How To STOP thinking about NECK pain, *late at night*

This email came in from another subscriber with neck and shoulder pain, earlier today:

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“Dear Leslie,

Another late night thinking about my neck problem again, so thought I’d share with you how I really feel:

Initially, I thought this little niggle would go away on its own and that I wasn’t so much affected. I thought to myself, this will pass, I’ve pulled my neck before, that it was OK with some rest last time, and I’m not going to rush into paying for something like physio, if it’s just going to go away on its own.

A few days of this I could handle.

But now I’m resigned to asking you a big question: Does physio offer the kind of real help that means my problem getting sorted is a certainty? Or is it just a FAD?

Whether physio is as good as you say it is, I’m not sure (admittedly that is starting not to matter), but it does sound interesting and I’m beginning to agree with a good friend of mine who said it really is the best option for someone like me, with this type of pain.

Last night I came up on the realisation that despite my early scepticism, I’m attracted to the confidence in which you and my friend have for Physio:

And strangely, despite my early cynicism about trying Physio…here I am…interacting with you about it…a feat.

The raw truth about Physio I’m not sure. But seems I’m going to have to find out for myself, so please bare with me as I courageously make my tentative way to coming in to see you.

In anticipation of your time, Much Thanks”.

– Susan J. 58, Ascot

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For some reason, this is a very familiar story that is not lost on me.

“I know I need to do something, I’m just a bit scared and nervous about getting it wrong, so I’ll wait a bit longer and see what happens”…

That’s kinda’ the message from Susan here.

And seriously though…

“It’s NOT needed”.

And she is right, I AM confident about Physiotherapy.

Because when it’s done right, it can be hugely effective and able to really help people with neck and shoulder pain – particularly those that have been putting up with it for a LONG while.

I’ve seen it work first hand, “1001 times” (if not more) over the last 20 years.

And, here’s the main reason why:

If your neck or shoulder is stiff or stuck, and you’re not moving it properly, *it’s slowly getting weaker*.

(And that’s what is likely causing your pain to get worse…)

So what we do for you from a Physio perspective is just give your body a little “push”.

It’s a simple case of getting your body moving again and getting all that is stuck, “unstuck”.

The science behind physio is really simple:

If something in your neck is stuck, we get it moving.

If a muscle is weak, we work out how to make it strong by showing you the right exercises.

If a muscle is tight, we relax it by releasing it.

If you’re worried or concerned about something, ask us the question and we’ll answer it. (Honestly and directly.)

Not much more to it to be honest.

And it really isn’t that difficult for us to help you.

But honestly, *I do get it*…That the biggest problem most people with shoulder and or even neck pain have, is that they just don’t know where to start.

If you confused. In a lot of pain and just need a no BS approach, getting the right facts and the appropriate treatment then we are here to help.

Here at Apple Physio all of our team have vast experience dealing with Neck and Shoulder Pain so if you need any advice please don’t hesitate to contact us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your neck and shoulder. We have a free neck and shoulder pain guide that we can send you. Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.

Neck/Shoulder Pain: The Problem With “Reading Before Bed” And Why It’s Likely To Be A Source Of Tension And Pain, NOT Pleasure.


One of the greatest mysteries of being 40+, is the sudden onset of neck pain and stiffness. It often creeps up on people with zero warning and usually offers NO explanation as to why you might all of a sudden wake up with neck pain that can torment the life out of you and make your enjoyment of life, very difficult!

Clients of mine suffering with neck or shoulder pain are often the most “confused” and will often find it difficult to remember anything that they’ve done, which has brought it on.

But asking a few simple questions usually gets to the root cause of the issue.

And what I nearly always find is that neck and shoulder happens due to an accumulation of things:

Like, sleeping with the incorrect number of pillows… or reading or watching TV right before bed, spending all day looking at a desk or computer screen, cleaning the house, ironing, preparing family meals and even reading the newspaper first thing on a morning are all on the face of it, simple activities and unlikely to cause any major problems.

Or so you might think……

Done on their own, and done once, any of these activities which I’ve just described are not going to cause a problem like neck and shoulder pain or stiffness. Do them all multiple times per day, every day, for 40+ years, and they are a problem.

Let’s look at reading before bed.

Who doesn’t love to read before they go to bed? It’s likely to be a habit that you’ve had since your Mother or Father started to read to you before bed when you were a child. And something no doubt you’ve done for your own children and will continue to do for any grandchildren you may or may not have. But think about the position that your head is in when you’re reading. It’s likely to be looking DOWN.

Now, what most people don’t know about their head is that it’s designed to be in a position where your “ears are level” with your shoulders. So, as soon as you begin to look down, as in when you’re reading a book, those ears are now not in line any more. Again, that’s okay if you only do it once. But if you’re doing it all the time, it is going to cause you a problem and your head will, after a few years, end up in a position that sees it put off “sync”. Then if that habit continues when you’re driving, watching TV, sat at a desk at work or in the kitchen and looking down to do the ironing or make tea, it’s easy to see why your ears may not now be level with your shoulders.

But there’s another problem with reading before bed and this is why lots of people end up with tight shoulder muscles and a neck that is very stiff and even suffer from tension type headaches throughout the night and first thing on a morning. When you are reading that book, you are having to hold it. And that means you’re adding tension to muscles and holing the book in place is going to put your neck into a locked and rigid position. Again, it’s not too bad at first, but doing it night after night isn’t helpful. My tip: if you do enjoy reading before bed, try not to do it any longer than for 20 minutes.

And here’s one more thing about neck and shoulder pain and bed times.. The number of pillows that you sleep with can also affect the position of your head. Think about it for a minute. If your sleep with two “thick” pillows it is going to push your head forwards meaning those ears are not in line with your shoulders. The same applies if the pillow is too low!

Not a problem at first, 10 years later and after spending 8 hours per night sleeping like that, it’s guaranteed to leave you with a less than healthy posture. And I know that these are “tiny little” changes that I’m offering up to you. But believe me, in the same way that lots of tiny little things add up to cause problems in your 30’s, 40’s, 50’s and 60’s, it’s lots of time little improvements or alterations that will also collide and see you feeling less stiff, less tense and living with more energy and freedom than anyone else you know.

Here at Apple Physio, all of our team have vast experience dealing with Neck and Shoulder Pain so if you need any advice please don’t hesitate to contact us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your neck and shoulder. We have a free neck and shoulder pain guide that we can send you. Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.


We’re Hiring!

Apple Physiotherapy is seeking an enthusiastic and highly motivated Physiotherapist who is an excellent team player to work at our Clinics in Windsor and Bracknell.

Here at Apple Physiotherapy we promote a healthy and friendly working environment. We value each member of our team equally and under the guidance of our director Leslie Abrahams we pride ourselves on providing expert assessment and diagnosis followed by effective treatment and management

Working across many disciplines including, Physiotherapy, Gait Analysis, Massage, Acupuncture, and Pilates our therapists have a broad knowledge base, which is continually shared across the practice.

We are dedicated to promoting wellness of both the body and mind and work with a large range of clients from top performance athletes to sedentary office workers.

Qualifications in Needling, Taping and Pilates (Mat and Equipment) would be advantageous, although training will be provided for exceptional candidate’s dependent on your experience. Membership to the CSP and HCPC are essential.

This is a Full Time Position. Employed and self-employed applications will be considered. Candidates with 1-5 years experience and beyond feel free to apply. Remuneration will be based on experience.

Applicants are required to work at least one evening and Saturdays.

Please note that we will only be able to contact those who are shortlisted to progress to the interview stage.

Please send your CV to: – olivia.hind@applephysio.com

Easy Ways To Ease Neck And Shoulder Pain That Keeps You Up Late At Night

Let’s talk about neck and shoulder pain, the one thing that gets on most people’s nerves because they don’t know what to do about it and think it’s just something they have to get on with day in, day out…

Meet John for example…

John is a long-standing patient of mine, and, as a painter and decorator, his job involves a mixture of heavy lifting to get around objects and standing on ladders at awkward angles to reach difficult spots on the walls.

A few months ago, John came to us with a daily, irritating pain in his left shoulder, and couldn’t understand why all of a sudden this pain could come on just from painting!

And it’s true! No one likes to believe it, but even a simple activity like painting (that you’d never think could cause an injury), can bring on shoulder pain.

Before coming in to see us, John’s left shoulder hadn’t felt right for weeks.

After the initial pain came on, he tried to get around it by switching up his job and painting with his right hand instead of his left, but all of the detailed trim and edge work could only be done with his left hand – which meant he had to grit his teeth and get on with it…

But even with the reduced workload, his shoulder was still in agony which meant he had to take two whole weeks off work – which isn’t great when you’re self-employed!

So what happened to John?

Something called ‘repetitive strain injury’ – this happens when a part of the body is overused while working in the wrong posture. Symptoms often include:

  • Aches and pains
  • Stiffness
  • Throbbing
  • Weakness and cramp

At first, you might only notice this kind of injury when you’re carrying out a particular task over and over again – in John’s case, painting. But if you don’t do something to ease the pain as soon as you feel it, it can end up lasting longer, cause swelling and can even stop you from going about your day and sleeping peacefully at night.

Any of this sound familiar?

If like John, you’re suffering from ANY aches of pains in your neck or shoulder area, then the good news is I’ve given you some quick and easy tips that you can do to help ease it right away…

Use Ice (…Not Heat) To Stop Pain

Ice by far is the best, (and quickest way) to ease pain.

My tip for you would be to apply ice as soon as you feel a slight twinge, or even a hint of neck or shoulder pain coming on, and to apply it whenever you’re feeling achy or painful – such as at the end of a very long day.

Apply an ice pack for 10 minutes at a time – little and often, every hour.

Use Heat To Ease Stiffness

Just like ice, heat can also help to treat shoulder pain, inflammation and swelling.

When to use it? I tell my patients to apply a hot water bottle on a morning when your neck or shoulder is likely to be feeling more stiff than painful. Again, 10 minutes should do it.

Sleep With The Correct Pillows:

Here’s a great tip you can start using as soon as tonight!

It might be difficult at first, especially if you’re used to sleeping with a certain pillow arrangement. Lie down on your side and put in pillows until you feel that your spine is in the correct alignment. Ask someone to look at your spine from behind to see if it’s in the correct position. Also make sure that you haven’t squashed your shoulder you lying on. This will lower the amount of stretching and tension it brings to your neck and shoulder area.

Shoulder tension and pain can be made worse by spending 8 hours every night in the wrong position.

If your Neck and Shoulder Pain has been annoying you for 9 days or more- you can, then, be sure that it’s not going to go away on its own.

Here at Apple Physio, all of our team have vast experience dealing with Neck and Shoulder Pain so if you need treatment or any advice please don’t hesitate to contact us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your neck and shoulder. We have a free neck and shoulder pain guide that we can send you.

Connect with us on 01344 489 398(Bracknell) , 01753 866274 (Windsor) or email us on bracknell@applephysio.com and tell us what’s going on.

A member of the team can take your details and we can email or post you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.

3 Things We Do Everyday That Cause Neck Pain… (And Do What You Can Do To Ease It Quick!)

Lets play a fun quiz that might help you live with less neck pain…

(And if you answer ‘yes’ to any of these questions… read on!)

When you sleep at night, do you find yourself sleeping on your stomach? Or with more than one pillow in a twisted position?

When you’re relaxing at home, do you find yourself looking up at the TV screen because it’s hung up high on the wall?

When you’re out and about do you carry your bag on one shoulder? Or hold your heavy brief case in one hand?

Chances are, you’ve answered ‘yes’ to at least one of these questions.

I may be wrong, your bag might not be heavy, and you might sleep with just the one pillow, but the reason why I guessed you’d answered ‘yes’ to one of these questions is because over the years, almost every patient that walks into our clinic who has been suffering with neck pain, has been doing one of these things.

So it’s no surprise that during my time as a Physio that one of the most regular injuries I see is ‘neck pain’.

And without even realising it, things that we do everyday can cause it.

So lets take a look 3 of the most common everyday mistakes I’ve found my patients doing that cause their ‘neck pain’…

  1. Watching TV

Watching TV is a habit – not saying it’s good or bad! But the real issue with watching TV, is HOW you watch it!

Are you doing it the way I see most of my friends and family watch it… With the TV hung above the fire place high on the wall, kicked back with your feet up (and neck!), while watching your favourite TV soap opera?

Even though you might think it’s comfortable and relaxing, truth is, there could be a problem waiting for you! If you’re watching TV like this it can be strenuous for your neck and head.

A lot of people make the same mistake, they don’t realise that the position they have it in, can actually affect their body and health.

Anyway, how to fix it? There’s a reason why TV stands are almost always the same height, and any decent one will mean that if you’re sitting on the sofa watching TV, the TV will be at eye level.

Watch TV so your head isn’t looking upwards, or reaching out, and this should help you avoid headaches, eye trouble and muscle tension.

  1. Your Bag

Carrying your bag on one shoulder, or holding a heavy brief case in one hand is something most of us are guilty of doing, but did you know that’s also one of the main causes of aches and pains in your neck and shoulders?

You see, since all of the weight of your bag is on one shoulder, or on one side of the body, it can throw your muscles and posture off balance, which is why you sometimes see people with one shoulder higher than the other!

Another thing, they way we carry our bags can cause our muscles to become stiff too.

So the way to solve this problem is reduce the weight of your bag, and to switch up the side you carry it on periodically.

Switching your bag over to the opposite side will help to balance out the way your body carries the weight, relieving any tension built up in your muscles, and solving any posture problems too! Switch it up every 10 minutes, or every time you walk past two streets.

  1. How We Sleep

Another daily habit that brings on neck pain is the way we sleep.

You see if you sleep with your head propped up on more than one pillow, your neck, and back aren’t going to be nicely in-line – meaning more pressure on your muscles and spine.

And if you find yourself sleeping on your stomach, your head is most likely going to be turned on it’s side – meaning your body is in a twisted position all night for hours!

Now can you see why you might wake up with a bit of a sore neck?…

Although your neck is built to rotate from side to side, it’s not designed to stay in that position for hours on end. So if you choose to sleep on your side, use a pillow that doesn’t prop your head too high up, but in-line with your shoulder instead. And if you choose to sleep on your back, sleep with one thin pillow so your neck and spine are nicely straight.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your Neck Pain. We have a Neck pain guide that we can send you. Connect with us on 01344 489398 or email us on bracknell@applephysio.com and tell us what’s going on with your neck. A member of the team can take your details and we can email or post you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.

What is Patella Tendinopathy?

Patella tendinopathy, also known as jumper’s knee, is an overuse disorder characterised by pain at the base of the patella (kneecap) with activities such as squatting, sitting or going up and down stairs.

The condition is known as jumpers’ knee because it commonly affects athletes involved in sports that require jumping and repetitive loading of the patella tendon, such as basketball, volleyball, football and tennis.

Landing and jumping activities put a great amount of stress on the patella tendon. This tendon is responsible for transmitting the full force of the quadriceps muscles to the lower leg and during activities such as jumping and landing, this force can actually be many times more than your body weight.

What are the symptoms?

 The hallmark sign of patella tendinopathy is sharp, localised pain in the patella  tendon just below the base of the patella. The pain is usually aggravated by activities that increase load through the quadriceps muscles such as squatting and jumping or as simple as going up and down stairs.

Pain associated with patellar tendinopathy usually occurs gradually, often when a person has been very active for a long period of time or if they have recently increased their training schedule. The pain will often start as a small niggle, gradually becoming more noticeable and there may also be a feeling of stiffness with movements of the knee or first thing in the morning.

How does it happen?

Patella tendinopathy is not a traumatic condition rather, it usually develops gradually over time due to prolonged overloading of the tendon. Like other tissues in the body, tendons are dynamic and can adapt to be able to withstand more force with training. However, if a tendon is unable to adapt to increased load quickly enough, it can develop micro tears leading to pain and dysfunction, known as tendinopathy.

The risk of developing this condition can be increased by external factors, such as the type of sports chosen, training volume and the hardness of the training surface. I’ve also seen an increase in tendon problems in the knee when patients have had a systemic virus. Certain medications too can cause a transient decrease in tendon integrity and can put you at risk of injury.

Intrinsic factors such as bone structure, muscle length, diet, age, muscle strength and overall health can also affect the ability of a tendon to adapt to forces. Anything that impairs the tendon’s ability to absorb force can lead to the development of tendinopathy. In general, men are affected by this condition more often than women.

How can physiotherapy help?

As with all conditions, the first step to effective treatment is an accurate diagnosis. Your Physiotherapist will be able to correctly identify this condition and any factors that have led to its development.

Treatment for any tendinopathy will involve a degree of rest and re-evaluation of your training schedule. Treatment of the tendon itself has been shown to be most effective with a targeted exercise program involving isometric and eccentric muscle contractions. These types of movements have been shown to help stimulate healthy tendon tissue to increase strength and support the damaged tissue, ultimately reducing pain.

Tendinopathies can be notoriously difficult to resolve without patience and commitment to a rehabilitation program guided by a Physiotherapist.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your knee. We have a free knee pain guide that we can send you. Connect with us on 01344 489 398 or click here to fill out our contact form. Please enter your details and tell us what’s going on with your knee. A member of the team can email or post you a copy.

FREE REPORT: “HERE’S HOW YOU CAN GET IN ON ALL THE FREE ADVICE CURRENTLY BEING GIVEN AWAY BY OUR BEST PHYSIOS TO PEOPLE WHO WANT TO KNOW HOW TO BRING A FAST END TO THEIR “DAILY, ANNOYING AND NAGGING” KNEE PAIN…BEFORE IT GETS ANY WORSE”!

…Meaning A Better Night’s Sleep, More Energy, Less Worry, And Above All…MORE Freedom To Do Things With LESS PAIN And Less Tension!… And That Would Be Nice, Right?

Yours Free From us here at Apple Physio……..

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.

Is meniscus causing your knee pain?


What is a meniscus?

The meniscus is a cartilage structure which is found within the knee joint. This cartilage structure acts as a shock absorber between the thighbone and shinbone. This acts as a cushion to distribute load within the knee. Forces which are transferred through the knee increase exponentially as speeds of activity increases i.e running.

Occurrence 

An injury may occur to the meniscus due to twisting or direct impact. These injuries are common during sporting activities. A tear may happen when sudden twisting of the knee occurs while the foot is still planted on the ground. Pain and swelling will occur within 24 hours. Walking, bending or twisting of the knee with difficult and painful. There may be a locking sensation when bending or straightening the knee. Injury may also occur due to repetitive wear-and-tear (degenerative) injuries. 

Diagnosis 

A full battery of diagnosis tests will be completed to determine a meniscus injury. Patients may have tears which cause few problems, while others may have tears which cause pain affecting activities of their daily living. MRI may be used to evaluate ligaments and articular cartilage health. Treatment ranges from non-operative to surgical, depending on multiple factors. These factors include symptoms, health status, age, type and location of the tear. 

Intervention

Acute, traumatic tears, are typically treated surgically. The goal is to repair the meniscus structure. There are a variety of surgical techniques to do this. Meniscus repairs are completed as one day arthroscopic procedures( Key Hole Surgery). Patients are typically discharged on the same day of surgery. Physiotherapy begins immediately after this surgery. An unrestricted return to sports is usually achievable with Physiotherapy six months after surgery. However this may vary dependant on your particular injury

Rehab 

The first goal of Physiotherapy rehab is to decrease post-operative pain and swelling. Physiotherapy interventions will include manual and exercise-based therapies. Physiotherapy will aim to restore full range of movement and strength within the early stages of healing. Next Physiotherapy will work to restore strength, balance and proprioception. Late stage rehab will include dynamic exercises such as jumping and directional change movements. We aim to achieve mutually agreed rehab goals with a return to baseline function.

 If you’d like more info on this, and some easy, actionable tips you can use now to start easing your knee. We have a free knee pain guide that we can send you. Connect with us on 01344 489 398 or click here to fill out our contact form. Please enter your details and tell us what’s going on with your knee. A member of the team can email or post you a copy.

FREE REPORT: “HERE’S HOW YOU CAN GET IN ON ALL THE FREE ADVICE CURRENTLY BEING GIVEN AWAY BY OUR BEST PHYSIOS TO PEOPLE WHO WANT TO KNOW HOW TO BRING A FAST END TO THEIR “DAILY, ANNOYING AND NAGGING” KNEE PAIN…BEFORE IT GETS ANY WORSE”!

…Meaning A Better Night’s Sleep, More Energy, Less Worry, And Above All…MORE Freedom To Do Things With LESS PAIN And Less Tension!… And That Would Be Nice, Right?

Yours Free From us here at Apple Physio……..


What is Runner’s Knee? (PFJ Syndrome)


Our knees are complex hinge joints, designed to provide stability from side to side and smooth movement forwards and back as you walk, kick and run. The patella, or kneecap, is a small bone embedded in the tendon of the quadriceps muscle that protects the knee and also provides extra leverage to the quadriceps, amplifying their strength. The patella moves up and down in a groove at the front of the knee as the knee bends and straightens. Usually this movement is smooth, with little friction, however, if something causes the patella to move in a dysfunctional way, the soft tissue between the kneecap and the knee can become irritated, causing pain in a typical pattern. This condition is often referred to as ‘runner’s knee’, PFJ Syndrome or patellofemoral pain syndrome (PFPS).

What causes it?

The patella usually sits in a balanced position in the shallow groove at the front of the knee and moves easily without friction. The patella is attached to the quadriceps muscle at the top and connected to the lower leg via the patella tendon at the bottom. When the quadriceps contracts, this pulls on the patella and acts to straighten the knee. If one side of the quadriceps is stronger or tighter than the other, it can cause the kneecap to pull to one side and over time become irritated.

There can be many factors that cause a muscle imbalance or weakness on one side of the quadriceps. In most people, the outer aspect of the quadriceps tends to be stronger and tighter than the inner muscle.

Certain postures and leg positions require the outer muscles to work harder and the inside muscles to become less active. Lack of arch support in your feet or simply a physical abnormality of the knee can also place stress on the movement of the patella.

What are the symptoms?

This condition is characterized by pain felt on the inside or behind of the patella with activities that require repetitive bending of the knee. There may be a sensation of crepitus, clicking or grinding and some people report that their knee suddenly gives way. The pain is commonly felt when running, going up and down stairs or when doing squats and is relieved with rest. The pain may start as a small niggle and gradually become worse over time.

How can physiotherapy help?

The first step in effective treatment is to exclude any other conditions and have Physiotherapist confirm the diagnosis. Your Physiotherapist is able to determine which factors are contributing to this condition, which could include poor posture, a lack of arch support in your feet or poor running technique.

Once these factors have been identified, you will be provided with a specific treatment program to best approach your condition. PFP syndrome usually responds quite well to biomechanical analysis and correction of any muscular weakness and imbalance. Having the correct shoes and orthotics can also make a huge difference. There are some short-term treatments, such as patella taping, try needling, trigger point therapy and ultrasound, which may help alleviate symptoms quickly and keep you active while you address the other factors contributing to your pain.

 If you’d like more info on this, and some easy, actionable tips you can use now to start easing your knee. We have a free knee pain guide that we can send you. Connect with us on 01344 489 398 or click here to fill out our contact form. Please enter your details and tell us what’s going on with your knee. A member of the team can email or post you a copy.

FREE REPORT: “HERE’S HOW YOU CAN GET IN ON ALL THE FREE ADVICE CURRENTLY BEING GIVEN AWAY BY OUR BEST PHYSIOS TO PEOPLE WHO WANT TO KNOW HOW TO BRING A FAST END TO THEIR “DAILY, ANNOYING AND NAGGING” KNEE PAIN…BEFORE IT GETS ANY WORSE”!

…Meaning A Better Night’s Sleep, More Energy, Less Worry, And Above All…MORE Freedom To Do Things With LESS PAIN And Less Tension!… And That Would Be Nice, Right?

Yours Free From us here at Apple Physio……..


What is total knee replacement?

Its an orthopaedic procedure where the articular surfaces (end of the bone) of the femur (thigh bone) and tibia (shin bone) are replaced.

A polyethylene piece is placed between the tibia and femur as a shock absorber.

In about half of cases the patella (kneecap) is also replaced.

Why get one?

The main reason people have a knee replacement is that they have most commonly over a period of time noticed

  • Increased pain at the knee joint that in the latter stages can affect sleep at night time
  • Decreased mobility to the point that they may require use of a walking aid

Outcomes anticipated from a TKR (Total Knee Replacement) are

  • Reduction in pain
  • Increase in Function

The most common cause of this is OA (Osteoarthritis). This is where the cartilage of the joint becomes damaged and is unable to absorb the shock as well as a healthy joint.

Anatomy:

The knee joint is made up of the Femur and Tibia with another joint at the front called the patellofemoral joint (Kneecap) encompassing the patella.

The knee is a modified hinge joint. The main movement is flexion and extension along with small amounts of internal and external rotation.

There is a thin layer of cartilage at the end of the bones and also the shock absorbers in the knee known as the cartilage.

There are large ligaments supporting the knee joint some of which are

  • ACL (Anterior Cruciate Ligament)
  • PCL (Posterior Cruciate Ligament)
  • MCL (Medial Collateral Ligament)
  • LCL (Lateral Collateral Ligament)

Who is more likely to have a knee replacement?

Risk factors that can increase your chance of a knee replacement are

  • Previous knee surgery (often to remove meniscus)
  • Previous Fracture
  • Rheumatoid Arthritis
  • Being Overweight

The Surgery:

The surgery can take about an hour and most frequently is under general anaesthetic.

The actual replacement has 3 parts

  • Femoral Component
  • Tibial Component
  • Polyethlene shock absorbent disc

The most appropriate size and shape of the prosthesis is chosen on a patient by patient basis.

When does Physiotherapy Play a Role?

Pre Surgery:

Physiotherapy can provide you with

  • Exercises to maximise the strength in the muscles pre-operatively
  • Show you the exercises that you will be doing post surgery to ensure that you are aware of the correct technique

Post Surgery:

  • Get you up and moving within 24-48 hours of surgery
  • Strength exercises
  • Balance exercises
  • Gait Re Education
  • Increase ROM (Range of Movement)
  • Decrease Pain

Examples of common exercises post Total Knee Replacement:

  • Ankle movement exercises
  • Knee ROM exercises e.g. heel slide into Knee Flexion/extension
  • Quadricep Strengthening exercises e.g. straight leg raise
  • Hamstring Strengthening exercises e.g. Bridging

Here at Apple Physio all of our team have vast experience dealing with Total Knee Replacements so if you need any advice please don’t hesitate to contact us.

 If you’d like more info on this, and some easy, actionable tips you can use now to start easing your knee. We have a free knee pain guide that we can send you. Connect with us on 01344 489 398 or click here to fill out our contact form. Please enter your details and tell us what’s going on with your knee. A member of the team can email or post you a copy.

FREE REPORT: “HERE’S HOW YOU CAN GET IN ON ALL THE FREE ADVICE CURRENTLY BEING GIVEN AWAY BY OUR BEST PHYSIOS TO PEOPLE WHO WANT TO KNOW HOW TO BRING A FAST END TO THEIR “DAILY, ANNOYING AND NAGGING” KNEE PAIN…BEFORE IT GETS ANY WORSE”!

…Meaning A Better Night’s Sleep, More Energy, Less Worry, And Above All…MORE Freedom To Do Things With LESS PAIN And Less Tension!… And That Would Be Nice, Right?

Yours Free From us here at Apple Physio……..

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.



The Surprising Truth about Knee Osteoarthritis

Sufferers of knee pain know that nothing can kill your optimism for a recovery faster than a diagnosis of Osteoarthritis (OA). Osteoarthritis is often seen as a kind of death sentence for joints. Many people believe that if you have OA your pain will never improve and will only get worse until a joint replacement can be performed. In fact, joint replacements for hip and knee OA are some of the most common and indeed successful operations performed by Orthopedic Surgeons.

At least this has been conventional wisdom for decades. Many of us see our bodies like cars, when a part ‘wears out’ it needs replacing with a new one. The truth is much more complicated, mainly due to our bodies’ incredible ability to adapt and change.

Physiotherapists have always known that the pain and disability that comes with arthritis can be improved with a closely targeted exercise program. In some cases, the pain that is attributed to OA is actually due to another, entirely treatable cause. In other cases, strengthening the musculature around the painful joint can have a significant effect by providing the joint with extra support.

The way we move is often affected negatively by pain and this in itself can create a downward spiral. This is not to say that in some cases, surgery is the best and most effective option to improve your quality of life. Rather that there is a strong case to see a physiotherapists to seek treatment for your knee pain first.

Physiotherapists are highly skilled at identifying exactly what is causing your pain and helping you reach the highest level of function. In fact, a recent study has shown that with targeted exercises, directed by physiotherapists – many patients who were scheduled to have surgery were able to improve their quality of life dramatically, avoiding surgery and getting back to their favourite activities.

While exercise is a very powerful treatment, it’s not that any exercise will take away any pain. To be effective, you will need to have a full assessment and have a personalized treatment program created by your physiotherapist. This can involve identifying weak muscles, limitations in flexibility, finding painful trigger points, restoring movement to stiff joints and providing biomechanical assessment to make a combination of changes that can make a large difference to your pain and activity levels.

Your Physiotherapist can also identify any external factors that may be contributing to your pain. Such as unsupportive footwear, workplace set up etc. Talk to us to see how we can help you manage your osteoarthritis.

If you have any further questions, please feel free to email us at bracknell@applephysio.com

 If you’d like more info on this, and some easy, actionable tips you can use now to start easing your knee. We have a free knee pain guide that we can send you. Connect with us on 01344 489 398 or click here to fill out our contact form. Please enter your details and tell us what’s going on with your knee. A member of the team can email or post you a copy.

FREE REPORT: “HERE’S HOW YOU CAN GET IN ON ALL THE FREE ADVICE CURRENTLY BEING GIVEN AWAY BY OUR BEST PHYSIOS TO PEOPLE WHO WANT TO KNOW HOW TO BRING A FAST END TO THEIR “DAILY, ANNOYING AND NAGGING” KNEE PAIN…BEFORE IT GETS ANY WORSE”!

…Meaning A Better Night’s Sleep, More Energy, Less Worry, And Above All…MORE Freedom To Do Things With LESS PAIN And Less Tension!… And That Would Be Nice, Right?

Yours Free From us here at Apple Physio……..

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.