Lateral Tendonopathy / Tennis Elbow

By Nic Andrews, Assistant Physiotherapist at Woollahra Physiotherapy


Tennis Elbow 1.png

Tendonopathy  of the elbow  (more commonly referred to as “tennis elbow”) is a painful overuse injury that affects the outside (or “lateral aspect”) of the elbow. In your elbow, there is a common extensor tendon which attaches a group of muscles from your forearm to your humerus.

 

As pictured above, this condition occurs when there is damage to the common extensor tendon.

As suggested by the colloquial name, Tennis Elbow, a common cause of this overuse injury is participation in tennis or other racquet sports. The repetitive motion of tennis shots is often an inflammatory factor for pain experienced with this condition . However, the injury can be caused by any contractile load on the extensor tendon such as excessive computer use, heavy weight lifting or repetitive vibration. The injury affects 1-3% of the population, with people aged 35-50 most at risk.

So, how can you tell if you have tennis elbow?

It’s important to consult your chosen Physiotherapist if you experience any of the following symptoms:

o   Pain a couple of hours after aggravating activity

o   Pain immediately after provocative activity

o   Pain during the provocative activity

o   Constant pain prohibiting activity

o   Radiating pain down the forearm

o   Difficulty with grip

If you experience these symptoms it is crucial that you see your Physiotherapist for professional assessment and classification of injury.

The good news….

Approximately 80-95% of people will experience successful recovery without surgery. However, early intervention is paramount in avoiding surgical outcomes.

There are many treatment options for lateral epicondylitis - strengthening exercises and stretches have proven success rates. It is best to consult your Physiotherapist for a individualised program that will be most effective for YOU.

At Woollahra Physiotherapy we utilise the Physitrack App, which allows our Physiotherapists to design and create unique programs that are made available to you on your smartphone and allows our Physiotherapists to track your adherence and responses to the exercises.

Some exercises that may assist you are pictured below but it is always best to consult with your Physiotherapist before commencing any rehabilitation exercises.

Please feel free to contact us on (02) 9362 9765 to book an appointment or you can book online. 

Tennis Elbow 2.png

Cycling Setup

By Nic Andrews, Assistant Physiotherapist: Woollahra Physiotherapy

 

Cycling or using an RPM bike at the gym is an excellent way to improve cardiovascular endurance as well as strength. It is often a preferred method of training because it has a lower impact on joints (ankles, knees and hips) when compared to other activities such as running.

However, there are still a few key steps to ensure you’re training in the safest most effective way possible! As always, its best to consult a physiotherapist to work out what’s best for you. In the meantime, these steps should assist you in preventing injury or exacerbating any symptoms you may be experiencing.

Seat Height:

Perhaps the most important aspect to get right is your seat height. Proper seat height ensures proper force production and goes a long way to preventing injuries on the bike. A quick and easy guide is to stand next to the bike and the seat should sit in line with the top of your hip bone.

Cycling set up 1.png

A physiotherapist can assist in making special adjustments if you are feeling pain at the front of the knee (therapist will adjust your seat to a 15-20-degree knee angle) or pain at the back of the knee (therapist will adjust your seat to a 25-35-degree knee angle).

Handlebar Height:

The next thing to get right is potentially the most ignored aspect of setting up your bike. Correct handlebar height is imperative for effective muscle recruitment which allows you to get the most out of your session!

As a guide the handlebar should be parallel with the seat or slightly below.

Cycling set up 2 .png

Seat Forward/Back:

This particular aspect can get a little tricky so be sure to consult a physiotherapist if you don’t feel confident. Essentially you want your pedals in a 3oclock and 9oclock position. With your lead leg on the 3oclock peddle, you should be able to draw a line down through the knee directly into the middle of the peddle.

Cycling set up 3 .png

 

 

Handlebar Forward/Back:

This aspect is crucial to protect your shoulders, spine and neck. With your buttocks comfortably positioned towards the back of the seat, your arms should create a 90degree angle with the handlebars.

 

Once you’ve nailed these steps you are in a safe position to begin your training session. It’s important to maintain your core throughout the activity to protect your back. Make sure you are managing your resistance in accordance with your training levels and goals.

For any further clarification please don’t hesitate to contact the team at Woollahra Physiotherapy we would be more than happy to assist. 

Severs Disease

By Nic Andrews, Assistant Physiotherapist: Woollahra Physiotherapy

Severs disease is a common cause of heel pain affecting mostly girls 8-10 and boys 10-12. The pain is caused by excessive forces and damage to the growth plate of the heel during the early adolescent years.

As a parent it’s important to notice if your child may be suffering from Severs Disease so they can be treated by a physiotherapist as soon as possible to prevent worsening symptoms.

Here’s what to look for:

-       Limping

-       Running awkwardly

-       Increased heel pain when raised on tippy toes

-       Pain may be felt in one or both heels

As physiotherapists it is our role to conduct in depth screening of foot and leg biomechanics as well performing a range of clinically diagnostic tests to identify Severs Disease. We assess the foot and leg for decreased ankle dorsiflexion, over-pronation / over-supination of the hind-foot, reduced calf length etc. All of which can be predisposing risk factors to Severs.

Once diagnosed, we will follow a 7 phase treatment process that aims to eliminate pain and restore normal function.

Phase 1: Early Injury Protection: Rest, ice and protect

Phase 2: Regain Full Range of Motion: Identify and correct stiff joints and tight muscles

Phase 3: Regain Foot Arch Muscle Control: Your Physiotherapist will assist you in maintaining dynamic stability in your foot.

Phase 4: Restore Normal Calf & Leg Muscle Control: Assess leg muscle function and provide necessary treatments or exercises.

Phase 5: Restore Normal Foot Biomechanics: Foot biomechanics are the main predisposing risk factor to Severs, after a biomechanical assessment your Physiotherapist may supple you with orthotics to correct your foot posture.

Phase 6: In order to prevent re-injury its important you correct your technique in these aspects.

Phase 7: Footwear analysis: Poorly designed shoes can contribute to your injury

To prevent Severs Disease it’s important to maintain good joint movement and muscle flexibility in those younger years.

Finally, it’s really important you listen to your child, if your child is suffering heel pain from the ages of 8-12 suspect Severs Disease until proven otherwise by a qualified Physiotherapist. 

 

 

Pre-screening and Injury Prevention 

By Nic Andrews, Assistant Physiotherapist: Woollahra Physiotherapy

The cool weather is looming and with that comes the commencement of the winter sporting seasons. You’ve been training for months now in preparation for the duress of competition and our role as Physiotherapists is keeping you fit and injury-free so you can get the most of your season.

It is often said that the best way to treat an injury is to prevent it and more and more studies are supporting this. Injury is a painful, time consuming and financially stressing condition. Participating in a physical screen before partaking in sport is a very useful tool in identifying any predispositions to injury.

A typical physical screening consists of non-invasive procedures such as; assessment of gait, postural analysis, muscle length and strength, joint range of motion and task-specific testing.

A comprehensive physical screen allows a Physiotherapist to identify any deficiencies or areas of concern that may expose you to greater risk of injury. Only after recognizing these issues can preventative strategies be put into place (such as stretching programs or strength plans put together by your Physiotherapist).

As well as a physical screen, an athlete should undergo a medical screen conducted by your GP or Sports Medicine Practitioner. This is particularly important for older athletes or those with pre-existing medical condition such as diabetes, asthma or high blood pressure.

Whether you’re an aspiring elite athlete or a social competitor, no-one wants to spend time on the sidelines, see a qualified Physiotherapist for expert assessment and advice to get the most out of yourself! 

Check out some stretches for common injury sites below: 

 

Blog pic 1.png
  • Hamstring Stretch
  • Lie on your back and secure your strap/belt/towel/theraband around the ball of your foot
  • Keeping your shoulders and non-stretching leg on the ground, raise your stretching leg to the point you can feel tightness and hold for 20-30seconds
  • Exhale, lower leg and repeat 3 times each leg.
  • Do not: push raise non stretching leg, compromise spine integrity, push beyond point of tightness.

 

  • Calf & Achilles Stretch
  • Facing a wall, hands at eye level, place stretching leg non-stretching leg
  • Keeping your back hell on the floor, bend your front knee until you feel a stretch in the back leg and hold this for 20-30seconds. Repeat 3 times each
  • In the same position, bend the back leg to feel a stretch in another part of the calf, hold for 20-30 seconds and repeat 3 times each leg.

           

  • Groin Stretch
  • Stand with feet wide apart, knees straight
  • Bend non-stretching leg and shift weight towards that side, ensuring stretch leg stays straight 
  • Should feel a stretch on the inner thigh of stretch leg. If you don’t, start with your legs wider part
  • Hold this for 20-30 seconds and repeat 3 times on each leg