Referred Pain

Posted on February 26th, 2012

Have you ever gone to a Physiotherapist reporting pain in your leg and they haven’t even touched your leg, but rather treated your back instead? This is because the Physiotherapist recognised that you were suffering from a phenomenon called ‘referred pain’.

Referred pain is a term given to any pain that is felt in an area of the body that is not the true source of the pain. For example, pain in the legs often arises from dysfunction in the lower back, and arm pain or headaches can both be caused by problems in the neck. Consider when someone suffers from a heart attack and they feel pain in the left shoulder/arm. Almost every structure in the body can cause referred pain, including muscles, joints, organs and nerves.

There are two types of referred pain:

  • Radicular pain: a sharp, shooting pain that occurs when a nerve gets irritated. This type of pain is usually associated with pins and needles, numbness or weakness. ‘Sciatica’ is one example.
  • Somatic pain: a dull, achy pain that is hard to pinpoint the exact location. This type of pain occurs when one nerve collects information from two structures in the body and the brain cannot distinguish between the two structures.

Treatment of any pain requires a thorough assessment of both the area of the body that the pain is being perceived as well as the areas of the body that can refer pain to that area. If the assessment is not comprehensive, and the diagnosis of referred pain is missed, then treatment of the perceived painful area will not be effective. If the pain is determined to be referred from another source, then treatment targeted towards the source should resolve the pain.

Chest Physiotherapy

Posted on February 14th, 2012

Some of you may be unaware that our clinic offers chest physiotherapy to treat respiratory conditions. The main reason people often come for treatment is to help clear excess mucus (sputum) from the respiratory system in order to improve the normal breathing process. Conditions which present include pneumonia, chronic bronchitis, bronchiectasis, cystic fibrosis, asthma, hyperventilation and chronic obstructive pulmonary disease. Physiotherapists are trained to assess respiratory conditions and treat and provide advice and management on them.

The physiotherapist will look at addressing air entry to the all the airways of the lungs. Sometimes the airways can collapse or become blocked as a result of a buildup of swelling or sputum, which obstructs the entry of air, reducing the lung’s capacity to deliver oxygen to the body. Physiotherapists can help by providing specific breathing exercises for an individual’s condition that will help to re-inflate the lungs. Physiotherapists can also perform postural drainage positioning or manual techniques directly to the chest. Vibration or cupping can be used to mechanically shake sputum loose and make coughing up secretions easier, as sometimes due to prolonged lung disease or infection, there can be an abnormal secretion of thick mucus that the body cannot effectively expel on its own. Chest physiotherapy is effective in all age groups from new-born babies through to geriatrics. If you would like to know more about chest physiotherapy, ask someone at the clinic today.

Core Stability

Posted on February 1st, 2012

Core stability is vital for normal functioning of the human body and is necessary to prevent and recover from a multitude of musculoskeletal injuries.

Core stability requires an intimate relationship between the “global muscle system” and the “local muscle system”. Together the local and global muscles work to stabilise and support the spine and pelvis in order to provide a solid base off which the extremities can move.

The global muscle system refers to the large, superficial, power-generating muscles, such as the rectus abdominis (6-pack muscle) and the obliques.  These muscles are movement muscles, and they switch on and off throughout the day as needed.

The local muscle system is made up of the smaller, deeper muscles, including the pelvic floor muscles (at the bottom), the diaphragm (at the top), the transversus abdominis (at the front), and multifidus and gluteals (at the back). These muscles are endurance muscles, and they must remain active throughout the day to maintain upright body posture.

In the presence of dysfunction, such as low back pain, the local muscle system becomes weak, fatigues quickly and essentially ‘switches off’, whereas the global system becomes overactive and tight. This imbalance between the two muscle systems further perpetuates the dysfunction and pain. In order to overcome this imbalance, rehabilitation of the core muscles must focus on the activation and endurance of the local muscle system as well as the relaxation of the global muscle system. Core stability training is a vital component in the prevention and management of low back pain as well as many other musculoskeletal conditions.

To locate your core muscles, lie on your back with your knees bent and your spine in a neutral position (not flat against the bed but not arched up). Focus on the area below your belly button and try to gently draw it in towards your spine. You can place your hands just in front of the hip bones to feel a slight bulge of the muscle as you contract it. You should be able to breathe at the same time as you contract the muscle. Initially aim to hold the muscle contraction for 10 seconds and repeat 10 times. Further exercise progressions are based on using the core muscles to maintain a steady spine and pelvis while adding movements of the arms and/or legs. Eventually the two muscle systems must be trained to work together to maintain a stable pelvis and spine in a variety of positions and throughout the variety of challenging tasks that your body undertakes every day.

A physiotherapist can perform a comprehensive assessment of your core stability and provide a progressive strengthening program that is tailored to your individual needs. They will also ensure you are performing the exercises correctly and activating the right muscles.