What is it?

The scaphoid is a small bone in the wrist that connects the radius to the hand, and it is situated near the thumb. Scaphoid fractures are a relatively common wrist injury and are commonly misdiagnosed as the pain can be quite mild even when the bone has been broken. 

Scaphoid fractures are notorious for their high incidence of complications healing due to low blood supply to the area and how easily their diagnosis can be missed. 

How does it happen?

A scaphoid fracture is often caused by a fall on an outstretched hand or a direct blow to the wrist. It is more common in young adults than in children and the elderly.

What are the symptoms?

Symptoms of a broken scaphoid include wrist pain, swelling, bruising or discolouration of the skin over the injured area and difficulty moving the wrist or hand. As the swelling subsides you might notice pain at the base of the thumb when opening jars or gripping objects. There may also be a deep, dull ache in the wrist that doesn’t settle easily.

How is it diagnosed?

If you suspect that you have a scaphoid fracture, you should consult your physiotherapist or GP who will refer you for an X-ray to confirm if the bone is broken. Occasionally scaphoid fractures will not show up on an X-ray, so if the findings are negative yet your medical team still suspect a fracture, they may wait a week then X-ray again or send you for an MRI or CT to double-check. Though these fractures can often be treated without surgery, doctors may recommend surgical intervention for more severe cases. 

How can physiotherapy help?

If you have a scaphoid fracture, your doctor will likely prescribe a splint or cast to ensure the wrist is kept still until healing is complete, usually for a minimum of six weeks. Healing times will vary depending on which part of the bone has been broken. Following the removal of the cast or splint, there is often residual pain, stiffness or muscle weakness. Your physiotherapist can help you restore any deficits as well as resolve any shoulder pain or headaches that may have resulted from altered biomechanics. 

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

A common fear for patients when discussing pain is the idea that their symptoms are ‘all in their head’ or that they won’t be believed either by friends, family, therapists or workplace. This fear can be worse when there appears to be no obvious cause for their pain or it has been present for a long time.

What is pain?

Many of the models used in the past to explain pain lead us to believe that the intensity of pain will always be proportional to the severity of an injury. The experience of pain is always real and usually distressing. However, pain is a warning system used by our nervous system to alert us to danger, not a direct indicator of damage done. This is a subtle, yet important distinction meaning that the experience of pain can be influenced by many different factors and not exclusively tissue damage.

How can stress impact pain?

Part of the role of your nervous system is to sort through a huge amount of sensory input and interpret it in a meaningful way. When pain is considered to be a serious threat to the body, the intensity of the pain will be worse.

This can happen in many situations, for example:

-The source of the pain is not well understood, leading to fear that the pain might be something very serious.

-The nervous system is in a state of hyper-arousal, such as when you are stressed or tired.

-The pain or injury could have a significant impact on your quality of life, career, relationships or hobbies.

-The injury occurred through a traumatic event such as a car accident.

What does this mean for my treatment?

Along with all our more traditional treatments, we also know that stress reduction strategies, mindfulness and addressing any emotional trauma associated with pain can all help to aid recovery and improve quality of life. Your physiotherapist is a great person to speak to about pain management strategies so you can get the most out of your life while dealing with long-term pain.

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.

What is it?

A broken collarbone, also known as the clavicle, is one of the most commonly broken bones in the body.

The collarbone connects the front of the ribcage to the shoulder and is the only bony connection the arm has to the rest of the body. Many muscles attach to the collarbone, including the Deltoid and Pectoralis Major.

How does it happen?

The most common way for this injury to occur is through a fall onto the shoulder. This can happen from a simple fall or sports such as mountain biking or rugby. It is a very common childhood injury but can happen at any age.

What are the symptoms?

Usually, a broken collarbone will cause moderate to severe pain over the broken area. The patient may have heard or felt a popping or cracking at the time of the injury and there may be an ongoing grinding or creaking with movements of the upper arm. If the skin is not broken there may be bruising and swelling over the painful area.

What is the treatment?

While very severe cases can be surgically fixed, more often a broken collarbone will be allowed to heal naturally with rest and monitoring. By supporting the arm in a sling and providing pain relief the arm will mend on its own. As with most fractures, there are also often other injuries that may need to be dealt with at the same time. There are many important structures near the collarbone that can also be damaged

including muscles, nerves and blood vessels. In very severe cases, the lung tissue under the collarbone can be damaged causing the lung to collapse. 

Physiotherapy and recovery:

Once a treatment plan has been decided by your medical team, your physiotherapist can help you to return to your pre injury strength and mobility with a full rehabilitation program.

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.

Anterior ankle impingement, also known as anterior impingement syndrome, is a musculoskeletal condition where repetitive forces compress and damage the tissues at the front of the ankle, causing pain and stiffness. It is a common injury that can affect people of all ages, however is usually seen in athletes of sports involving repetitive or forceful upward movements of the ankle, such as sprinting, landing from long jump, uphill and downhill running.

What are the symptoms?

Pain at the front of the ankle is the primary symptom of anterior ankle impingement. This can be felt as an intense, sharp pain occurring with ankle movements or a dull ache in front of the ankle following periods of exercise. Pain can also be felt when putting weight through the ankle while standing, walking or running. Night-time aching, stiffness, swelling and reduced ankle flexibility are also common symptoms of anterior ankle impingement.

How does it happen?

Anterior ankle impingement is caused by traumatic or repetitive compression to the structures at the front of the ankle as the tibia and talus move towards each other during ankle movements. The tissues that are affected become damaged and inflamed, causing the pain typical of ankle impingement. Chronic inflammation can lead to further stiffness, exacerbating the impingement process.

The most common risk factor for ankle impingement is a previous ankle sprain that was not adequately rehabilitated, as this can result in a stiff or unstable ankle. Another cause of impingement is the growth of small osteophytes or bony spurs around the ankle joint that press against the nearby soft tissues. These can be due to osteoarthritis or grow as a reaction to impingement itself.  Training errors, muscle tightness, unsupportive footwear and a hypermobile ankle have also been shown to be risk factors for anterior ankle impingement.

How can physiotherapy help?

Depending on the cause, mild cases of anterior ankle impingement usually recover in one to two weeks with rest and physiotherapy intervention. For more severe impingement, the ankle may require up to six weeks of rest and rehabilitation to recover. In rare cases, surgical intervention will be required to remove any physical causes of impingement, such as osteophytes to restore impingement free movement of the ankle. Your physiotherapist will first identify the cause of your ankle impingement and help you to choose the best course of action to reduce your symptoms. They are able to advise you on the appropriate amount of rest and provide stretches and exercises to restore strength and flexibility to the ankle.

Mobilization techniques and range of motion exercises can also reduce stiffness of the ankle, restoring normal joint movement. Moreover, balance and proprioception exercises are included to prevent further ankle injury. Balance exercises challenge the way your body reacts to outside forces. With this, your balance will be improved, and you’ll have a more stable ankle.

Ideally, physiotherapy treatment is the first step before considering surgery. If surgery is required, your physiotherapist can help you to make a full recovery with a post-surgical rehabilitation program.

Why are workplace injuries so common?

The nature of work is that we are often required to complete the same task for hours. We can also find ourselves faced with time constraints and deadlines that lead to lazy postures and taking shortcuts, simply to get the job done.

How can they be prevented?

Workplace injuries can happen suddenly, through an accident like a fall or by lifting something too heavy, however, the vast majority of workplace injuries occur over time due to repetitive tasks. Often these conditions begin slowly and take many months to resolve. Here are a few tips to keep yourself pain free in the workplace.

Moving Items:

It’s important to assess the risk before you start. Do you need to ask for help or use an assistive device? Your legs are the strongest part of your body and ideally, you should use them to power the movement, rather than your arms or back. 

Bending and twisting when lifting is also a common mechanism for injury. It is much safer to lift, then step to turn before putting an object down again. Pushing is a much more efficient movement than pulling and is always preferable if you have a choice. Try to push at waist height and keep forces as close to your body as possible. 

Office Work:

Overuse injuries can occur by using the same side of your body rather than alternating sides. Practise using both left and right hands for taking phone calls and mouse work. 

Be aware of your posture. Good posture isn’t having a rigid and upright spine. It’s about being able to let your spine sit comfortably in its natural curves and be able to move in and out of this easily. Stretching can help to counteract positions you find yourself in for long periods.

Your physiotherapist is a great person to speak to about preventing injuries in your workplace.

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.