HOW DO I GIVE MY HIPS & KNEES THE BEST CHANCE OF SURVIVAL?

Osteoarthritis is the medical name for the changes which happen in a joint with age. In most people, this process plays out as a natural part of aging, and is really nothing to worry about (no more so than grey hair and wrinkles!). In some people, osteoarthritis can start to become painful, and it's a pretty common reason for seeing your GP or physiotherapist. While we can’t cure arthritis, there’s plenty we can do in terms of exercise and lifestyle to manage it well. Joint replacements are often discussed as a potential treatment, but it's not just as simple as swapping out a mechanical part. It involves a pretty substantial surgery, a years worth of rehab, and the new joint will need replacing again after roughly 15 years.

In the past, we’ve always thought of arthritis as being mainly a mechanical issue, wear and tear. This has always made exercise sound a bit counterintuitive, why would you exercise on a joint which is already worn out from too much use? More recent research has found out that rather than worrying about the wear, we should be thinking of osteoarthritis as being in the same camp as things like high blood pressure, type II diabetes and heart conditions. For this reason, regular general exercise, at least 30 minutes every day is essential.

On top of general exercise, we also know that specific strengthening of your thigh, buttock and trunk muscles can take some pressure off the sore joints, and make them last longer. These can range from simple squeezing exercises all the way to weighted squats. This is where it's worthwhile checking in with a physiotherapist, too much or too little strength work will be like taking medication at the wrong dose.

Lastly, your general health and wellbeing plays a huge role in the comfort and health of your joints. Your GP is your best port of call for general check ups and pain relief. Getting a nutritionist or dietician to take a fine tooth comb over your diet is also really helpful and worthwhile. Body weight and general inflammation play a huge role in making arthritis better or worse, and even small changes to your diet can make a huge difference.

We know that people who make a sustained effort with their general fitness, strength, general health and lifestyle can put off joint replacements for years, or even get rid of the need altogether!

Our Ask A Physio series is a collection of micro blogs aimed at giving a basic understanding to some frequently asked questions. If you have an injury or are experiencing discomfort please book for an assessment, or contact reception for more information.


What is manipulation and is it enough to treat injuries?

Have you ever clicked your fingers or between your shoulder blades and felt some pressure release? That’s manipulation; in technical terms it's a quick thrust right at the end of where a joint can move. There’s a bit of debate about what the “click” actually is, but our best guess is that quickly changing the shape and space of a joint makes tiny gas bubbles “pop”.

It can be a really useful treatment technique in the right situation, particularly for stiff backs, but there are a few caveats. Manipulating a joint early on can make swelling and damage worse; imagine trying to click your fingers when you’ve just sprained one. The other important thing is that manipulation is only for relieving pain and stiffness, it doesn’t solve your issue, or put anything into place.

You often hear about people going to get their backs “clicked” every week, and after a couple of days the effect wears off. It’s a bit like taking a cough drop or a panadol, you still need to put some work in with a well set out home programme if you want a long term fix.

Shoulder Pain: When Should I Be Worried?

The shoulder is a pretty remarkable piece of kit; it’s by far the most flexible joint in our body, capable of loading up in an almost infinite combination of movements. It’s also the fastest; a good thrower can make it turn at an acceleration of 6000-7000 degrees per second! All this performance doesn’t come without a few issues though, and shoulder injuries are some of the most common reasons people come to our clinic.

The most common pattern we see is called rotator cuff related pain, sometimes also called bursitis, impingement, subacromial syndrome or any combination of those. This is generally from a big spike in how much you’ve been using your shoulder. Think push up challenges during the COVID lockdowns, heavy loads of laundry, or doing lots of throwing after time off over winter. It’s a soft tissue injury, irritation or damage to the big 4 muscles which rotate your shoulder, and the network of other tissues around them.

Most of the time, this is pretty simple to manage. Early on, basic range of motion, grip strength and gentle loading exercises help to keep things steady. This is also where you might consider some pain relief, heat packs and making sure you’re getting plenty of good quality sleep and food.

*Example movement exercises courtesy of Physiotec - the program we use to provide patients with their individualised exercise programs.

If you find that after 5-7 days of this, the pain is sticking around and you’re still a bit weak or stiff, a good physiotherapist can point you in the right direction with more specific exercises targeted at your specific issues. If this sounds like you, you shouldn’t be worried at all. These injuries can be a bit stubborn and take a few months to settle completely, but it’s rare for them to stick around beyond that.

More serious shoulder injuries can be spotted by pain levels, strength levels and by big, fast, high impact stories. Normal rotator cuff pain will settle with rest, basic pain relief and heat. If you find that isn’t that case and your pain is throbbing when you’re at rest or trying to sleep, it’s a good idea to get checked out. If you get really weak after your injury, with or without pain, then that can also be a sign of some more substantial soft tissue damage. It’s actually not uncommon for more serious rotator cuff injuries to be pretty much pain free early on. If you can’t lift your shoulder above rib height in the first 48 hours, and you can’t support the weight of your own arm, that’s another reason to come in ASAP for some more tests.

Lastly, if you got injured by something big, heavy and/or fast, then there’s a higher chance of something serious happening. This is particularly true if you felt the joint “pop” in or out, or if you felt something move in the joint. You don’t necessarily need surgery if this is the case, but catching big injuries early on gives us a much better chance of getting you a good outcome.

The bottom line is to keep moving, do your basic rest and pain relief early on, and if there’s anything stubborn or suspicious from what I’ve mentioned above, then come in for a check up.

Our Ask A Physio series is a collection of micro blogs aimed at giving a basic understanding to some frequently asked questions. If you have an injury or are experiencing discomfort please book for an assessment, or contact reception for more information.


How soon post injury should I see a physio?

Ideally ASAP! A bit like an issue with your car or house, the sooner we can get you doing the right things, the better chance we have of getting you back to normal sooner. Particularly when it comes to sport and exercise, we’ve got good research showing that the first 72 hours can make your recovery a lot faster or slower.

If it’s an injury or issue you’re really familiar with from previous experience, then you’ll already know the routine for the first week. In that situation I usually tell people to manage it how they’d manage a stomach bug; do what you know for the first 48 hours. If you’re not getting anywhere doing what you know, then check in with us.

If in doubt you can always book for a free 15min phone consult with one of our Physiotherapist!

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