conditions we treat  

 

The aim of our Physical Medicine clinic is to correctly diagnose somatic (bodily) dysfunctions, including restricted joint motion, muscles which are in spasm or which are hypotonic, altered muscle firing patterns and tight connective tissues such as ligaments or fascia. Such dysfunctions typically cause joint restrictions, pain, and nerve or vascular entrapment.

 

Diagnosis depends on taking a thorough history, noting the severity and location of the symptoms. Examination takes into account posture, gait and muscle behaviour patterns. The aim is then to reproduce the symptoms by palpation and joint motion testing. Care is taken to exclude possible underlying disease.

 

Some of the problems that we may be able to assist you in the management of are:

 

·           migraine-like headaches, cervicogenic headaches

·           neck stiffness or pain, acute and chronic whiplash

·           shoulder stiffness or pain, shoulder dysfunction

·           musculoskeletal chest pain, mid-scapular pain

·           acute and chronic lower back pain

·           musculoskeletal pelvic pain and dysfunction

·           peripheral limb pain or paraesthesiae

·           peripheral joint dysfunction

·           elbow tendonitis

·           foot pain, heel pain, ankle dysfunction

·           disturbance of gait or posture

·           TMJ dysfunction

 

Treatment will depend on examination findings, their severity and whether they are acute or chronic. This practice uses a broad variety of manual (hands on) treatment modalities, as listed below:

 

Mobilisation employs rhythmical oscillations of a joint to encourage freer motion.

 

Manipulation involves applying a short thrust to a restricted joint to remove a dysfunction.

 

Muscle energy technique can be used to find and treat the causes of all types of pain. It relies on the concept that joints are held out of place by muscles  which have too much tone. The technique uses a series of gentle muscle contractions, coordinated with breathing, to recalibrate the precise muscle spindles which cause the muscles to hold the bones in less than optimal position.

 

Counterstrain is a subtle indirect technique which involves placing the  tight muscle or joint in a position of maximum comfort, holding this position till the tissues soften and then slowly returning the body to a neutral position.

 

Facilitated positional release is another indirect technique which involves positional placement towards a direction of freedom and away from restriction barriers. Positional placement involves a balance in flexion, extension and side-bending and then applying either compression or torsion which then induces release of tight or restricted tissue.

 

Ligamentous release works on the ligaments or connective tissue sheets (fascia) that surround a tight joint. It aims to rebalance tight or loose ligaments to return a joint to its normal physiological position. It involves compressing or decompressing tight tissues until a balance is found allowing a release into normal functional position.

 

Myofascial spray and release technique involves using a vapo-coolant spray (ethyl chloride) being applied to tight or painful muscles before using muscle energy technique to release them. This is useful for acute or chronic conditions and is especially valuable where a body region has become too sensitive.

 

Other modalities may involve the injection of a short acting local anaesthetic (1% xylocaine) into chronic painful muscle tender points before applying some of the above techniques.

Likewise low-level infrared laser (830 nm Ga-Al-As) or ultra-sound may be used to augment the therapy.

 

Exercise prescription is one of the most essential principles of our treatment regime. Once your key problems are identified, specific exercises can be taught to help alleviate your problems. Photocopied sheets of these exercises will be provided and you will be encouraged to undertake an appropriate exercise or stretch program. For chronic or recurrent problems, treatment by experienced practitioners is not enough to keep pain at bay. A daily release program is required for this; for example, home exercises augmented by weekly yoga, Pilates or Tai chi classes. Regular swimming, walking or gym classes may be prescribed.

 

REALTIME ULTRA SOUND OF CORE - Realtime ultrasound assisted core muscle re-training:

 

Lack of abdominal corset stabiliser activity has long been recognised in association with back dysfunction.  The recent availability of RealTime ultrasound based assessment and retraining techniques represents, in the hands of a skilled operator, a great step forward in treating this problem.  RealTime ultrasound biofeedback techniques utilising a monitor attached to the machine allow certainty in targeting the correct core muscle groups, and also in developing an appropriate individualised home exercise program.

 

For balance or coordination problems we provide a range of twister and multiplane balance boards for loan to assist in rehabilitation.

For assessment of foot dysfunction or leg length discrepancies advice is provided on orthotics, heel raises and footwear.