Have you ever suffered from pain in you lower back?
Bending makes the pain worse and sitting in one place for too long can cause back pain? What if I were to tell you that the pain was not actually coming from the lower back but from two joints called the Sacroiliac joints. About 10% to 25% of low back pain patients are thought to be actually experiencing pain from the Sacroiliac joint (SIJ)1 because the pain and symptoms can closely mimic those of low back pain. We call this PELVIC GIRDLE PAIN.

The SIJ’s are located on either side of the spine and join the pelvis to your tail bone. The joints themselves are typically very stable as they have fantastic ligament support as well as being surrounded by some of the strongest muscles in the body. Their job is to do two things. First, absorb and shift load between the spine and legs. Walking is a good example of this job. The bones can't absorb force, but the joints can, protecting the bones of the pelvis and hip from bone stress which would lead to a break. Second, their ligaments allow for expansion of the pelvis, during pregnancy.

When Pelvic Girdle Pain strikes, it can cause pain across the lower back, shooting or stabbing pain, as well as tenderness around the area. It is essentially a joint sprain, but needs attention. Left unmonitored or if not treated correctly, the pain can linger and escalate, making everyday tasks like bending or sitting a nightmare. Typically the driver is a lack of muscular coordination, endurance and support of these joints. It can also be the opposite with overactive muscles squeezing and pressurising the joints to much.

Its important to see a physiotherapist and get the proper diagnosis for your Pelvic Girdle Pain so the right treatment can be commenced straight away. Correctly targeted treatment will help to reduce the pain and symptoms so that you can get moving towards your regular lifestyle.

Our comprehensive physical examination to evaluate the Pelvic Girdle region and the back-hip area includes a biomechanical assessment to identify weakness, incoordintaion and movement faults. Even the thorax and its mechanics need to reviewed. In essence, we assess the whole of you.

With a solid diagnosis formed, treatment to relieve symptoms and fix the causes will address the supportive muscles of the Pelvic Girdle, offloading pressure with manual therapy, breathing control and potentially strapping. This may include medicine to manage inflammation.  From there strength and coordination to keep 'form under load' will be the primary goal to get the pressures moving through the Pelvic Girdle back to normal with every day activity.
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It is clear that Pelvic Girdle Pain needs a completely different treatment strategy compared to low back pain, this is why it is important to get the correct diagnosis so your problem can get the treatment tailored to it.

References

1. ​Seidenberg, F., Bowen, F., & King, D. (2017). The Hip and Pelvis in Sports Medicine and Primary Care. Cham: Springer International Publishing.

Do you, or have you ever had elbow pain with gripping or wrist movements? Has a simple task like opening a jar triggered pain around your elbow? If so, this article will be a game changer!

What you are experiencing is called lateral epicondylalgia A.K.A tennis elbow. Now I know what you must be thinking: “but I don’t even play tennis! So what does tennis elbow have to do with me?” While tennis elbow is common in tennis players, with one in two players experiencing it at some stage in their career (2), it is also common in repetitive upper extremity activities. For this reason, it is commonly seen in people with repetitive one-sides movements in their jobs such as electricians, carpenters, gardeners and desk bound jobs (3).

Tennis elbow is an overuse injury that can linger if left untreated and it can cause a harmful loop where the more you use your arm the more it starts to hurt. This can make day to day activities a nightmare, especially considering that the majority of cases are in the dominant arm. Some patients also experience interrupted sleep, with things like pulling up the covers triggering pain.

Research suggests that exercise and hands-on physiotherapy is the most effective course of action, above the use of injection and medications (1). Physiotherapy will work towards identifying the problem and target it using tailored treatment. This can rectify imbalances and de-load overstressed structures, ultimately breaking the overuse cycle and allowing healing to occur.

Tennis elbow pain can be caused by many things and it is a physiotherapists role to identify the primary contributors. This could include:

• Tendonopathy, the tendon (the muscle bone attachment tissue) is unhealthy.
• The neck is a background driver to the problem.
• The nerve system ‘changes gear’ and works differently in response to movement and use.
• One of the elbow joints is inflamed, stiff or potentially not stable.

There may be a combination of all of these factors.

Depending on the cause, physiotherapy will likely involve the following:
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Muscle and tendon training: This an include making the muscle contract without moving, tightening as it is being stretched or we tech you to slide the radial nerve as it passes the elbow to sooth and add load resilience.
 
Structure de-loading: Therapeutic tape can be used to offload the soft tissues to allow them to recover and prevent the nerve system over-reacting, by giving it some downtime from being over stimulated. Don’t forget that the soft tissue re-positioning may also improve muscle function, a good reason to see tape as more than a crutch.
 
Optimal loading: Changing how you do certain provocative things will change how much load is being put through certain structures. This could involve changing your grip, wrist position to lift carry and push as well as pacing activities to do as much but do it differently.
 
So what are you waiting for?! If you want to end all the tennis elbow racquet and give your elbow the love it deserves, serve up some of these tips and check out our video above by clicking on the image, to help you net some results!

​A recent study found that patients with low back pain who saw a physiotherapist early, had significantly lower out of pocket healthcare costs and decreased use of opioids than those who saw physiotherapist later or not at all (1). When you consult with us, we will work with you to provide an adequate explanation of the nature and prognosis of sciatica. In the early stages, international guidelines suggest that bed rest is not recommended unless pain is significantly disabling. In fact, we will work with you to keep you physically active and doing activities that are important to you. We will combine activity with nerve relief manual therapy and nerve easing position and movements for you to do at home.

Once relief has been achieved, treatment will be more recovery focused, and involve muscle memory tasks and goal specific rehabilitation.

Physiotherapy uses a combination of evidence-based research, clinical experience and clinical training to diagnose and treat your presentation of sciatica. ​For examples of exercises that can be used, remembering that every sciatic presentation is an individual one, check out this exercise video for sciatica below: