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The Benefits of Physiotherapy and Pilates After a Total Knee Replacement

Recovering from a total knee replacement (TKR) can be a long journey. However incorporating physiotherapy and Pilates into your rehabilitation plan can significantly enhance your recovery. Both physiotherapy and Pilates help improve strength, balance, and proprioception – critical components in regaining full mobility and function after surgery.

Why Physiotherapy and Pilates Matter

1. Strengthening: After knee replacement surgery, the muscles around the knee often become weak due to disuse. Physiotherapy exercises target these muscles to rebuild strength, helping support the knee joint and reduce the risk of injury. Pilates, with its focus on controlled movements and core engagement, further strengthens the entire lower body, which provides better support and stability for the knee.
2. Balance: Both physiotherapy and Pilates emphasise balance exercises that help restore stability and coordination. After surgery, many patients experience difficulty standing or walking without assistance. Balance training strengthens stabilising muscles, improving your confidence and independence as you move through daily activities.
3. Proprioception: This is your body’s ability to sense its position in space. After knee surgery, proprioception can be impaired, leading to difficulty with tasks like navigating uneven surfaces. Pilates and physiotherapy focus on exercises that challenge and retrain proprioceptive abilities, helping you regain awareness of your knee’s position and improving your overall movement control.

4 Easy At-Home Exercises after a Knee Replacement

1. Quad isometrics
   Target: Quadriceps muscles
   How to do it: Sit with your leg extended straight out in front of you. Tighten your thigh muscle by pushing the back of your knee down toward the floor. Hold for 10 seconds, then relax. Repeat 10-15 times.

Dosage: 2 x 10 reps, 10 second holds

• Seated knee extension
  Target: knee range of motion, quadriceps
  How to do it: Sit upright in a chair with your feet flat on the floor and your knees bent to a comfortable position. Slowly straighten your injured knee, then lower it back to the starting position. 

Dosage: 3 x 10 reps

• Semi tandem stance balance
  Target: Balance and proprioception
  How to do it: Stand tall, have your injured leg forward, slightly in front of the other with feet about 10cm apart. Change feet and repeat again. 

Dosage: 3 x 30 secs each side. 

• Standing knee flexion 

Target: knee range of motion, hamstrings

Start standing with your feet hip width apart and have something to hold onto in front of you (i.e. chair or kitchen bench). Slowly bend your injured knee, taking your foot towards your bottom. Slowly lower your foot back to the floor. 

Dosage: 3 x 10 reps.

Additionally incorporating physiotherapy and Pilates into your post-knee replacement routine offers a holistic approach to healing. Furthermore strengthening the muscles around the knee, improving balance, and enhancing proprioception can lead to better long-term outcomes, increased independence, and a faster return to normal activities. Book in with one of our experienced physios before starting any exercise routine to ensure these movements are safe and appropriate for your recovery stage.

Understanding Ankle Sprains: Recovery, Physiotherapy, and the Importance of Early Loading

Ankle sprains are among the most common injuries, particularly in athletes and active individuals. They occur when the ligaments that support the ankle stretch, strain or tear, often resulting in pain, swelling, and limited mobility. However, with the right approach, recovery can be efficient and effective.

Recovery Process

The first step in recovering from an ankle sprain is to manage pain and swelling. The POLICE method—Protect, Optimal Loading, Ice, Compression, Elevation—is a cornerstone of initial treatment.

• Protect the area from any further damage i.e. wearing a brace, CAM boot or crutches.
• Optimal Loading, gradual, controlled movements and weight bearing as tolerated. This helps stimulate tissue repair and retains strength and mobility
• Ice, 15-20 mins every 1-2 hours within the first 48 hrs, this helps reduce the swelling
• Compression, such as a tubi grip bandage or another type of gentle compression to manage swelling.
• Elevation, above hip height throughout the day to reduce fluid retention at the ankle.

Physiotherapy Management

Once the initial swelling subsides, physiotherapy plays a crucial role in recovery. Physio’s will assess the injury and create an individualised rehabilitation program. This typically includes:

– Manual Therapy: Techniques to enhance mobility and alleviate pain.

– Balance Training: Exercises to improve proprioception and prevent future injuries.

– Strengthening Exercises: Gradual loading of the ankle muscles to regain strength.

The Importance of Early Loading

Recent studies emphasize the importance of early loading in recovery. Instead of completely staying off the ankle, introducing controlled weight-bearing activities shortly after the injury can promote healing and restore function faster. This approach helps stimulate tissue repair and enhances joint stability.

Examples of Exercises

1. Range of Motion: Gently drawing the Alphabet with your ankle.

2. Strengthening: Progress to resistance band exercises targeting the calf and ankle muscles. I.e. toe pointing against a theraband. Can then progress to standing heel raises.

3. Balance: Semi tandem stance or tandem stance balance to improve stability. Can then progress to SL balance eyes open then eyes closed. Make sure you have something close by to hold onto (a chair), just in case!

Ankle sprains can be frustrating, but with proper management, including physiotherapy and early loading, most individuals can return to their normal activities in a matter of weeks. If you have sprained your ankle recently or would like to prevent it from happening, book in to see one of our Physios at Physio On Miller.

Understanding De Quervain’s Tenosynovitis: How Physiotherapy Can Help Relieve Pain and Restore Function

De Quervain’s tenosynovitis is a painful condition that affects the tendons located on the thumb side of the wrist. It is characterized by inflammation of the sheath surrounding the abductor pollicis longus and extensor pollicis brevis tendons. This condition can arise from repetitive wrist and thumb movements, making it common among individuals engaged in activities that involve gripping or grasping, especially in the post-partum period for women.

Symptoms

The hallmark symptoms of De Quervain’s tenosynovitis include:

• Pain and Tenderness: Patients typically experience pain at the base of the thumb and along the wrist, which may radiate up the forearm. This pain often worsens with activities involving hand movements, such as gripping or pinching.
• Swelling: Inflammation may lead to noticeable swelling over the thumb side of the wrist.
• Difficulty with Thumb Movement: Patients may find it challenging to perform tasks that require thumb motion, such as opening jars or using a smartphone.
• Crepitus: A grating sensation or sound may occur when moving the thumb.

Pain and Tenderness: Patients typically experience pain at the base of the thumb and along the wrist, which may radiate up the forearm. This pain often worsens with activities involving hand movements, such as gripping or pinching.

Management

Effective management of De Quervain’s tenosynovitis involves a combination of conservative and, in some cases, more invasive treatments:

• Rest: Avoiding activities that exacerbate symptoms is crucial. Resting the affected wrist can help reduce inflammation.
• Ice Therapy: Applying ice packs can alleviate swelling and provide pain relief.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen can help manage pain and inflammation.
• Splinting: A thumb spica splint can immobilize the wrist and thumb, promoting healing by minimizing movement.
• Corticosteroid Injections: For persistent symptoms, a healthcare provider may recommend corticosteroid injections to reduce inflammation.

Physiotherapy Treatment

Physiotherapy plays a vital role in the recovery process. A qualified physiotherapist will tailor a treatment plan that may include:

• Therapeutic Exercises: Gradual stretching and strengthening exercises can restore function and flexibility. These exercises focus on improving the range of motion in the wrist and thumb.
• Manual Therapy: Techniques such as joint mobilization can help reduce pain and improve mobility.
• Education and Ergonomic Advice: Patients are educated about proper wrist mechanics and provided with strategies to modify activities to prevent recurrence.
• Modalities: The use of ultrasound or electrical stimulation may help alleviate pain and promote healing.

Early diagnosis and a comprehensive management plan, including physiotherapy, are essential for effectively treating De Quervain’s tenosynovitis. If you’re experiencing symptoms, don’t wait—book into see one of our physios for a thorough evaluation and a personalized treatment approach that gets you back to doing what you love!

Maximise Injury Rehab and Sports Performance with Ice Baths: A Guide from Your Physiotherapy Experts

Ice baths, or cold water immersion, have become a staple in sports recovery and injury rehabilitation. At Physio On Miller, the science behind this effective method supports recovery and can complement your physiotherapy to enhance both injury rehab and sports performance.

1. Combat Inflammation and Swelling

One of the most significant benefits of cold water immersion is the ability to reduce inflammation and swelling. When you experience an injury or engage in intense physical activity, inflammation can impede healing and exacerbate pain. Ice baths work by constricting blood vessels and reducing blood flow to the injured area. Furthermore this which minimises swelling and alleviates discomfort. Incorporating this complementary method into your rehab routine, as guided by your physiotherapist, can accelerate recovery and ease the pain associated with injuries.

2. Accelerate Muscle Recovery

Athletes and active individuals often turn to ice baths to enhance muscle recovery. During and after intense exercise, muscles can become sore and stiff due to the accumulation of metabolic waste products like lactic acid. However, ice baths help flush out these byproducts, reduce muscle soreness, and speed up the recovery process. By integrating it into your post-exercise regimen, your physiotherapy plan can more effectively address muscle fatigue and ensure quicker returns to training.

3. Prevent Injuries with Regular Use

Regular ice baths can be a proactive measure for injury prevention. By managing muscle inflammation and improving recovery times, you can reduce the risk of overuse injuries and strains. A consistent cold water immersion routine, tailored by your physiotherapist, helps maintain optimal muscle function and flexibility, which is crucial for preventing injuries during high-intensity activities.

Best Practices for Ice Bath Integration

For effective use, aim for ice baths of 10 to 15 minutes at a water temperature between 10°C to 15°C. Ideally, use cold water immersion within 30 minutes post-exercise or injury. It’s essential to consult with your physiotherapist to integrate ice baths into your treatment plan effectively and address your unique recovery needs.

Our team of physiotherapy experts can guide you on how to incorporate ice baths into your rehabilitation and prevention strategy. Contact us today or book online to learn how this powerful recovery tool can complement your personalised physiotherapy treatment plan.

Understanding and Managing Plantar Fasciitis with Physiotherapy

Plantar fasciitis is a common condition causing pain in the heel and bottom of the foot. It’s particularly prevalent among runners but can affect anyone who puts significant stress on their feet. Physiotherapy is essential for assessing and managing plantar fasciitis, helping to alleviate pain and improve mobility.

Physiotherapy Assessment

A thorough physiotherapy assessment is the first step in managing plantar fasciitis. This typically includes:

• • Past Medical History: Understanding the patient’s medical background and any previous foot issues.

• • Physical Examination: Checking for tenderness in the heel and along the plantar fascia, assessing foot alignment, and evaluating gait. Assessing the flexibility and strength of the calf muscles and Achilles tendon.

Physiotherapy and Self-Management

The gold-standard management for plantar fasciitis involves a combination of treatments designed to reduce pain and inflammation, improve strength and flexibility, and prevent recurrence.

1. Pain Relief and Inflammation Reduction

• • Ice: Applying ice to the affected area to reduce inflammation.

• • Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended.

2. Stretching and Strengthening Exercises

• • Calf Stretching: Stretching the calf muscles to relieve tension in the plantar fascia.

• • Plantar Fascia Stretching: Specific stretches targeting the plantar fascia to improve flexibility.

3. Footwear and Orthotics

• • Supportive Shoes: Wearing shoes with good arch support and cushioning.

• • Orthotic Inserts: Custom orthotics to support the arch and reduce strain on the plantar fascia.

4. Manual Therapy

• • Massage: Techniques to loosen tight muscles and improve blood flow.

• • Mobilisations: Manual adjustments to improve foot and ankle alignment.

• • Dry Needling

5. Taping

• • Taping: Applying tape (low-dye) to support the arch and relieve pressure on the plantar fascia. Taping can provide immediate pain relief and support during activities.

Effective Exercises for Plantar Fasciitis

Certain exercises are particularly effective in managing plantar fasciitis:

• • Calf Raises: Strengthen the calf muscles, which support the plantar fascia.

• • Towel Stretch: Stretch the plantar fascia and Achilles tendon.

• • Toe Curls: Strengthen the intrinsic muscles of the foot.

Plantar fasciitis can be a painful and debilitating condition, but with proper physiotherapy assessment and management, relief is possible. Combining pain relief strategies, stretching, strengthening exercises, taping, and appropriate footwear can significantly improve symptoms and prevent recurrence. If you’re struggling with heel pain, please contact us to book an appointment with one of our physiotherapists!