio at the beginning of treatment how much time may be needed for a full and effective treatment program. Once

pain and symptoms have resolved, it is also important to complete a full rehabilitation to help prevent future injuries.

3.  Your injury required medical or surgical intervention.

There are a small percentage of injuries that will require more intensive intervention to heal fully. It is often recomended that physiotherapy be trialled before attempting more invasive treatments. Your physiotherapist and medical team often work together to evaluate your injury and decide the best course of treatment.

4. Your physiotherapist was simply not the right fit.

While all physiotherapists are trained to an excellent standard, occasionally you might find that the treatment style of one therapist works better for you than another. It can be worth working with a new therapist before giving up on the idea of physiotherapy altogether. Often physiotherapists within the same clinic are happy to collaborate and offer new perspectives.

Our physiotherapists are happy to discuss any concerns you have regarding your treatment including issues with previous treatments. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. 

Roasted Cauliflower And Quinoa Salad - Physio Direct NZ

Roasted Cauliflower And Quinoa Salad

Ingredients:

1 Head Cauliflower

1 Small Red Onion

2 Tbsp. Olive Oil

1 handful Fresh Coriander

2 Clove of Garlic

1 tsp. Turmeric

½ tsp. Cumin

2 cups Quinoa

1 fresh Tomato

2 cups Vegetable Stock

¼ cup sliced Almonds

Salt and Pepper

  1. Preheat oven to 180 degrees Celsius and line a baking tray with baking paper. Chop cauliflower into small cubes and drizzle with olive oil, turmeric and cumin. Slice onion into very small strips and add cauliflower pieces to a baking tray and cook for 30 minutes until soft and brown. Remove from heat and set aside.
  2. In a medium-sized mixing bowl, add diced coriander (or basil), diced garlic, white balsamic vinegar, olive oil, diced tomato, almonds, salt and pepper. Mix together and set aside.
  3. Bring a medium pot of water to boil and salt slightly. Add 2 cups of quinoa and cook for 5-10 minutes until cooked. Strain excess water and stir through olive oil mixture. Add roasted cauliflower and serve when ready.
Balsamic Glazed Pumpkin with Parmesan & Basil - Physio Direct NZ

Balsamic Glazed Pumpkin with Parmesan & Basil

Ingredients:

500g Fresh Pumpkin

3  tbsp. Balsamic Glaze

½ tbsp. Thyme

1 handful Fresh Basil

1 Clove of Garlic

2 Tbsp. Olive Oil

100gm Fresh Parmesan

Salt and Pepper

  1. Preheat oven to 180 degrees Celsius and line a baking tray with baking paper. Chop pumpkin into slices or cubes and drizzle with olive oil.
  2. In a medium-sized mixing bowl, add diced basil, thyme, salt and pepper. Mix pumpkin through and allow all pieces to be coated evenly. Coat pumpkin pieces with balsamic glaze and place on baking tray.
  3. Bake in the oven for 40-50 minutes, depending on the size of the pieces, turning the pumpkin halfway through. Remove from oven and serve either as a delicious side dish.

Garnish with Parmesan and basil

Roasted Almonds with Dates and Rosemary - Physio Direct NZ

Roasted Almonds with Dates and Rosemary

Ingredients:

200g Whole Almonds

2 Sprigs Fresh Rosemary

100g Medjool Dates

100g Goats or Feta Cheese

1 Clove of Garlic

2 Tbsp. Olive Oil

1 Tbsp. Fresh Lemon Juice

Salt and Pepper

  1. Preheat oven to 180 degrees Celsius and line a baking tray with baking paper. Spread dates over baking tray and drizzle with olive oil, salt and pepper. Cook for 10 minutes.
  2. Add almonds to the baking tray; add a crushed clove of garlic and a sprig of rosemary. Continue baking for a further 10 minutes until almonds are toasted but not burnt.
  3. Remove from oven and set aside to cool. Add goat’s cheese and drizzle with lemon juice before serving.

Garnish with rosemary and serve as a delicious starter or snack.