Knee and Leg

Physiotherapy will relieve pain and swelling and restore range of movement, strength, balance and stability, to enable you to reach your goals and achieve your maximum of physical functioning.

An initial assessment will determine the underlying cause of your knee and leg problem. A rehabilitation program will then be developed to ensure that your return to everyday activities, sport, hobbies as soon as possible with confidence and success.

At Core Physio we will also advise you on how to pace your activity so that you return to sport and everyday tasks with confidence and success. Physiotherapy will promote healing, reduce pain and improve muscle strength and flexibility and speed up your recovery.

Your physiotherapist will also advise you on how to pace your activity so that you return to sport and everyday activities as soon as possible and reduce the risk of re-injury.

Physiotherapy will promote healing, reduce pain and improve muscle strength and flexibility and speed up your recovery.

A rehabilitation program and changes to your practice routine can bring about positive results. Rehabilitation will consist of manual therapy to relieve tightness in the IT band and get rid of trigger points in the gluteus (hip muscles). Strengthening of the hip abductors (muscles that move the hip outwards) are also critical to relieving this condition.

IT band syndrome is a condition that takes a long time to go away, months or even more than a year. Even after symptoms appear to cease, you still need to continue with prescribed exercises. It is therefore imperative that you consult a physiotherapist to help you get on the road to recovery. They will guide you in the proper way to stretch – you should not overstretch – and perform the strengthening exercises.

ACL injury

Physiotherapy for Anterior Cruciate Ligament (ACL) injury

A person with an ACL injury will benefit from physiotherapy treatment. Tears of the ACL usually occur following sporting injuries, e.g. football, basketball, netball and skiing and can have a significant impact on a persons mobility and independence with everyday activities, such as climbing the stairs.

Treatment at Core Physio will promote your recovery and get you back to the sports you enjoy as soon as possible with safety and confidence.

Benefits of physiotherapy following an ACL injury include:

• Reducing pain
• Reducing swelling
• Improving pain free range of movement
• Increasing muscle strength
• Improving balance and proprioception (awareness of limbs in space)
• Enhancing overall fitness
• Promoting independence with everyday activities
• Speeding up recovery and return to sport

Your physiotherapist will advise and support you on when and how to commence the right activities at the right time to improve flexibility, strength and function in a safe and effective way.

Our specialist musculoskeletal physiotherapists are experienced at treating people following an ACL injury and provide comprehensive assessment and treatment to ensure you make the best recovery.

Treatment will be tailored to the activities you enjoy and may include:

• AlterG anti-gravity rehabilitation
• Gentle range of movement exercises to relieve pain, stiffness and swelling
• Isometric strengthening exercises
• Once pain free range has been achieved your strengthening exercises will be progressed through range
• Balance training
• Core stability work
• Functional activities based around everyday tasks
• Sport specific exercises

Anterior Knee Pain

What is anterior knee pain? 

Anterior knee pain refers to pain over the front of the patella (kneecap) aggravated by climbing the stairs, prolonged bent-knee sitting, squatting, running and jumping activities.

What causes anterior knee pain? 

There are many causes of anterior knee pain which may include:

• Strained tendons (tendinitis)
• Poor alignment of the patellofemoral joint
• Softening of the cartilage cartilage that lines the underside of the kneecap (chondromalacia patellae).
• Biomechanical disadvantages such as flat feet
• Tightness or weakness of the muscles on the front (quads)and back (hamstrings) of your thigh
• Repetitive strain
• Inflammation of the bursa inside the knee (bursitis)

What are the symptoms/effects of anterior knee pain? 

People with anterior knee pain usually experience an aching pain at the front of the knee and around or under the knee cap that may increase to sharper pain with activity.

Physiotherapy for anterior knee pain

Our specialised physiotherapists at Core Physio will provide accurate assessment and treatment as well as a careful explanation of your condition to ensure an optimal outcome in the short and long term.

Physiotherapy treatment for anterior knee pain will vary according to the exact diagnosis and the underlying causes but may include:

• Stretching exercises for the hamstrings, quadriceps, calf muscles and iliotibial band
• Strengthening exercises for the quadriceps, hip abductor and hip external rotator muscles
• Patella mobilisation
• Core stability exercises
• Soft tissue massage to relieve pain and stiffness

Your rehabilitation program will be tailored to your needs and lifestyle to ensure you get the most out of your treatment.

Physiotherapy will reduce pain and stiffness, promote healing and increase muscles strength and flexibility in order to get you back to your normal activities as quickly as possible.

Most commonly this is caused by an inflammation of the knee joint, such as occurs with various types of arthritis or a knee injury, especially a cartilage tear. When the popliteal bursa fills with fluid and expands, the result is a bulge called a Baker’s cyst. Treating the probable underlying problem usually relieves the swelling and discomfort of a Baker’s cyst.

These cysts occur most often in adults between 55 and 70 and in children between 4 and 7 years old. Up to one in five people with other knee problems may develop a Baker’s cyst.

Signs & Symptoms

In some cases, a Baker’s cyst causes no pain and goes unnoticed.

The signs and symptoms you may notice can include:

• Swelling behind your knee, and sometimes in your leg or foot
• Knee pain when you fully extend your knee or when you are active
• Tightness in the back of your knee, sometimes a bulge can be felt
• Stiffness

Complications

Rarely, a Baker’s cyst bursts and synovial fluid leaks into the calf region, causing sharp pain in the knee, swelling and sometimes redness of the calf. These signs and symptoms closely resemble those of a blood clot in your leg. If you have swelling and redness of your calf, you’ll need prompt medical evaluation, because a blood clot may require urgent treatment.

Physiotherapy Treatment

If the cyst is very large and causes a lot of pain, your physiotherapist may use treatments including. Applying ice packs, a compression wrap, and crutches may help reduce pain and swelling. Gentle range of motion and strengthening exercises for the muscles around your knee may also help to reduce your symptoms and preserve knee function.

If your doctor or physiotherapist determines that a cartilage tear is causing the overproduction of synovial fluid, he or she may recommend surgery to remove or repair the torn cartilage.

In some instances, particularly if you have osteoarthritis, the cyst may not go away even after your doctor treats the underlying cause. If the cyst doesn’t get better, causes pain and interferes with your ability to bend your knee, or if — in spite of aspirations — fluid in the cyst hinders knee function, you may need to be evaluated for surgery to remove the cyst.

Knee Trauma Operation

Some people require orthopaedic surgery following a knee injury.

Physiotherapy treatment must commence from the time of injury, not surgery, as this may be months later.

Pre-operative physiotherapy

Pre-operative physiotherapy starts with acute injury management and progresses to improving strength and range of movement to allow accelerated post-operative recovery.

Pre-operative physiotherapy may include:

• Reduction of pain and swelling
• Advice about the modify activity
• Stretching the muscles in the leg and hips
• Strengthening exercises
• Soft tissue massage to lengthen any tight muscles around the knee and reduce pain

Information about your surgical procedure and what to expect afterwards

Post-operative physiotherapy 

Our physiotherapists at Core Physio commonly treat people following knee operations such as arthroscopies, meniscectomies, ligament reconstructions and knee replacements to promote healing and enhance recovery.

Advise on how to modify activity and when to progress exercises safely

Physiotherapy treatment will be individualised and tailored upon your current symptoms and level of function to improve your mobility and increase your independence with everyday activities.

At Core Physio, physiotherapy treatment before and after your knee operation will ensure you get back to the activities you enjoy to the best of your ability.

Rehabilitation following an MCL injury is best provided by a specialist musculoskeletal physiotherapist

At Core Physio, we have experienced musculoskeletal physiotherapists, who use a combination of hands-on techniques, therapy equipment and exercise to promote healing and maximise physical function.

Physiotherapy treatment will depend on your individual needs and requirements but may include:

• Structured exercise program to stretch and strengthen the muscles which surround and stabilise the knee.
• Balance training
• Activities based around everyday tasks

Sport-specific exercises

Physiotherapy treatment will ensure you make the best possible recovery following your injury and return to sport with confidence and success.

Your physiotherapist will develop a structured rehabilitation program tailored to you to gradually strengthen your knee and keep your muscles flexible.

Our musculoskeletal physiotherapists use a variety of techniques and equipment, to promote healing and aid recovery and may include:

Gentle range of movement exercises to relieve pain, stiffness and swelling

Graduated exercise program including stretching and strengthening activities

Activities to improve balance

Core stability exercises

Functional activities based around everyday tasks

Sport specific exercises using anti gravity treadmill, gym balls

Your treatment program will progress you through a range of activities including short and long term goals, to ensure that you return to walking, running, and training at your normal level with success.

Calf Pain

Calf pain is a common presenting complaint and if not managed properly it can persist for months or recur.

What causes calf pain? 

Common causes of calf pain include:

Muscle strains – calf strains are the most common cause of calf pain.

Cramps

Biomechanics – such as flat footedness

Referred Pain – from the lumbar spine or knee joint

Physiotherapy for calf pain

• An initial assessment with one of our specialised physiotherapists at Core Physio will diagnose the cause of your calf pain and develop a treatment plan suited to this.
• Physiotherapy treatment will depend on your current symptoms, and the underlying cause of your calf pain but may include:
• Passive stretching
• Calf strengthening exercises once pain has settled to get you back to your sporting activities as soon as possible.

Hands on treatment is often administered in conjunction with an exercise program to relieve pain and stiffness

Advice about orthotics to correct your foot posture

At Core Physio, physiotherapy treatment will not only alleviate your calf pain but prevent future reoccurrence.

Calf Strain

Calf strain ranges from the tearing of a few muscles fibres to completely rupturing the muscles itself causing pain and reduced function.

What causes calf strain?

A sudden contraction of the calf muscle such accelerating from a stationary position or when lunging forwards to play a ball at squash or tennis can cause a calf strain.

A calf strain may also be caused by gradual wear and tear associated with repetitive jumping and distance running or walking.

What are the symptoms/effects of calf strain?

The main symptoms of a calf strain injury are pain which can range from a still cramping and tightness during the stretching or contraction of the muscles at the back of the lower leg, to immediate pain and even soreness when touched. In the worse cases, there can be acute stabbing pain and the person will be unable to walk meaning the muscle may have completely torn. Often bruising and swelling occurs.

Physiotherapy for a calf strain

Physiotherapy treatment is vital to hasten the healing process, ensure the best outcome as soon as possible and minimise the likelihood of re-injury.

Physiotherapy treatment at Core Physio will be tailored to your individual needs but may include:

• Cryotherapy to reduce pain and swelling
• Joint mobilisation
• Graduated exercise program which will include leg and hip stretching and strengthening exercises and how to progress these safely and effectively
• Running program promoting a gradual return to activity

It is important to seek physiotherapy treatment as soon as possible for the best possible results in the short and long term.

Physiotherapy treatment will reduce pain and swelling, promote healing and improve muscle strength and flexibility in order to get you back to sport and everyday activities in good time

Compartment Syndrome

There are various compartments in the lower leg that enclose the muscles. The posterior muscle compartment is the largest compartment in the lower leg that contains the calf muscles.

What is Posterior Compartment Syndrome?

Posterior Compartment Syndrome is a painful condition occurring when the muscles, nerves and blood vessels out-grow the space within the compartment created by the enclosing sheath. This increases the pressure inside the area and consequently on everything within the compartment causing pain.

What Causes Posterior Compartment Syndrome?

Posterior Compartment Syndrome can be caused by any acceleration movement which involves powerfully pushing off with the feet, like running, kicking, jumping or over-extending the foot by going up onto your heals or onto your tip toes.

Other causes of posterior compartment syndrome resulting in bleeding or swelling in the compartment may include:

• Direct trauma or impact to the back of the lower leg
• Extreme physical activity
• A muscle tear or calf strain

What are the symptoms/effects of Posterior Compartment Syndrome?

The main symptoms of posterior compartment syndrome are pain and tightness along the inner aspect of the shin and / or back of the lower leg. These symptoms generally increase with exercise and decrease with rest and can occur in one or both legs.

People may also experience a burning sensation or numbness in the calf and pins and needles in the foot.

Diagnosis of Posterior Compartment Syndrome

A thorough examination by a physiotherapist or doctor will diagnose compartment syndrome.

Physiotherapy treatment for Posterior Compartment Syndrome 

Your physiotherapist at Core Physio will initially assess your lower leg and then analyse your training methods, running gait and types of shoes to determine any contributory factors.

A treatment plan will then be developed tailored to your current symptoms and diagnosis which may include:

• Alternating cold and heat therapy
• Soft-tissue massage of the calf muscles
• Modifying activity program while you recover
• Advice about orthotics and appropriate foot wear
• Mobilisation of the ankle joint
• Stretching exercises
• Progressive strengthening exercises to improve balance and strength
• A gradual return to activity program

Physiotherapy treatment will reduce pain and gradually increase muscles strength and flexibility so you can return you to the activities important to you as quickly and as safely as possible.

What Causes Sciatica?

Although the cause of Sciatica lies in the spine, not all sufferers will experience back pain and symptoms can be variable. The problem can manifest as back pain with leg pain, or leg pain only. The major cause of Sciatica is a disc prolapse (more commonly known as a ‘slipped disc’) at the bottom of the back. Other factors however that can cause sciatica include injury to the buttocks, prolonged external pressure on the nerve, pressure from a tight muscle or nearby structure.

Sciatic can be triggered by very small, normal movements like bending over to one side at a bad angle to pick something up, as well from suffering a trauma like falling off a ladder and landing on your back. What happens in all cases is that the sciatic nerve is compressed and consequentially causes you pain.

What are the symptoms/effects of Sciatica?

The most common symptoms of sciatica is pain which can range from mild to debilitating. Other symptoms include weakness, numbness or tingling that generally begins in the lower spine and radiates down through the hips and buttocks and down the leg.

Additional more serious symptoms may include:

• Impaired circulation.
• Numbness of muscles, or a feeling of weakness, along the nerve pathway in the leg or foot.
• Loss of bladder or bowel control.
• Difficulty in moving and controlling the leg

Physiotherapy Treatment for Sciatica

Physiotherapy treatment is very effective in the treatment of Sciatica.

Physiotherapy treatment at Core Physio will relieve nerve root compression and prevent further episodes of sciatic pain by teaching correct postural techniques, and exercises to correct any muscle imbalance in the spine.

Common treatments used to treat Sciatica include:

• Joint mobilisation
• Stretching
• Postural advice
• Massage therapy including trigger point techniques
• Acupuncture
• Injection Therapy
• Core stability exercise

Your treatment program will be suited to your needs and lifestyle to ensure you make significant long term improvements and continue with everyday activities you enjoy will less pain and discomfort.

Physiotherapy for shin pain

Physiotherapy at Core Physio will firstly involve an assessment to diagnose the cause of your shin pain followed by a comprehensive treatment plan to enhance recovery and get you back to your sporting and everyday activities as quickly as possible.

Physiotherapy treatment will depend on the cause of your shin pain and current symptoms but may include:

• Ice therapy to reduce swelling
• Passive stretching
• Graduated exercises program to improve muscle strength and flexibility and correct any muscle imbalances
• Advice about appropriate footwear and orthotics
• Running program

Your physiotherapist will guide you through an individualised treatment program to reduce pain, improve muscle strength and length and prevent future reoccurrence.

What are the symptoms/effects of shin splints?

The main symptom of shin splints is pain on the inner side of the tibia during and after exercise. Sometimes there is swelling and even lumps on the bone. In some cases, it is painful to bend the foot or toes downwards and the inside of the shin appears to be red.

Physiotherapy Treatment

Physiotherapy treatment will speed up the healing process and ensure you continue to make improvements in the long term and prevent it from re-occurring.

Physiotherapy at Core Physio for shin splints may include:

• A range of exercises of strengthening and stretching exercises for the Achilles, the upper and lower calf, and the hamstrings.
• Advice about low-impact exercises such as swimming

In the long-term you may need to change your running style in order to correct the way that the foot hits the ground, as well as making sure that good footwear is worn.

Orthotic advice to help raise fallen arches

Your physiotherapist will devise a graduated training programme to promote recovery and help you return to your usual sports activities.

Physiotherapy treatment will reduce pain and restore range of movement and strength to your muscles as soon as possible.