There are many forms of fractures, each causing a dilemma in our lives and requiring the help of a physiotherapist in order to heal safely and properly. One of the most common types of fractures seen in sports medicine today is called a “hairline” or “stress” fracture. Hairline fractures are caused by repetitive strain and excess training. Hairline fractures are minute cracks on the bones, which can become severe if not immediately treated. The main causes of a hairline fractures are:
- Traumatic Incidents
- Repetitive Stress
- Pathological
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Basically, hairline fractures are caused by the depressed response of the bone with the ground reaction forces that are applied to the bones during certain activities such as: running, jumping, or walking. Symptoms may include pain and tenderness to the affected bone. Repetitive stress or a sudden fall or strike to the area can also cause hairline fractures.
The best way to treat a hairline fracture is to refrain from any activities that can aggravate the injury. Recovery time can span from two weeks to a month and a half. Once the bone is healed from its minute cracks, you can gradually resume normal activities. In extreme circumstances, the affected area must be put at rest and must be immobilized by casting or bracing. The stages of healing a fracture through physiotherapy are as follows:
- Muscle Assessment
- Joint Mobilisation
- Massage Therapy
- Heat and Electro Therapy
- Gait Education
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Shoe inserts like supportive orthotics and walking crutches may also be recommended by your physiotherapist. Treatment through physiotherapy is advised through strengthening exercises that are non-weight bearing like swimming. Luckily, hairline fractures rarely need surgery because they can easily be mended with just two weeks of rest. However, the injury can worsen if not given the proper medical attention.
If you happen to suffer from a hairline fracture and you are looking for a way to relieve pain, and recover from an injury, adding physiotherapy to a routine wellness plan can maximize recovery time and optimize your healing process. Our physiotherapists at Triangle Physiotherapy can be a powerful ally when combating daily stress, muscle pain, and general health issues when it comes to hairline fractures. Not only does physicaoherapy relieve pain, increase energy levels, and improve overall physical and mental performance, it prevents further injuries. The experienced, professional physiotherapists at Triangle Physiotherapy are available at five convenient locations: Etobicoke, Oakville, Mississauga, North York and Toronto. At Triangle we customize your physiotherapy sessions to address your individual needs.
A knee sprain is an injury of the ligaments; tough bands of fibrous tissue that connect the bones of the upper and lower leg at the knee joint. One of the main forms of knee sprain is in the anterior cruciate ligament (ACL). The ACL and the posterior cruciate ligament (PCL) bridge the inside of the knee joint, forming an, “X” pattern that stabilises the knee against front-to-back and back-to-front forces. There are certain movements in the knee that causes a sprain in the ACL such as: a sudden stop; a twist, pivot, or change in direction at the joint; extreme over-straightening (hyperextension); or a direct impact to the outside of the knee or lower leg. These injuries are quiet common among athletes in sports such as: football, basketball, soccer, rugby, wrestling, gymnastics, and skiing.
It is suggested that when one knee ligament suffers a sprain, there is a good chance that the other parts of the knee may also be injured, most commonly the ACL. Knee sprains are very common. ACL sprains tend to cause more significant symptoms compared to MCL injuries. The most frequent signs of an ACL sprain are:
- A pop heard or felt inside your knee at the time of injury
- Significant knee swelling within a few hours after injury
- Severe knee pain that prevents you from continued participation in your sport
- Black-and-blue discoloration around the knee
- Knee instability- the feeling that your knee will buckle or give out
After injury, a physiotherapist will examine both knees, comparing the injured knee to the uninjured one. During this exam, the physiotherapist will check your injured knee for signs of swelling, deformity, tenderness, fluid inside the knee joint and discoloration. If the patient does not have too much pain and swelling, a physiotherapist will then evaluate the knee’s range of motion and will pull against the ligaments to check their strength. During the exam, the patient will have to bend their knee and the physiotherapist will gently pull forward or push backward on their lower leg where it meets the knee.
Based on the results of the patients’ exam, diagnostic tests may need to be performed to further evaluate the condition of the patients’ knee. These tests may include standard X-Ray’s to check for ligament separation from bone or fracture. Tests may also include a MRI scan or a camera –guided knee surgery (arthroscopy). The expected duration of the injury depends on the severity of the patients’ knee sprain, their rehabilitation program, and what type of sports the patients play. In general, milder sprains heal within 2-4 weeks, whereas other types may take 4-12 months. There are many ways of preventing ACL knee sprain, to help sports related injuries you can:
- Warm up and stretch before participating in athletic activities
- Do exercises which strengthen the leg muscles around the knee, especially the quadriceps.
- Avoid sudden increases in the intensity of a training program. Do not push too hard or too fast. Gradually increase intensity.
- Wear comfortable, supportive shoes that fit your feet and fit your sport
About 90% of people with ACL injuries can expect a full recovery after proper treatment and a good physical therapy program. As a long-term complication, some patients who suffered from an ACL sprain eventually develop pain from osteoarthritis in the joint where the knee has been injured. This symptom may not become present until 15 to 20 years after the initial knee injury.
Call a professional when:
- Knee becomes very painful or swollen
- Cannot bear weight
- Feels as if it will buckle or give out.
Are you feeling a bit of a pain in the neck lately? Does your neck feel stiff, painful, tender, or are you not able to turn it and move around as much as you used to? You may be victim to whiplash. Whiplash is most associated with traumatic events involving sudden acceleration-deceleration forces mainly on the neck. Whiplash can affect a variety of issues pertaining toyour muscles, joints, bones, ligaments, discs, and nerves. Whiplash is mostly associated with car accidents, but other causes may include roller-coasters, bungee jumping or a sports-related condition. Symptoms and severity of whiplash can vary significantly between people. The most common reported symptom is neck pain or stiffness. This can occur anywhere from immediately after the injury to several days after.
Symptoms may include:
- Neck pain or stiffness
- Headache
- Shoulder pain, arm pain, or upper back pain
- Dizziness
- Altered sensation
- Weakness
- Visual disturbances
- Hearing difficulties
- Difficulty speaking or swallowing
- Difficulty swallowing
Fortunately, most people recover from the pain and stiffness associate with whiplash in a matter of weeks, but some cases require longer recovery time and treatment from a physiotherapist. Healing time varies with the level of tissue damage and promptness of treatment.Most whiplash patients will start to feel better within a few weeks of the injury from physiotherapy treatment. At Triangle, our physiotherapists will aim to:
- Reduce neck pain, headaches, and inflammation
- Normalise joint range of motion
- Gain strength in your neck
- Strengthen your upper back muscles
- Improve neck posture
- Normalise your muscles lengths and resting muscle tension
- Resolve any deficit in neural tissue extensibility
- Improve neck proprioception, fine motor control and balance
- Improve your ability to cope with everyday activities
- Minimise your chance of future neck pain or disability
Whiplash injuries can take from a few days to several months to rehabilitate. Just as the symptoms and severity of whiplash can vary from person to person, so can the recovery time. The large majority of whiplash sufferers do recover with actively guided treatment. Depression and trauma-related anxiety may impact the healing process of whiplash. Please consult with a qualified health professional to give yourself the best chance of recovery.
For more advice or any questions, please contact one of our physiotherapists at Triangle Physiotherapy at: https://www.trianglephysiotherapy.com/mail/mail.html
One of the most common questions physiotherapists are asked on a daily basis is whether to apply ice or heat to an injury. The answer to this question is dependent on whether the injury is acute or chronic.
An acute injury has a sudden onset, and is typically caused by a significant or traumatic event. Examples of these conditions include: ligament sprains, muscle or tendon tears, joint dislocations, and bone fractures. These injuries are accompanied by immediate symptoms including: sharp localized pain, inflammation, swelling, and bruising.
Within the first 48-72 hours of acute symptom presentation, it is advised to use ice therapy. In addition to pain control, the effects of ice help reduce swelling and inflammation. Ice application causes a local decrease in body temperature, which reduces metabolic rate and leads to blood vessel constriction. These physiological responses result in less bleeding and fluid accumulation in the area of injury, reducing the amount of swelling and active inflammation. For best results, it is advised to combine ice therapy with rest, elevation and compression (RICE) of the injured area.
Parameters for ice application:
For use on distal extremities (ex. hands and feet) ice should be applied for 15 minutes or less at a time. For more proximal areas (ex. the shoulder or the hip), ice can be applied for up to 20 minutes. It is important not to exceed this time period, as reverse effects such as blood vessel dilation will occur. Additionally, consecutive sessions of ice therapy should be at least 1 hour apart, to provide the skin time to return to normal temperature between treatments.
A chronic injury is gradual in onset, and is most often caused by repetitive strain or overuse of a joint or muscle group. Examples of these conditions include: tendon strains, muscle strains, and joint capsule adhesions. These injuries typically have no active inflammation due to their slow symptom development, and pain is often milder and more diffuse.
Heat therapy is indicated in the treatment of chronic injuries to help with pain reduction, to accelerate the healing process, and to restore range of motion and reduce joint stiffness. Heat application causes blood vessel dilation and an increase in the metabolic rate, resulting in increased blood circulation, increased enzyme activity and increase in available oxygen to the tissues. These effects accelerate the rate of healing in the area of injury. The use of heat also causes an increase in the extensibility and elasticity of soft tissues (such as muscles, tendons and ligaments) allowing for increased range of motion and joint flexibility.
Heat can also be applied to any of the above acute injuries after the first 72 hours has passed, or the swelling and inflammation have resolved. This is because at this stage of the injury, the goal of treatment changes from restricting acute inflammatory activity to tissue stretching and healing.
Parameters for heat application:
Heat may be applied to any injured area for 15-20 minutes at a time. In order to prevent burning, the temperature of the heat should be kept below 45 degrees Celsius.
Important Tips:
- Do not apply heat or ice to an area where sensation is impaired
- Do not apply heat over a region of a known or suspected blood clot
- Do not apply heat over the low back or abdomen of a pregnant woman
- Do not apply heat or ice directly over an open wound
- The positive effects of both heat and ice therapy are best observed when combined with physical therapy and exercise!
For information about what will work best for your injury, ask your physiotherapist at Triangle Physiotherapy and Rehabilitation!
Written by: Melanie Glazer, Physiotherapy Resident
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