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Why Does My Hip Hurt?1/15/2025
What is it? The gluteal muscles, or ‘gluts’, are a group of three muscles that sit around the hips. They are responsible for extending (lifting the leg backward) and abducting (lifting the leg to the side) the hip, as well maintaining stability during standing and walking. Like all muscles, they are attached to bone at either end via a tendon. At times these tendons can become irritated and inflamed which can cause pain, stiffness, and weakness. Why? Tendons become irritated and inflamed when they are over-worked, and the body can’t keep up. This can be a result of sudden increase in load such as standing, running, or other forms of physical activity. Sometimes there is no change to the amount of activity, but the body’s ability to recover has changed. This can be the case as we age or when there is a sudden change in hormones, particularly during menopause in women. How is is diagnosed? Physiotherapists are trained to assess pathology to determine the source of your symptoms. We use a combination of the subjective history (what you tell us), careful questioning, functional assessments and special tests to rule in and rule out different structures and pathologies. Imaging such as x-rays or ultrasounds are rarely necessary or definitive in cases of suspected gluteal tendinopathy as these images often show that there are changes to these structures even when they are not the source of symptoms. What can be done? Once diagnosed the first goal is to bring the pain under control. This means reducing load on the specific tissue that has become aggravated. Very rarely is complete rest recommended and your physio can work with you to adapt your physical activity to reduce load while still maintaining as much as possible. The next step is to gradually increase load on the tendon. It is important to build the tendon and muscle strength up in a controlled way. This will involve some fairly light glut specific exercises at first targeted at the gluteal muscles and then progressing to more challenging exercises.
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Lateral Ankle Sprains1/6/2025
What have I injured? There are a number of structures that may be damaged when rolling the ankle – bone, ligaments, muscles, and tendons. Through their assessment, your physio will identify which structures are likely to be injured. Each of these injuries have different properties, different healing times, and management strategies. How do I treat it? Initially the goal is to protect and calm down pain without completely restricting movement. Treatment in the initial 24 to 48 hours includes:
After a day or two swelling and pain should start to subside This is the time to start some movement and exercise. Your physio will be able to help guide you through this process by providing appropriate exercises and support for your specific injury, this rehab program will likely include:
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Vertigo - BPPV10/8/2024 What is it? BPPV (benign paroxysmal positional vertigo) a very common cause of dizziness. It can be associated with trauma to the head or neck but often occurs without an obvious injury. It is caused by a disruption to the vestibular system – the organ in the inner ear which senses position and movement of the head. In this condition the small calcium crystals in the inner ear which help sense head position, called otoconia, become dislodged from one part of the vestibular system and begin to move around in another section. This means that the system senses motion even when the head is still, resulting in an uncomfortable dizzy sensation which can often feel like the room is spinning.
hile uncomfortable, BPPV is rarely a sign of serious pathology but can become a safety risk if it causes loss of balance or falls.
Signs and Symptoms
How can physio help? After taking a thorough history, if your physio suspects you may have BPPV they will perform a clinical test, called the Hallpike-Dix manoeuvre. This test aims to reproduce symptoms in order to confirm the diagnosis. After the diagnosis is confirmed, your physio can perform a technique called the Epley manoeuvre in order to treat the condition. This technique involves moving the head and body through a series of positions which moves the otoconia back into the correct part of the vestibular system so that the vestibular system can work properly and stop your dizziness. It is very common for the first treatment for BPPV to effective, resulting in a complete resolution of symptoms. Your physio may also teach you how to perform this technique yourself at home if your symptoms recur. Your physio may also teach you some vestibular rehab exercises which can help retrain your vestibular system and improve your balance. These exercises focus on retraining eye movement control and balance training with the goal of helping you mange dizziness symptoms should they return. |