No need to see your doctor first
The first question many people ringing the clinic for an appointment ask is ‘Do I need to see the doctor first before attending the physiotherapist’. The answer is no. Chartered Physiotherapists are trained to assess and treat a wide variety of complaints. At Cahir Physiotherapy Clinic we specialise in musculoskeletal complaints. These are injuries and symptoms coming from the muscles, tendons, ligaments, joints and bones. A doctor’s referral is helpful as it usually contains details of medications and past medical history however, it is not necessary.
When you come in for your appointment, we will ask you many questions about your symptoms. For example- how long have you had them, or what activities make the symptoms worse? After that we will examine you based on what you’ve told us. Our university training and post-graduate experience will guide us to find what the problem is (a diagnosis) and to begin to fix the problem. At Cahir Physiotherapy Clinic we will always address the underlying causes of the problem too. You will be prescribed exercises to do at home. If there is anything that we hear while listening to you, or see when examining you, that we are unhappy with, we will contact your doctor immediately by phonecall or letter. You’re in safe hands.
I have attended my GP/ Consultant and now need physiotherapy
When you attend for physiotherapy on your doctor’s advice please bring whatever letter/note you received from your doctor. This usually contains information on what the doctor’s diagnosis of your injury is. This helps us, especially in the case of patients who have undergone surgery, for example, surgery following a bone break. In addition, with a doctor’s referral, you can claim 20% of your physiotherapy fees against your income tax in a given year by filling out a Med1 Form.
Frozen shoulder is a condition that affects both men and women in which the shoulder becomes painful initially and then very stiff. It affects normal daily activities, like brushing hair and getting dressed and driving. It mostly occurs in patients between the ages of 40 and 65 years of age and it usually lasts 1- 2 years.
What causes frozen shoulder?
When a patient arrives at the clinic, they usually say that they can’t remember ‘hurting it’ and say that the pain started for no particular reason. There are some people more prone to this condition than others, those with Diabetes or a heart or lung disease.
Frozen shoulder occurs when there is swelling and thickening of the stretchy covering that surrounds your shoulder joint. This tissue is known as a capsule. In cases of frozen shoulder, it seems that bands of scar tissue form inside this tissue, causing it to thicken, swell and tighten.
Stages of Frozen Shoulder
There are usually 3 phases of variable duration of the condition. Initially the patient complains of increasing pain with normal daily activities and later on the shoulder becomes stiffer. This phase can last anything from 2 to 9 months. In the second stage, the pain stops getting worse or may improve, but the shoulder stiffness is worst- ‘frozen’ and is quite debilitating. This stage lasts from 4-9 months. Finally, the pain subsides and the shoulder gradually regains movement ‘thaws’.
Physiotherapy for Frozen Shoulder
It is a common occurence that a patient would arrive in the clinic complaining of a frozen shoulder, when they may have a different shoulder condition. A Chartered Physiotherapist will ask you lots of questions to ensure that you are treated correctly. At all stages of the condition, physiotherapy is aimed at reducing pain and maintaining movement, education about the condition and encouraging normal movement. It is really important to try to use the shoulder as much as possible. Ice and heat may help with symptoms. Your General Practitioner may suggest a corticosteroid injection also. The combination of injection and physiotherapy has been found in research to be helpful to relieve symptoms.
Cruciate Ligament tears
Anterior cruciate ligament (ACL) tears of the knee are back in the news recently with Colm ‘Gooch’ Cooper’s injury and subsequent surgery making the headlines. Born and reared in Co. Cork, I can’t say that I shed any tears for the consequences for Kerry football myself. But, for those Kerry folk hoping for a quick return to play later on in the year for the star footballer, they would be better off if he delays his return to matches until much later in the year or even next year.
After cruciate ligament knee surgery, returning to sport at the same level that you were playing (club or county) at when you got injured, is a big challenge. The risk of re-injury to the same knee or the opposite knee after undergoing ACL reconstruction surgery is as high as 30%. The risk is higher if you are under 18 years of age.
Rehabilitation post surgery
Following ACL surgery, successful return to full activity and prevention of reinjury require advanced rehabilitation led by a Chartered Physiotherapist. What’s important is that the risk factors that may have led to injury injury in the first place are tackled in your rehabilitation. You will need the expertise of a Chartered Physiotherapist to safely assess your movement and progress your rehabilitation to the point when you are safe to return to action. Poor control of hip and knee movement in activities like jumping, landing and rapid changes of direction is something that can be improved with exercises. Based on your particular sport your Chartered Physiotherapist will design a programme of advanced exercises to improve your balance, strength, agility and power. These will be challenging exercises and will require hard work on your part.
Return to Sport
Based on your ability to perform these more challenging exercises, your Chartered Physiotherapist will be able to decide when it is safe for you to return to sport, to training and to matches. The perserverence and patience required to stay focused will play a large part in how successful your return to sport is. This mental strength that Colm Cooper is credited with, will ensure a successful return to play for the star in 2015. Despite my lack of love for Kerry football I do (really, I do!) wish Colm well with his rehabilitation.