Pelvic Malalignment

Written by Amanda Olsen

Did you know that your pelvis can go out of alignment? It occurs more often than you’d think, and can be a cause of certain ailments/pain OR can be the result of other issues occurring in your body.

A general overview of the anatomy of the pelvis…
– The pelvis, or “the pelvic girdle” is made up of three components: the two hip bones (the ilia), the sacrum, and the coccyx (your tail bone).
– The area where the sacrum meets the hip bone (ilia) is called the sacroiliac joint (dimples at low back).
o This is the most common place for dysfunction to occur in the pelvis – this joint can also refer pain into the low back
– These three components are held together by many ligaments and muscles

What happens?
– Whether due to a sudden traumatic experience (i.e. car crash, landing forcefully on one leg) or a prolonged onset from muscle imbalances, the pelvis can become mal-aligned
– The different types of mal-alignment are:
o Upslip: one hip is higher than the other
o Forward/backward rotation: one side of pelvis is either more forwards or more backwards than the other side
o Inflare/Outflare: one side of pelvis either flares out from mid-line more or more towards mid-line more than the other side
o Leg Length Discrepancy: one leg may be longer than the other because of a forward rotation of the pelvis on the side of the longer leg
o Sacral torsion: the sacrum is tilted or rotated more to one side

Signs & Symptoms:
– Pain at site of sacroiliac joint (dimples of low back)
– Low back pain
– Buttock pain
– Feeling “off kilter” or “out of balance”

How physiotherapy can help:
– Your physiotherapist will carry out several tests and measures to determine if you have a pelvic mal-alignment that could be causing your current symptoms
– If a mal-alignment is confirmed, the following things can be done for it:
o Muscle Energy Techniques: there are a few, but the one specific to your findings is the one that will be used – this helps get the pelvis back into alignment
o Dry Needling: if muscle tightness is causing the mal-alignment then dry needling will help loosen it out and its hold on the pelvis will be released
o Trigger point/myofascial release: alternative to dry needling where the therapist’s hands are loosening out the muscle and connective tissue around it
o Exercises: specific exercises will be given to you based on what the findings are, and are tailored to keep the pelvis in its corrected alignment

Having a pelvic mal-alignment can create a knock-on effect to the back, hips, knees, and feet. So if you are experiencing any of these, it’s possible that your pelvis needs to be corrected!

Pelvic bones
Pelvic mal-alignment
Skeleton mal-aligned

Physiotherapy After Hip Replacement

Hip replacements are one of the most common joint replacement procedures performed in hospitals today. They are normally performed on individuals who have a history of hip pain due to wear and tear in the hip joint. The hip is a ball and socket joint, the ball being the head of the femur (thigh bone) and the socket being the acetabulum. The ball fits snugly into the socket and is helped kept in place by ligaments, muscles and other structures. However, with the enormous amount of movement available at this joint, it can lead it wear and tear. If the wear and tear in the hip joint becomes quite painful, you may have to get a hip replacement.


There are different types of hip replacement:

  1. Total hip replacement – This involves a total replacement of the painful and damaged joint structures in the hip which artificial materials. The replacement will consist of a ball, socket and stem.
  2. Hemi replacement – This is a partial replacement of the hip joint, whereby only the ball (head of femur) is replaced. The new metal ball fits into the original socket of the hip joint.
  3. Surface replacement – This is another total replacement of the hip, however, some of the bone is spared and not replaced with artificial prosthesis. Normally, the ball is reshaped to fit into the new artificial socket.

After surgery, there is a lot of work to do. Due to pain being present in the hip for some time, the muscles are weak and tight. In order to provide the strength, control and stability that is needed around the hip, a rehabilitation program consisting of exercises and hands on techniques will be needed to get you back to normal. Find more information at The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) http://www.niams.nih.gov/Health_Info/Hip_Replacement/. This publication contains general information about hip replacement. It describes what a hip replacement is, who should have it, and alternatives to surgery. If surgery is required, it explains what the surgery involves, recovery, and rehabilitation.

If you have further questions contact one of our Chartered Physiotherapists at Archview Physiotherapy Clinic, Dublin 6 and Dublin 14 for a consultation on 01 4913228 or email info@archviewclinic.ie.

Muscle Cramps Driving You Mad?

Nearly everyone has had or will experience a muscle cramp at some point. Muscle cramps are painful and involuntary muscle contractions that can occur suddenly and can be temporarily debilitating. Cramps can occur at rest, or during or after exercise. Muscle cramp either during or immediately after exercise is commonly referred to as “exercise associated muscle cramping”. This can be painful, spasmodic and involuntary contractions in muscle that occur immediately after exercise. Cramps are not specific to environmental conditions such as exercise in the cold or heat, but many people find that they suffer more cramps at this cold time of year. The most common site for cramps in the body is the calf.

The treatment of cramp can include passive stretching for 20-30 seconds. There is no proven strategies for the prevention of exercise induced muscle cramping but regular muscle stretching, correction of muscle imbalances and posture may be helpful. To help prevent cramps you should make sure you are well hydrated by drinking plenty of fluids, especially if you’re exercising. Warm-up and stretch before and after using a muscle for a long period of time. If you’re inclined to get muscle cramps at night, you can also stretch for a few minutes before sleep. A lack of electrolytes such as sodium, potassium, magnesium or calcium can also lead to muscle cramps. Individuals taking diuretics may be more likely to lacking these essential electrolytes and should ask their doctors if they are experiencing cramps. Sports drinks can help replenish electrolytes, however look for ones that don’t have lots of added sugars or artificial flavours/sweeteners. Coconut water is a great sports drink alternative.

Remember if your muscle is cramping, stop the activity that triggered the pain and gently stretch/massage the muscle, holding the stretch until the pain improves and rehydrate!! Dry needling is very effective for relieving tightness and cramps in the calf and foot. If you are suffering from persistent cramps contact one of our Chartered Physiotherapists at Archview Physiotherapy Clinic, Dublin 6 and Dublin 14 for a consultation on 01 4913228 or email info@archviewclinic.ie.

knee_injury-150×150

Sit-up Exercise – Anatomy of Core Strengthening

Many people engage in core strengthening to get those infamous abs or the much sought after six-pack! Your core acts as a stabiliser and helps transfer forces placed on the body. The core can be trained in isolation doing crunches or back extensions,  and with functional movements like deadlifts, overhead squats, and push-ups. There is not just one single muscle responsible for your core strength, the abdominal region is composed of several key muscles that contribute to core function. These include the obliques, transversus abdominis and rectus abdominis among others. Check out this great video which demonstrates the key muscles at work during the sit-up exercise and visualise your muscles as you work out!!

Obliques: Rotate your torso and work with the transversus abdominis to support your centre during movement.

Rectus Abdominis: The contracted rectus abdominis form the “six-pack.” While it helps stabilise your core, its main function is to flex or curl the trunk.

Transversus Abdominis: This deep muscle acts like an internal weight belt wrapping laterally around your centre.

Psoas Major/Iliacus: These hip flexors lift the thigh toward the abdomen and limit excess movememt of the hip.

Erector Spinae: These muscles straighten the back and support the spine along with the multifidus muscle.

 

Physiotherapy for Neurological Conditions

Neurological conditions such as Multiple Sclerosis, Stroke, Parkinson’s Disease, Cerebral Palsy are conditions whereby the nervous system is affected. As a result, muscle strength, mobility, co-ordination, balance and endurance can be significantly reduced. These factors combined will have an effect on you quality of life and independence. Early intervention by your physiotherapist will help minimise physical deterioration, as well as reducing the stress and strains you may be feeling about your condition.

 What can Physiotherapy do?

  • Increase muscle strength and power
  • Improved mobility and independence
  • Better balance and co-ordination
  • Improved posture
  • Increase endurance levels
  • Boost spirit and confidence
  • Improved sleep quality
  • Chest physiotherapy
  • Maintain skin integrity
  • Encourage and advise ways to return to exercise or sporting activities within your community

We advise on transfer techniques, lifestyle modification, house adaption, seating, cushions, mattresses, night time position, splints, walking aids and many more things which can enhance your quality of life. Our Chartered Physiotherapists are neuro-rehabilitation specialists providing you with lots of confidence and full of positive energy. They will inspire you to live as independently as possible. At Archview Physiotherapy we provide assessment and treatment at our clinics and also in the comfort of your own home. Call 01 4913228 to book an appointment or to chat with one of our physiotherapists.

”Look at your condition from our vision….We see only improvements”

 Archview Physiotherapy and Massage Therapy Clinic, Dublin 6 and Dublin 14. Experts in the field of Pain and Sports Injury. Locations: Ranelagh and Dundrum, Dublin. Ph: 01 4913228 Email: info@archviewclinic.ie

Dry Needling Dublin 6

At Archview Physiotherapy our chartered physiotherapists are expertly trained in dry needling for the treatment of muscle problems & headaches. Dry needling can be used for the treatment of painful conditions and sports injuries.

What? Dry Needling is an effective deep muscle release therapy which relaxes knots in muscle tissue that can cause muscle pain, dysfunction, weakness and tightness. Dry needling involves gently inserting a sterile single use Acupuncture needle directly into muscle trigger points. Dry needling helps the muscle relax.

Where do you get Trigger Points and Myofascial Pain? Anywhere! Common causes of persistent headache are muscles around the shoulders and neck. Trigger points that build up due to poor posture and long periods of sitting at a desk are a very common cause of shoulder pain. Trigger points and myofascial pain in the spine can cause back pain, while in the buttock it can cause hip and leg pain.

What does it feel like? Generally, the needle insertion is not felt, the local twitch response may provoke a very brief somewhat painful response. The “twitch” resets the muscle and nerve supply, increasing the blood flow to the area which helps to relax the muscle. This is the first step to breaking the pain cycle and releasing tight trigger points.

Side effects/ Effectiveness? After dry needling treatment, the area that is treated will feel much softer and relaxed and the person will feel looser. Post-treatment some discomfort may be felt in the area and referral zone lasting anywhere between 1-48 hours. Once this has subsided there should be an improvement in symptoms. You may be advised to use heat over the sore area and may need to modify exercise for a day afterwards. Multiple sessions may be necessary to resolve the symptoms fully.

What can be treated with Dry Needling?

  • Back and neck pain, including postural problems and tension
  • Headaches
  • Neck
  • Shoulder & Arm pain (frozen shoulder, impingements, tennis or golfer’s elbow)
  • Carpal Tunnel
  • Pelvic girdle pain
  • Gluteal & Leg pain (Sciatica)
  • Hamstring strains
  • Knee & Shin pain
  • Calf tightness & Cramps
  • Repetitive Strain Injuries

Contraindications? There are very few reasons why a person is not suitable for dry needling, these include obesity and pregnancy. If you are taking anticoagulant medicines (eg. Warfarin) or if you have skin infections near the trigger points, then needling shouldn’t be used. 

Additional benefits! Frequently people find it can also result in better energy levels, appetite and sleep, along with an enhanced sense of overall well-being.

Archview Physiotherapy and Massage Therapy Clinic, Dublin 6 and Dublin 14. Experts in the field of Pain and Sports Injury. Locations: Ranelagh and Dundrum, Dublin. Ph: 01 4913228 Email: info@archviewclinic.ie

 

Foam Rolling Exercises….Everybody’s Favourite Frenemy

Do you have tight muscles, suffer from injuries and muscular imbalances, feel stressed or experience tension in your body…then foam rolling is for you!!

WHAT?

Foam rollers are shaped like pool noodles and made from dense foam. They are often used to help massage and stretch sore muscles. Multiple types of foam rollers are available, with different sizes, firmness and colour.

WHY?                                                                                                                                    

Using a foam roller helps to stretch muscles and tendons, and breaks down soft tissue adhesions and scar tissue. Foam rollers work by using the body’s natural response to pressure. You use your body weight and support some of your weight elsewhere, using your arms, adding more pressure as the muscles relax. By using body weight you can perform a self-massage or myofascial release, breaking up trigger points, soothing tight fascia, while increasing blood flow and circulation to the soft tissues. On very tight spots, applying constant pressure may be better than rolling back and forth. By slowing rolling over areas of your body you can break up scar tissue, help speed up the recovery process and really stretch the muscle fascia.

HOW?                                                                                                                                  

When you are exercising you can roll over the entire body when warming up to stimulate the body and increase blood flow. After your workout go slowly and hold the roller in spots for longer while practising deep breathing. Foam rolling can be incorporated to intensify your normal workout, strengthen core muscles and challenge stability and balance.

WHEN?                                                                                                                  

ANYTIME! Foam rolling is both a recovery and preparatory tool. It’s a way to smooth or iron out connective tissue and tight muscles. Foam rolling increases circulation so the connective tissue and muscle are getting more oxygen and water than if you just stretched. You should foam roll, then lightly stretch those muscles and begin your exercise. This will give your muscles more flexibility and help your tight muscles release. If you are new to foam rolling take it easy with the pressure and gradually build up to deeper pressure.

At Archview Physiotherapy we use foam rolling as part of our overall physiotherapy approach when required. If you think could benefit from a foam rolling programme or want to learn new foam rolling techniques for your problem areas contact Archview Physiotherapy Pain and Sports Injury Clinic on 01 4913228/01 2963490 or at info@archviewclinic.ie for an appointment.

Are You Suffering With A Golf Injury?

Don’t let your pain hinder your golf game!! Golf injuries affect 15-20% of golfers annually, with backs, elbows, shoulders, and wrists the most common areas. Recreational golfers sustain more golf injuries than professionals and the rate of injury increases with advancing age. If you are carrying a golf injury or have a problem that it is aggravated when you play you may need to be assessed at Archview Physiotherapy Clinic by a Chartered Physiotherapist.

The Most Common Golf Injuries

Low Back Pain: The lower back is the most commonly and frequently injured area of the body in golfers. The golf swing requires flexibility and rotation in the back. Back pain can me due to many different factors and can appear as pain in the lower back, muscle stiffness, spasms, or pain radiating down into the leg.

Golfer’s Elbow/Tennis Elbow: Pain, tenderness and inflammation on the outside (Tennis Elbow) or the inside (Golfers Elbow) of the upper arm near the elbow. Tennis Elbow is at least four times more likely to occur than Golfers Elbow. Overuse during excessive practice or decreased forearm muscle strength can be part of the cause of these injuries.

Shoulder Pain: Shoulder or upper arm pain can catch at various phases of the golf swing, at night time, or with overhead activities. Rotator cuff tendinitis, tearing or impingement in the rotator cuff, AC joint arthritis, and joint instability can all lead to shoulder pain. Additionally shoulder soft tissues can become aggravated with repetition. Older golfers may have pain due to bursitis or rotator cuff injuries with reduced circulation to the shoulder muscles. In younger golfers joint laxity or a high-velocity swing can cause micro-trauma to the rotator cuff.

Knee Pain: Knee pain, clicking, swelling of the knee aggravated by twisting, squatting, and walking can present in golfers. This can be caused by any of numerous underlying issues involving the meniscus or cartilage, knee osteoarthritis, or kneecap pain.

Carpal Tunnel Syndrome: Golfers may experience numbness and tingling of the fingers (especially at night), decreased grip strength and clumsiness. Carpal Tunnel Syndrome is a repetitive stress injury that occurs in the nerves of the hands.

De Quervain’s Tenosynovitis: This causes pain, swelling, and tenderness in the wrist near the base of the thumb and due to inflammation in the tendons that control the thumb. Typically pain can present in the left wrist at the top of the backswing.

Fractured Hamate Bone: Pain and tenderness in left palm, numbness in ring and little finger can be due to a fracture of the hamate.This is a small bone on the little finger side of the wrist. If like many golfers you grip the club by putting the butt-end of the club right up against the hook of the hamate during the swing a fracture can develop.

Trigger Finger: Trigger finger can cause a finger to lock up and I can become stuck in a bent position. Your finger may straighten with a snap like a trigger being pulled and released. This is caused when the area through which the finger tendons run is damaged.  Repetitive gripping actions used in golf increase the risk of developing this injury.

If you think you are suffering from any of the above injuries or want to learn how to avoid injuring yourself while playing golf contact Archview Physiotherapy Pain and Sports Injury Clinic on 01 4913228/01 2963490 or at info@archviewclinic.ie for an appointment.