Musculoskeletal

The musculoskeletal system includes the bones, joints, muscles, fascia and tendons as well as the way in which they all interact and work together. The musculoskeletal system gives the body its shape and enable movement. Physiotherapists often use the term: “Everything is connected in the kinetic chain”. Each component of the system could sustain an injury. This could be due to direct trauma, or altered biomechanics. At IR Physio we have a passion for biomechanics and finding the root cause of the dysfunction. This often requires a holistic approach.

Shoulder Pain

The shoulder is a complex joint as it requires multiple joints working together to give you full function of your arm. Shoulder injuries can be acute or as a result of overuse. The shoulder joint is one of the most mobile joints in the body and it could be greatly affected by soft tissue dysfunction. Overhead athletes often develop instabilities and swimmers can complain of shoulder pain due to muscle shortening. One sided sports athletes like baseball, golf or tennis can struggle with muscle imbalances. As there are several structures that could be affected, the severity of this condition needs to be assessed. Your physiotherapist can evaluate and treat all shoulder related injuries.

Rotator Cuff

The rotator cuff is a term used to describe the four muscles with their tendons that allow for stability and movement of the shoulder complex (joint). Supraspinatus, Infraspinatus, Teres Minor and Subscapualris muscles make up the rotator cuff. These muscles are responsible for the functioning of the shoulder girdle by controlling the position of the head of the humerus in the glenoid fossa. Overuse and over-head activities are the most common causes of injury for the rotator cuff and can result in impingement syndrome and poor biomechanics. The rotator cuff can also be affected by aging resulting in degeneration, impingement or different grades of muscle tears. Trauma and falls can also cause injury to the rotator cuff. Physiotherapy can effectively diagnose and treat your rotator cuff injury and assist you with the correct exercises and return to normal functioning and sport.

Soft Tissue Dysfunction

The whole body is made up of connective tissue. We are able to stand up straight or move due to connective tissue that works with muscle, ligaments, joints and nerves. There are approximately 640 skeletal muscles in the human body and we have kilometres of nerve and connective tissue. Adaption or imbalances in this connective tissue due to posture, injuries or compensation can be called a dysfunction. Soft tissue myofascial release, dry needling, muscle energy techniques and muscle retraining are used as treatment for soft tissue dysfunction.

Back and Neck Pain

Pain in the back and neck are common complaints during one’s lifetime. In their lifetime, 80% of adults will experience back pain. Your physiotherapist is trained to identify and treat the cause of your condition. With an assessment, we aim to determine the origin of the pain, be it joint, muscle, nerve, neuromuscular control or a combination of the above. We also refer you on to a specialist, if we see in the assessment that it is necessary. Back and neck conditions can also cause referred pain to your legs, arms and head and this can also be determined through a physiotherapy assessment. Headaches and sciatica are two such examples.

Back and neck pain can further be classified into postural syndromes. Specific treatment and education regarding the cause of the pain is done. Treatment may include soft tissue release, stretches, neuromuscular stimulation and rehabilitative exercises. We use a bio-psycho-social approach which includes education, maintenance therapy, exercises, lifestyle management and pacing. You can make an appointment directly at your physiotherapist.

Chronic pain syndromes, including chronic back and neck pain is a complex problem and needs a multi-faceted approach. Feel free to read more about this at the chronic pain syndromes tab further down.

Slipped Disc

Often if you experience back or neck pain, it could be described to you as a slipped disc. Latest research has now shown us that a disc cannot really “slip”. In fact, a better explanation might be that the disc or structures in the back could become irritated and this may cause inflammation. Inflammation may cause pressure on the nerve and this can be very painful. Discs could originally be the problem, but as the pain becomes more chronic, there could be different contributing reasons for the pain. During your first physiotherapy consultation a full assessment will be done to identify which structures are causing the irritation that results in pain. Further treatment may include decreasing the inflammation, active exercises, stability work and pain control.

Whiplash

Whiplash injuries are not limited to motor vehicle accidents, but can include falls, bumps, and tackles. Whiplash can be graded from mild to severe and x-rays are at times needed. In an acute whiplash injury, the priority is to educate the patient on management plans, decrease pain, and gain a wider range of motion. This can be done with soft tissue treatment, ice packs, electro therapy, strapping, advice specific to the patient and history of the injury/trauma. As the whiplash injury improves, the focus shifts to gaining a full range of motion and strengthening the muscles supporting the neck and shoulders. Re-educating the neck on proprioception (the joints ability to support itself in space) is key to manage and prevent recurrence of pain and dysfunction. One would like to exclude any concussions associated with whiplash, as the management of concussions and whiplash is patient specific and needs to be guided.

Headaches

Headaches are a common and at times a debilitating condition. There are different types of headaches. Physiotherapists work mainly with tension type headaches, migraines and cervicogenic headaches.

Cervicogenic headaches are the result of pain that originates from the cervical spine or upper part of the neck. This can be due to a dysfunction (misuse) at the first 4 vertebrae. Tension type headaches are mainly linked to high stress levels and the muscles in the neck and shoulders. Migraines are at times associated with tension or cervicogenic headaches and physiotherapy can help to manage flare-ups.

An assessment can help with clear identification of your headaches. Treatment may include postural correction, stretches, strengthening and heat packs for muscle tension. Sometimes a more holistic approach is necessary including mindfulness, medication and relaxation therapy. If you often suffer from headaches your physiotherapist can assist you with a maintenance program that can prevent the onset or manage the symptoms of a headache once it arises to allow you to function better.

Postural Correction

Prevention is better than cure! This well known saying is part of our approach to postural conditions. Posture can be negatively affected by work, school or while participating in sport. Correcting posture, once there is a dysfunction/pain, is a priority, but postural assessment and education should be done with all individuals. Treating scoliosis is also part of postural correction.

Musculoskeletal

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