A 17 year old student developed frequent right knee medial patella or kneecap dislocation. This is very painful.
The initial incident was in May 2018 and it reccured 5 times in the following 3 weeks.
She consulted Jennifer Casemore, chiropractor, here at SalisburyChiroPhysio in November 2018 presenting with oedema or swelling and tenderness under her right patella. After full examination, Jenny referred on to Andy Cook our sports therapist and personal trainer, to focus on exercises to improve the strength and condition of the knee in preparation for surgery. This was scheduled for February 2019, having already seen a consultant orthopaedic surgeon and having had an MRI scan in the months following the initial dislocation.
Her right knee was very painful on the initial visit to Andy Cook on 28/11/19 as she had suffered another dislocation that day.
Action A: progressive exercise programme was started a week after the initial visit. This aimed to improve the strength, condition and proprioception (joint position sensation) of the soft tissues (muscles and ligaments) acting over the knee which initially were poor.
Action B: Kinesiology or elastic K Tape was also used to help stabilise the patella and support the lateral structures. The exercises were carried out at home on a daily basis along with regular rehab sessions at the clinic.
As the weeks went by and symptoms improved the exercises progressed accordingly. Dislocations became far less frequent and surgery was postponed in order to see if conservative treatment would be successful.
After an 8 week period this year, without any incident of dislocation, it appeared that conservative management was working well. Unfortunately an apparent random dislocation, whilst asleep recently, has potentially altered the current thinking and a surgical intervention may still be required. Despite this she has done extremely well to improve the overall condition of her knee and will no doubt benefit from the hard work she has put in.
We aim to answer this question for you with the combined approach of chiropractic and physiotherapy working together.
We pay particular attention to when you first got back pain and what treatments you have tried before.
It is so important to know your whole story in order to understand what is wrong and then help you to get better.
Back pain is a combination of mechanical factors such as how the joints and muscles of your spine are functioning, inflammation of the soft tissues and lifestyle factors. This is affected by your posture, general health and physical fitness as well as attitudes and beliefs often brought on by anxiety and stress.
Misconceptions and concern about what you think is the problem can prevent recovery.
Usually acute or short duration back pain gets better quickly but it is important to see someone early for reassurance and advice to prevent it becoming chronic. Manual therapy or manipulation and exercises are recommended treatments.
Chronic long term recurring back pain requires working out the cause and what the patient can do to help themselves. Manual therapy and manipulation may help once a diagnosis has been made or an exercise programme specially designed for the condition. Sometimes the nervous system which is so complex learns the pain which has been demonstrated by functional MRI brain scans and this requires careful cognitive advice and pain management. Regular care is sometimes beneficial to keep the problem under control and to help you to self manage.
More complex problems may require imaging in the form of MRI scan and in some cases Quantitative Fluoroscopy scanning to identify a specific mechanical problem in order to decide if manipulation or exercise stabilisation will help or further intervention in the form of spinal injections or stabilisation surgery.
Professor Alan Breen who founded this clinic runs the Biomechanics Research department at the AECC (see links on our website)…….which has pioneered this work and we can assess patients this way with upright MRI and QF studies.
Here at SalisburyChiroPhysio we are fortunate to have this close multidisciplinary relationship to be able to help more complex patients in this way.
Here at Salisbury ChiroPhysio we welcome Gemma Kiddle, chiropractor, BSc (Hons), MChiro. DC. to our team.
Gemma graduated from the Welsh Institute of Chiropractic in 2016 and also holds a degree in Sport and Exercise Science from the University of Birmingham.
She practices a diversified technique and has an interest in sports injuries. She has also completed a course in K-taping to support and help the recovery of muscle and joint injuries.
She is passionate about chiropractic and treating patients of all ages with a wide variety of conditions, particularly neck and back pain as well as strains and sprains of other joints such as shoulders and knees.
In her spare time she enjoys participating in sports including tennis and trampolining. She lives in Bournemouth with her pet cat.
Generally skiing is very good exercise even if you have low back problems because you bend your knees as you fly down the slopes! Your legs act as a suspension mechanism and you don’t jar your back.
Its a good idea to check your lower back is free and mobile to help with this cushioning mechanism and that your sacro-iliac joints are moving well and there is no torsion or twist in your pelvis.
Simply having a checkup with your chiropractor can save you having problems on your holiday.
Here are some simple tips and exercises for skiing below.
Have fun and enjoy those lovely snowy mountain views and all that fresh air.
Quite advanced exercises but good for mobility and strength in the legs….so go slowly…
JENNY CASEMORE, EXPERIENCED HORSE RIDER AND CHIROPRACTOR GIVES ADVICE TO ALL THOSE EQUESTRIAN ENTHUSIASTS OUT THERE……..
I thought I would mention the lovely pleasure ride at Fonthill that I went on a few weeks ago. This annual ride is run by members of the BHS (British Horse Society!) They do an amazing job with the organization, marking the way (and removing later), parking lorries/trailers and keeping an eye on the riders during the ride and checking they all come back!!
So we had a great ride. However, discussions with a keen horseman before the ride brought to light some of the musculoskeletal problems suffered by riders who do long distances on their horses or ponies. The most common complaint is simply low back pain and of course there are a number of possible reasons for this, ranging from simply tired muscles to inflamed facet joints. There is of course a lot of shock or jar that it is transmitted to the rider’s joints when the horse’s feet make contact with the ground and the forces travel upwards. The limiting factors to this are importantly the horse itself, the type of pace it has, i.e. ground shuddering or light as a fairy! The horse’s connective tissue system, like ours, ligaments, muscles, tendons, joint cartilage should effectively absorb some of these unwanted forces.
So what makes a difference to the rider:-
- Body position, sitting with a bend at the hip and knee joints which can open or close with impact.
- Sitting with the spine in a neutral position, too much extension and the joints are compressed too quickly, too much flexion and the discs may be at risk of rupturing fibres and even the central pulp exuding from the disc (slipped disc).
- Keeping head and neck aligned correctly over spine unless in a forward galloping position when the head may be extended over the spine.
- The saddle can make a huge difference by allowing the rider to sit comfortably in the flexed hip/knee position described. It needs to be placed at the right position of the horse’s back. It may help to have a knee roll on the saddle flap itself or the under panel correctly placed for the riders leg length/shape.
- The pads/numnahs that the saddle sits on can be made of shock absorbing material helping both horse and rider.
How to help stiffness or pain in the rider’s back:-
- For simple muscle and/or joint stiffness, try exercises to stretch the back and leg muscles, for example, bringing both knees to the chest, stretching hamstrings.
- Foam rollers can be very useful to massage and stretch the back muscles.
If pain persists, visit your chiropractor so that you can continue with those long summer rides!
We have decided to change are name to Salisbury Chiropractic and Physiotherapy as we now have physiotherapist Dawn Cornforth and sports therapist Andy Cook, providing regular physio, massage and exercise training.
This combination of having chiropractors Jennifer Casemore and Nigel Hunt working in combination with the therapists will integrate care helping to resolve complex spinal and joint problems. We think this will be more effective and beneficial to patients.
Often persistent neck and back pain needs both manipulation and soft tissue treatment, as well as posture and core stability training, with specific exercises designed especially for you.
The physios can also treat sports injuries and other joint problems such as shoulders, elbows, hips and knees. Andy and Dawn have a sports background and are very experienced in advising about these conditions.
They can also provide you with relaxing or sports massage.
Do call if you would like to book and appointment or discuss your problem with one of us.
Many people choose to do their shopping online but is it good for you and your posture?
Shopping in comfort, in our own home, no queues, no crowds of people and our own supply of tea, mince pies and even mulled wine. It seems like a no brainer!
However, sitting in front of a computer for hours, hunched over, in the same position, searching for the perfect present for our relatives, getting stressed when we find it’s out of stock and then the inevitable happens, the computer decides to update …. Again!
The result of this can be a very stiff and painful neck or back or both which can be treated by painkillers or maybe even having a massage but that may not be enough.
Equally if the condition is left with no treatment this can result in a painful back or neck, probably with a headache, which is going to spoil your pre-Christmas festivities.
The real solution is to let Salisbury Chiropractic and Physiotherapy Clinic sort out your problem at the earliest stage, so that you can enjoy Christmas to the full.
If you can’t get here before Christmas, then download our helpful exercises which will show you how to achieve the correct posture very simply.
And remember sometimes it is better to brave the real shops as this involves, walking, fresh air and a chance to revel in the Christmas atmosphere even treating yourself to mince pie and mulled wine in one of the many coffee houses and restaurants in Salisbury. Just don’t be over ambitious and try to do it all at once, so you end up carrying heavy bags, which can put strain on arms, neck and back.
Stay positive, do exercises and enjoy the Christmas season. Remember if you really are in pain call us for an appointment or book a pre-Christmas treatment just in case.
Merry Christmas and a Happy New Year to everyone….
See our Reverse the Slump exercises (attached) for sitting at the computer or when doing Christmas cards! … a great stretch to reduce neck and upper back strain!
HUNT’S SLUMPED POSTURE EXERCISE (HSPE)
Hunt’s Slumped Posture Exercise prevents slumping and strengthens your neck, upper back and core muscles. It promotes stability and relaxes muscles that tighten due to postural stress (see Figure 1). Check the tension in your upper back and shoulders in the slumped posture and then in the posture exercise position. Muscle tension is dramatically reduced. Another check is to turn your head in the slumped and corrected postures. There is an improvement in the posture exercise position.
FOLLOW THESE SIX STEPS:
- Sit with on the edge of your chair.
- Spread your legs apart slightly and turn your toes out.
- Rest your weight on your feet and relax your abdominal muscles.
- Arms straight by your side and turn your palms outwards.
- Tuck your chin in and open up your chest with a deep breath, then squeeze your shoulder blades together and downwards as you breathe out.
- ….so chin in and chest out……reverse the slump!
This postural exercise should be done for 10 seconds every 20 minutes especially when sitting at a desk or computer. It can be incorporated into sitting, standing, walking, and lifting. Within a few weeks, you will sit and stand straighter naturally. When this occurs, conscious effort is not as necessary because you have learned a new skill and postural habit.
www.salisburychiropracticclinic.co.uk 01722 328606