Cortisone vs Physiotherapy vs Both For Shoulder Pain/Impingement.

Shoulder exercises

Corticosteroid injection and physiotherapy are common treatments for shoulder pain, especially shoulder impingement and shoulder bursitis. Recent study even found that only half of patients experiencing shoulder pain completely recover after six months.

That is a long time to live with and suffer from shoulder pain!

There is recent evidence comparing these two treatments for pain, range of movement and shoulder function in patients diagnosed with subacromial impingement syndrome. Here are some findings:

  • Physiotherapy treatment included strengthening exercises, stretching, soft tissue techniques and patient education. Treatment ranged from once a week to couple of times a week for 6 to 12 weeks.
  • Corticosteroid was not superior for range of movement or pain at any time period, including 4 weeks, 12 weeks, and 48 weeks.
  • The evidence showed that corticosteroid was superior to physiotherapy for shoulder function at 6-7 weeks. It was not superior for function at longer time periods.

With these findings as clinicians, we need to weigh the short-term benefit of corticosteroid vs the risks of its side effects, such as immune system compromise and cartilage damage. The combination of exercise, physiotherapy treatment and corticosteroid may be beneficial to some patients that have stubborn shoulder pain not resolving with physiotherapy management alone. This may be true for people who are still training in the gym, continuing at work and not effectively able to modify activity to reduce the symptoms.

If you are suffering from shoulder pain, book a consultation with our clinicians to discuss the options available for complete recovery.

TPC Team

Muscle strength and Osteoarthritis of the knee

knee osteoarthritis, knee pain. kneecap pain

Muscle strengthening interventions are a foundation of physiotherapy recommendations to improve knee symptoms and functional disability.

A recent systematic review by Patterson et al. in 2022 investigated muscle strength and osteoarthritis of the knee. Common findings are listed below:

  • Low knee extensor strength was associated with an increased risk of worsening tibiofemoral (Knee Joint) and patellofemoral (Knee cap) OA.
  • Low knee flexor strength was associated with an increased risk of tibiofemoral (Knee Joint) OA worsening.
  • Sub-group (by sex/gender) pooled estimates reveal significant associations for women but not men.
  • In those who already have OA, low knee extensor strength was not associated with an increased risk of tibiofemoral (Knee Joint) joint OA.

As physiotherapists working with patients with knee OA, we can take some guidance from the knowledge that lower limb strength is a key aspect of the management for the patient. Other essential factors to consider on top of strength would be other modifiable factors such as nutrition, weight management and occupational/ recreational activities.

This is one area where we can have the biggest impact on our patients (especially females) who come in with knee pain in early life. If we cement the importance of developing lower limb strength early, we can minimize the impact of OA as they age.

TPC Team

SCIATICA! Not as scary as it sounds

The sciatic nerve is the largest and longest nerve in the body, and is made up of five nerve roots that exit the lower spinal column and merge to form the sciatic nerve. The nerve then travels through the pelvis and down the back of the thigh, eventually branching off into smaller nerves that supply the lower leg and foot.

It can be caused by a variety of factors, including disc bulge or protrusion, spinal stenosis, degenerative disc disease, Periformis syndrome. The risk factors for sciatica include age, obesity, a sedentary lifestyle, and occupation.

Sciatica is a condition that occurs when there is irritation or compression of the sciatic nerve. It is characterised by pain, numbness, or tingling that radiates along the sciatic nerve, which runs from the lower back down through the glutes and legs.

Physiotherapy management for sciatica typically involves a combination of exercises to improve strength, flexibility, advice on initial activity modification as well as manual therapy techniques to help reduce pain, irritation and improve joint mobility in the affected area. The specific physiotherapy management will depend on the underlying cause of the sciatica. Physiotherapy should focus on muscle and nerve stretching and strengthening exercises to improve spinal stability such as core and hip stability exercises.

If you are suffering from Sciatica, book in a consultation with us today to assist you with managing the condition so you can keep participating in the things you love.

TPC team

Shoulder Bursitis? How can physiotherapy help.

Shoulder bursitis is a condition in which one or more of the small fluid-filled sacs called bursae in the shoulder joint become inflamed or irritated (has an inflammatory response).

What is the role of a Bursae?

The bursae act as cushions between the bones, tendons, and muscles, and help to reduce friction and allow for smooth movement of the joint. When the bursae become inflamed, they can cause pain and limit shoulder movement, especially lifting overhead, reaching back and even lying on the affected side.

There are several common causes of shoulder bursitis. Individuals who perform heavy/repetitive manual labor, sports or activities that involve repetitive overhead shoulder movements or older individuals are at increased risk of developing shoulder bursitis.

Physiotherapy has shown to be effective in managing shoulder bursitis. It involves performing specific exercises to help improve the strength and range of motion of the shoulder joint. These exercises include specific strengthening exercises for the rotator cuff muscles, shoulder blade or scapular muscles and improving the quality of movement.

Manual therapy, which involves hands-on techniques such as joint mobilization, soft tissue massage, and trigger point release may also be used to help alleviate pain and improve shoulder function.

Overall, physiotherapy treatment for shoulder bursitis can be effective in reducing pain, improving range of motion, and restoring function in the shoulder joint. If you are suffering from shoulder bursitis, there are many modalities we can use to assist you to get back to pain free shoulder movements and as always doing the things you love.

Call the clinic to book a consult today on 9116 8691.

The physio crew

What Can You Do About Low Back Pain

Low back pain, spine, disc bulge, disc herniation

A prevalent condition in Australia, affecting up to 80% of adults at some point in their lives. A 2018 study found that low back pain was the leading cause of disability globally, with a significant impact on individuals and the healthcare system. In Australia, low back pain accounts for approximately 3% of all hospital admissions and is a leading cause of absenteeism from work.

The most common symptoms of low back pain include pain, stiffness, referral pain into the leg and limited mobility in the lower back. Fortunately, evidence-based rehabilitation has been shown to be an effective treatment approach for low back pain. Studies have found that exercise, such as strength and flexibility training, Pilates and exercise can reduce pain and improve function in individuals with low back pain.

Manual therapy, including spinal mobilisation and massage, can also be beneficial in reducing pain and improving function in individuals with low back pain. Education on exercise, body mechanics, modified activities and pain management strategies can help prevent future episodes of low back pain and promote long-term health and wellness.

With adequate treatment and self-management strategies, individuals with low back pain can improve their quality of life and get back to their daily activities.

To book in a consultation with our therapist to see how we can help manage and eliminate back pain please call on 9116 8691 or book online.

The physio crew team

Do you ever ask yourself, how do I get Muscular? Stronger?

Here are the facts!

Muscle hypertrophy (growth) refers to the process of increasing muscle size, which is often associated with an increase in muscle strength and mass. At the cellular level, muscle hypertrophy is primarily caused by an increase in the size and number of myofibrils. Resistance training in particular, is a potent stimulus for muscle hypertrophy, as it causes muscle fibers to experience tension and damage, which stimulates the production of new muscle proteins and the growth of muscle fibers. Here are three important factors to consider when aiming to increase muscle size and hypertrophy:

First, progressive overload is key. This means continually challenging your muscles by increasing the weight, reps, or sets performed over time. By gradually increasing the workload, you can stimulate muscle growth and hypertrophy.

Second, nutrition is essential. Consuming enough protein to support muscle growth, as well as carbohydrates and healthy fats, can help provide energy and nutrients to fuel workouts and support recovery. Eating whole, nutrient-dense foods can help ensure you’re getting the necessary vitamins and minerals to support muscle growth.

Third, recovery is crucial. Allowing your muscles adequate rest and recovery time between workouts is essential for muscle growth and hypertrophy. Getting enough sleep and taking rest days can help your muscles repair and grow.

In summary, muscle hypertrophy requires a combination of progressive overload, proper nutrition, and adequate recovery to achieve muscle growth and size. By focusing on these three factors, you can optimize your training and nutrition to achieve your goals. To create a customised training plan, call the clinic to book in a session.

Amar Sran
TPC