Maintaining Strength and Range of Motion in Your Elbow

Rear view of tennis player serving during a match.

Whether you’ve recently recovered from a shoulder injury, fracture, tennis elbow or just want to prevent future injuries, strengthening and range of motion exercises can help. By exercising each muscle and moving a joint through its full range of motion, you can keep it flexible, reduce pain and improve strength. Below are some exercises that can help you maintain balance and strength in your elbow.

 

Fist Clench

Weak grip strength is a common contributor to tennis elbow and elbow ligament injuries. Improving grip strength by building the muscles of the forearm can help improve ability to perform daily activities. Fist clench exercises can be completed easily using a table and a towel.

  1. Sit at a table with your forearm resting on top.
  2. Hold a rolled up towel or small ball in your hand.
  3. Squeeze the towel or ball and hold for 10 seconds.
  4. Release and repeat 10 times. Switch and do the other arm.

 

Forearm Supination

Your supinator muscle in the forearm attaches to your elbow and is responsible for turning the palm upward. Elbow injuries often arise from movements involving this large muscle.

  1. Sit holding a 1kg dumbbell vertically with your elbow resting on your knee.
  2. Use the weight of the dumbbell to rotate your arm outward, turning the palm up.
  3. Rotate the hand back the other direction until your palm is facing downward.
  4. Repeat this action 20 times on each side.
  5. Try to isolate the movement to your lower arm, keeping your elbow and upper arm still.

 

Elbow Extension

To improve your ability to fully straighten your elbow, you must work on elbow extension range of motion exercises.

  1. Sit in a chair with your elbow straightened out all the way and resting on a table.
  2. Apply pressure to your forearm or wrist to add overpressure to the stretch
  3. Straighten your elbow out as far as possible and hold for five to 10 seconds.
  4. Release the stretch and allow your elbow to bend a bit.
  5. Repeat the exercise for 10 repetitions.

You can also add to the stretch of your elbow extension by holding onto a 1kg weight.

 

Wrist Extension and Flexion

The wrist extensors are a group of small muscles responsible for bending the wrist. These muscles connect to the elbow and are often subject to overuse, particularly during racquet sports.

  1. Sit holding a 1kg dumbbell with your palm down and elbow resting on your knee.
  2. With your palm down, extend your wrist by curling it towards your body.
  3. Return to starting position and repeat 10 times on each side.
  4. Try to isolate the movement to the wrist, keeping the rest of your arm still.

Do this exercise with your palm facing upwards to exercise your wrist flexors, which are small muscles that work opposite your wrist extensors.

 

Scapula Setting

The strength of your shoulder muscles also plays an essential role in preventing injury and providing overall strength and stability in your elbows. This exercise strengthens your upper back at your shoulder blade.

  1. Lie on your stomach with your arms by your sides.
  2. Place a pillow under your forehead for comfort, if required.
  3. Gently draw your shoulder blades together and down your back.
  4. Ease about halfway off from this position and hold for 10 seconds.
  5. Relax and repeat 10 times.

 

Physiotherapists in Melbourne and Sydney

Pinnacle Health Group provides a range of health services including physiotherapy, massage, clinical pilates, yoga, general health check-ups and more in multiple locations across Victoria and New South Wales. If you’re injured or need health advice, book an appointment from one of our CBD based health clinics or join a wellness class near you.

What To Do If You Think You Have Knee Bursitis

Man suffering from joint pain in knee

Knee injuries are extremely common and range from soft tissue injuries like ligament sprains and muscle strains to bone conditions and biomechanical dysfunction. Your knees each have a bursa sack that’s filled with fluid. When these get inflamed or infected, the condition is called knee bursitis.

 

What is Knee Bursitis?

Knee bursitis can cause pain above, below or on your kneecap depending on which bursa is inflamed. A bursa is a thin sack filled with synovial fluid, a natural lubricating fluid. This slippery sack allows muscles, tendons and skin to slide over bony surfaces without friction. Your bursa essentially prevents different tissues and structures from catching on one another.

Your knee consists of up to 11 bursae. The ones most prone to bursitis are the:

  • Prepatellar bursa – Lies just above the kneecap between the skin and the kneecap. Prepatellar bursitis is common for carpet layers, gardeners, roofers, plumbers and other professions that require a lot of kneeling.
  • Infrapatellar bursa – Consists of two bursae, one below the patella tendon and one between the patella tendon and tibia (shin) bone.
  • Pes anserinus bursa – Located in the lower inside part of the knee in close to the upper part of the tibia. Bursitis here usually affects overweight people and middle-aged women.
  • Suprapatellar bursa – Extends from beneath the patella under the quadriceps muscle. It can be injured due to acute trauma and repeated microtrauma, for example, falls onto the knee, overuse injuries such as running on soft or uneven surfaces or from jobs that require being on your knees such as carpet laying.

 

Common Causes of Knee Bursitis

Knee bursitis can occur due to a variety of factors, including:

  • Direct trauma or blow to the knee
  • Repeated, prolonged pressure on the knee
  • Overuse or strenuous activity
  • Arthritis in the knee
  • Bacterial infection of the bursa

 

Symptoms of Knee Bursitis

Symptoms of knee bursitis include:

  • Swelling over, above or below the kneecap
  • Redness and heat coming from the site of the bursa
  • Pain when moving your knee
  • Limited mobility of the knee

 

Knee Bursitis Treatment

Depending on the severity of the issue, treatment can range from rest to medication and physiotherapy. If you think you have knee bursitis, try resting for a few days and avoid strenuous exercise. Put an ice pack on your knee 3-4 times a day for 20 minutes at a time. If required, take a mild, over-the-counter anti-inflammatory drug like ibuprofen. If inflammation persists after a few days, you should get a proper diagnosis from a medical professional to determine the exact cause of your bursitis.

If it’s not related to trauma, potential factors may include muscle weakness, tightness, pain inhibition, leg length discrepancy, training techniques and more. From there, treatment may include aspiration (draining the fluid from your knee), physical therapy or a corticosteroid injection. You may also be given knee bursitis exercises to do to assist in your recovery.

 

Quality Physiotherapy in Melbourne and Sydney

Pinnacle Health Group provides a range of services including physiotherapy, massage, clinical Pilates, yoga and more in multiple locations across Victoria and New South Wales. If you’re injured or need health advice, book an appointment from one of our CBD based health clinics or join a wellness class near you.

5 Steps to Maximise Your 1st Online Physiotherapy Consultation

Video consultation
Written by Tom Bosna, Physiotherapist and Director of Pinnacle Health Group.

With the rapid advancement of technology over the last five years, online video consultations (often referred to as telehealth) have become an excellent way of reaching remote, at risk or time poor individuals who need to get their healthcare on the go!

At Pinnacle Health Group we have been offering video consultations for corporate clients for many years – using Skype and Zoom and more recently things have changed fast.

Due to the COVID-19 global crisis we have seen a huge uptake in video consultations for Physiotherapy in the last week. With clients wanting to stay physically active, pain free and mentally sharp – we have reviewed and updated our treatment protocols and staff training to optimise our service delivery.

With so many of our corporate clients working from home, we have reinvested in the most up to date technology available (PhysiApp – download and check it out)  to ensure your video consultation experience is world-class and frictionless.

 

It’s just like a normal consultation

Just like a normal consultation, you can expect a discussion about your wellbeing goals, specific questions relating to your area of concern and discussion about the best way to treat your presenting concern or condition.

For example, a Physiotherapy consultation normally begins with questions about the injury or area of concern, the experienced Physiotherapist will know which questions to ask to ascertain a diagnosis, a prognosis and then treatment pathway that will most likely include rehabilitation.

Rehabilitation will include follow up with the client with a tailored exercise program with an app called PhysiApp. You will also be given evidence based self mobilising, stretching and self release technique advice – with the Physiotherapist ensuring correct technique before the session ends.

To optimise your experience and based on the last three weeks of video consults – here are our top steps you can take to maximise your first online video consultation with our experienced team.

 

1. Check your tech

The video consultation experience is one of excitement for both the Physiotherapist and client. To connect so seamlessly and in the comfort of your home is often reported as a real time saver for clients.

The only thing that can potentially add friction to your experience is dreaded technological issue.

The video consultation can be done via a PC, laptop, mobile or tablet -you choose your own adventure here – but we ask that you ensure a few things:

  1. The camera and sound is enabled on your device
  2. You connect to WiFi
  3. Your battery is charged

I know these points are obvious but we would hate for your appointment to be interrupted by a bad signal or a vintage device!

 

2. Space to move

We love to get you moving and grooving and our advice for the video consultation is simple: get yourself comfortable in your home.

A study, spare room, nook or lounge room is a perfect space for your consultation.

To begin the consultation you will be sitting in front of the device and talking with the Physiotherapists.

Once the session progresses into assessment, it is likely that you will be asked to move into standing or lying to do some movement tests and analysis!

 

3. Dress active

If you have a back or lower limb issue – we ask that you are comfortable enough in your dress, pants or shorts to bend your hips and knees without ruining your clothes. If you are unsure – always wear some leggings or shorts – this will save you time and make the assessment more accurate and effective. An example of a movement test would be the Physiotherapist watching you do a squat.

If you have a shoulder, upper body or neck issue – we will most likely need to look at your shoulder movement – past ninety degrees and over your head. Ideally wearing a t-shirt or some loose clothing will allow the Physiotherapist to see what is really going on. An example of a shoulder test would be asking you to do a push up against the wall.

Dress for activity.

 

4. Bring your tools

Most of our clients will have purchased some mobility or strength tools over the years.

Here is a list of some common pieces of equipment that we would love you to bring.

  1. Theraband (stretchy coloured bands – great for strength, stretch)
  2. Foam roller
  3. Swiss-ball (aka fit-ball)
  4. Dumbbells
  5. Kettle bells

All of these tools, small or large can be so beneficial when it comes to the treatment planning stage of your consultation.

When used correctly – the Physiotherapist can ensure you get the most value out of your initial purchase and speed up progress to your desired outcome – whether that be to run five kilometres pain free or to be able to lift up your children for a cuddle.

 

5. Write some questions

Sometimes when we visit health professionals we have so many questions before the appointment and then we walk out and forget to ask the important stuff! It happens all the time and we encourage you to ask us as many questions as you need. Some of our most dedicated clients actually write a list of questions on a piece of paper. We welcome this and accept follow up phone call or email questions.

Here are some great sample questions we encourage you to ask:

  1. How long do you expect this issue to go on for?
  2. What should I be doing to help this issue over the next 1-2 weeks?
  3. Do you recommend I see any other health professionals to help my issue?
  4. What do you think is the main cause of my issue?

Video consultations are easily accessible and perfect for time poor individuals who want to take control of their issues.

Ensuring you get the most value out of your experience and working collaboratively with your Physiotherapist is the best mindset going into your first video consultation.

 

Online video consultation – Physiotherapists in Melbourne and Sydney

Pinnacle Health Group provides a range of online video consultations including physiotherapy, podiatry, psychology, dietetics, and ergonomics. If you’re injured or need health advice, book an appointment from one of our CBD based health clinics or join a wellness class near you.

Suffering from Back Pain? Treat It in Your Head, Not in Your Back

Close up young man has muscle injury during outdoor exercise

Back problems can arise due to disc injuries, sciatica, lifting heavy objects or some other non-specific injury. Lower back pain is a leading cause of disability, affecting approximately 9.4 per cent of the global population. To the surprise of many, including health professionals, studies are increasingly indicating that chronic back pain isn’t always the result of an injury or condition. Instead, it can be all in our head.

 

How Back Pain Differs From Other Injuries

When our back hurts, it makes sense to assume that we’ve suffered an injury or have a disease or condition. After all, most pain works this way. However, back pain is different. There isn’t a close connection between the condition of the spine and whether people report feeling pain. Perceptions of stiffness and pain may not reflect the actual state of the spine and joints at all.

Research shows that most people who have never reported having any significant back pain have the same abnormalities such as bulging or herniated spinal discs that are blamed for chronic back conditions. There are also millions of people with severe chronic back pain who show no structural abnormalities in their back whatsoever.

 

A First World Problem

Interestingly, chronic back pain is nowhere near as common in developing countries. This should strike us as odd considering that back-breaking hard labour is more common and those who do such work don’t have easy access to quality medical treatment. Nor do they sleep in specialised mattresses for back health or sit in ergonomically designed chairs.

Since there is so little correlation between the physical condition of the back and a person’s reported experience with back pain, we’ve started looking at how psychological and behavioural patterns might contribute.

 

How Back Pain Can Be In Your Head

Things like stress, your personal health beliefs and coping strategies can influence your perception of pain. For example, anxiety and catastrophic thinking can manifest pain from your expectations of it. People with these pre-existing psychological attitudes tend to have abnormalities in their regulation of brain chemicals like dopamine and brain functions related to emotional control, anxiety and attention.

Our psychological vulnerabilities are powerful enough to rewire the brain into generating pain, distress and limited movement. When your physical movement is limited, this can cause further psychological distress that can worsen the pain. This is how a cycle of endless chronic pain can work.

 

What Can Help This Kind of Back Pain?

Research shows that training people with chronic back pain in mindfulness or cognitive behavioural therapy (CBT) works significantly better than traditional forms of medical care alone to reduce both their pain-related suffering and disability. Mindfulness teaches us to be aware of and accept moment-to-moment sensations of discomfort, while letting go of our usual negative reactions.

Instead of thinking about the burden of our back pain, seeking relief and worrying about our prognosis, you learn how to be with the pain. You pay attention to how it feels in each moment and relax your tendency to tense up while observing thoughts and feelings as they come and go. CBT takes the approach of observing and identifying negative thoughts about your condition and replacing them with more realistic ones. Both methods help you better see the functioning of our minds and the role that anxious thoughts and feelings about our condition play in worsening your condition.

 

Quality Health Services in Melbourne and Sydney

Pinnacle Health Group provides a range of health services including psychology, physiotherapy, massage, clinical Pilates, yoga, general health check-ups and more in multiple locations across Victoria and New South Wales. If you’re injured or need health advice, book an appointment from one of our CBD based health clinics or join a wellness class near you.

The Best Sleeping Position For Shoulder Pain

Woman in pyjamas sleeping on bed with blue background

When it comes to shoulder blade pain, sleeping position can make a big difference. An improper sleeping position can often mean waking up with a sore shoulder that bothers you all day or can even persist for days at a time.

Other times, shoulder pain during sleep is a symptom that stems from existing conditions such as shoulder impingement, bursitis, tendinitis, rotator cuff tears, frozen shoulder and arthritis. Either way, there are ways you can help reduce shoulder pain while sleeping with healthier sleeping positions.

 

Sleeping on Your Back

Sleeping on your back is one of the most effective positions for shoulder pain relief as it allows a neutral, even distribution of weight. The position supports your neck, head and spine, allowing your body to rest in a stress-free posture. When you sleep on your back, your shoulders are relaxed rather than being compressed in different directions. Despite the benefits, only eight per cent of us are back sleepers.

If you are already a back sleeper but still experience shoulder pain, try placing a pillow in your armpit area. This prevents you leaning on your shoulders during sleep. Having the right thickness of pillow under your head is also important. Your neck shouldn’t be bending up to the ceiling, nor should your chin be tucked downwards. Your neck and head have interconnected muscles, meaning if those areas suffer from imbalance or pressure, your shoulders will also be affected.

 

Sleeping on Your Painful Shoulder Elevated

For this sleeping position, you put a pillow on top of your stomach then add another pillow in your armpit area to push up, support and restrict pressure on the sore shoulder. Ensure your hand or elbow are not resting too high. This can prevent proper blood flow and cause numbness. Place another pillow between your legs on your upper hip. This releases the stress from the pelvis, keeping the body in a neutral position while you sleep. This position also helps the pelvis, spine and shoulders straighten up in addition to relieving shoulder pain so you can have a restful slumber.

 

Sleeping on Your Affected Shoulder

In some circumstances, it can be beneficial to sleep on your sore shoulder as it can alleviate the pain. This is also handy for people who find it difficult to sleep on their backs. To sleep on your sore shoulder, turn to your side and place a pillow beneath your mid-hips and back. Some people have a wider pelvis than their shoulders, so placing an extra pillow will balance out the position of the body and support restful sleep.

You’ll need to place an extra pillow beneath your head since your body is lifted. This position can provide comfort and relief as well as aligning your spine correctly. Another option is to roll back or lean. This places the pressure on your shoulder blade rather than the painful part of the shoulder. Do this by placing a pillow behind your back to maintain the place. These positions are not suitable for every case of shoulder pain. You should consult a health professional to find the most suitable sleeping position for your individual situation.

 

Visit Us for Help With Shoulder Pain in Melbourne or Sydney

Pinnacle Health Group provides a range of services including physiotherapy, massage, clinical Pilates, yoga and more in multiple locations across Victoria and New South Wales. If you’re injured or need health advice, book an appointment from one of our CBD based health clinics or join a wellness class near you.

Can You Get Tennis Elbow From Not Playing Tennis?

Man holds a painful elbow

Most people who suffer from tennis elbow didn’t get the condition playing tennis. This injury of overuse can be caused by a wide range of activities from climbing and doing handstands to typing at a computer and lifting light objects. It’s a common injury that often heals with minor treatment and rest but can occasionally develop to become a chronic condition.

 

What Causes Tennis Elbow?

Known to health professionals as lateral epicondylitis, tennis elbow is caused by inflammation where tendons attach to muscles responsible for raising your wrist. Activities like tennis, lifting objects or typing creates micro tearing where the tendon attaches to the bone. When you grip with your hand or bend your wrist back, the muscles on the back of your forearm contract. These contracting muscles pull on the tendon outside of the elbow.

Repetitive activity or a sudden massive contraction can strain this tendon, leading to inflammation and pain. Since these muscles are often used for daily activities, they come under regular stress and strain, eventually becoming tight and placing a constant pull on the elbow which makes it difficult to heal.

 

Symptoms

Common symptoms of tennis elbow include:

  • Sharp pain directly on the outside of the elbow during activity
  • Aching in the forearm or outside of the elbow at rest
  • Pain when raising your wrist backward against resistance
  • Tenderness on the outside of the elbow when you press against the bone
  • Weak grip

Everyday activities such as picking up your coffee cup, typing and using a mouse or wringing out a towel may be painful and unmanageable. Over time, these symptoms can worsen.

 

Why Does Tennis Elbow Get Worse?

Over time, your body’s inability to deal with the initial inflammation results in the production of different cells. Instead of inflammatory cells, the body produces fibroblasts, which cause the collagen to lose strength. After that, it becomes more fragile and can be easily injured.

Every time the collagen breaks down, more scar tissue gets formed in the tendon. Eventually, the tendon becomes thickened from extra scar tissue and no longer functions properly. At this point, pain can persist even in the absence of activity. You’ll also find it increasingly difficult to grip or lift things. This can severely undermine your quality of life, especially if tennis elbow is affecting both your arms.

 

Treatment and Prevention

Tennis elbow can initially be treated with rest, ice and mild pain killers with success. If pain persists after 6 to 12 weeks, you may need to see a physiotherapist who can help treat the issue with exercises to stretch and strengthen the affected muscles. Other treatment may include wearing a brace or strap to reduce stress on the area.

Your physiotherapist may also suggest different ways to do certain tasks to reduce the strain on your arm. If the pain is severe and doesn’t improve, a doctor might suggest corticosteroid injections for short term relief or platelet-rich plasma injections. In rare cases, surgery may be an option if other treatments don’t work over several months.

 

Physiotherapists in Melbourne and Sydney

Pinnacle Health Group provides a range of health services including physiotherapy, massage, clinical Pilates, yoga, general health check-ups and more in multiple locations across Victoria and New South Wales. If you’re injured or need health advice, book an appointment from one of our CBD based health clinics or join a wellness class near you.

When Shoulder Pain Is Actually Coming From Your Neck

Woman suffering from neck pain

Can your neck cause shoulder pain? Yes. There are a lot of interconnected muscles in the shoulder and neck. This means that pain in one place can often come from the other. The way our bodies report pain is sometimes unreliable. Neck and shoulder pain can often indicate another problem or be a sign of overlapping problems. When an injury occurs to these areas, the brain can’t always trace the pathway of that pain to its source because the neck and shoulder have so many connected nerve pathways.

 

Signs Shoulder Pain is Related to Your Neck

Inflammation of any of the 14 nerves or eight pairs of joints in the neck can cause shoulder pain as well as neck pain. As one of the hardest working areas of our body, it’s not surprising that they’re responsible for a lot of cases of shoulder and neck pain.

Symptoms that may indicate your shoulder pain is related to your neck includes pain that is:

  • Radiating to your shoulder blade, close to or on the side of your neck
  • Stabbing, burning or tingling
  • Persisting even during rest
  • Radiating down your arm when you twist or extend your neck
  • Going away when you support your neck

Since pain in one area can be confused with another, only a thorough examination by a medical professional can determine the cause. This includes motion testing and strength testing.

 

Shoulder Pain Causes

The eight nerve roots branching from each side of the cervical spine in the neck are labelled C1-C8. Nerve roots C3 to C8 all go through a specific part of your shoulder. If any of these cervical nerve roots become compressed or irritated in the neck, pain can radiate along the path of the nerve into the shoulder, arm or hand. This is called cervical radiculopathy.

Common neck problems can cause symptoms of cervical radiculopathy, including:

  • Cervical degenerative disc disease – This occurs when the intervertebral discs between the vertebrae lose too much hydration over time, becoming thinner and unable to do its job. This can produce pain, irritation and pressure on the nearby nerve root.
  • Cervical herniated disc – If the outer layer of the intervertebral disc gets a tear that allows the inner gel to leak out, it can inflame and irritate the nerve root nearby.
  • Cervical osteoarthritis – When a facet joint in the neck is affected by arthritis, inflammation and excess bone growth can alter the joint’s size and spacing, resulting in a nerve root being irritated or impinged.
  • Cervical foraminal stenosis – When the nerve root becomes compressed while going through the foramen (a small hole in the bony vertebral construct), it can result in shoulder pain. The narrowing of the foramen can occur in several ways, from the overgrowth of bone spurs to a herniated disc.

This isn’t all the conditions that can cause radicular pain in the shoulder. You should always consult a health professional for an exact diagnosis.

 

Consult With A Professional In Melbourne or Sydney

Pinnacle Health Group provides a range of services including physiotherapy, massage, clinical Pilates, yoga and more in multiple locations across Victoria and New South Wales. If you’re injured or need health advice, book an appointment from one of our CBD based health clinics or join a wellness class near you.

Elbow pain, what can be causing it ?

A female holding her elbow due to pain

Article by Steve Pacini – Physiotherapist

We’ve all heard of tennis elbow, otherwise known as lateral epidondylalgia. In fact approximately 40% of us will experience the pains associated with tennis elbow at some point in our lifetime, With symptoms including pain focused around the elbow or radiating down the forearm and can be aggravated by almost any task that involves gripping or repetitive movements of the wrist, such as typing, using the mouse, cooking and cleaning.

But why is it that so many of us suffer from this condition when we don’t all play tennis ?

What Causes Tennis Elbow

Lateral epidondylalgia is commonly caused by repetitive overuse or misuse of the muscles in the forearm, in the office setting this could be due to how we use our mouse and keyboard.  Symptoms can often last for months to years and re occurrence is common. This is because along with painful inflammation there is commonly damage to our common extensor tendon, which is the tendon that attaches the muscles of your forearm to the bone in our elbow (the Lateral epicondyle).

How to Relieve Tennis Elbow Pain

So what do you do if you have tennis elbow ? Act early. Begin by limiting aggravating activities and try using ice over the painful area.

Early intervention and treatment are key to managing painful symptoms and will significantly decrease your recovery time.

  • Treatment may include:
  • Soft tissue and joint releases
  • Taping and bracing
  • Targeted rehab exercises – the most important !
  • Dry needling

 

To explore your treatment options, or to find out more come see us at the Wellness Centre. Book an appointment online today!