At this very moment 1 in 6 people on the Northern Beaches is suffering from back pain due to a variety of different back problems. Back pain doesn’t discriminate and its causes are as varied as its symptoms. Back pain can be caused by sitting too much, by standing too much and by running too many loops of the Manly to Dee Why coastal walk. Back pain can affect your work, sports, mental health and especially your sleep. Getting a good night’s sleep is so important for recovery and back pain is notorious for being worse at night, creating a self-perpetuating loop of poor sleep that exacerbates the back pain.
What causes back pain?
Having spent my career as a musculoskeletal physiotherapist on the Northern Beaches, many of my clients suffering from back pain have injured a muscle in or surrounding the back. In fact, studies have shown that around 70% of all back pain is a direct result of muscular injury? Repeated heavy lifting and sudden awkward movements are the big causes of back pain and as we get older it gets easier to give it a twinge. Other common back pain causes we see here at Dee Why include:
- Arthritis – Nobody likes the A word but it’s something that will affect around 1 in 7 Australians during their lives. Lumbar arthritis pain is caused by movement and inactivity so you can’t win and affects the lower back and can extend to the pelvic area, sides of the buttocks and can even be felt in the thighs.
- Sporting injuries – Northern Beaches physios treat back pain every day that has been the result of an injury caused by playing sport. Sports like volleyball, gymnastics, surfing and running are the cause of plenty of sore backs between Manly and Dee Why, that’s for sure!
How do physiotherapists treat back pain?
How long have you got? Titled Musculoskeletal Physiotherapists can draw on years of study, observation and curing back pain of all varieties and use literally dozens of different techniques for treating back problems. First things first though, your physio will take you through an in-depth physical examination in order to determine the exact cause of your back pain – back pain can have a variety of root causes.
Titled Musculoskeletal Physiotherapists understand the complexity of lower back pain and use an evidence based approach to injury management in order to get results. Musculoskeletal physiotherapy is the most common form of intervention for chronic back pain and your back pain physio on the Northern Beaches will create and prescribe a bespoke program to not just combat the pain, but to protect and strengthen your back against future problems.
If you are suffering from back pain on the Northern Beaches and avoid seeing a physio you are increasing your chances of your back pain persisting longer and a recurrence of the injury in the future. Don’t wait until the pain becomes severe or chronic, give The Beaches Sports Physio a call on (02) 8964 4086 or email us to book at firstname.lastname@example.org.
Knee injuries are among the most common type of injuries treated by physiotherapists on the Northern Beaches and are also at the top when it comes to re-injuries. I don’t know how many times I’ve seen a patient who ended up having a serious knee injury and they said they just tried to ‘run it out’. If you are involved in physical activity or sports such as netball, volleyball, beach volleyball, soccer, AFL and rugby league, you are at a much higher risk of suffering a serious knee injury compared to the rest of the population. If you are suffering from pain or swelling in the knee, please don’t try and run it out, jump in the car and head down to your local Northern Beaches physio for some hands on treatment and get a plan for recovery so you don’t end up suffering ongoing pain or movement issues.
These are the most common types of knee injuries treated by musculoskeletal physiotherapists:
Torn ligaments and ligament strains
Like a lot of musculoskeletal injuries, it’s the most active people who get the wrong end of the stick when it comes to suffering them. Your knee contains a number of ligaments connecting bones to other bones in and around the knee joint that are susceptible to damage when you take a sharp change in direction, land wrong from a jump, or commonly from force directly to the knee, such as in soccer or footy tackle. The knee is made up of 4 ligaments that can all be torn or strained:
ACL – The ACL is the big daddy of knee injuries, the most painful and also the most common. The ACL connects the thigh bone to the shin bone and is most likely to strain or tear when pivoting or landing from a jump, around 80% of ACL tears are non-contact injuries.
PCL – The PCL is there to stabilise the tibia and prevent it from being bent too far backwards, commonly tearing or becoming strained due to forced hyperextension. It is the least common of the knee injuries, accounting for around 10% of them in total.
MCL – Your MCL is located on the inner side of your knee and connects the medial femoral condyle and the medial tibial condyle. MCL injuries usually take place during a sharp change in direction, when the knee is twisted while your foot stays in place, landing incorrectly from a jump, or from a hard direct hit to the knee, commonly in a footy tackle.
LCL – Like the ACL and MCL, your LCL helps control the sideways motion of the knee, connecting your femur to the fibula. LCL injuries only account for less than 5% of knee injuries, but they are known to be pretty darn painful.
Once your physio has conducted a thorough physical examination, they will be able to give you a good idea of the grading of the injury (1 being the lowest, 3 the highest) and begin treatment. Depending on whether you have suffered a strain or a tear, you may be required to undergo surgery and your physio will be able to design an in-depth prehab and rehab program for you that will aim to:
- Reduce pain and swelling
- Return the joint to its full range of motion
- Strengthen the area surrounding the knee such as hamstrings and quadriceps
- Improve your proprioception, agility and balance
- Improve your technique and function specific to any sports or your circumstances
- Get you back into your sport, regular activities and exercises
- Minimise your chance of re-injury
Fractures and dislocations
Musculoskeletal physiotherapists commonly see knee fractures and dislocations paired with ligament damage, they tend to go hand in hand unfortunately. Not only are patellar fractures relatively common, they are also painful and can take a good deal of healing time. A patellar fracture is a break in the patella, or knee cap which is a small bone sitting at the front of your knee. The knee cap acts like a shield for your knee joint and is vulnerable to fracturing if you fall directly onto your knee or cop a big hit in sport or commonly in a car crash.
A patellar fracture may be a clean and even two-piece break or the bone can break into many pieces (ouch). If you are lucky enough when suffering a patellar fracture and the pieces of bone are not displaced, you may not need surgery.  Because treatment for a patellar fracture includes a period of time where you need to keep your leg immobilized in a cast, it’s not uncommon for your knee to become stiff and your thigh muscles to shrink. During the rehabilitation your physiotherapist designs, will be given a number of specific exercises to help improve the range of motion in your knee, strengthen your leg muscles surrounding the knee cap and manual therapy in order to decrease stiffness.
The most painful part of dislocating the patella is the immediate time after; with most people having a sort of relief in the hours after it is re-located. Because a dislocation or fracture commonly occurs with a ligament strain or tear, your rehabilitation will take at least 8 to 12 weeks to successfully heal the area and decrease your chance of a recurrent dislocation.
If you have:
- Sudden or severe pain in the knee
- Heard a loud pop or snap during sport or exercise
- Swelling in the knee after feeling pain
- A feeling of looseness in the joint
- An inability to put weight on the joint without pain, or any weight at all
Get down to your local physio ASAP. You’re only doing yourself further damage and increasing your chances of re-injury by putting it off.
 Schuett DJ, Hake ME, Mauffrey C, Hammerberg EM, Stahel PF, Hak DJ. Current treatment strategies for patella fractures. Orthopedics. 2015;38(6):377-84.
Physiotherapy is a broad and multi-dimensional treatment process designed and ever expanding to treat a huge number of conditions. While physiotherapy mostly focuses on the diagnosis and rehabilitation of musculoskeletal and circulatory system issues, a growing number of practitioners also treat conditions like sports injuries, various forms of arthritis and respiratory problems such as cystic fibrosis. From bone breaks to bursitis to Temporomandibular Joint Pain, physiotherapists have a special knack for canvassing the human body for the cause of pain and dysfunction and getting it back to full performance using a number of high-tech and low tech treatment options. For all the technology in the world, a musculoskeletal physiotherapist gets the best results with their hands.
Below are the 5 most common treatment techniques used by physiotherapists every day in order to get their patients back to optimal health and performance, free of aches and pains.
- Physical examination and assessment
The first and most important step in the treatment process is the physical examination and assessment your physiotherapist will complete on your first visit. Expect to have a real deep and meaningful chat with your physio where they will ask you a number of detailed questions about your general health, activities and how your aches or pain came about. It’s at this point a good physio becomes a bit like Sherlock Holmes, sometimes it takes a bit of sleuthing to get to the bottom of some injuries and pain as they can be the result of an injury that starts in another area of the body.
Following the getting to know you part, your physio will begin to lay out a treatment plan personalised to your current situation. Depending on where you are on the injury and pain scale, the first course of action might be a prescription for some recovery and icing of the affected area before moving forward with physical therapy.
- Joint and soft tissue mobilisation
Joint and soft tissue mobilisation techniques are forms of manual therapy that have been tried and tested over decades. When joints and other soft tissue become painful due of trauma, overuse or disuse, they can become dysfunctional and unable to perform the movements they were designed for. Soft tissue injury is an umbrella term used to describe injuries affecting your muscles, tendons, or fascia that usually occur as a result of sprains, strains, contusions, tendonitis, bursitis and stress injuries. Soft tissue mobilisation has also been called therapeutic massage and has been designed to relax a patient’s muscles and reduce swelling in certain areas, making it a perfect treatment for relieving pain associated with sporting injuries.
Joint mobilisation is a technique used by physiotherapists by performing a back and forth oscillation of the joint in order to restore full range motion and limit pain. Joint mobilisation is helpful in cases where pain and joint tightness limit motion such as frozen shoulder. Joint mobilisation treatment varies depending on your circumstances but will generally include gentle joint mobilisations, joint manipulation and none of the old school snap, crackle and pop techniques that have little long term benefit.
- Acupuncture and Dry Needling
Dry needling and acupuncture are two of those treatments that always raise my patient’s eyebrows. At first, not many people are keen on the prospect of being jabbed with tiny needles, it sounds counterproductive to kicking pain doesn’t it? But after one session, they’re converts.
Contrary to popular belief, dry needling is not the same as acupuncture, although there are similarities between the techniques. The main difference between dry needling and acupuncture is found in the theories behind why each of the techniques works. Dry Needling focuses on the reduction of pain and restoration of normal function by releasing myofascial trigger points in muscle. In contrast, acupuncture is dedicated to the treatment of medical conditions via the restoration of the flow of energy (chi) through key points in the body to restore balance.
- Ergonomic, biomechanical and sports specific technique correction
If your visit to the physiotherapist was brought about by suffering an overuse or acute injury at work, during sport or just by living your normal life, you’re really doing yourself a disservice and increasing your chances of re-injury if you don’t take adequate steps at changing your movement patterns or technique. Poor technique and posture are two of the most common sources of repeat injury observed by physios. Biomechanical assessment, technique observation and diagnostic skills are all part of the skill set of your musculoskeletal physiotherapist and allowing them to observe you in your environment or using your regular physical techniques will ultimately help you to avoid musculoskeletal and sports injuries in the future.
Think of your local musculoskeletal physiotherapist as a pain doctor, or body mechanic. They have at their fingertips a range of tried and true methods of getting you back into 100% health and kicking that pain to the curb. If you are experiencing any muscular, joint or physical pain don’t hesitate to make a booking at your local 5 star rated physiotherapist on the Northern Beaches. Your body won’t regret it.