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Physiotherapist or Sports Rehabilitator: Not The Same!

By Chris Liversidge In , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

With the advent of Sports Rehabilitation as an Undergraduate Degree, and Sports Rehabilitators appearing in the marketplace, I’m often asked what the difference is ~ and whether someone should seek help from a Physiotherapist or Sports Rehabilitator for a musculoskeletal condition.

What is a Physiotherapist?

  • The term “Physiotherapist” describes a professional who uses physical and manual methods to restore function, and rehabilitate ‘patients’ with physical conditions
  • Both “Physiotherapist” and “Physio” are legally protected titles. This prevents anyone without a certified degree in Physiotherapy from
    • using the title of Physiotherapist
    • or describing their role as that of a Physiotherapist
  • Physiotherapists are, alongside all other Professions Allied to Medicine (PAMs), required to have registration with the Health and Care Professions Council (HCPC), a regulatory body requiring members to demonstrate appropriate continuing professional development, to maintain their registration. Without this, a Physio is not entitled to practice

To complete the undergraduate degree, a Physiotherapist must study and demonstrate competence in the care of a range of conditions – not only musculoskeletal in nature, but also neurological conditions, respiratory disease, general surgical and orthopaedic surgical conditions and more.

The qualified Physiotherapist is then armed (as most do initially) to take up a post in the NHS or other medical institution, to continue to develop their practice. It is during the initial 2-3 years that the Physio will work across all fields of the profession, and also begin to develop a special interest in a specific area (e.g. musculoskeletal, neurology, etc.). As experience and depth of knowledge is gained, there is too much ongoing learning required to maintain expertise in more than one area.

Having said that, the early broad learning in the Physiotherapist’s career is essential, as there is a great deal of overlap in some areas. For example, some neurological knowledge is key to musculoskeletal rehabilitation, as the two systems are not mutually exclusive.

What is a Sports Rehabilitator?

  • Having completed an undergraduate degree in Sports Rehabilitation, this practitioner has knowledge specifically in the assessment and rehabilitation of sporting/musculoskeletal complaints
  • As the title suggests, the emphasis is often on returning a ‘patient’ to a specified level of sporting capacity. Manual/hands-on therapies are also used by a Sports Rehabilitator
  • However
    • There is no training offered in a broader systems rehabilitation approach (e.g. neurological rehab)
    • This practitioner is currently not a “Professional Allied to Medicine”
    • The qualification is not currently regulated by the HCPC, and practitioners are therefore not required to meet their standards to practice
  • There is also currently no avenue for the Sports Rehab practitioner to work in the NHS or medical institutions, nor to register with health insurance providers such as BUPA, AXA, etc.

Overlap
There is a great deal of overlap. Both practitioners are able to provide hands on treatments and exercise prescription, to improve symptoms. Technically and literally, a Physiotherapist practicing in the musculoskeletal specialism, rehabilitating patients back to sport, is a sports rehabilitator.

However at the time of writing this blog, the lack of HCPC registration means the Sports Rehabilitator is not found working in the field of elite sport, because of the extent of medical overlap often required in musculoskeletal roles within professional sport.

Extended Scope
It is also worth noting that, critically, a large number of medical conditions can masquerade as musculoskeletal problems. The key here, is to have a practitioner who has the correct experience to differentially diagnose whether your condition is truly musculoskeletal, or is masquerading for an underlying medical problem.

Physiotherapists with this level of expertise are highly experienced, usually having worked in a hospital/medical setting in musculoskeletal care, for at least 8, or up to 10 years, and have seen a very large volume of differing conditions over many years. They are referred to as Extended Scope Physiotherapists (ESPs).

The key skill of an ESP is knowing what is a rehabilitation problem, what isn’t a rehabilitation problem, and for the latter, who is the correct professional to refer to.

Summary

  • The key thing to remember, whichever practitioner you choose, is experience
  • A Sports Rehabilitator has a good depth of training, and many offer a good service in managing the recreational athlete
  • However, one must bear in mind the breadth of training in Physiotherapy, and the advantage of the medical training incorporated in the Physiotherapy degree

Of course, the extent of experience of your chosen clinician is vital too. For me, the choice to open a Clinic was one I gave a lot of consideration to.  I felt this choice was realistic after I had accumulated 10 years of experience, knowing I felt confident to assess whoever walked in through our front door – but I also continue to humbly accept that I have, by no means, learnt all there is to know!

Best Wishes,
Chris

Chris Liversidge (MSc, BSc (Hons) 1998,2001, MCSP) is an Extended Scope Physiotherapist (Musculoskeletal/Orthopaedics) and Practice Prinicpal at North Light Physiotherapy Associates, UK.

To book an appointment with the experts at North Light Physiotherapy, PLEASE DO NOT LEAVE A COMMENT HERE! 

Call us on 01484 660663,  or click on our Contact page

Neurological Rehab at North Light Physiotherapy

By Chris Liversidge In , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Chris Shorter North Light PhysiotherapyFor our latest blog, Chris Shorter, our Neurological Rehab specialist at North Light Physiotherapy discusses the specifics on offer

“Physiotherapy is strongly recommended in the national guidelines for rehab and management of neurological conditions”, he says.

Experience
From working in the field of neuro-rehab for over 14 years now, Chris has seen its effectiveness first hand in many ways.  Conditions treated include, but aren’t limited to Parkinsons Disease, Multiple Sclerosis and Stroke. Neurological disorders and disease are vast. Chris relishes the variety, and the challenge this variety presents, and takes an enormous amount of satisfaction in patient outcomes.

Chris says: “We are now very happy to offer assessments and treatments at North Light Physiotherapy, either in our clinic or in our spacious gym setting, which has level access. We know that in some cases mobility can be severely limited, so we can also offer the option of home visits. *”   (* – within a maximum range of 3 miles from the Clinic)

Neurological physiotherapy Rehab North Light Physiotherapy

Expectation

“Physiotherapy begins with a thorough assessment: gaining information on the patients’ goals and targets for rehab / condition management.  A typical physical assessment may include assessment of movement, strength, muscle tone, balance and gait pattern. There are also more condition-specific assessments that we would include, depending on the presentation.”

“Treatment may entail work on improving movement and strength through a combination of exercise, hands on therapy and movement re-education. Advice on orthotics or walking equipment is also considered. Balance rehab and specific feedback on how to improve gait (walking) pattern is also a common approach. ”

Whether your problem is pain caused by your condition or balance problems, maybe even falls,  we would provide treatment or advice for this. A goal for many of our patients is to improve mobility levels. This can be broken down into more specific steps, and advice can be provided on the areas to work on along with education on what may be causing the current problems.

Treatment Specificity

As an example, one persons problem may be due to weakness around a specific joint or more than one joint, for another it may be due to higher level balance problems; the role of the physiotherapist is to identify the contributing factors causing the problem and to provide specific advice on how to work on this.

Living with a neurological condition that can often be for the long term can be a strain on our resources and motivation. However a therapeutic alliance between physio and patient is key. We give our patients the time they need to discuss how their conditions impacts on their wellbeing, because an empathic listening approach is therapy in itself and helps the rehab process.

One on one rehab can be a very motivating experience and achievement of goals is rewarding no matter how small…and when our patients takes control of their condition, that’s our favourite outcome!

For details of how we can help with your Neurological condition, get in touch!

To book an appointment with Chris Shorter or any of our expert Team at North Light Physiotherapy Associates, PLEASE DO NOT LEAVE A COMMENT HERE ~ Use our Contact form, or call us on 01484 660663. 

Sports Massage at North Light Physiotherapy

By Chris Liversidge In , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Who can benefit from Sports Massage?

Sports Massage at North Light Physiotherapy

Sports Massage is useful for various problems, not just in a sports context. Often muscles can feel tight or stiff after heavy or repeated physical activity this can be sporting, occupational or recreational. Muscular tightness and restriction can be reduced, and pain alleviated as part of a more broad based management strategy that may form part of a regular training programme, or a course of Physiotherapy or rehabilitation.

Expertise

Our team have a wealth of experience and expertise.  We have worked with professional sports people, and this experience is invaluable in working with athletes at all levels and abilities.  We can support you, whether in preparation for athletic events, such as endurance running, cycling sportives, or if you only take part in your favourite activities for fun and wellbeing.

To book your Sports Massage, call North Light Physiotherapy on 01484 660663 or head over to our Contact page – looking forward to seeing you!

Dizziness: Life in A Spin…?

By Chris Liversidge In , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

http://northlightphysio-co-uk.stackstaging.com/life-spin-dizziness/Physiotherapy is highly effective for the diagnosis and treatment of dizziness, and for balance rehabilitation.  In this piece we look at Vestibular Rehabilitation at North Light Physiotherapy, with Chris Shorter

Dizziness can be very limiting on our lives, impacting our ability to move normally and has a huge impact on our emotional wellbeing. It often leads to falls and causes anxiety and avoidance of many activities. Many people live very restricted lives with this condition.

If dizziness is related to the inner ear (a problem with our peripheral vestibular system), Physiotherapy can be highly effective. For example: the Epley technique is a postural movement technique than can reverse dizziness. Specific eye and head exercises are often used to challenge the balance system in order to improve it. A graded exposure to dizziness is also recommended, the system will only reset itself if we expose ourselves to dizziness, and this is carried out gradually at a rate the patient can handle.

Some medical causes of dizziness can be ruled out during Physiotherapy assessment, such as postural hypotension (blood pressure drop that occurs during a change in posture) or VBI – vertebrobasilar insufficiency- where the blood supply to the brain gets temporarily blocked by neck movements. A key role of the Physiotherapist is ascertaining what isn’t manageable with Physiotherapy, and in these cases, referring on to the correct specialist.
Postural hypotension and VBI can be medically managed, and if these problems are found during screening we would provide advice and then refer to your GP for further assessment.

Factors such as stress and anxiety are also considered in the holistic process of assessment and treatment, as in my clinical experience dizziness is often linked with times of stress, poor health or even bereavement. Addressing these factors or even making the links to your dizziness symptoms can also play a big part in recovery.

If your life is limited by dizziness, you have a problem with your balance, or you are prone to falls, Physiotherapy may well be the solution!

Call North Light Physiotherapy Associates on 01484 660663, or send a message on our Contact page.

 

Chris Shorter of North Light Physiotherapy Associates, Huddersfield, UK, qualified as a Physiotherapist in 2003.  He has a special interest in balance and vestibular issues, which he comes across daily in his clinical practice.

Shockwave Therapy at North Light Physiotherapy

By Chris Liversidge In , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Extracorporeal Shockwave Therapy for Musculoskeletal Conditions

Extracorporeal Shockwave Therapy (ESWT) has been successfully used for the management of a variety of musculoskeletal conditions for over 20 years. It is now available at North Light Physiotherapy!

In Urology, shockwaves are used to disintegrate kidney stones, whereas in Musculoskeletal medicine, its use is to induce tissue repair and regeneration on a cellular level. The mechanism by which this takes place is not fully understood, despite many studies showing positive outcomes in a variety of conditions.

Principle of Treatment

Shockwave patterns differ from Ultrasound waves, in that ESWT generates significantly higher pressure. Primarily, this generates a mechanical force focussed on the target tissue. This generates a response within the target cells, and in areas around the target tissue. Many patients we treat with ESWT present with tendon pain- commonly in the Achilles, knee-cap (Patellar) tendon, the Plantar Fascia, and at the elbow (so called “tennis elbow”, or lateral epicondylitis), or shoulder.

Problems with tendons seem to occur more frequently with a big and relatively sudden increase in physical workload. Examples include suddenly running much further than usual, suddenly lifting more heavily in the gym or other physical activity, such as CrossFit.

When people are new to physical exercise, problems can occur during the time it takes for the body to develop the robustness to tolerate more physical work. For this reason, ESWT will only ever form part of the overall treatment, because sensible management of physical workload, in view of individual physical capacity, is the key to success.

If you believe ESWT may be appropriate to help manage your problem, we will always consider this as a management option as part of a comprehensive assessment. ESWT as a standalone treatment, is likely to be less effective than when combined with comprehensive Physiotherapy care.

Plantar Fasciopathy (Fasciitis)

Many studies have shown ESWT to be effective in the treatment of Plantar Fasciopathy. Success rates vary between 34% to 88%. This may depend on severity of the problem, and how long the condition has been present before treatment. Good quality evidence suggests that treatment must incorporate a suitable loading programme (Physiotherapy-type exercise).  This ensures the Plantar Fascia retains/improves its ability to tolerate the force required for exercise.

Achilles Tendinopathy (Tendonitis)

A common problem with runners, the Achilles tendon may generate symptoms in the mid-portion (half way up), or at its insertion into the heel bone (calcaneus). The insertional Achilles pains tend to be more stubborn to settle. However, studies have shown that both insertional and mid-portion Achilles problems are responsive to ESWT. In many cases, runners will present to our specialist running clinic, during which we may discuss and suggest modifications to running gait, and recommend modifications to running workload (distance, intensity).

Patellar Tendinopathy (Tendonitis)

 

 

Another frequent problem with running athletes, powerlifters and CrossFit-ers. Success rates have been reported to be as high as 74-88% with ESWT. Commonly, knee and hip control issues can play a part in the onset of problems, and will need addressing as part of a comprehensive treatment regime. Our specialist Running Clinic often identifies related areas to improve on, to modify and improve on pain and control of the knee.

Shin Splints (Medial Tibial Stress Syndrome- MTSS)

Often seen in running athletes, and more frequently in females- sufferers will experience pain at the inner side of the shin. Particularly evident on landing, during running. Modifications can often be made to the ankle and foot, in respect of strength and control of the rear part of the foot during landing. Sometimes orthoses (in-soles in the trainers) can make a difference. ESWT has been shown in some studies to make a positive contribution to symptoms of MTSS, and others not so much. Again, ESWT will be considered as part of a course of Physiotherapy, which will address any contributing factors.

(Calcifying) Tendonitis of the Shoulder

 

Success rates for treatment with ESWT have been reported in the 78-91% range, in studies, with ongoing relief beyond 2 years. The benefits include improved joint movement, and therefore improved ability to use the arm, particularly in overhead activities.  Swimmers and other overhead athletes, such as racket-sport players, and bowlers (cricket) can tend to be affected. The effectiveness of ESWT is again supplemented by a good course of Physiotherapy rehab, and workload modification principles.

If you are affected by a problem for which ESWT may be useful, please do get in touch – North Light Physiotherapy will be pleased to support you. You can get in touch via our Contact page, or on 01484 660663. See you soon!

 

Chris Liversidge (MSc, BSc (Hons) MCSP, SRP) is Practice Principal at North Light Physiotherapy Associates, Huddersfield HD4 7NR.  Visit www.northlightphysio.co.uk or call 01484 660663

Extended Scope Physiotherapy at North Light

By Chris Liversidge In , , , , , , , , , , , , , , , , , , , , , , ,

North Light Physiotherapy Associates’ Practice Principal, Chris Liversidge, is an Extended Scope Physiotherapist (ESP)

What does Chris’s expertise mean for you?

In a nutshell, being treated by an Extended Scope Physiotherapst often means faster differential diagnosis of acute physical injuries, and many other longer term musculo-skeletal conditions.

ESPs are able to work beyond what is usually recognised as standard Physiotherapy practice.

However, many people will suffer an injury or acute muscular problem (for example, following a fall or accident, an episode of back pain or a sporting injury) and assume their GP is the best place to go.

Waiting times can be long, and GPs don’t always have the depth of up-to-date developments in physical medicine –  so whilst they may usefully prescribe painkillers or anti-inflammatories, combining this with a course of immediate Physiotherapy treatment may actually be far more successful than pain relief alone.

When you are suffering acute pain, an Extended Scope Physiotherapist (ESP) often provides:

  • a faster differential diagnosis of the injury/problem
  • more specific treatment
  • a faster recovery and return to normal function
  • If tests or other medical investigations are required, an Extended Scope Physiotherapist can recommend which is most suitable to request, and in many cases, directly order investigations.

A faster solution to pain – that’s got to be a winner!

 

Extended Scope Physiotherapy North LightWhat does the term “Extended Scope Physiotherapy” actually mean?

Extended Scope Physiotherapy (ESP) practice is growing in prominence, both in private medicine and in the NHS.  On their website, Cumbria Partnership NHS Foundation Trust describe an ESP as:

“A Clinical Physiotherapy Specialist with an extended scope of practice.  This implies working beyond the recognised scope of Physiotherapy practice, for example requesting investigations (ultrasound scans/nerve conduction studies), using the results of investigations to assist clinical diagnosis and appropriate management of patients; listing for surgery, and referring to other professionals.  ESP’s hold post-graduate qualifications (eg. MSc), Society of Orthopaedic Medicine (SOM) membership or equivalent, and most have a Diploma in Injection Therapy.”

You can also find out more about the work of Extended Scope Physiotherapists at www.CSP.org.uk

To work at this level requires a number of years of experience, with a wide variety of conditions.                             Critically, this involves identifying conditions which are not suitable for Physiotherapy, as quicly as possible, and referring on to the correct specialist, as soon as possible.

To make an appointment with Chris Liversidge or any of our expert Team at North Light Physiotherapy, use our Contact form or call 0845 177 0780

Fear Avoidance (What you Resist, Persists…) by Chris Shorter

By Chris Liversidge In , , , , , , , , , , ,

Evening folks! Hope you’re all keeping warm in the snow!

I’ve got a real winter warmer for today’s #Advent blog series: a guest blog from my colleague at North Light Physio, the multi-talented Christopher Shorter.  He’s done a great piece about what we in the #pain management business refer to as “Fear-Avoidance”!

Check out Chris’s website: www.mind-body-rehab.com

Without further ado, over to Chris! Enjoy!

What do #backpain and #dizziness have in common? Answer: Fear

More notably fear avoidance of movement.

I work with a number of different conditions in the public and private sector and despite the large variety of cases I see, there are many common themes. Fear avoidance is a big one, it was first defined by Lethem et al. in 1983 but I’m guessing it was around much longer than that.

Fear keeps us safe, fear holds us back from injury and shoots us with a boost of adrenaline when needed. However when fear turns into a chronic apprehension of movement it begins to work against us.

You can acronym fear down to this: (I’m not claiming this, I heard it on a podcast a long time ago!)

  • F  = FALSE.

  • E = EVIDENCE.

  • A = APPEARS.

  • R = REAL.

So we can fear something that is not real. Some evidence may suggest it is, such as the belief that pain is always a sign of damage or symptoms occurring when we move, but in a huge amount of cases it is our beliefs that need changing…it is basically just false evidence.

Let’s apply the fear avoidance pattern to dizziness (aka vertigo/ labarynthitis/neuritis). Dizziness can be due to problems with the balance control system of inner ears. It is in fact very common and a high proportion of A and E visits can be due to this. The dizziness linked to the inner ears / nerve pathways of the ears is called a vestibular problem. In some people you can get a short lived vestibular problems just like most of us will get an episode of back pain once in our lives, the causes can be diverse (but that’s for another blog maybe),  both can resolve can quickly. Some facts about dizziness are:

  • Almost 1 in 4 adults under 65 report dizziness or vertigo, often causing occupational difficulties or preventing employment, but less than 25 per cent had received treatment (Collertan et al 2012).

  • Dizziness is one of most frequently reported symptoms for people over 75 seeking medical assistance (Sloane & Dallara 1999).

Sometimes the dizziness symptoms persist. They may not be as intense as the initial episode but they are enough for us to start to limit our movement and cause us some anxiety about keeping the dizziness at bay. Medication can also be prescribed as a dizziness sedative, but patients should be encouraged to wean off this. So a typical coping mechanism is commonly to self-restrict neck and head movements, limiting activities around the home or out and about. Classically busy places such as supermarkets become tricky to move around in. Our movements can change, when we turn the head we tend to turn the whole body in a robotic manner. Stiffness can also develop in the muscles and joints of the neck, as well as neck pain and headaches. This is where the importance of education comes in and I commonly tell my patients the following:

  • For the vestibular (balance) system to reset itself (to recover) it needs to experience normal movement of the head and neck. It also needs to experience error signals (i.e  – dizziness). It is OK to move the head and neck and it is also OK to feel some dizziness when doing this (this helps to re-calibrate the system).

Being told to move normally again is often quite anxiety-inducing in patients but believe me it works and it can be done at a pace comfortable for the patient (known as graded exposure to movement, not “in at the deep end” stuff!).

If we now look at this pattern in back pain. As physio’s we often find the patient is very apprehensive when bending forwards. For example and they may use mal-adaptive movement patterns (not moving normally), such as keeping the back entirely straight or arched when bending to pick an item from the floor. This is fear avoidance due to fear of pain, or fear of damage, or both. I accept that in the first few days, sometimes weeks of back pain we maybe move less to protect our self but if this goes on for many weeks, months, even years in some cases, it can become very disabling.  So just like a dizziness problem the area affected can become stiff, tense, very sensitive and weaker, not to mention in a lot of cases the pain persists. So again for clinicians; education and listening skills are vital. Hearing from the patient why they have changed their way of moving and what they are fearing is very important and can lead to a lot of clinical reassurance and confidence building. Movements restriction are often due to outdated beliefs, for example thinking our back remains damaged long after the time for healing has occurred. So just like for vestibular rehab, movement is encouraged, with bags of reassurance when needed.

In vestibular rehab when we start to move our head again it can invoke some discomfort or dizziness, remember this is normal. Similarly when moving our back again it can induce some pain or stretching type discomfort. Beginning to move normally again may initially feel stiff or painful, but this is hurt not harm.

A great line which also applies on many levels in life is ‘what you resist persists’. So if you are resisting movements due to dizziness or pain linked to fear of worsening symptoms, be open to the fact that your self-restriction may be holding you back.

This blog is a guide to give an idea of the concept of fear avoidance on how it applies to subsets of two conditions. This may not be the definitive answer but in some cases it is. A full assessment is always required.  Pain and dizziness have many more factors feeding into them, anxiety is a big feeder, as is our emotional health.

Contact me for a more detailed consultation.   I offer consultations and treatment for vestibular rehabilitation and assessments for chronic and acute pain.

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Chris Shorter is a Chartered Physiotherapist with North Light Physiotherapy Associates, Huddersfield, UK.  Find out more about Chris and his work at at www.mind-body-rehab.com

 

Posterior Ankle Impingement

By Chris Liversidge In , , , , , , , , , , , ,

Afternoon!

Here’s the latest #Advent instalment in our series. A daily evidence-based info-hit from the North Light world of physical health, wellbeing & performance! This is a day late-you know, like when you forget to open your calendar on one day, so you get 2 the following day? (Another instalment to uploaded earlier this afternoon!!)

Also look out for an announcement in the next couple of days in the run-up to Christmas – you can be involved, as long as you’re not on the naughty list!.

So…
I had the privilege recently of attending the operating theatres at Leeds Nuffield hospital to observe Mr Mark Farndon carry out a hindfoot endoscopy (keyhole surgery approaching from the back of the ankle). These opportunities are a key part of the ongoing development of our private service provision at North Light Physio, our individual professional development and in our responsibilities to the sporting partners we provide to. Critically, a great means of reinforcing well-grounded knowledge, and developing relationships with surgical staff – collaborative working being critical to patient care.

The case in question related to a cricket player (bowler) complaining of pain at the back of the (in this case, left) ankle on delivery of the ball. See image of the front foot below, and how the shin bone is angled backwards against the back of the foot/ankle (forced weight-bearing dorsiflexion).

http://northlightphysio-co-uk.stackstaging.com/posterior-ankle-impingement/

This is not uncommon, but we weren’t able to settle his symptoms sufficiently with Physiotherapy alone. On referral for imaging, an os trigonum (accessory bone at the back of the Talus) was demonstrated- see images below.

http://northlightphysio-co-uk.stackstaging.com/posterior-ankle-impingement/

The consequence is the likelihood of impingement in the back of the ankle, due to a physical lack of space – the joint lining can become inflamed, and swelling can build. The long tendon flexing the big toe (Flexor Hallucis Longus, FHL), can also become involved, given its proximity.

In this particular case, following surgery to remove the Os Trigonum, recovery has been excellent, and as we speak, the player is taking a full part in pre-season training, with no symptoms at all.

 

So, what did I learn from this case?

1. As good as we are as Physiotherapists, we can’t solve everything through Physio – knowing when to refer on is critical. The skill of knowing when to refer-on takes years of exposure – especially with conditions which do not appear regularly in our practice.

2. Reinforced my strongly-held belief in team-working across specialities- and how vitally important this is outside of the hospital setting, particularly when working in different geographical areas to the surgical team. Being there to discuss the rehab with the surgeon during the procedure is completely invaluable.

3. Knowing the pathology, the surgeon, the individual, and the feeling from the surgeon as to how well the procedure went, all give us a great advantage in preparing for, and delivering high-quality and timely ankle rehabilitation, to allow a speedy recovery!

An informative case to work on, and rewarding to see excellent progress!

Remember- get in touch below if you want our advice with your ankle problem!

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Christopher Liversidge (MSc, BSc (Hons) MCSP, SRP) is Practice Principal at North Light Physiotherapy Associates, Huddersfield, UK.  Click here to contact Chris, or call 01484 660663

5 Keys to Healthy Knees – use our expertise!

By Chris Liversidge In , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Having specialised in the rehabilitation of lower limb injuries, and particulary knee injuries, for many years now, I have observed 5 key objectives to achieve quickly to optimise knee function. This is irrespective of whether the rehab is post- injury, or post-operative. With these 5 goals in place, the knee will quickly function more normally.

1. Reduce swelling.

After an injury to structures inside the knee, it will swell- an effusion. This is known to cause reflex muscle inhibition, which can cause the quadriceps muscle to switch off, and the knee to feel as though it may give way. Minimise the effusion to optimise quads activity.

2. Restore full Active Extension.

The ability to actively fully straighten the knee is critical. This is the ability for you to switch on and tense your front thigh muscle (Quadriceps) by choice.  If this is not possible, you cannot actively keep yourself upright on your feet- the knee will give way.

3. Restore full Passive Extension.

This is the ability of an external force, i.e not you or your quadriceps muscle, to straighten your knee: e.g. ability for it to sag straight under the weight of gravity, or for someone (usually a Physio, when testing the knee), to pull it into a fully straight position. If this is not possible, it may indicate something inside the knee is mechanically blocking it. This must be dealt with quickly, as a block to extension left untreated can leave the knee stiff in the long-term, and will disable your ability to actively straighten your knee, and may again lead to giving-way or buckling of the knee.

4. Mobilise the Patella.

The patella (kneecap) is free to be moved within a specific range when the knee is relaxed. Often, usually after surgery, this ability for the kneecap to be freely moved is limited, and can have a consequential negative impact on the ability to develop quadriceps strength, and cause kneecap pain.  This can be restored by manual therapy during Physio sessions.

5. Normalise Gait.

The walking (gait) cycle is often significantly affected by pain/stiffness after injury or surgery. The adaptations to the walking pattern, if left unaddressed, can have significant negative effects on knee health: loss of movement, stiffness, muscle shortening and quadriceps inhibition. Normalising the gait cycle as quickly as possible is critical to knee health!

If you, or anyone you know are affected by these problems, please don’t hesitate to get in touch. Our expertise will get you on the path to healthy knees in no time!!

 

To book an appointment with the experts at North Light Physiotherapy, PLEASE DO NOT LEAVE A COMMENT HERE! 

Call us on 01484 660663,  or pop over to our Contact page