NEW TREATMENT for Chronic Tendon Pain

NEW TREATMENT for Chronic Tendon Pain Tendinopathies are usually associated with overuse in sport or work. The aging population is also more prone to ...
Author: Kelly Palmer
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NEW TREATMENT for Chronic Tendon Pain Tendinopathies are usually associated with overuse in sport or work. The aging population is also more prone to tendon tears and tendinopathies as their tissues become more fragile and the circulation to them isn’t what it was when they were younger. We have just purchased a new machine that is showing great promise with the treatment of chronic tendinopathies. Conditions that shock wave therapy can assist include:  Shoulder tendinitis, - supraspinatus and biceps tendinopathies and bony spurs  Gluteal tendinopathies and bursitis,  Achilles tendinitis  Plantar fasciitis and spurs  Tennis elbow. Shock Wave Therapy was developed after it was found that patients receiving Extracorporeal ShockWave Lithotripsy (ESWL) for kidney stones had improved vascularisation in their kidneys in the area treated. This led to more research and development of shock wave therapy in a milder dose that causes a similar response in more superficial tissue. The theory of the mechanism of shockwave generation in ESWT is to produce interstitial and extracellular responses that lead to tissue regeneration (Ogden, Toth-Kischkaf, et al., 2001). Pain Relief The literature suggests that ESWT provides pain relief through hyperstimulation analgesia, and it has been demonstrated that ESWT acts on the expression of substance P and calcitonin gene-related peptide (CGRP) in the dorsal root ganglion (Melzack, 1979; Takahashi, Wada, Ohtori, Saisu, & Moriya, 2003).

Tissue Regeneration ESWT has been shown to stimulate tissue regeneration, and it is suggested that ESWT results in increased collagen production, matrix turnover and increased vascularisation (Bosch et al., 2009; Bosch, van Schie, van de Lest, Barneveld, & van Weeren, 2007; R. W. W. Hsu, Hsu, Tai, & Lee, 2004; C. J. Wang et al., 2003). Destruction of Calcifications There have been suggestions that ESWT can eliminate calcifications in tendons, with some in vivo studies demonstrating resolution of calcification in shoulder tendinopathies (Daecke, Kusnierczak, & Loew, 2002b; Peters et al., 2004a) Tendinopathy In the past 10-15 years, ESWT is emerging as a clinically useful treatment modality for chronic tendinopathy conditions (Ching-jen, 2012). As further research continues to show positive treatment effects, ESWT is gaining popularity across the medical community. It is widely accepted that ESWT is indicated in the treatment of chronic tendinopathic conditions of duration greater than three months and who have failed appropriate conservative management (van der Worp, van den Akker-Scheek, van Schie, & Zwerver, 2013a) Our physiotherapists will be providing detailed initial assessments on clients regarding history, view any scans and to ascertain their pain and functional loss and weaknesses. The treatment will then be implemented which usually involves up to 6 sessions with a gap of about 4 days between sessions. We will also combine strengthening programmes once pain and function have improved. Many of these conditions are accompanied by poor posture and weak musculature. Our in house clinical trial to date have had clients reporting a decrease in pain and especially of note was that they could sleep better as their shoulder or gluteal tendinopathy was not waking them when they rolled on that side. Does the treatment hurt? The treatment while ballistic is not painful but more like a rubber band flicking the skin or a strong vibratory sensation.

STAFF NEWS Dan Langdon has finally completed all his university studies and has now taken up a full time position with us where he will be working in our Pilates studios as well as being the Course Coordinator for the Pilates Institute of Queensland, the course training arm of our company. In other news, we would like to wish Amelia and her family all our warmest and very best wishes for the safe and arrival of their little new born! Amelia will finish work with Agility on Saturday, 22 August.

NEW DIPLOMA STUDENTS Our second Diploma course commenced in July and we now have 4 new students doing their practical observation and supervision hours in our studio. Welcome Ayesha, Liz, Kalii and Helen to our studio.

QUT Exercise Physiology Students We currently have Chris doing a practical placement in our studio at Albion. Chris is keen to learn and assist clients with those springs and straps. He can assist you with the finer features of postural alignment while you are doing Pilates.

SPRING BACK INTO EXERCISE! While we have had more than our fill of

cold mornings, the sun is

starting to rise earlier, the Ferris Wheels are up at the EKKA, and it’s time to embrace Spring and EXERCISE.

SPECIAL OFFERS Barre Classes These classes are a variant mix of Pilates, Ballet and aerobics to get your legs, butt and stomach toned with some cardio thrown in. Many of the exercises are done at the ballet barre. Come and give it a try. Train with Emma at Bulimba or Lydia at Albion. Bring a copy of this voucher for your first session FREE. Then buy a 10 pack for $160.00, usually $180.00 If you feel Barre classes aren’t for you, please pass this voucher onto a family member or friend.

Studio circuit classes These are designed for the healthy population who want a strong core, be toned and burn some calories. The circuit will include Reformer, Trap table, Wunda chair and Ball. It’s 60 minutes of hard core work but with the control and finesse of Pilates. Bulimba: Albion:

Special introductory price – only $20 per session for Aug/ Sept. Bookings essential

Tuesday and Thursday 9.15am Tuesday and Thursday 2.00pm

Private studio sessions Train with your friends! Book the studio with one of our instructors at our off peak times and you can be the only client, or you can bring up to 5 friends and split the cost. Private studio sessions are $95.00

Lateral Hip Pain Lateral hip pain or trochanteric pain syndrome is fast becoming one the most prevalent conditions in today’s society with 23.5% of women and 8.5% of men between the ages of 50 and 79 acquiring a tendinopathy in the hip muscles. A tendinopathy refers to a breakdown of a tendon due to an inability for the body to heal as quick as wear and tear occurs. Tendinopathy’s in the lateral hip are the most common tendinopathy in the lower limb. 20% of people with lateral hip pain also have trochanteric bursitis. This is where fluid builds up in the bursa (a sac designed to prevent ware between bone and muscle) located over the bone on the side of the hip.

Lateral hip pain has a severe impact on quality of life. Those affected by the condition often complain of an inability to sleep at night, ascend and descend stairs/hills, and difficulty getting out of low chairs.

The most common causes of tendon breakdown are  Compressive forces acting on a tendon  Sudden increase in tensile stress through a tendon that hasn’t been accustomed to such stresses  Overuse of a tendon (more common in older populations)  Poor choice of muscle use around the hip  Weakness of specific muscles around the hip

How to avoid lateral hip pain  Don’t cross your legs, sit with knees together or knees far apart  Don’t sit in low chairs or couches  Don’t stand with your hip pushed out to the side (aim for equal weightbearing through each leg)  Stop walking like a model (pushing hips out to the side as you walk)  If you’re a side sleeper, put a pillow between your knees  Ease into a new exercise program  If you begin to feel lateral hip pain, book in with your physio to identify the best course of action for your situation

Some health practitioners will recommend a cortizone injection but it is important to know that this is only a temporary pain relief. It is essential to work with a physiotherapist to retrain specific muscles in the area to function correctly and prevent further breakdown.

Our shockwave therapy has been proving quite successful in pain reduction + healing in a number of our clients with lateral hip pain. If you are experiencing any hip, gluteal or buttock pain, it is important to receive treatment early. Please come and see us for an assessment.

33 Collingwood Street ALBION | 130a Quay Street BULIMBA Phone: (07) 3862 2322 Phone: (07) 3399 2244 Fax: (07) 3862 2332 Fax: (07) 3399 2280 Email: [email protected]

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