By Capt Ross Railton, 2HSB

As the year draws to a close, it may be a good time to recall the essential elements of the many physio articles that have appeared in Defence Newspapers since August 2001.

Articles that have been presented fall into three categories:

• Specific injuries.
• Prevention of injuries.
• Education regarding injury prevention or treatment.
  

Specific injuries discussed included:

• Tennis elbow – treated effectively with ice, exercise modification, bracing and analysis of aggravating factors.
• Shin pain – commonly a biomechanical problem managed with exercise modification, massage, stretching and orthotics.
• Neck pain – often caused by faulty work posture and treated with correct ergonomics, mobilisation, massage and exercises.
• Shoulder problems – often caused by too much upper body exercise but successfully treated with re-education of rotator cuff muscles and exercise modification.
• Hamstring strains – often related to a lower back problem. Acute injuries are managed with the RICE regime and gradual return to activity.
• Ankle sprains – one of the most common sporting injuries but have an excellent chance of full recovery if treated correctly early.
• Lower back pain – care with lifting techniques, weight control and sporting activities can prevent injuries from occurring. Physio can be beneficial for pain relief and back education programs.
• Anterior knee pain – correction of muscle imbalances, biomechanical analysis, exercise modification and patella re-alignment may assist with decreasing this type of knee pain.
• Plantar fasciitis – this annoying condition often responds well to rest, massage, arch support and reducing the aggravating factors.

Prevention of injuries:

• Ergonomics – the ability to function for lengthy periods without developing injuries equates to good machine-human integration.
• Posture – if the spine is not correctly aligned, it can contribute to problems such as lower back pain, decreased efficiency in running and degenerative spinal joints.
• Core stability – the ability to move, lift or throw with the body well supported around a stable base, thus preventing injury.
• Taping and bracing – only a few joints can be successfully taped without losing capability through restriction of movement.
• Selecting a running shoe – running shoes should be replaced regularly and be selected with regard to flexibility, midsole density, heel counter, outsole and biomechanical characteristics.

Educational topics included:

• Healing process – muscle, tendon, ligaments and cartilage all take considerable time to heal. The process cannot be accelerated but is easily adversely affected by returning to activity too soon.
• Electrical apparatus in physiotherapy – such as ultrasound and laser have not been proven to be effective. Treatments such as ice, heat, massage and mobilisation may be more beneficial in healing.
• The effectiveness of muscle stretching – the role of stretching in pre and post-activity warm-ups may not be as important as commonly thought.

One of the underlying principles developed in these articles has been to illustrate the importance of early presentation to the doctor or physio so that proper treatment can be commenced as soon as possible. In this way, further damage can be avoided and the best long-term result achieved.

Given the high cost of injury rehabilitation in monetary terms and days lost from work, attention to the content of the physio articles may assist in reducing this load on valuable resources.

Similarly, to continue to train or exercise with an injury will, in most cases, result in worsening the situation and only increase the time off work and away from the desired activity or sport.

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