0800 627 497 10 tips based on contemporary knowledge of how to treat lower limb tendinopathy. A video summary of Prof Jill Cook’s La Trobe Sport and Exercise Medicine Research Centre blog.
Healing
By Ryan Hickling – Staff Physiotherapist
As physiotherapists, a common question that a lot of our clients ask us is ‘how long will this take to heal?’ Unfortunately, the answer to this can be complicated and differs between individual’s due to various reasons. It also requires some understanding of how the different tissues in the body heal.
Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and this can be dependent on the individual and their specific health status/history.
Understanding the type of tissue injured and their different healing times is an important part of how your physiotherapist determines the treatment plan and goal setting for each client. On an client-specific level, a patient’s age, the location and severity of the injury and the way the injury was managed in the acute/early stage (approximately 72 hours) will all affect the healing times of your injury.
As we age, injuries do tend to heal more slowly than when we are young. Any medical conditions that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate.
There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected. Muscles are full of small capillaries, giving them a rich blood supply, and as such, they have a comparatively fast healing time of about 2-4 weeks for minor tears. For larger tears and more complicated injuries this timeframe is usually longer.
Ligaments and tendons have less access to blood supply, therefore tears/sprains to these tissues generally take longer to heal. Complete tears of many soft tissues, may not be able to heal themselves and in rare cases and will then require surgery to mend the tear back together.
Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint. This tends to take a longer period of time to heal compared to muscle strains.
While the different tissues of the body all have different healing times, they do follow a similar process of healing with three main stages, an initial acute inflammatory phase, the proliferative stage and lastly, the remodeling stage. The inflammatory stage occurs immediately after an injury and is the body’s primary defense against injury. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase, the body sends white blood cells to remove damaged tissue and reduce any further damage. This stage usually lasts for 3-5 days. The proliferation stage is the phase where the body starts to produce new cells. Swelling and pain decreases and scar tissue is formed which then regenerates into new tissues. This stage usually occurs after the acute phase and lasts up to 2-3 weeks following the injury. The final stage, known as the remodeling stage is when the body completes healing with the reorganization of scar tissue and the laying down of new and more mature tissue. This stage usually occurs roughly 2-3 weeks after the initial injury is sustained.
At each stage of the body’s natural healing process, a different treatment approach is required and your physiotherapist can help to guide you through your recovery. Goals are usually set by your physiotherapist by keeping these healing time frames in mind.
North City Physiotherapists will endeavor to put together your individual rehabilitation plan to guide us and you towards your goals and optimal physical health.This will follow healing times and your injury or condition.
As physiotherapists, a common question that a lot of our clients ask us is ‘how long will this take to heal?’ Unfortunately, the answer to this can be complicated and differs between individual’s due to various reasons. It also requires some understanding of how the different tissues in the body heal.
Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and this can be dependent on the individual and their specific health status/history.
Understanding the type of tissue injured and their different healing times is an important part of how your physiotherapist determines the treatment plan and goal setting for each client. On an client-specific level, a patient’s age, the location and severity of the injury and the way the injury was managed in the acute/early stage (approximately 72 hours) will all affect the healing times of your injury.
As we age, injuries do tend to heal more slowly than when we are young. Any medical conditions that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate.
There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected. Muscles are full of small capillaries, giving them a rich blood supply, and as such, they have a comparatively fast healing time of about 2-4 weeks for minor tears. For larger tears and more complicated injuries this timeframe is usually longer.
Ligaments and tendons have less access to blood supply, therefore tears/sprains to these tissues generally take longer to heal. Complete tears of many soft tissues, may not be able to heal themselves and in rare cases and will then require surgery to mend the tear back together.
Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint. This tends to take a longer period of time to heal compared to muscle strains.
While the different tissues of the body all have different healing times, they do follow a similar process of healing with three main stages, an initial acute inflammatory phase, the proliferative stage and lastly, the remodeling stage. The inflammatory stage occurs immediately after an injury and is the body’s primary defense against injury. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase, the body sends white blood cells to remove damaged tissue and reduce any further damage. This stage usually lasts for 3-5 days. The proliferation stage is the phase where the body starts to produce new cells. Swelling and pain decreases and scar tissue is formed which then regenerates into new tissues. This stage usually occurs after the acute phase and lasts up to 2-3 weeks following the injury. The final stage, known as the remodeling stage is when the body completes healing with the reorganization of scar tissue and the laying down of new and more mature tissue. This stage usually occurs roughly 2-3 weeks after the initial injury is sustained.
At each stage of the body’s natural healing process, a different treatment approach is required and your physiotherapist can help to guide you through your recovery. Goals are usually set by your physiotherapist by keeping these healing time frames in mind.
North City Physiotherapists will endeavor to put together your individual rehabilitation plan to guide us and you towards your goals and optimal physical health.This will follow healing times and your injury or condition.
Ryan Hickling is one of our staff physiotherapists working out of our clinics in Porirua.
Would you like to see Ryan, why not book online now:
https://northcityphysio.co.nz/booknow
or call us on 0800 627497 for a booking
No pain no gain!
Now I’m sure this is an expression that many of you have heard before and have quite potentially said yourself. It’s that little mental game that we tend to play without ourselves to try and make pain seem like it isn’t as bad as it is. It great when we are trying to push ourselves particularly at the gym or when trying to increase our fitness. But there is also a time when pushing ourselves isn’t such a good thing.
I know that I’m not a stranger to that ‘being a bit sore when starting to exercise’ feeling. This may be felt a little bit more if you are going straight into a hard workout without warming up. So to prevent feeling achey when you start out in exercise it is always good to do a warm up, and even a warm down to make the next session that little bit easier! If you are feeling sore at the start of exercise, take it easy to start with and make sure you are warming up well. If you don’t and push through the pain (to try and make the gain) then there is the chance that you may damage your muscles or ligaments. Stretching and doing a warm up is a really essential part to making sure that pain doesn’t cause you an injury or aggravate one that may still be sitting there niggling away at you.
If you suddenly get pain whilst doing anything, particularly when working out, then this isn’t such a good sign and normally is telling you that something is wrong, but I’m sure everyone would have guessed that anyway. If this happens to you it is generally best to stop what you are doing and rest. This sudden pain can happen for a number of reasons. It can be because you have somehow injured yourself in a new way or may be trying to get back to sport too quickly after a pervious injury. What I tend to see day to day is people who have had previous injuries are better at stopping if they get pain, but it’s those who aren’t expecting it that tend to push through. There are a whole different range of causes for this sudden pain and is probably a good indication that it is time to see a physio or other health professional to get it properly diagnosed and to ensure that it won’t become that annoying pain that prevents you from doing things like you normally would. If you don’t get it treated it can turn into a chronic injury which often takes longer to treat and fix than a fresh injury.
Pain whilst exercising can also indicate that you aren’t doing the activity exactly as you need to, which is common with weight training. Backs are often the first thing to complain at you if you are lifting or bending incorrectly with weights, but it can involve any part of the body. This is often the hardest pain to understand. If you are weight training, you will be wanting to get that burn, but listening to your body is really important to be able to decide if pain is good or not so good. Technique is so, so important with exercise, especially if exercise is something you do for fun rather than as a job.
So yes, we do want to induce some pain to know that what we are doing is working, but we always want it to be a good pain and not a bad pain. A good indication of a less ideal pain is if it is present for more than 48 hours and doesn’t ease with rest. If you are unsure with your pain and know if it is something that will help or hinder you then book in for a free phone consultation or come and see us in clinic.
Bridget is one of our staff physiotherapists working out of our clinic in Johnsonville
Would you like to see Bridget, why not book online now:
https://northcityphysio.co.nz/booknow
or call us on 0800 627497 for a booking.
Grind, Crack, Creak – Why are my knee’s noisy?
I see a lot of clients in the clinic who come to me for knee pain or in fact I am seeing for something different and state their knee’s make noise, like a crack, or a creaky sound. I’m sure I speak on behalf of our team and in fact many health professionals we get asked this a lot.
So let’s consider the below info-graphic…have a look
So the real take home message is the majority of people without any knee problems have noisy knees, so lets consider this to be actually normal. Noise does not mean arthritis and neither does pain for that matter.
Even researchers and clinical people are undecided really whether this noise (known as crepitus) signals the beginning of arthritis.
So what exactly is joint crepitus? Most importantly does crepitus really matter? We need to determine what this cracking, grinding, creaking, clicking, clunking, popping and other adjectives used for the phenomena of joint crepitus is.
Loud isolated cracks and pops.
These are often seen during warm ups and activities involving crouching down. Some people even feel better after the knee has cracked. This will either be bubbles of gas popping, just like when someone cracks their knuckles, (which by the way does not lead to arthritis!), or the patella locating into the groove underneath as the muscles warm up. Neither are a case for any concern whatsoever, and should be seen as entirely normal.
Pathology
People will very often associate their joint noise with a diagnosis of osteoarthritis (especially if someone in their family has osteoarthritis). A true osteoarthritic joint creak almost resembles a creaky door. This is indicative of bone on bone advanced osteoarthritis. This noise is quite different from the fine grating that often originates from a non-arthritic patellofemoral joint. Ironically clients with advanced degenerative disease rarely complain of this as their pain, deformity and or functional loss is normally a much bigger problem.
It is much more likely that many of our clients will have fine crepitus of a non-arthritic origin. Some of these people may have chondromalacia patellae,(CMP) of the patellofemoral joint, an extremely common finding indicating fissuring of cartilage on the back of the patella but not a loss of vertical cartilage height.
So if you are concerned about your crepitus or noisy knees then for sure it is of interest to us the physios. Though a really good assessment looking at you thoroughly we hope to empower you and alleviate your concerns.
Atif is one of our senior physiotherapists working out of our clinics in Porirua.
Would you like to see Atif, why not book online now:
https://northcityphysio.co.nz/booknow
or call us on 0800 627497 for a booking
Tips For Helping Kids of Today Stay Active
Research shows that many children today are struggling to meet their daily recommended targets for physical activity. We know that inactivity is a risk factor for a multitude of chronic diseases and many of the habits that shape our adult lives are set in childhood. Physical activity is important for a growing body as movement and weight bearing have a large impact on bone strength, muscle and tendon health. Here are some tips to make sure your child is staying as active as possible.
1. Find an activity that suits your child’s personality and abilities.
Children who are very coordinated and excel in competition may find team sports both increase their self-esteem as well as keep them fit. For other children, being a part of a team can cause embarrassment and they may say they dislike exercise, when in fact what they dislike is feeling like a failure and letting down the team. These children may prefer a sport where success measured by improving on their own performance, rather than being compared to other children. Surfing, yoga, martial arts, dancing or gymnastics may be activities that suit your child if competitive and team sports cause them to be discouraged
2. Do get injuries checked out by a professional and invest in proper rehabilitation.
While children do bounce back quickly from injuries, they also may have difficulty expressing themselves and their worries when they have pain. A niggling pain that won’t go away may cause your child to say “I don’t like sport” rather than mentioning that they are in pain. Some children may retain worries that they will hurt themselves again because of a previous injury and avoid exercise because they don’t feel completely confident. Your physiotherapist can help to identify any issues that your child is having and help to resolve them.
3. Set fun and challenging goals for them to complete during their daily routine.
As less children are walking and riding to school, try to find ways to fit extra activities into the day. Have a daily long jump competition in the back yard at the same time each day or have bed making time trials. Have a routine before bed of age appropriate exercises, such as star jumps, hopping, balancing and running on the spot. You can make this part of the night or morning ritual, just like brushing your teeth.
Talk to your physiotherapist for more tips on how to increase your child’s activity levels. Finding an activity that matches your child’s age level is key to keeping them engaged and active
Pain and Me: Tamar Pincus talks about chronic pain, acceptance and commitment
