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ANKLE LIGAMENT INJURY – WEAK ANKLE

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Author: Admin

ANKLE LIGAMENT INJURY – WEAK ANKLE

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Description/Introduction:

The ligaments of the ankle joint are comprised of the medial (inner) and lateral (outer) compartments. They work together to provide stability to the ankle. The medial ligaments are thicker and stronger than the lateral ligaments because the medial bands form a mass surrounding the inner part of the ankle. This is why it’s relatively more common to see lateral ligament injuries.

Cause of Injury: Twisting/rolling mechanism i.e. walking with high heels, landing on uneven ground, playing sports

Clinical Signs and Symptoms of Ankle Injury:

  • Pain and tenderness with pressure and stretching
  • Swelling
  • Redness and warmth
  • Limping due to pain
  • Difficulty bearing weight on affected foot

Physiotherapy Options to relieve ankle pain:

  • Cryotherapy
  • Electrotherapy
  • Laser
  • Ankle taping
  • Exercises
  • Transverse friction massage
  • Gait assessment
  • Balance and proprioception exercises

Self-Help Tips:

  • Relative rest
  • Elevate and Ice the ankle to reduce swelling and inflammation
  • Support the ankle with a brace and supportive shoe
  • Avoid H.A.R.M. – Heat, Alcohol, Running, and Massage

Upper Cross Syndrome- Physiotherapy for Upper Cross Syndrome

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Description/ Introduction

Upper Crossed Syndrome aka “proximal or shoulder girdle crossed syndrome” involves a delicate imbalance of muscles. It is characterized by tightness in some muscles (the upper trapezius and levator scapula) on the dorsal side crosses paths with tightness in others (the pectoralis major and minor) along with a weakness of the deep cervical flexors (ventrally) crosses with weakness of the middle and lower trapezius. This intricate pattern of imbalance creates joint dysfunction that causes postural changes as well as pain/discomfort and stiffness in the neck and shoulder. The Physios at our clinics aim to combat Upper Crossed Syndrome and its symptoms by using a variety of treatment techniques and modalities to provide lasting long-term relief.

Clinical Signs and Symptoms

UCS manifests as:

  • Headaches
  • Neck pain or strain
  • Chest tightness
  • Upper back pain, especially in the shoulders
  • Restricted neck or shoulder range of motion
  • Numbness, tingling, and pain in the upper arms
  • Posture changes (Rounded Back and Forward Head)

Physical Therapy for Upper Crossed Syndrome

Physical Therapy helps patients with Upper Crossed Syndrome by helping address the issue at its root cause. A combination of manual techniques, modalities, strengthening exercise, postural retraining, as well as patient education will help treat the symptoms of the condition as well as prevent its reoccurrence.

Services Offered by Us:

Physical therapy can help manage Upper Crossed Syndrome and aid in returning to normal everyday function without difficulty/discomfort. Our PTs are trained to provide relief by doing the following:

  • Laser Therapy and Ultrasound Therapy: Used for heating and promotes tissue healing.
  • Interferential Therapy: Stimulates the muscle and nerve fibers.
  • Shockwave Therapy: to relieve pain.
  • Exercise Therapy: Muscle Strengthening and Stretching and training to improve overall function.
  • Postural Training: for the best positions for weight bearing to reduce stress on the muscles and joints.
  • Education: Learning different techniques to perform daily activities even while being limited
  • Manual Therapy: Manual techniques such as trigger point release is beneficial in improving mobility and reduce pain.

Shoulder Pain- Physiotherapy for Shoulder Pain

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Description/Introduction

The Shoulder is one of only two ball and socket joints of the body, this allows it a greater degree of freedom when it comes to movement, at the cost of stability. A painful shoulder can cause hindrances to daily activities such as difficulties is reaching and lifting objects as well as difficulty with tasks such as bathing and dressing/ undressing. Physio Asia Therapy Centre aims to target shoulder pain at the root and build a strong foundation of strength and mobility to prevent secondary injuries.

Clinical Signs and Symptoms

Pain in the shoulder may also present with:

  • Muscle tension around the area of the neck and arm
  • Pain that can be felt radiating down the arm.
  • Swelling and Stiffness around the joint
  • Pain/ Stiffness during reaching for objects and picking up objects from the ground.
  • Difficulty in daily activities such as bathing, eating, and dressing/undressing.
  • Numbness on the joint and even down the arm
  • Muscle Spasm

Causes

Shoulder Pain may be caused by one of the following underlying conditions.

  • Rotator Cuff Injuries:
    • Rotator Cuff Tears: Partial or full tears of the tendons connected to the arm bone. These can result from trauma or repetitive motion.
    • Tendinitis: Inflammation of the rotator cuff tendons due to overuse.
  • Arthritis:
    • Osteoarthritis: Wear and tear of the joint cartilage.
    • Rheumatoid Arthritis: An autoimmune condition affecting the shoulder joint.
  • Bursitis:
    • Inflammation of the fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles near the shoulder joint.
  • Adhesive Capsulitis (Frozen Shoulder):
    • A condition characterized by stiffness and reduced range of motion in the shoulder joint.
  • Fractures:
    • Bone fractures in the shoulder due to direct injury or osteoporosis.
  • Referred Pain:
    • Pain originating from other areas (e.g., neck arthritis, liver or lung diseases) but felt in the shoulder.
  • Muscle Strains:
    • Injury or inflammation of shoulder or upper arm muscles.
  • Labral Tears:
    • Cartilage injuries within the shoulder joint.
  • Nerve Compression or Injury:
    • Conditions affecting the brachial plexus or other nerves in the shoulder region.
  • Shoulder Instability:
    • Dislocation or subluxation of the shoulder joint.

How Can Physiotherapy Help with Shoulder Pain:

Physical therapy can help manage shoulder pain and aid in returning to normal everyday function. Our PTs are trained to provide relief by doing the following:

  • Laser Therapy and Ultrasound Therapy: Used for heating and promotes tissue healing.
  • Interferential Therapy: Stimulates the muscle and nerve fibers.
  • Shockwave Therapy: to relieve pain.
  • Exercise Therapy: Muscle Strengthening and Stretching and training to improve overall function.
  • Postural Training: for the best positions for weight bearing to reduce stress on the muscles and joints.
  • Education: Learning different techniques to perform daily activities even while being limited
  • Manual Therapy: Manual techniques such as trigger point release is beneficial in improving mobility and reduce pain.

Frozen Shoulder- Physiotherapy for Frozen Shoulder

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Description/ Introduction

Adhesive Capsulitis aka “Frozen Shoulder” is a condition that is caused by the thickening of the shoulder capsule –a sheath that encases the joint of the shoulder, thus restricting movement. The main symptoms of frozen shoulder are joint pain and stiffness that worsen over time. The Physios at our clinics aim to combat Adhesive Capsulitis and its symptoms by using a variety of treatment techniques and modalities to provide lasting long-term relief.

Clinical Signs and Symptoms

Frozen Shoulder often presents with symptoms such as:

  • Sharp pull or pain in the middle of upper arm on sudden movements, like a flash of lightening 
  • Difficulty raising your arm sideways or forwards or carrying objects.
  • Difficulty putting the arm behind your back. 
  • Pain in mid-range of shoulder movement 
  • Pain in shoulder lasting for more than a few days.
  • Swelling or significant bruising around the shoulder or arm
  • Shoulder pain that occurs at night or at rest, also disrupting normal sleep patterns

1. Freezing Stage

  • Duration: Lasts approximately 2 to 9 months.
  • Characteristics:
    • Pain takes center stage.
    • Any shoulder movement triggers discomfort.
    • Gradual loss of shoulder mobility.
    • Simple tasks such as fastening a seatbelt or reaching for a cup becomes difficult.

2. Frozen Stage

  • Duration: Persists for about 4 to 12 months.
  • Characteristics:
    • Pain may ease, but stiffness intensifies.
    • The shoulder resembles a rusted hinge, resisting movement.
    • Everyday activities like putting on a coat, combing hair become impossibly difficult.
    • Nocturnal discomfort/pain that disrupts sleep.

3. Thawing Stage

  • Duration: Gradual improvement over 5 to 24 months.
  • Characteristics:
    • The shoulder cautiously thaws, like a winter morning yielding to the sun.
    • Movement becomes less painful.
    • Range of motion gradually returns.
    • Patients regain the ability to reach overhead and perform daily tasks.

How Can Physiotherapy Help Frozen Shoulder Patients

Physical Therapy for Frozen Shoulder focuses on the management of symptoms present and reduction of pain and increasing available range of motion. Physiotherapy can help patients achieve decrease in pain/discomfort, improvement in muscle strength, return to activities of daily living, etc.

Services provided by Us:

Our physiotherapists will assess the painful area and treat the symptoms with a combination of techniques, some are as follows:

Physical therapy can help manage shoulder pain and aid in returning to normal everyday function. Our PTs are trained to provide relief by doing the following:

  • Laser Therapy and Ultrasound Therapy: Used for heating and promotes tissue healing.
  • Interferential Therapy: Stimulates the muscle and nerve fibers.
  • Shockwave Therapy: to relieve pain.
  • Exercise Therapy: Muscle Strengthening and Stretching and training to improve overall function.
  • Postural Training: for the best positions for weight bearing to reduce stress on the muscles and joints.
  • Education: Learning different techniques to perform daily activities even while being limited
  • Manual Therapy: Manual techniques such as trigger point release is beneficial in improving mobility and reduce pain.

How to manage Acute Injuries and Pain

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What happens during an injury?

When you get injured, the body’s natural response will be inflammation.  Signs and symptoms of acute inflammation will be swelling, redness, heat and pain.  Mainly caused by the increased blood flow associated with swelling.

Thus, initial management of an acute injury will be to reduce the inflammation and swelling.

How?

P.R.I.C.E.R.

P = Protect

R = Rest

I = Ice

C = Compression

E = Elevation

Protect

The injured area should be protected to prevent further injuries.  The injury can be protected with arm sling, braces, splint or taping and aids such as crutches can be used.

 Rest

Resting the injured area will prevent further injuries and also help start the healing process.  The injured area will usually be weak and more vulnerable to further injury.

Ice or cold therapy

Ice helps decrease blood flow to the injured area by constricting the blood vessel, thus minimise swelling / inflammation

Compression

Applying compression around the injured area helps minimize swelling by preventing the build-up of fluid.  Compression can also help relief pain by immobilizing and providing support to the area.  It should not be too tight that it interferes with blood flow.

Elevation

Elevation of the injured area (above the level of the heart) will allow fluid to drain away from the area.  With gravity, swelling or fluid can pool at the joints below.

Referral

Referral refers to consulting a Doctor or a Physiotherapist for further treatment.  Especially if you are unsure of the extend of injury and if the injury does not get better by 3 to 5 days.

PRICER should be administered within the first 48 to 76 hours after an injury.

Heel spur causing heel pain

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A heel spur is a bony growth that forms under the heel bone, and it can cause sharp or nagging pain and inflammation in the heel and its surrounding areas. Heel spurs are often caused by overuse, wrong shoes, improper foot mechanics, and certain medical conditions such as plantar fasciitis.

Heel pain from a heel spur is typically felt in the bottom of the heel and can be accompanied by:

  • Sharp pain when standing or walking
  • Pain that is worse in the morning or after prolonged sitting
  • swelling or redness in the heel
  • bony protrusion that can be felt or seen on the heel

Treatment for heel pain from a heel spur may include:

  • Rest and ice: Applying ice to the affected area can help reduce pain and inflammation.
  • Stretching and exercises: Stretching the calf muscles and Achilles tendon and doing exercises to strengthen the muscles in the foot and leg can help improve flexibility and reduce stress on the heel.
  • Orthotics: Customised shoe insoles can help correct any improper foot mechanics that may be contributing to the heel spur.
  • Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help to reduce pain and inflammation.
  • Physiotherapy: A physiotherapist can treat this using Laser, Ultrasound and Radial Shockwave therapy and  exercises to improve strength, flexibility, and range of motion.
  • Surgery: In some cases, surgery may be recommended to remove the spur, but it is usually considered as a last resort.

 It is important to consult with a healthcare professional to determine the underlying cause of heel pain and the appropriate course of treatment. Additionally, some lifestyle modifications such as switching to shoes with a cushioned heel, avoiding high-impact activities, and incorporating low-impact exercises like swimming, cycling or yoga can also be beneficial in managing heel pain from heel spur.

You may contact us if you need help with your heel pain.

 

Foot and Heel

Plantar fasciitis is felt as a pain around the heel and arch of the foot. It can be felt as a discomfort or sharp pain in the heel on weight bearing especially after a rest period. As a person gets older, the fascia becomes less elastic. The heel pad becomes thinner and loses the capacity to absorb as much shock. There may be some swelling, small tears or bruises in the plantar fascia with the pounding force on the heel. Plantar fasciitis can also be a result of overuse in activities such as long-distance running, basketball, ballet dancing or dance aerobics. It settles down quickly if treated early and given enough rest, but may become worse and  chronic if initial symptoms are ignored.

To reduce the pain of plantar fasciitis, try these self-care tips:

  • Give adequate rest to your feet. Avoid prolonged standing or high impact activities like running that cause repeated loading on the foot. If you need to stand for long time, then shift your weight from one foot to the other or use a footrest under the affected foot to offload it for a while.
  • Don’t walk barefoot,especially on hard surfaces, as this puts extra stress on the plantar fascia. It is advisable to wear soft heeled footwear or footwear with scooped out heels to avoid pressure on the heel.
  • Wear supportive shoes.Choose shoes with a low to moderate heel, supportive arches and good shock absorbency.
  • Avoid high heels especially when you need to walk long distances or stand for long periods of time. High heel shoes exert additional pressure on the inflamed fascia and lead to more heel pain.
  • Do not wear worn-out shoes.Replace old, tattered, non-supportive shoes. This is very important if you walk or run in these shoes. A good way to tell that your shoes need replacing is to look for thinned (worn) out areas on the sole of the shoe.
  • Apply ice: This can be done on the painful area three or four times a day, especially at the end of the day. Icing helps to reduce pain and inflammation. Icing can also be done with a frozen bottle of water rolled under the foot while sitting.
  • Massage: Self massage can be done by rolling a tennis ball under your foot while sitting. As mentioned above, a frozen water bottle can also be used.
  • Change your sport.Try a low-impact sport such as swimming or bicycling instead of walking or jogging while the plantar fascia is inflamed/painful.
  • Maintain a healthy weight. If you are overweight, then try to lose some weight. Extra weight can put extra stress on your plantar fascia.
  • Exercise before getting out of bed in the morning or after prolonged sitting(sit to stand): Plantar fasciitis pain is usually at its worst in these two situations. A good way to combat this is to perform circular movements at the ankle (clockwise and anticlockwise) and a few seated calf stretches before weight bearing on the feet.
  • Do your stretches.Simple home exercises can be done for plantar fasciitis. Perform this stretch when waking up, mid-day, and before bed. It is also very important to perform these stretches in the warm up and cool down phase of your exercise routine, even after you recover from plantar fasciitis pain. This will help to prevent any recurrences. 

Heel Spur Causing Heel Pain

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Description/Introduction:

A heel spur is a bony growth that forms under the heel bone, and it can cause sharp or nagging pain and inflammation in the heel and its surrounding areas. Heel spurs are often caused by overuse, wrong shoes, improper foot mechanics, and certain medical conditions such as plantar fasciitis.

Heel pain from a heel spur is typically felt in the bottom of the heel and can be accompanied by:

  • Sharp pain when standing or walking
  • Pain that is worse in the morning or after prolonged sitting
  • swelling or redness in the heel
  • bony protrusion that can be felt or seen on the heel

Treatment for heel pain from a heel spur may include:

  • Rest and ice: Applying ice to the affected area can help reduce pain and inflammation.
  • Stretching and exercises: Stretching the calf muscles and Achilles tendon and doing exercises to strengthen the muscles in the foot and leg can help improve flexibility and reduce stress on the heel.
  • Orthotics: Customised shoe insoles can help correct any improper foot mechanics that may be contributing to the heel spur.
  • Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help to reduce pain and inflammation.
  • Physiotherapy: A physiotherapist can treat this using Laser, Ultrasound and Radial Shockwave therapy and exercises to improve strength, flexibility, and range of motion.
  • Surgery: In some cases, surgery may be recommended to remove the spur, but it is usually considered as a last resort.

 It is important to consult with a healthcare professional to determine the underlying cause of heel pain and the appropriate course of treatment. Additionally, some lifestyle modifications such as switching to shoes with a cushioned heel, avoiding high-impact activities, and incorporating low-impact exercises like swimming, cycling or yoga can also be beneficial in managing heel pain from heel spur.

You may contact us if you need help with your heel pain.

TREATMENT for PAIN IN NECK IN SINGAPORE

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Description/Introduction

Bending on your computer or phone? Is your back is slumped right now? Are your shoulders rounded? Is your chin going too far forward? These are common postures to be seen now a days with the world of technology and gadgets, we prefer to slump with gravity as it’s an effort to sit otherwise.

Hence lots of us suffer from neck aches and neck pains resulting from the posture of tilting you’re the head down to look at the screens and devices. We tend to spend many hours a day sitting in these kind of postures hunching over the gadgets, whether it’s for work or leisure .

Causes of Neck Pain:

When you tilt your head forward or look down, this increases the weight of the neck and pressure on the neck muscles, soft tissues, and cervical vertebrae. 

Neck muscles have to work to hold the head up, and the more you look down, work gets hard for muscles work to keep your head up. Over time, the repetitive strain results in soreness, stiffness, and even injury to the neck muscles and cervical spine.

Clinical Signs and Symptoms of Neck Pain:

  • Ache or pain in the neck, shoulders, and upper back.
  • Sharp, stabbing pain in the same areas.
  • Stiffness. 
  • Increased neck and shoulder pain when looking down. 
  • Tingling, numbness, or weakness in the hands —spinal nerve pain
  • Temporomandibular joint (TMJ) problems
  • Cervical spondylosis

Tips by Physio Asia, an experienced physiotherapy centre in Singapore

  • Keep your screens at eye level. 
  • Invest in good supportive chair with a great headrest and lumbar support.
  • Strengthen and stretch your muscles. Learn correct exercise from the physiotherapist
  • Take frequent breaks to get up, walk around, and stretch for a minute every 15-30 minutes to help ease tension in the neck and body.
  • Correct your posture. Stand straight with your head centred over your neck and keep a neutral spine, so your ear is in line with your shoulders. 
  • Apply ice. You can apply ice for the first 48 to 72 hours to relieve pain in a stiff and sore neck. Then switch to warmth with a heating pad, hot compress, or warm bath to heal and stretch your muscles and tendons.
  • Visit our physiotherapist to help you relieve the pain

Try and follow preventative methods to prevent the aches and pains associated with posture. If your symptoms do not improve, you should seek help from a qualified health professional for neck pain treatment in Singapore. Call us for an appointment or send your queries to: info@physioasia.com. 

Real Time Ultrasound for Pelvic Floor Muscles or Diastasis Rectus

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Real Time Ultrasound Imagery (RTUS) uses sound waves to provide a visual image of muscle, tissue, and ligaments in our bodies. RTUS is a not a treatment tool but is a diagnostic and learning modality, that allows the physiotherapist and visual learner a picture and active image of parts of their body and their functioning.

RTUS is a wonderful tool to view the Diastasis Rectus (DR) abdominal muscle separation that may occur because of pregnancy, trauma, birth defect and or obesity. Measurements can be taken with RTUS and an image stored to view later, to evaluate the success of the physiotherapy program provides great motivation and feedback for both the client and physiotherapist.

RTUS is painless, noninvasive and a fabulous diagnostics tool to allow physiotherapist trained in this area, a platform from which to create an individualized educational exercise or training program for our clients.

In the post-partum period, when mums are very concerned about returning back to exercise, and what kinds of eerie they should be doing – the use of RTUS allows for a clear visual image of their DR separation and from there a return to core fitness and a fun exercise program can be tailored for the client.

RTUS is also a fantastic tool to allow women to view their Pelvic Floor Muscles (PFMs) to see whether the PFMs are working affectively again and to see if any dysfunctions such as changes in muscle tone and recruitment patterns are noted.

RTUS can be used safely while pregnant, as well as after you have delivered your baby. Please come in with a semi full bladder, as this allows a clear view of the PFMs, no vaginal probe will be used. A RTUS sound head will be placed on your skin in the lower pelvic area to view your bladder and PFMs. This is completely noninvasive and painless. Everyone usually really enjoys seeing their body muscles and how they function from the outside in!

CERVICAL SPONDYLITIS OR SPONDYLOSIS

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Cervical spondylosis, also known as cervical osteoarthritis or cervical spondylarthrosis is a natural age-related wear and tear (degeneration) process of the neck. It can involve the bones, discs, and joints of the neck.

With age or with over use in wrong postures ( at an early age too) as the cartilage wears out, the discs loose their original volume and can become dried and develop cracks and eventually become stiffer.  If left unchecked they can further develop into disc herniation, commonly known as slip disc.

Cervical spondylosis can also lead to ligament thickening and formation of bone spurs (osteophytes) in the areas where the bones rub against each other due to the lack of top layer of protective cartilage. All of these changes can lead to narrowing of the spinal column or the openings where spinal nerves exit, leading to a condition known as spinal stenosis.

Symptoms of cervical spondylosis:

Cervical spondylosis usually occurs in middle-aged and elderly people. One or more of these symptoms may be seen:

  • Neck pain
  • Stiffness in the neck
  • Pain or tingling numbness may radiate to the arm, forearm and/or hands and fingers.
  • Muscle weakness in the upper limbs.
  • Headaches, originating from the back of the head.

However, these symptoms can be easily managed by maintaining a good posture and maintaining flexibility and strength of the neck muscles.

But if the symptoms get worse it is always better to address them with a physiotherapy session. Physiotherapy can help to manage neck pain and stiffness and other symptoms caused by cervical spondylosis. Physiotherapy treatments can help patients achieve improvements such as reduction of pain, increased neck movements, increased neck strength, improved posture and therefore helps to return to activities of daily living and eventually potential return to sports.

Our physiotherapists will assess your neck and treat the presenting symptom with a combination of therapies, some of which are mentioned below:

  • Manual therapy such as mobilisations
  • Tissue releases
  • Laser
  • Ultrasounds
  • Short wave diathermy
  • Different current forms
  • Postural and ergonomic education are also a vital part of the treatment.

Home treatment includes exercises for stretching the tight muscles, strengthening exercises for weak muscles and use of cold packs to ease the inflammation.

We are also well versed with specialized treatment techniques such as:

  • Dry needling
  • Decompression therapy
  • Radial shock wave
  • SCORES – Spinal Core Stability Program for muscle strengthening and diaphragmatic breathing control, to strengthen the deep stabilising muscles of the spine.
  • Achievo pressure feedback system – This provides an audio-visual indication of whether you are working the correct postural muscles in the right manner when performing specific core exercises.

These specialized treatment techniques give an added advantage to the patient as they help to fasten healing and thus speed up the recovery time.