Understanding Referred Pain - Physio Direct NZ

Understanding Referred Pain

Pain is one of the most complicated processes in the human body. You may have experienced this is you ever saw a physiotherapist for pain in one part of your body, and they started to treat an entirely different area. Some people are born with no sensation of pain at all, and amputees sometimes continue to feel pain where their limbs used to be. The complexity of pan is one of the reason’s why physiotherapists conduct such a thorough physical examination before being able to determine the exact source of your pain.

Why is pain so complicated?

Unfortunately, we are still don’t understand everything about the way pain is processed.  Usually, when an injury or damage occurs to body tissues, a signal is sent to the brain, which begins to interpret this signal and creates the sensation of pain. Pain is thought to be a warning signal to let you know to avoid danger and pay attention to the injured body part. Occasionally this system goes a little haywire, and pain signals are sent when there is no damage or the location of the pain is misdirected.

Referred pain is the term used when pain is felt at a different location to the source that is sending the pain signal. There are many kinds of referred pain, and some are easier to explain than others.

What are the different types of referred pain?

In some cases, if it is a nerve that is sending the pain signal, then pain can be felt all along the length of the nerve. Patients often describe this as a sharp burning pain along the skin. One of the most common examples of this is sciatica, where the large nerve that runs down the back of the leg is irritated around the lower back. The source of the pain signal is near the spine. However, that pain follows a distinctive pattern down the leg. In other cases, it is the muscles and not the nerves that are referring pain elsewhere. Muscular trigger points are taut bands that develop within muscle tissue that is undergoing abnormal stress. Poor posture, lack of movement, and overuse can cause muscles to develop areas of dysfunction. These trigger points can cause pain that radiates out in distinctive patterns. Trigger points are diagnosed as the source of pain if symptoms are reproduced when a therapist presses on a specific point.

If that wasn’t confusing enough, we know that our internal organs also refer pain.  Pain referred by internal organs is frequently described as a deep, ache, and usually not influenced by movements of the limbs or back.

Organs often distribute pain in patterns that are very obscure and sometimes don’t even create any pain at their location. For example, kidney pain often feels like lower back pain. Tragically there have been patients who have failed to seek treatment in time as they mistook a serious condition for a simple backache.

There are many other fascinating aspects to pain, and understanding how it works is an important part of managing your symptoms. To understand how referred pain may be affecting you, chat to your physiotherapist who can help with any questions. 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.

Common Running Injuries - Physio Direct NZ

Common Running Injuries

Running is a great way to stay in shape, manage stress, and increase your overall wellbeing. However, it’s not without its drawbacks. While being a low-risk activity, there are a few injuries that commonly affect runners. As running is a repetitive impact activity, most running injuries develop slowly and can be challenging to treat. Here are three of the most common conditions faced by runners. 

1. Runner’s Knee: 

Runners’ knee is a persistent pain on the inside of the knee caused by the dysfunctional movement of the kneecap during movement. The kneecap sits in a small groove at the centre of the knee and glides smoothly up and down as the knee bends and straightens. If something causes the kneecap to move abnormally, the surface underneath can become damaged, irritated, and painful. The pain might be mild to start with; however, left untreated, runner’s knee can make running too painful to continue. 

2. Shin Splints:

Shin splints is a common condition characterised by a recurring pain at the inside of the shin. While the cause of this condition is not always clear, it is usually due to repeated stress where the calf muscles attach to the tibia (shin bone). Why this becomes painful is likely due to a combination of factors that can be identified by your physiotherapist to help you get back on track as soon as possible. 

3. Achilles Tendonitis: 

The Achilles tendon is the thick tendon at the back of the ankle that attaches to the calf muscles. The amount of force that this tendon can absorb is impressive. It is vital in providing the propulsive force needed for running. If the stresses placed on the tendon exceed its strength, the tissues begin to breakdown and become painful. Treatment is focussed on helping the healthy tendon tissues to strengthen and adapt to new forces while allowing the damaged tissue to heal and regenerate.

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

Basil Pesto Gnocchi - Physio Direct NZ

Basil Pesto Gnocchi


500g Fresh Gnocchi

4 large mushrooms, sliced

¼ Fresh Zucchini, sliced

50g Butter

1 Tbsp. Olive Oil

1 tsp. crushed Garlic

100g Shaved Parmesan Cheese

1 cup Rocket Leaves

Salt and Pepper


1 clove of Garlic, peeled

Sea Salt

Ground Black Pepper

1 large bunch of Fresh Basil, diced

50g Pine Nuts

3 Tbsp. Olive Oil

50g Parmesan, finely ground

  1. Prepare the pesto ahead of time by crushing garlic with salt and pepper in a pestle and mortar. Add the basil leaves and pine nuts and grind until a paste forms. Add the olive oil and Parmesan cheese, continue to blend ingredients and set pesto aside. Pesto can be stored in the fridge until ready to use.
  • Heat a medium-sized pot of salted water to high temperature and bring to the boil. Add gnocchi and cook until soft and gnocchi are floating. Strain gnocchi and set aside.
  • Add butter to a large frying pan heat to medium. Add gnocchi and cook until slightly brown and crispy. Stir gnocchi regularly to prevent burning.
  • In a separate frying pan, heat olive oil and fry sliced mushrooms and zucchini until soft and slightly browned. Remove from heat and stir through to cooked gnocchi.

Stir through basil pesto and garnish with rocket and Parmesan cheese. Serve immediately.

Red Lentil and Coconut Dahl - Physio Direct NZ

Red Lentil and Coconut Dahl


2 cups dry Red Lentils

2 Tins Whole or Diced Tomatoes

1 Tin Coconut Milk 

2 Tbsp. Garam Masala

1 cup Vegetable Stock

½ tsp. Cinnamon

1 tsp. crushed Garlic

½ White Onion, Diced

½ tsp. paprika

1 Tbsp. Coconut Oil

1 tsp. Salt


½ cup Plain Yoghurt

1 tsp. Lime Juice

½ Cucumber, Diced

3-4 Fresh Mint Leaves, Diced

Heat a medium-sized saucepan to high temperature. Add oil, diced onion, garlic, paprika, garam masala, cinnamon and salt. Cook until onion begins to soften, stirring frequently and lower heat to medium

Rinse lentils with cold water, strain and add to the saucepan. Stir lentils until coated evenly by oil and spices.

Slowly add vegetable stock, stirring through lentils. Next, add tinned tomatoes and coconut milk. Stir thoroughly, reduce heat and allow to simmer for 15-20 minutes. Continue to stir occasionally until lentils are soft and liquid is absorbed. 

Combine yoghurt, lime juice, diced cucumber and mint leaves in a small bowl and stir until mixed evenly.

Serve with rice and toasted garlic naan bread, add raita for taste.

Five Shortcuts To Improve Your Health - Physio Direct NZ

Five Shortcuts To Improve Your Health

Better health isn’t just about looking better. It can also help you to feel stronger, more flexible, reduce pain and feel happier overall. If you’re an inactive person, it can be challenging to change your lifestyle. Here are a few tips that might make it a bit easier.

Sign up for a race or event. 

Fear is a powerful motivator, and having a challenge looming can create a sense of urgency to improve your fitness. You don’t need to sign up for a marathon straight away, but something that lies just outside your current fitness level is a great place to start. 

Join a team.

You may not feel committed to your exercise routine, but being part of a team can get you out of the house when you’d much rather be a couch potato. Joining a team can have added social benefits by increasing your sense of community and expanding your social circle. 

Make it a habit.

Upgrade your daily exercise to be a non-negotiable part of your routine, increase the priority level and refuse to reschedule. In the long run, you’ll be grateful that you have created a habit that’s difficult to break. If you can also keep track of your attendance, set yourself the added challenge of not missing a day to put the habit in place.

Be honest about what you enjoy and what you don’t.

We all have different preferences when it comes to activity, and taking the time to identify which sport is right for you can be the secret to long term success. If you’re a thrill-seeker, you might find mountain biking infinitely more rewarding than an hour at the gym. For others, the peacefulness of a yoga session can be just what they need after a stressful workday. There are many options other than a gym membership, and many come with added benefits of improved self-esteem as you learn a new skill and are an easy way to make new friends.

Reward yourself.

Many of us respond better to positive reinforcement than punishment, or at least it is a nicer experience. For example, rather than restricting calories when you miss a day of exercise, reward yourself with a massage when you have reached a small goal. Choosing a reward that is also beneficial for your health can help avoid a boom/bust attitude towards your health. 

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

Focus On Osteoporosis - Physio Direct NZ

Focus On Osteoporosis

Osteoporosis is a widespread condition characterized by low bone mass or density. It is primarily a metabolic disorder related to age and general health with a variety of risk factors and causes. The most common and well-known consequence of osteoporosis is weakened bones that can break from small forces that would usually be harmless.

In osteoporosis, both the matrix of the bone (similar to scaffolding) and the density of the bone are affected. While bone seems like a static part of our body, bone is continuously laid down and removed by our bodies. In osteoporosis, there is an imbalance between the growth and reduction in the bone where the bone becomes progressively weaker. As such, it is a progressive disorder that worsens with age, and while the disease process might begin much earlier, symptoms are usually only noticed over the age of 50. 

What are the signs and symptoms?

Often called a silent disease, many people with osteoporosis will have no idea that they have the disease, as there are no visible symptoms. Sometimes the first sign that an individual has osteoporosis is when the first bone breaks; unfortunately, these bones are also slower to heal than healthy bones which can lead to ongoing complications. Broken bones are not the only symptom of osteoporosis, as bones lose density and strength, they can also become compressed and develop wedge fractures under the weight of the body. 

When the spine is affected by osteoporosis, people may develop a hunched or stooped posture, which can itself lead to respiratory issues and places pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have a distressing impact on their overall quality of life.

What causes it?

As a metabolic disorder, osteoporosis can be caused by any process that interferes with the body’s ability to maintain bone density. This includes gastrointestinal conditions that prevent adequate absorption of calcium, required for bone growth, lack of dietary calcium or low levels of vitamin D, which are essential for the absorption of calcium. Some medications can contribute to bone loss as an unfortunate side effect, especially if they are taken for a long time or in high doses. A well-known example is the long-term use of steroids which are prescribed for long periods to reduce inflammation.

Inactivity can also predispose a person to osteoporosis as bones respond to force and weight-bearing by building more bone. Having a sedentary lifestyle or choosing activities with low levels of impact can mean that without the weight-bearing stimulus to make bone, bones are less dense over time. Osteoporosis is a common issue for elite cyclists and swimmers, who are more likely to develop the condition if they don’t also include weight-bearing activities such as jogging in their training program.

How can physiotherapy help?

Physiotherapy can help you to improve your overall bone health, avoid or recover from fractures. Physiotherapy exercises can direct you to safely increase your weight-bearing, which can help build bone mass. Balance training is also an important factor as this can reduce your risk of falls. Your physiotherapist can also help you to adjust your lifestyle, at home or at work, to protect your bones and improve your posture.

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

What Is Frozen Shoulder? - Physio Direct NZ

What Is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition affecting the joint capsule of the shoulder. It is characterized by inflammation of the capsule, leading to pain and stiffness with shoulder movements. 

Frozen shoulder is categorized as either primary or secondary. Primary frozen shoulder occurs for no clear reason, while secondary frozen shoulder develops following an injury or surgery of the joint. 

Frozen shoulder usually follows a typical pattern and can be separated into three stages, freezing, frozen and thawing. The pain begins in the freezing stage as an ache or twinge with movements. The pain gradually increases, and the shoulder begins to feel stiff as well as painful. Usually, shoulder movements away from the body or rotating outwards are the most painful and restricted. 

As the condition progresses, everyday activities can be significantly impacted, with activities such as dressing, grooming, reaching overhead and behind the back becoming difficult. Lifting heavy objects can be very painful, and the pain is often felt at night-time, interrupting sleep. The three stages follow a typical pattern; 

Freezing – Pain is present at rest/night, increasing pain and stiffness with shoulder abduction and external rotation. 

Frozen– Pain starts to lessen, but the stiffness of the shoulder joint increases.

Thawing – Pain reduces to lower levels and movement begins to return.

Frozen shoulder will usually resolve on its own without any long-lasting stiffness. However, complete recovery does not always occur. 

Frozen shoulder usually affects people over the age of 40 and women are affected more often than men. While no definite cause has been identified, there are some factors that increase the risk of developing a frozen shoulder. These include diabetes, prolonged immobilization, trauma, stroke, thyroid dysfunction, heart disease and autoimmune disease.

The early stages of frozen shoulder can mimic other shoulder conditions, and these should first be ruled out by a thorough examination. While frozen shoulder is a self-limiting condition, meaning it will resolve on its own without treatment, this can take up to 2-3 years. Physiotherapy during this time focuses on reducing pain as much as possible and helping patients to cope and adapt to their symptoms during the freezing and frozen stages. 

As the condition moves into the thawing stage, physiotherapy aims to help restore strength, movement and control to the shoulder. The entire process can be extremely distressing for patients and providing support and education as they move through the stages of the condition is an essential part of treatment. 

If you have any concerns about shoulder pain that is not resolving, come and have a chat with one of our physiotherapists to see how we might be able to help you. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your injury. 

Shoulder Instability - Physio Direct NZ

Shoulder Instability

What is it?

Shoulder instability is a term used to describe a weakness in the structures of the shoulder that keep the joint stable, often leading to frequent dislocations. As one of the most flexible joints in the body, the shoulder maintains stability through a balance of support between the dynamic structures (muscles and tendons) and static structures (ligaments and joint shape).

Shoulder instability typically occurs in one of two directions, anterior (forward) or posterior (backwards), anterior instability or dislocations are far more common than posterior. 

What are the symptoms?

The most noticeable symptom of shoulder instability is dislocation or subluxation of the joint. This is often accompanied by pain, clicking sensations, a feeling of instability and in some cases, weakness, tingling, and pins and needles in the arm. Many patients report a feeling of apprehension or instability, as if ‘something is not quite right’. Posterior instability can also cause reduced range of movement and might mimic other common shoulder conditions, which need to be ruled out first. 

How does it happen?

Shoulder instability is also classified as traumatic, occurring after an injury or atraumatic, where the shoulder is exceptionally flexible and prone to dislocations from everyday forces. Instability can also occur from chronic overuse where the shoulder joint is damaged slowly over time.

Traumatic shoulder instability is the most common form. Often the joint is dislocated by a strong force and damaged, leaving it more unstable and vulnerable to future dislocations. Rugby and football players are commonly affected. However, dislocations can occur in the general public from something as simple as falling onto an outstretched hand. 

How can physiotherapy help?

Shoulder instability is a complex condition, and each person will have a different combination of causes and structural deficiencies. Physiotherapists are trained to identify issues of coordination, control and strength that may be contributing to instability and provide an extensive rehabilitation program. For some patients, surgery is recommended to help restore some static stability to the joint. However, this is not the best pathway for everyone. If surgery is indicated, a full rehabilitation program is also recommended for the best outcomes. 

Helping patients to understand and manage their condition is an essential part of recovery. Physiotherapy is usually always recommended as the first line of treatment before surgery and can have excellent outcomes, with or without going under the knife. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your injury. 

Blueberry Compote French Toast - Physio Direct NZ

Blueberry Compote French Toast


4 Slices of Brioche or Sourdough Bread

1/2 Cup Whole Milk

1/2 tsp. Cinnamon

1 Large Egg, beaten

2 Tbsp. Butter


Finely grated zest of one Lemon

2 Tbsp. Lemon Juice

1 cup Blueberries

2 Tbsp. Castor Sugar

2 Tbsp. Water

  1. Heat a medium-sized saucepan to high temperature. Add blueberries, sugar, water, lemon juice and zest, mix and bring to boil for 5 minutes. Lower temperature and simmer for 20 minutes or until a thick, sticky sauce is formed.
  • In a medium-sized mixing bowl, mix eggs, milk and cinnamon until thoroughly combined. 
  • Heat a large frying pan to medium temperature and add 1 Tbsp. of butter or coconut oil. Dip one slice of bread into batter and cover both sides thoroughly.
  • Cook bread on the frying pan for 1-2 minutes, turning once when golden brown. Repeat with other slices. Pour berry compote over toast and serve while warm.

Garnish with mint and serve – berry yogurt or mascarpone optional.

Plantar Fasciitis - Physio Direct NZ

Plantar Fasciitis

What is it?

Plantar fasciitis is a common condition of the foot and heel affecting both athletes and members of the general public. The plantar fascia is a fibrous band of tissue that attaches to the base of the heel and supports the muscles and arch on the base of the foot. When the plantar fascia becomes chronically irritated, it is referred to as plantar fasciitis. 

What are the symptoms?

Plantar fasciitis is characterised by pain at the base of the heel. The pain is usually noticed upon waking when people take their first steps of the day. The pain usually settles down after walking around, yet may reappear after sitting for a while and getting up again. The pain can usually be reproduced when the inside of the heel is pressed, and the calf muscles might be noticeably less flexible. 

Plantar fasciitis can usually be diagnosed with a physical assessment by a physiotherapist. Left untreated, plantar fasciitis can lead to chronic heel pain, which can have a significant impact on quality of life, interfering with day to day activities. 

What are the causes?

The plantar fascia supports the arches in the foot during weight-bearing and acts as a shock absorber. Small tears can appear in the fascia when it is exposed to excess tension and stress over time. While the exact cause is unknown, there are several risk factors that can increase the risk of this condition developing.

These include obesity, excessive foot pronation, inadequate shoe support, prolonged standing and excessive running. It has previously been thought that plantar fasciitis is linked to or caused by heel spurs. However, this has been shown to be untrue, and many people have heel spurs without any symptoms. 

How can physiotherapy help?

The goal of physiotherapy is to reduce symptoms and support the fascia to reduce and repair any tissue damage. This is done through short term pain reduction strategies such as ice application, rest, activity modification and gentle stretches.

To help reduce the tension on the fascia, lower leg strengthening and balance exercises will be implemented along with orthotics, night splinting and in some cases, corticosteroid injections. A night splint can be helpful in keeping the calf muscles lengthened as they often rest in a shortened position overnight. 

Other treatment options include extracorporeal shockwave therapy and endoscopic plantar release. However, these interventions will also be coupled with physiotherapy treatment for best results. Patients who are not responding to physiotherapy and other conservative management are candidates for surgical release of the plantar fascia. 

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. 

What Is Chronic Ankle Instability? - Physio Direct NZ

What Is Chronic Ankle Instability?

Chronic ankle instability, as the name implies, is a chronic condition of instability affecting the ankle and it’s surrounding structures. It usually develops after a severe ankle sprain. However, some people are born with less stable ankles; these individuals are generally extra flexible throughout their bodies. Approximately 20% of ankle sprains lead to chronic ankle instability due to the resulting changes in ligament support, strength, postural control, muscle reaction time and sensation. 

What are the symptoms?

As well as being more susceptible to ankle sprains, people with chronic ankle instability may notice they are extra cautious during high-intensity activities, if running on uneven surfaces or when changing directions quickly. They may experience a sense of weakness or frequent ‘giving way’ when weight-bearing.

What are the causes?

The primary causes of this condition are ligament laxity, decreased muscle strength of the muscles surrounding the ankle and reduced proprioception. 

Following an ankle sprain, ligaments can be stretched and slightly weaker; in severe cases, they have torn altogether, leaving the ankle structurally weaker. Without full rehabilitation, the surrounding muscles also become weaker, and studies have shown that balance and sensation of the ankle can also be reduced. This means that the ankle is more likely to be injured again, creating a vicious cycle leading to further instability.

How can physiotherapy help?

Physiotherapy treatment for chronic ankle instability focuses on improving strength, control and balance with a variety of techniques. This approach can significantly improve ankle stability and reduce the risk of future sprains. Physiotherapists can help patients to regain confidence and get back to their best performance. 

In some cases, orthotic braces for support can be used. However, this can lead to dependence and further loss of strength and control if used unnecessarily. In cases of extreme ligament laxity or if physiotherapy fails, surgery to repair the damaged ligaments is considered. This is usually combined with a full physiotherapy rehabilitation program for greatest success.

If you don’t feel 100% confident with your ankle, come and have a chat with one of our physiotherapists to see if we can help improve your ankle stability. 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. 

Beetroot & Haloumi Couscous Salad - Physio Direct NZ

Beetroot & Haloumi Couscous Salad


5 Medium sized beetroots

1/2 small Red Onion, diced

2 cloves of Garlic, diced

2 cups Vegetable Stock

2 cups Israeli Couscous

100g Haloumi Cheese

5 Tbsp. Olive Oil

Salt and Pepper

2-3 fresh Mint leaves


Finely grated zest of one lemon

2 Tbsp. Lemon Juice

1. Tbsp. Olive Oil

½ Tbsp. Paprika

  1. Heat olive oil in a large pot on medium heat and add diced onion, garlic, salt and pepper. Peel and chop beetroot into small squares and add to pan. Cook on medium heat, stirring frequently until beetroot begins to soften.
  2. Add vegetable stock to the pan and bring to boil. Add couscous to boiling mixture, cover and cook for 20 minutes, stirring occasionally. Once couscous is cooked all the way through, remove from heat, strain any excess liquid and allow to cool.
  3. Heat a separate pan to medium and add 1 Tbsp. of olive oil. Cut haloumi into slices and cook for 2-3 minutes on each side until brown and crispy.
  4. Mix dressing ingredients together and stir gently through couscous. Serve and add haloumi.

Garnish with mint and serve.

Tomato, Basil and Barley Soup - Physio Direct NZ

Tomato, Basil and Barley Soup


2 tins diced Tomatoes

1 small Red Onion, diced

2 small carrots, diced

1 handful Fresh Basil

2 cloves of Garlic

2 cloves of Star Anise

2 cups Vegetable Stock

2 cups Water

1/2 cup Pearl Barley

100g Fresh Parmesan

2 Tbsp. Olive Oil

Salt and Pepper

  1. Heat olive oil in a large pot on medium heat. Add diced onion, carrots, basil and garlic and cook until onions begin to soften. Soak barley in a separate pot of cold water for 10 minutes and set aside.
  2. Add tomatoes, vegetable stock, water and star anise to the pot and bring to boil, stirring occasionally.
  3. Drain barley and add to the soup mix. Reduce heat and simmer for about 30-40 minutes, add salt and pepper to taste. Remove from heat and serve while hot.

Garnish with basil and Parmesan cheese

Move More, Sit Less – 5 Tips From Your Physio - Physio Direct NZ

Move More, Sit Less – 5 Tips From Your Physio

More movement in your day can improve mental, physical health and even workplace productivity. Physiotherapists know that one of the most significant contributors to pain and injury is simply lack of physical activity. Getting more movement in your day doesn’t need to be about high-intensity exercise, all movement can be beneficial. Here are a few tips to help increase the amount of motion in your day. 

1. Try the Pomodoro Technique at work or when studying

The Pomodoro Technique, developed in the late 1980s, recommends breaking work into intervals, usually 25 minutes at a time interrupted by short rests. Studies’ have shown that by creating small time limits, you can focus more intently and the breaks can be useful motivators. 

Use these intervals as prompts for a short walk, some squats or stretches. Not only will you have made your day more productive, but you will also have added some movement to your day. 

2. Challenge a friend to match your steps

A little healthy competition is a great way to keep you motivated to move more. You can set daily, weekly and monthly targets and compare progress to keep you on track. You can use an app like ‘Habitica’ to help track and create movement habits in a game format. 

3. Park further away 

This is an oldie, but a goodie. If you can’t ride or walk to your daily destinations, try parking further away and using the opportunity to walk. Taking the stairs instead of the elevator and getting up and walking while taking phone calls are also great ways to increase your daily movement. 

4. Have a kettle boiling exercise routine.

The time spent waiting for the kettle to boil can feel like an eternity. Use this time to undertake a mini exercise routine. Try fitting in two sets of five squats, five lunges; five heel nurses or try to balance on each leg for two minutes. 

5. Stretch before bed

Gentle stretches before bed are a great way to relax and keep your joints mobile. Create a routine and make it part of our nightly ritual for better sleep and a healthier body. 

Our physiotherapists are happy to help you find strategies to create more movement throughout the day. Come and have a chat with us to see what might work for you.  

ACL Tears - Physio Direct NZ

ACL Tears

What is an ACL tear and how does it occur?

The ACL, or anterior cruciate ligament, is a strong piece of connective tissue, which attaches the thigh bone (femur) to your leg bone (tibia). The ACL provides stability to the knee joint as it prevents the tibia from sliding forward relative to the femur.

ACL tears are a common sporting injury; however, can also occur from everyday activities. The most typical mechanisms of injury are landing awkwardly from a jump, twisting the knee, or suddenly stopping while running. The ACL may also be injured during knee hyperextension, or when hit from the outside. Often, other tissues surrounding the knee are also damaged, including the medial collateral ligament, meniscus, joint cartilage, and bone surfaces. The ligament can be stretched, partially damaged or completely torn.

What are the signs and symptoms?

Many people report hearing a “pop” in the knee along with immediate pain and swelling. Decreased range of movement of the knee is common, and the injured knee is typically unable to take full weight when standing or walking. The knee may also feel unstable, with a sensation of “giving way”. Poor balance and coordination may also be experienced. Smaller tears of the ligament may have only mild symptoms, however, more severe tears will have more significant pain, swelling and instability.

Is surgery necessary?

Traditionally, surgery was thought to be necessary for all full-thickness ACL tears. A series of recent studies have shown, however, that outcomes are often the same for people who chose surgery and those who don’t, both in terms of recovery and future risk of osteoarthritis. Individual circumstances will impact this decision; elite athletes and patients with additional meniscal tears often do best with surgery. Generally speaking, however, with time and full rehabilitation, many people can return to their previous levels of activity without surgery. 

How can physiotherapy help?

For both surgical and non-surgical recovery from ACL tears, physiotherapy rehabilitation is essential for a full recovery. Your physiotherapist will assist you with improving your knee’s range of movement, lower limb strength, balance, stability and coordination. You will re-learn the tasks of walking, using stairs, and negotiating obstacles with retraining of your balance and control. 

Early in rehabilitation, the RICE protocol (rest, ice, compress, elevation) is used in conjunction with static resistance type exercises to improve muscle contraction in the leg and increase blood flow in the area.

Throughout your rehabilitation program, you will progress through a variety of strength and mobility exercises targeted towards your individual needs, with goals of returning to your favourite sport or hobby as soon and as safely as 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.