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Risk factors for non contact ACL ruptures

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Risk factors for non-contact ACL

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Post menopausal Osteoporosis

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Compressive loads and their effect on tendons.

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What can cause lateral hip pain?

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What can cause lateral hip pain?

Quick fire differential diagnosis:

1. Referral from…. intra abdominal/ lumbar spine/ knee

2. Trochanteric pain syndrome

3. Glut medius syndrome

4. Trochanteric bursitis

5. Tear, degeneration or strain of gluteal muscles/tendon.

6. Average hip= 6 bursae

7. Hip Pointer

8. Snapping hip syndrome

9. Glut med tendinopathy.

10. Meralgia Paresthetica

 

 

Remember: Extra articular tend to radiate to the posterior or lateral aspect of the hip whereas intra articulate may present with groin pain. Find out more about lateral hip pain here…

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Physio’s Role in Public Health: BMI

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Physio’s Role in Public Health: BMI

With an ever growing, ageing popular it is becoming increasingly important for people to take responsibility for their own health and to reduce their risk of common conditions and diseases such as diabetes, stroke and heart disease. There is also a growing body of evidence that reducing weight can have a positive effect on reducing pain in knee OA.

The following tool is a  great opportunity to teach patients how to work out their own BMI and use this as an objective measure for their progress. This usually takes 5 minutes and can be a great tool to encourage patient to use online resources and increase awareness of their own health. To be able to use this tool they need to have access to the internet and one barrier may be that they are not familiar with searching for this tool. If you direct them to www.physiowizz.co.uk it can be found at the bottom of the homepage.

 

content provided by NHS Choices
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What are the risk factors non contact ACL injuries?

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What are the risk factors for ACL rupture in non contact sports?

It is known that women are at a 4 to 6 times greater risk for sustaining a non-contact ACL injury compared to a male

Risk factors can include environmental, hormonal, neuromuscular, anatomical. These include:

  • Weather : Dry weather could increase the friction coefficient and torsional resistance from the shoe-surface interface.
  • Type of foot wear
  • Playing surface
  • Sport

What other factors increase our risk of non contact ACL injuries?

  • Weak hamstrings
  • Muscle fatigue
  • Decreased core strength
  • Decreased proprioception
  • High dorsiflexion of ankle
  • Low trunk, hip, knee flexion angles

 

These are important things to take into consideration when starting a prehab program. Be sure to build into your usual training hamstring strengthening exercises, core strength training and proprioceptive education.

Risk Factors and Prevention Strategies of Non‑Contact Anterior Cruciate Ligament Injuries (2014)  

 

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What are the benefits of aerobic exercise in stroke?

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What are the benefits of aerobic exercise in stroke?

We all know the great impact exercise can have on normal healthy adults and those with disability. Today we break down a quick summary from the paper “Application of principles of exercise training in sub-acute and chronic stroke survivors: a systematic review  (2014) FREE FULL TEXT.  Why not have a read of the full free text to update your knowledge.

1. Its is thought that exercise has a positive impact on cognitive ability in healthy adults and those with mild cognitive deficit (Lautenschlager et al, 2008)

2. Promotes neuroplasticity by the upregulation of neurotrophins (Mang et al, 2013)

3. Intensive rehabilitation in the chronic stage of stroke reduced blood pressure and improved arterial function (Takortori et al, 2012)

4.Allows people to maintain ability to perform functional tasks such as transfers and mobility contributing to a more independent lifestyle (English et al, 2014)

5. To help reduce risk of secondary stroke. 30% of stroke survivors will have recurrent stroke within their lifetimes, of which 18% will prove fatal. (Billinger et al, 2014) If optimal fitness reduces the risk of subsequent stroke why not encourage pts to get fit?

 

The following may be unrealistic for a stroke survivor but rather aims to challenge your belief system of age and expectation. With an ageing population physios need to be pushing public health messages more than ever and helping people take responsibility for their own health and where possible, assisting them to achieve their full potential.

 

 

References 

Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, MacKay-Lyons M, Macko RF, Mead GE, Roth EJ, Shaughnessy M, Tang A: Physical Activity and Exercise Recommendations for Stroke Survivors: A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke 2014, 45(8):2532-2553. 

English C, Manns PJ, Tucak C, Bernhardt J: Physical activity and sedentary behaviors in people with stroke living in the community: a systematic review. Phys Ther 2014, 94(2):185-196.

Lautenschlager NT, Cox KL, Flicker L, et al. Effect of physical activity on cognitive function in older adults at risk for Alzheimer Disease; a randomized trial. JAMA.2008;300:1027–37.

Mang CS, Campbell KL, Ross CJ, Boyd LA: Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther 2013, 93(12):1707-1716. 

Takatori K, Matsumoto D, Okada Y, Nakamura J, Shomoto K: Effect of intensive rehabilitation on physical function and arterial function in community-dwelling chronic stroke survivors.Top Stroke Rehabil 2012, 19(5):377-383. 

 

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How can you help manage your stress?

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What is the single best thing we can do for our health?

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How can I help patients remember?

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How can I help patients remember?

Based on (Silbermann et al, 2008)

A study was carried out in 2011 which discussed the factors affecting patient recall of information following GP visits. It found that patients that had multi morbidities ( ie had to recall more information) recalled less. Lack of understanding and recollection will reduce patients satisfaction and adherence to treatment (Watson and McKinstry, 2009). Recollection declines with age (Kessel, 2003) and is most effective when combining oral and written information (Jansen et al, 2008). We’ve put together some top tips to help your patients remember information and therefore improve effectiveness of physio!

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  • Avoid using medical terminology which is difficult to understand (Watson and McKinstry, 2009)

 

  • Keep it simple and use language that fits with previous education (ie if talking to another physio/nurse you may be able to help understanding with medical terminology- but don’t assume doctor/nurse will use the same terminology as physios!) (Watson and McKinstry, 2009)

 

  • Evidence suggests that people recall diagnosis best and advice or instructions least so perhaps off further written information to improve this recall. People appear to recall information best at the BEGINNING of the consultation.

 

  • Repetition: Repeating information may help.

 

  • Categorisation: Physio allows information to be categorised ie recommendations may be split into ‘lifestyles recommendations’ or ‘medical recommendations’

 

  • Summarisation: At the end summarise previous recommendations. ie “So i want you to go home and try to complete the exercises 3 x a day, apply the heat and then continue to keep active.

 

  • Importance emphasis: These exercises are important because they will help re educate the control around your shoulder. If you only complete them a few times we will not know if they are being effective before I see you next week. If you are unable to commit to performing these regularly perhaps book in to see me in 2 weeks instead.

 

  • Written materials: Providing written materials that patients can take away as visual cues and reminders will help to improve recall of information.

 

  • Patient understanding of assessment. Provide an opportunity for patients to clarify any areas they may not understand. For example asking “Do you have any questions? Has everything I’ve said been clear to you?

 

  • Explain rationale of each recommendation to the patient so that they understand why each instruction is important. ie It is important to massage around the scar site to help reduced sensitivity of the area and increase blood flow.

 

  1. Ley P: Memory for medical information.
    Br J Soc Clin Psychol 1979, 8:245-55.
  2. Kessels RP: Patients’ memory for medical information.
    J R Soc Med 2003, 96:219-22. PubMed Abstract | Publisher Full Text |PubMed Central Full Text
  3. Watson PW, McKinstry B: A systematic review of interventions to improve recall of medical advice in healthcare consultations.
    J R Soc Med 2009, 102:235-43. PubMed Abstract | Publisher Full Text |PubMed Central Full Text
  4. Kessels RP: Patients’ memory for medical information.
    J R Soc Med 2003, 96:219-22. PubMed Abstract | Publisher Full Text |PubMed Central Full Text
  5. Jansen J, Butow PN, van Weert JC, van Dulmen S, Devine RJ, Heeren TJ, Bensing JM, Tattersall MH: Does age really matter? Recall of information presented to newly referred patients with cancer.
    J Clin Oncol 2008, 26:5450-7.
  6. Silberman J, Tentler A, Ramgopal R, Epstein RM: Recall-promoting physician behaviors in primary care.

    J Gen Intern Med 2008, 23:1487-90.

photo credit: Audringje via photopin cc

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