Musculoskeletal pain can be complex, and orthopedic tests and hands-on treatment, sometimes, can be a limited tool to individualise what is happening with the body’s internal structure. Indeed, there are times when a deeper look is required to ensure we are on the right path. This is where body scans imaging comes into play to identify presentations like tendinopathy, bursitis, ligament tear or other underlying conditions. The Role of Body’s Scan in Diagnosing Pathology Body scans include a series of imaging technologies, such as ultrasound, x-ray, MRI, to name a few. Ultrasound is a highly effective imaging tool used to assess soft tissue structures in real-time. Unlike X-rays, which primarily show bone, ultrasound provides detailed images of muscles, tendons, bursae, and ligaments. This makes it an excellent tool for diagnosing conditions such as: Tendinopathy – A chronic condition involving tendon degeneration due to overuse or injury. Bursitis – Inflammation of the bursae, the small fluid-filled sacs that reduce friction between tissues. Those tissue types are found along different body joints, like the shoulder and the hip. Ligament Tears – Partial or complete tears of ligaments, often occurring after trauma or excessive stress. Baker’s cyst – is a fluid-filled swelling that forms behind the knee, often resulting from knee joint conditions like arthritis or meniscal tears, causing discomfort and limited mobility. When we are suspicious of one of those presentations, due to positive results obtained by orthopedic test and medical history, including mechanism of injury, we attempt a recovery process, based on the type of injury, symptoms, and other relevant information. Along this recovery process, we may start with isometric exercises. If, with the first 6 weeks, and a series of sessions, 3 to 4 sessions with this time frame, we still don’t see a major recovery, then we may want to get extra investigation ongoing via an ultrasound scan, which can clarify the underlying pathology. It allows us to confirm or rule out certain conditions, ensuring that treatment strategies are aligned with the actual tissue damage (if any is present). On the other hand, based always on the individual case, we could also require X-rays, which are often more helpful in diagnosing conditions related to the bones, such as arthritis or fractures, as they provide a clear view of bone structure and joint spaces. MRI is a scan that is used for Brain imaging, and when the investigation needs higher details, like when looking at the spine or a joint that via ultrasound was not giving any sign of issue. Ultrasound is also comparable to MRI, as it is faster, easier to deliver, and has fewer complications. How can myotherapy treatment help recovery from what a body scans would show? As we already discussed in another blog, Myotherapy is a practice that looks into the well-being of the skeletal muscle structure. To understand what can be done about a painful presentation, we would initially take a detailed clinical history, then look into objective measurements, such as your movement and body presentation. Given the result we can obtain, we would build up a treatment plan which includes: Hands-on Treatment – Techniques such as deep tissue massage, myofascial release, and dry needling can help reduce pain and improve mobility. Exercise Prescription – Strengthening and mobility exercises help restore function and prevent future injuries. Load Management Strategies – Proper guidance on activity levels ensures tissues heal without excessive strain. That management technique would then be combined and adjusted around the scan’s results. Here are a few examples: Bursitis: If a bursitis is confirmed, medications may be given to reduce the inflammation of the bursa, for that, we concentrate on MLD treatment to further reduce the inflammation and exercises to build strength on the structure that needs support. Ligament tear: When talking of ligament tear, the healing time can dilagate to months if not also a year, so we know now why the 6 weeks program may was not as responsive. We will keep focusing on the strength of the muscle that surrounds the specific joint, and use hands-on treatment to boost blood to the area affected. Arthritis: Medication or dietary change may be put in consideration for pain management and inflammatory reduction. Also in this case, MLD can be used to manage the pain response, and exercises for mantain movement in the affected joint/s. When Should You Consider an Ultrasound or other body scans? If you experience ongoing pain, swelling, or restricted movement that is not improving with therapy, an ultrasound or other scan helps identify the cause. This can prevent prolonged discomfort and allow for a more targeted treatment approach. At Melbourne Massage and Treatment, in Fitzroy North, we aim to provide the most effective care possible. If you’re dealing with persistent musculoskeletal pain, book a consultation with Giovanni today. Together, we’ll determine the best action to get you back to optimal function. Frequently Asked Questions (FAQs) About Musculoskeletal Pain and Body Scans Imaging 1. What are body scans, and how do they help diagnose musculoskeletal pain?Body scans include imaging technologies such as ultrasound, X-ray, and MRI. These scans help diagnose soft tissue injuries (like tendinopathy, bursitis, and ligament tears) or bone-related conditions (such as fractures or arthritis). They provide a clearer picture of what might be causing pain, inflammation, or restricted movement. 2. Why is ultrasound commonly used in diagnosing soft tissue injuries?Ultrasound is highly effective for real-time imaging of soft tissues like muscles, tendons, bursae, and ligaments. It helps diagnose conditions such as tendinopathy, bursitis, and ligament tears, providing a dynamic view of the area being studied without the need for invasive procedures. 3. When should I consider getting an ultrasound or other scans for my injury?If you’re experiencing persistent pain, swelling, or limited mobility that isn’t improving with initial therapy (such as exercises or hands-on treatment), it might be time to consider an ultrasound or other scans. These can help identify the underlying cause of your symptoms and allow for a more targeted treatment approach. 4. How do orthopedic […]
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Why Exercises are the way to go for Greater Trochanteric Pain Syndrome (GTPS)
Feb
Greater Trochanteric Pain Syndrome (GTPS) is a common condition that causes persistent lateral hip pain, often making everyday activities like walking, climbing stairs, or even lying on your side difficult. GTPS primarily affects middle-aged individuals, particularly women, and is commonly linked to issues such as gluteal tendinopathy and weakness in the hip stabilizing muscles. At Melbourne Massage and Treatment, our focus is on evidence-based approaches to managing GTPS, and the latest research strongly supports the role of exercise as the first line of treatment for this condition. GTPS Symptoms Greater Trochanteric Pain Syndrome can present with a series of symptoms that are local to the side of the hip. Here are the most common: Lateral hip pain: Persistent pain on the outer side of the hip, which may extend down the thigh. Pain when lying on the affected side: Discomfort that worsens when lying directly on the hip. Tenderness to touch: Sensitivity around the greater trochanter, which may be painful to press. Pain with movement: Aggravation of pain during walking, climbing stairs, or standing for prolonged periods. Weakness in hip muscles: Reduced strength in the gluteal muscles, leading to instability in movement. Difficulty sitting for long periods: Sitting on hard surfaces can exacerbate discomfort. Mechanism of Injury for GTPS GTPS is primarily associated with tendinopathy of the gluteus medius and/or minimus muscles, with or without accompanying bursitis. As per many tendon injuries, this condition often arises from repetitive stress or overuse, leading to microtrauma and degeneration of these tendons. On the other hand, abnormal hip biomechanics can exacerbate the issue, as compressive forces cause impingement of the gluteal tendons and bursa onto the greater trochanter by the iliotibial band during hip adduction. Contributing factors to GTPS include acute trauma, such as a fall onto the lateral hip, prolonged pressure from lying on one side, and overuse from activities like running or stair climbing. Additionally, conditions like iliotibial band disorders and gluteal muscle weakness can increase the risk of developing GTPS. Understanding these mechanisms is crucial for effective management and prevention of GTPS. Evaluation of GTPS Diagnosing GTPS typically involves a combination of clinical examination and medical history assessment. After taking your clinical history, including sports and work activity, I will perform a series of tests to validate the suspicions of GTPS. Those tests include single-leg stance and resisted hip abduction, which we would expect to show weakness in single-leg standing and pain during the abduction movement. Lastly, we would also palpate the area, which is a test that is kept for last because we want to avoid flair the presentation, which may be painful with any other test after that. In some cases, imaging techniques like ultrasound or MRI may be used to rule out other conditions and confirm gluteal tendinopathy or soft tissue abnormalities. I personally do not recommend image testing as the first way to go because the impact of seeing physical damage can also have a negative impact on self-perception, making a recovery harder. At Melbourne Massage and Treatment, our focus is on evidence-based approaches to managing GTPS, and the latest research strongly supports the role of exercise as the first line of treatment for this condition. The difference between GTPS and Femoroacetabular Impingement (FAI) The difference between GTPS and FAI stands in the hip area involved in the injury. The GTPS is relative to the side of the hip and involves the gluteus medius and minimus tendon and the bursa that separate that tendon from the greater trochanter of the femur. On the other hand, FAI is a presentation that still involves the hip, but it does take place on the anterior portion of the hip, as is characterised by and overgrowth of tissue on the femur head or the hip socket, and it does manifest with hip flexion and external rotation. That’s why it is important to receive an evaluation of the presentation from a professional, in order not to mix the two presentation, or also, in order to evaluate if both presentation are present at the same time, which can also happen. The Role of Exercise in GTPS Treatment A recent systematic review and meta-analysis analyzing multiple randomized controlled trials found that structured exercise provides significant benefits for individuals with GTPS. The findings revealed that: Long-term pain reduction: Exercise can lead to slight but meaningful reductions in hip pain over time. Improved physical function: Patients who engage in targeted exercise programs experience better mobility and overall hip function. Increased likelihood of meaningful recovery: Compared to corticosteroid injections, exercise significantly increases the chances of noticeable improvement in symptoms. One of the most notable takeaways from this research is that exercise has a long-lasting effect, whereas treatments such as corticosteroid injections may provide only short-term relief. Additionally, no serious adverse effects were reported with exercise-based interventions, making it a safe and sustainable approach to managing GTPS. Why Choose Exercise Over Corticosteroid Injections? Corticosteroid injections have often been used for GTPS pain relief, but the research indicates that exercise leads to better long-term outcomes. While injections may offer temporary symptom relief, they do not address the underlying causes of GTPS, such as gluteal muscle weakness or tendon dysfunction. Exercise, on the other hand, strengthens the hip muscles, improves joint stability, and reduces the likelihood of recurring pain. In a previous blog post, I spoke about the key role of Gluteus Medius as a pelvis stabiliser. Effective Exercises for GTPS At Melbourne Massage and Treatment in Fitzroy North clinic, I design individualized exercise programs to help patients with GTPS regain strength and function. Some of the most effective exercises for GTPS include: Isometric exercises: Holding static positions to engage the hip muscles without excessive movement, reducing pain and improving muscle endurance. Strength training: Progressive strengthening of the gluteus medius and minimus muscles to enhance hip stability. Functional movement training: Exercises that mimic daily activities to help improve movement patterns and prevent pain triggers. These exercises can be performed both at home and under professional supervision to ensure […]
Oct
In the world of fitness and wellness, stretching has long been hailed as a crucial component of any exercise regimen. But what if we told you that the benefits of traditional stretching might not be as clear-cut as we’ve been led to believe? At Melbourne Massage and Treatment in Fitzroy North, we believe it’s essential to examine the science behind standard practices. Let’s dive into why the traditional notion of stretching might be more myth than fact. The Stretching Paradigm For decades, stretching has been touted as the go-to method for improving flexibility, preventing injury, and enhancing performance. From pre-workout rituals to post-exercise cooldowns, the idea is ingrained in our fitness culture. However, recent research suggests that many of these beliefs may lack substantial scientific backing. Limited Evidence for Injury Prevention One of the primary arguments for stretching is its role in preventing injuries. Yet, numerous studies have indicated that static stretching (holding a stretch for a period) before exercise may not effectively reduce injury risk. In fact, some research shows that static stretching can temporarily weaken muscles, potentially leading to decreased performance, especially in sports requiring strength and power. Flexibility: A Double-Edged Sword While flexibility is important, excessive stretching can sometimes lead to hypermobility, which can be just as problematic as tightness. Hypermobile individuals may experience joint instability, increasing their risk of injury. Instead of focusing solely on stretching, a balanced approach that includes strength training and stability work may offer a more effective solution. The Case for Dynamic Movement Instead of traditional stretching, consider incorporating dynamic movements into your warm-up. Activities like leg swings, arm circles, and bodyweight exercises can effectively prepare your muscles for activity without the potential drawbacks of static stretching. Dynamic movements increase blood flow and activate muscles, leading to better performance without the risk of overstretching. If you are not sure what movement fit your needs, think about what exercises or sports acitiviy you are about to perform. An example would be a soccer match. Soccer involve running, quick change of direction, hip flexion and more lower body work. So what about doing some calf raises to warm up your calf muscles, which are going to be ready to make your run? Go for some squats that can focus on glute activation and quods activation, based on the type of squat that you are performing. Lunges that would ensure your quods warm up and your knees take some load. Plyometrics are a good way to warm up, too, such as skipping the rope or explosive squat. The Role of Massage and Other Therapies At Melbourne Massage and Treatment, we emphasize the benefits of massage therapy, myofascial release, and other treatments that promote muscle recovery and relaxation. These techniques can enhance flexibility and range of motion without the risks associated with excessive stretching. By addressing muscle tension and improving circulation, these therapies can provide a holistic approach to wellness. Tendons and Ligaments: The Stretching Sensitivity Tendons and ligaments are essential components of our musculoskeletal system, providing stability and support to our joints. Unlike muscles, which are designed to stretch and contract, tendons and ligaments are less pliable and don’t respond well to excessive stretching. When stretched beyond their natural limits, they can become overstressed, leading to micro tears or even injury. This lack of elasticity is why it’s crucial to approach flexibility with caution—overstretching can compromise the integrity of these structures, increasing the risk of strains and sprains. Instead of focusing on prolonged stretching, prioritizing strength and stability can help maintain healthy tendons and ligaments, ensuring that your body remains resilient and injury-free. What indeed our tendons and ligaments prefer as a form of activation are the isometric exercises. Conclusion While stretching may have its place, it’s crucial to question its effectiveness as a one-size-fits-all solution. Instead of defaulting to stretching, consider a more integrated approach that combines dynamic movement, strength training, and bodywork therapies. At Melbourne Massage and Treatment in Fitzroy North, we’re here to help you develop a personalized plan that prioritizes your health and well-being, and to start your journey book now a 15 minf free consultation for a treatment plan. Remember, wellness isn’t about following trends; it’s about finding what truly works for your body. Let’s move beyond the myths and embrace a more science-backed approach to fitness and recovery. FAQ Q: Why has stretching been considered important in fitness for so long? A: Stretching has been viewed as essential for improving flexibility, preventing injuries, and enhancing athletic performance, leading to its widespread adoption in pre- and post-workout routines. Q: Is there scientific evidence supporting the claim that stretching prevents injuries? A: Recent research indicates that static stretching before exercise may not effectively reduce injury risk. In fact, it can temporarily weaken muscles, potentially decreasing performance, especially in strength and power sports. Q: Can excessive stretching be harmful? A: Yes, excessive stretching can lead to hypermobility, which may cause joint instability and increase the risk of injury. A balanced approach that includes strength training is often more beneficial. Q: What are dynamic movements, and why are they preferred over static stretching? A: Dynamic movements, such as leg swings and arm circles, effectively prepare muscles for activity by increasing blood flow and activating muscles. They help improve performance without the drawbacks associated with static stretching. Q: How can I warm up effectively for specific sports? A: Tailor your warm-up to the activity. For example, before a soccer match, you might include calf raises, squats, and lunges to activate the necessary muscle groups and prepare your body for movement. Q: What role does massage therapy play in fitness and recovery? A: Massage therapy and myofascial release enhance muscle recovery and relaxation, improving flexibility and range of motion without the risks of excessive stretching. Q: How do tendons and ligaments respond to stretching? A: Tendons and ligaments are less pliable than muscles and can become overstressed when stretched excessively. This can lead to microtears or injury, making it important to approach flexibility with […]
Aug
Tendinopathy refers to the tendon’s painful or irritating condition, usually brought about by repetitive stress or overuse. Symptoms include pain, tenderness, and swelling in the affected area. It often results from activities that put excessive strain on the tendon or sudden increases in activity levels. What is a tendon? A tendon is a tough, flexible band of fibrous connective tissue that ties a muscle to a bone. The force generated by the muscle would be relayed through tendons onto the bones, thereby allowing movement of the body. Tendons are made of closely packed bundles of collagen fibers, which enable them to be strong enough to bear such stresses of activities. As tendons are not as stretchy as muscle fibres, they deal with load differently. Indeed, if put under an intense load, repetitively stretched, or used for repetitive movement, tendons get irritated. What are the stages of tendon degeneration? Regardless of age or biological gender, we will all experience some form of tendon degeneration throughout life. The more tendons are used, the earlier the degenerative process will be. In this context, we must reevaluate the negativity of the world’s “degeneration.” So, instead of giving a negative value to this world, let’s consider tendon degeneration only as a process of change in the tendon structure. This process is made of 3 stages: Reactive Tendinopathy: The first stage is characterized by a non-inflammatory reaction with a thickened tendon from increased protein production. The tendon can return to normal if the stress is reduced. Tendon Disrepair: If untreated, this is typically the second phase after reactive tendinopathy and is identified by further separation of collagen, disorganization of matrix, increased vascularity, and neural ingrowth. It normally needs to be diagnosed through imaging. Degenerative Tendinopathy: This is the final stage, characterized by permanent changes including cell death and marked matrix disorganization; it results in thickened and nodular tendons. Poor prognosis is associated with this condition. What to do when experiencing tendon pain? As you start experiencing pain, it is always suggested to reach out to a professional health therapist to evaluate what the problem is. In regards to tendon pain, the first step, independently from which stage of degeneration the tendon is in to, is suggested rest from the movement that flair up the area. On top of that the usage of heat pack is reccomended for a couple of times a day for 10 to 15 minutes. Tendon have a low blood supply compared to muscles, and the heat applied from outside can help in driving more blood to the area. Moving forward, if the pain is still present after three days, then the usage of an anti-inflammatory is recommended. The suggestion is to wait 3 days because, in the first three days of pain, the body puts in place what we call the “initial inflammatory response”, a phase in which the body increases blood volume to the area together with other biochemical reactions that kickstart the healing process. If, after three days, the inflammation has not ceased, that’s when the anti-inflammatories are needed. How do we treat tendinopathy at Melbourne Massage and Treatment? As a Clinical Myotherapist, I would suggest starting in the early stage with hands-on treatment and exercises-rehabilitation, such as a Myotherapy session. Past the first 3 days of inflammatory response, is good to start looking into why the presentation is not progressing for the better. Treatment modalities: Deep tissue massage is a modality that can stimulate relaxation and drive more blood to the area affected. Myofascial Dry Needling (MDN) can target the muscle attached to the tendon/s. It can help boost a new inflammatory response, desensitise the painful area, and increase muscle activation by interacting with the central nervous system. Exercises are then the takeaway for home. In the early stage, we would use isometric exercises to desensitize the area, partially load the muscle and keep the tendon active with constant load. This type of exercise can be used during the 1st or the 2nd week, based on the degenerative process we are dealing with. In terms of the time of load, based on the subjective finding, a time would be outlined. Roughly, we know that we are looking at an isometric load that would last about 30 to 45 secs with a break between one load and the next one, of the equivalent time. How long could it take to recover fully? Scientific studies have shown that the recovery process for tendinopathy varies from 3 weeks to 6 months. This is a big range of time, of course, and it is all about the gravity of the presentation, the tendon location, and the amount of rest that can be achieved along the recovery process. That said, as per all the exercises, the program is suggested for a minimum of three days a week and a maximum of five days a week. That would give enough time for the structure to be loaded and have time to recover, too. In conclusion, if you are suspicious of suffering from a tendinopathy, do not hesitate to reach out to Giovanni and Book Now for your next Myotherapy treatment. FAQ Q: What is tendinopathy? A: Tendinopathy is an injury to the tendons and results from repetitive stress or overuse. The result of the tendinopathy is pain, tenderness, and swelling into the affected area. Common activities causing this generally include over-straining or suddenly increasing the level of activity. Q: What is the degeneration process of the tendons? A: The tendon degeneration progresses in three stages: 1) Reactive Tendinopathy. 2) Tendon Disrepair. 3) Degenerative Tendinopathy. Q: What should I do if I have tendon pain? A: If suffering from tendon pain, basic things that you may try include: Rest the tendon from any activities that worsen the pain. Apply a heat pack for 10-15 minutes several times during the day as this helps to increase blood flow. Anti-inflammatory medication can be considered after three days, as this is typically when the initial inflammatory response has […]