By Allister Horncastle

A question I am frequently asked is: “I have a sore calf, have I strained it?”

The best way to answer this is to ask yourself:

1. Was there was an event that caused immediate calf pain?

2. Or did it build up slowly?

The answers to these questions will almost always dictate whether you have an acute calf injury or something else.

I have recently seen an increase in patients presenting for an assessment of calf pain.

The majority are returning to regular exercise – and particularly running type activities – after a layoff. The two most common presentations are:

1. Acute onset pain when jogging/running, or explosive type movements.

2. General soreness that appears during or after activity.

The main reasons for both presentations are generally unaccustomed loading and weakness.

Here are some self-management strategies for both pain types:

Acute pain:

  • Follow POLICE rules (Protection/Optimal Loading/Ice/Compression/Elevation).
  • Avoid HARM (Heat/Alcohol/Running/Massage).
  • Avoid Anti-inflammatory drugs (Nurofen/Voltaren).
  • Listen to your body: if you are limping, your body is being protective of the painful area. Know that limping is ok for a short period of time.
  • Finally, get an appointment with your physio to guide management.

Slow onset pain:

  • A rest period of 24 hours between aggravating activity may help.
  • Use heat through the muscle.
  • Massage and stretching may help.
  • If it is ongoing for longer than 24 hours, it is probably not just muscle ‘soreness’ and therefore, it needs to be assessed by a physio.

This is not by any means an exhaustive list of calf pain causes, but is a quick and simple guide to help you decide what needs to be done. 

If you have calf pain and are unsure about management, contact your local Physio Pro clinic for an appointment.

June 15-22 is Men’s Health Week, so it’s time to talk about prostate health!

What is the prostate?

The prostate is a walnut sized gland that sits below the bladder and produces majority of the fluid that makes up semen. It is normal for the prostate to grow as men age; however, as the prostate surrounds the urethra, this can cause difficulty urinating.

In Australia, prostate cancer is the most common cancer among men. It occurs when abnormal cells develop in the prostate and continue to multiply in an uncontrolled manner. Generally prostate cancer is slow growing, however high-grade disease can spread quickly.

Should you be getting checked?

Men over 50 years of age, or over 40 with a family history of prostate cancer, should talk to their doctor about screening for prostate cancer as a routine part of their annual check-up.

What symptoms should you ask your doctor about?

  • Frequent or sudden urge to urinate
  • Difficulty urinating eg. slow to start or weak flow
  • Discomfort when urinating
  • Blood in urine or semen

What about physiotherapy?

If you have pain in your lower back, thighs, or hips, talk to your PhysioPro. They are experts in diagnosis and treatment of musculoskeletal complaints. Your PhysioPro will refer you for further investigation if required.

Some men will undergo a procedure called a radical prostatectomy to remove their prostate. Up to 95% of men experience urinary leakage (incontinence) as a side effect of the surgery.

There is evidence that practicing an individualised pelvic floor exercise program both before and after surgery can help men to get drier, faster.

PhysioPro’s Sophie has completed post-graduate studies in continence and men’s health. She helps prepare patients for their prostatectomy surgery through education, use of real-time ultrasound (a non-invasive assessment technique), and prescription of pelvic floor exercises.

For more information on men’s health physiotherapy, please contact your local PhysioPro.

To all our breastfeeding mums: did you know our women’s health PhysioPro Sophie treats blocked ducts and mastitis?

Sometimes the ducts that carry the milk from deep in the breast to the nipple can become blocked. Milk builds up behind the blockage, resulting in a painful lump.

If the blocked duct is not cleared quickly, milk can be forced into nearby breast tissue, resulting in tissue inflammation called mastitis, and sometimes infection.

Some tips to manage blocked ducts at home are:

  • Apply a warm compress to the area before feeds
  • Get into a comfortable relaxing position before breastfeeding
  • Breastfeed regularly and from the affected side first
  • Ensure baby is well attached, and vary the feeding position
  • Gently massage the lump towards the nipple during feeds
  • Ensure breasts are fully empty: express if needed afterwards
  • Apply cool packs to relieve pain and inflammation

Find more information here.

If you are unable to clear the lump within a couple of days, it is time to consult your PhysioPro for further advice and treatments including ultrasound therapy.

If you are feverish or feeling unwell, consult your GP as you may require antibiotic treatment.

By Allister Horncastle

As we all keep to the government’s regulations – which thankfully are continuing to ease – in the clinic I am noticing an influx of people with non-specific knee pain. It’s often from an increase in running or from commencing a running program. However, it’s not just runners that are getting this pain: it’s also experienced by gym junkies, gardeners, walkers and non-fitness folks alike.

With this type of knee pain, you often don’t remember a specific event that injured your knee. Instead, you notice that your knee starts to hurt during, after or the day after physical activity.

What you’re experiencing is likely Patellofemoral Joint Pain (PFJP), commonly known as ‘Runner’s Knee.’

It’s likely you’ll have pain at the front of the knee towards the middle, but pain can also present on the outside, at the back or any combination of the above. It may warm up as you exercise, worsen so you have to stop or you may only notice it post activity.

A recent patient of mine started running after a long layoff and pulled up sore.

This continued for 2 weeks until she attended the clinic. Her pain was under the kneecap and towards the middle, and it would be sore while she running, with the pain continuing until the following morning. Interestingly, she had the same pain when she was sitting at her desk with her knee bent for prolonged periods at work, even when she had rested the day prior. This is another common characteristic of Runner’s Knee. It might sound familiar to some of you?

What’s occurring in this scenario is an abnormal biomechanical load through the patellofemoral joint (the joint between the kneecap and thigh bone). Unlike the majority of joints in the lower limb, the patellofemoral joint isn’t rigidly held in position by strong and taught ligaments, so it is more vulnerable to a number of internal and external factors. 

Internal factors include:

  • Tight and/or weak muscles around the hip and the rest of the leg
  • Stiff joints
  • Flat feet
  • Inflammation
  • Previous injury
  • Poorly aligned bony architecture

External factors include:

  • Inappropriate footwear
  • Altered training surfaces
  • Altered training loads
  • Ergonomics
  • Diet
  • Age

A physiotherapy program can be tailored to target an individual’s internal and external factors, and in the vast majority of cases, you will return to your chosen activity. In other more severe cases, external referral may be required and this can be provided by your physiotherapist. In either case, if your knee pain sounds anything like this, physiotherapy should be your first point of call.

For my patient, her knee pain was caused by a combination of both internal and external factors. We were able to:

  • Alter her running program to allow sufficient rest between runs
  • Get her in more appropriate shoes for her foot type
  • Loosen tight muscles
  • Reduce inflammation
  • Strengthen the muscles around the hip to allow normal biomechanics of the lower limb

This process took multiple sessions over only a few weeks and she is now running pain free and would have been able to run the HBF Run-For-A-Reason in May.

For more assistance, please contact your local Physio Pro.