VMO Taping - Does it work?
I am interested to know if anyone has regular success with VMO taping for Anterior Knee Pain. My experience of anterior knee pain is that the knee often falls into a valgus position due to foot bio-mechanics or weakness around the hip. I usually find there is weakness with-in the hips abductors and by improving strength the knee stays in a better position and the pain subsides. I therefore don’t use taping on a regular basis and would like to know how effective people think it is.
Orthotics v’s Pronation control trainers
What are peoples thoughts on trainers with built-in pronation control versus using orthotics in neutral running shoes. I’ve recently been on a seminar day on running and the podiatrist was suggesting that it might even be a good idea to buy three different makes of running shoes( with the appropriate control for your feet) and alternating them, so there is slightly different stresses going through the body, instead of exactly the same stress on each run. Might be difficult to persuade the average runner to part with the cash! Can be difficult enough getting people to change trainers once every six monthes. Oldest pair that I have seen a patient wear were older than his twenty year old daughter.
Recruitment for Newbies!
Hi
I was keen to find out how many vacancies people have for newly qualifying Band 5’s. This is the time of year, if not before, where thousands of students start looking for jobs. It has been widly reported over the last few years the lack of jobs and I just wanted to get an idea of how things stand this year. Any info would be of use. Also if you are going to be newly qualified, how is the job market for you?
Accelerated Rotator Cuff Protocols
Hi All
This post is to see what experience you have of rotator cuff repairs post-op. I am trying to find whether the consultants you work with follow the G.O.S.T. guidelines or their own. Also are they conservative or are they happy for a quicker rehabilitation. There are 2 views where I work. The first is 6 weeks in a sling, whereas the other is 3 weeks in a sling before starting active-assisted flexion. We will hopefully gather evidence for the differences and report on it. I will publish the 2 protocols in the next 2 days
Acupuncture - Past or Present for Physio’s?
Following a discussion with colleagues last week, it became apparent that the number of physiotherapists practicing Acupuncture in our NHS department had dropped significantly. The general consensus was that it had some benefit but other modalities may be used in the first instance. There are now 4 physio’s instead of 8 who still use Acupuncture. Of these, two use it a lot less than they used to and are considering whether to update their competencies. The discussion was started in the wake of the new Low Back Pain guidelines from NICE which state patients are entitled to Manual Therapy or Acupuncture if they are still experiencing problems after 6 weeks. We felt there might be an increase in patient’s wanting to try Acupuncture and whether we had the scope at present to cope with an increase in demand. At present we will use a wait and see policy but it would be interesting to note other practitioners views on their use of Acupuncture.
ACL rehab for rugby( Draft only)
This is a draft of some information for a patient booklet on acl rehab. Any thoughts welcome. Still in the draft phases so needs editing and pictures adding.
Rugby places high physical stresses on the knee and ACL due to the forces from contact in tackle situations, from high speed cutting maneuvers and sudden changes of direction and deceleration.
Different playing positions and roles mean that there are varying situations where stress is put on the knee. The back row and three quarters tend to perform more high speed changes of direction and the forwards are put under different stresses in the scrum,ruck, maul and lineout situations.
Due to the amount of change in direction,speed and force involved in rugby it is vital that rehab following surgery incorporates not only strength but balance(proprioception) and agility drills. This should result in a stable knee and should retrain the nervous system to be able to sense abnormal displacement and initiate protective muscle reflexes to help prevent further injury.
Fatigue can put further stress on the knee as your responses and skill levels will be affected so it is important to continue to work on your stamina.
1.Driving in the loose/in a scrum
2.Sidestepping at full pace
3.Running jump to catch the ball and landing.
4.Sudden deceleration and change of direction
5.Combined sudden deceleration, change of direction and tackling to the side.(High impact contact situations)
1. Driving in the loose/scrum
quadriceps strengthening exercises from earlier in the rehab should be continued and resistance progressed.
Running with resistance e.g . Dragging weight or running parachute.
Scrummaging against machine/ opposing scrum.(dependant on position)
Start straight run 10 metres and arc around 5 metre semi circle run back to start. Repeat in opposite direction. Repeat x 5. Gradually increase pace and shorten arc to increase dificulty.
Figure 8 Runs. Run around cones set 5 metres.
Zig-zag running. Cones set diagonally 10 metres apart. Run diagonally from cone to cone. Repeat x5
3.Running jump,catch and landing.
Jump off trampete and absorb landing . Two feet landing initially then progress to one foot. Can be started from week -
Jogging around pitch , jump (two feet) and land and continue jog. Repeat every 10 metres.
Cones set 20 metres apart .Run out and have assistant throw ball up for you to jump and catch. Land and continue to jog to next cone turn and pass to assistant. Repeat back to first cone. Repeat x5.
Have somebody kick the ball to you to run , jump, catch and land.
Shuttle Runs – Increasing pace.
Have five tackle bags positioned 3m apart. Lie on front, run out to tacklebag 5m in front and tackle. Then run diagonally back to start line and lie on front. Run forward to next bag and tackle then repeat drill for remaining bags. Repeat x3 . ( may need diagram to explain)
How many exercises do you give?
This is an interesting question and one which leaves physiotherapists divided. Experience has led me to give upto 3 exercises at any one time. I feel this is achievable for most patients at least once a day. I used to give more but when asked to show me the exercises, patients often forgot at least 1 exercise and performed them incorrectly. Some experienced physiotherapists may only give 1 whereas newly qualified physiotherapists may give more. This isn’t to say it is incorrect but I feel you have to put yourself in the patients position. Do you feel you could remember and complete 5 exercises twice a day for 1 week? Unlikely due to time constraints and possibly motivation. I find even with exercise reminders patients often forget the exercises or lose the exercise sheets. Hopefully with an on-line reminder system it will be easier for patients to perform their exercises. Let me know what you think on your experiences with prescribing exercises.
We’re really excited
Physio toolbox has been a concept 2 years in the making. We’re a group of physios who are tired of paying through the nose for software that we think is outdated, bloated, and too expensive!
We also know that the internet is a massive way to reach small and medium size physio businesses who dont want to spend a lot for the features they need. We know they exist because we work with them.
Our new product promised to do all of the things the prescription tools we use day to day but at a fraction of the cost. We’re even planning a free trial so you can try before you buy! Watch this space.
