Physiotherapy Archives - opusbiological.com

The Importance of Criteria-Based ACL Rehabilitation: A Structured Approach

Nov 18, 2024

Recovering from an ACL injury can be daunting, but with the right plan, our patients can rebuild strength, regain confidence, and return to the activities they love. A structured, criteria-based approach is essential not just for recovery but for reducing re-injury risk and achieving long-term success.

Here’s the criteria based approach we use to guide our patients:

Acute Phase The focus is on reducing pain (≤3/10 on VAS), managing swelling, and restoring full knee extension. Early progress in these areas is crucial for setting the foundation for later phases. Key methods: neuromuscular stimulation, passive/active extension exercises, and gait re-education drills.

Early Rehabilitation This phase targets movement and endurance. Goals include achieving 120° of knee flexion and improving muscular control with exercises like leg presses and single-leg squats. Building strength here supports long-term stability.

Strength & Control We move into heavier strength training, focusing on 2–4 sets of 8–10 reps at 60–80% of one-rep max. Controlled jumping and landing drills (e.g., sub-maximal bilateral landings) are introduced to prepare for higher-intensity demands.

Advanced Plyometrics Single-leg plyometric training and advanced strength work dominate this phase. We aim for functional goals like an 80% limb symmetry index or 1.5× body weight on leg presses. This phase is about translating strength into power and functional movement.

Return to Sport Here, sports-specific training and multidirectional movements take priority. A safe return to play requires not only physical readiness but psychological confidence, assessed through validated tools and a multidisciplinary team (MDT) approach.

Why This Approach Works:

Recent research highlights the effectiveness of criteria-based protocols:

Tailored Programs: Improve outcomes and reduce re-injury rates, ensuring progress at each phase of recovery (Griffin et al., 2020; Hewett et al., 2019).
Strength and Neuromuscular Control: Critical for knee stability, reducing risks of compensatory injuries and re-injury (Krebs et al., 2021).
Psychological Readiness: Athletes report higher confidence and readiness to return to sport when mental readiness is prioritised (Fitzgerald et al., 2020).

Conclusion:

Recovering from an ACL injury isn’t just about regaining movement it’s about returning stronger and more prepared for the challenges ahead. A criteria-based approach ensures that every phase of rehabilitation has clear goals tailored to each athlete’s unique needs.

References:

Fitzgerald, G.K., Paterno, M.V., and Myer, G.D. (2020). Psychological readiness to return to sport after ACL reconstruction: A systematic review. Journal of Orthopaedic & Sports Physical Therapy, 50(10), pp. 558–566.
Griffin, L.Y., Albohm, M.J., and Arendt, E.A. (2020). Understanding and preventing noncontact anterior cruciate ligament injuries: A review of the literature. Sports Health, 12(3), pp. 240–246.
Hewett, T.E., Myer, G.D., and Ford, K.R. (2019). Preventing knee injuries in athletes: An evidence-based approach to training. Clinical Sports Medicine, 38(1), pp. 1–24.
Järvinen, T.A.H., Järvinen, T.L.N., and Kalimo, H. (2021). Rehabilitation of the anterior cruciate ligament: A review. Sports Medicine, 51(3), pp. 447–461.
Krebs, A., Naal, F.D., and Maffulli, N. (2021). The role of structured rehabilitation in the management of anterior cruciate ligament injury: A systematic review. British Journal of Sports Medicine, 55(12), pp. 684–690

Biopsychosocial Considerations of Sports Injury and Rehabilitation: A Holistic Approach to Athlete Recovery

Oct 14, 2024

Opus, founded by David Porter, a new perspective on sports injury rehabilitation is taking shape. Together with Professor of psychology Dave Collins and lead physiotherapist Ian Gilham, the team promotes the biopsychosocial (BPS) model—a comprehensive approach that goes beyond treating the physical injury to address the mental and social factors that impact an athlete’s recovery.

This method aims to support athletes fully, enabling them to return to peak performance with resilience.

Key Points:

Interdisciplinary Teamwork: The BPS model draws on a team of specialists, including doctors, physiotherapists, psychologists, nutritionists, and coaches. This interdisciplinary approach ensures that all aspects of an athlete’s recovery are covered, promoting a more rounded and complete rehabilitation.
The Biopsychosocial Model: Traditionally, rehabilitation focuses on the physical aspects of injury. However, the BPS model acknowledges that injuries affect athletes in other ways too, such as their mental health (e.g., anxiety or loss of identity) and social status (e.g., their role within the team). The model addresses these factors together for a holistic recovery.
Patient-Centred Care: One of the core principles of the BPS model is putting the athlete at the centre of their care. This patient-centred approach ensures that athletes are actively involved in their recovery process, which can increase motivation and help tailor the rehabilitation to their specific needs.
Real-Life Examples: The article shares practical case studies where the BPS model has been effectively applied. In one case, a competitive equestrian rider with a severe pelvic injury received coordinated care involving medical, psychological, and social support, which helped her overcome fears about returning to competition.
Rehabilitation Stages: Recovery under the BPS model follows a clear, structured path, with each phase of rehabilitation managed by the interdisciplinary team. Early stages focus on reassurance and stabilisation, while later stages incorporate goal-setting to keep the athlete motivated and engaged.
Social Support: The social aspect of recovery is vital for maintaining mental wellbeing. The BPS model encourages athletes to remain connected with their teams during rehabilitation, helping them feel included and supported throughout the process.
Goal Setting and Progress Measurement: Setting clear, achievable goals is central to the BPS model. Breaking the rehabilitation process into manageable steps allows athletes to see progress and stay motivated. Tools like the “Challenge Ladder” help measure this progress, giving athletes a clear path forward.
Addressing Psychological Barriers: Injuries often bring psychological challenges, such as fear of reinjury. The BPS model incorporates psychological support to address these fears early on, helping athletes regain their confidence and return to competition without hesitation.
Clear Roles for Specialists: With many professionals involved, clear communication is essential. The BPS model establishes well-defined roles for each specialist, doctors, physiotherapists, and coaches, ensuring consistency in care and avoiding confusion for the athlete.
A Look to the Future: The authors advocate for broader adoption of the BPS model across sports rehabilitation settings, noting that its holistic approach leads to more effective and complete recovery. This model is particularly beneficial in helping athletes not only return to play but come back stronger, both physically and mentally.

In this article, David Porter, Dave Collins, and Ian Gilham highlight the benefits of the biopsychosocial approach to sports injury rehabilitation.

Focusing on the athlete’s physical, mental, and social well-being, the BPS model provides a more complete path to recovery. Through interdisciplinary collaboration and patient-centred care, this approach ensures that athletes return to their sport stronger and more resilient.

This innovative approach is setting a new standard in sports medicine, helping athletes achieve the best outcomes in their recovery journey. To learn more about how the BPS model can enhance sports injury rehabilitation, read the full article here

Injuries in paddle

Oct 10, 2024

Paddle tennis has increased in popularity over the last few years and due to the fast-nature of the sport, it is unsurprising that musculoskeletal injuries are very common. Paddle takes place on a small field and surrounded by glass which increases the speed of the game. Paddle requires ‘motor anticipation, explosive force, reactive speed (acceleration and deceleration), resistance, flexibility and agility’(Virgolino, 2022). These components of fitness are key for health, wellness and longevity however there is an increased risk of injury if one does not apply appropriate preventative techniques (Virgolino, 2022).

The most common MSK injuries in senior players include knee sprains, lateral epicondylitis, shoulder pain (20.6%) and lower back pain (27.5%) (Castillo-Lozano, 2017). However, lower back pain is the most prevalent among junior players (Virgolino, 2022). These findings enable practitioners to create preventive strategies and programmes which focus on scapular stability, trunk stability and lower limb strength (Castillo-Lozano, 2017). Despite the risk of injury, paddle provides many benefits, especially to elderly players. There is a variety of research demonstrating the physical advantages (muscular strength, endurance and reaction time) of paddle, however literature has shown paddle to also provide psychological benefits such as reducing anxiety and stress (Eirale, 2023).

Elbow tendinopathy mostly impacts novice players. This is most likely due to players hitting backhand strokes in wrist flexion, the sudden increase of eccentric loading of forearm extensors and the vibrations impacting the elbow when the ball reaches the racket. Lateral epicondylitis is extremely common due to the repetitive movements and duration of the game (2-4hours). However there have been recent improvements in racket technology which reduce the risk of epicondylitis. It is also unsurprising that patella tendinopathy often occurs due to repetitive jumping and sudden change in direction. Interestingly, males are 2-4 times more likely to develop patella tendinopathy, whereas females are more likely to experience chondromalacia patellae (Eirale, 2023).

Woman feeling back pain while exercising in gym

Disc-related lower back pain and facet joint syndrome are predominantly the main cause of lower back pain (LBP) in paddle. Sward et. al found 50% of their participants suffered with LBP and 1/5 experienced severe symptoms. This is likely due to paddle incorporating all ranges of motion in the lumbar spine combined with explosive movements; therefore, it is important to consider trunk stability and lumbar mobility to prevent injury (Eirale, 2023).

Lastly, repetitive movements such as ‘smash’ and ‘bandejas’ cause muscle imbalances in the shoulder, increasing the risk of rotator cuff injuries and scapular instability. Also due to repeated overhead movements, there is a possibility of impingement in the glenoid humeral joint leading to a SLAP lesion. Consequently, rotator cuff strengthening and scapular stability are key to prevent shoulder injuries (Eirale, 2023).

Reference list

Castillo-Lozano, R. (2017). Epidemiology and prevention strategies for the musculoskeletal injuries in the paddle-tennis senior players. Science & Sports, 32(3), pp.e101–e106. doi:https://doi.org/10.1016/j.scispo.2016.09.009.

Eirale, C. (2023). Aspetar Sports Medicine Journal – INJURIES IN PADEL. [online] Aspetar.com. Available at: https://journal.aspetar.com/en/archive/volume-12-targeted-topic-sports-medicine-in-padel/injuries-in-padel [Accessed 22 Aug. 2024].

Virgolino, M. (2022). Running in Paddle. Springer eBooks, pp.179–183. doi:https://doi.org/10.1007/978-3-662-65064-6_19.

Stay Active, Stay Healthy: The Importance of Physiotherapy for Active Individuals

Oct 3, 2024

Photo by Annie Spratt on Unsplash

Maintaining an active lifestyle is crucial for overall health and well-being in today’s fast-paced world. Whether you’re a seasoned athlete or simply someone who enjoys staying active through sports and exercise, taking care of your body is paramount. However, as you age, changing your approach to fitness is essential to stay active. Proactive preventive approaches such as physiotherapy can prevent injuries, enhance performance, and enable you to continue enjoying the activities you love for years to come.

Who is a physiotherapist? How can a physiotherapist help me?

Physiotherapists, also known as physical therapists, are highly trained healthcare professionals who specialize in assessing, diagnosing, and treating a wide range of musculoskeletal and movement-related conditions. Their primary focus is on optimizing movement, promoting physical well-being, preventing injuries, and rehabilitating individuals who have experienced physical impairments. Here’s an overview of what physiotherapists do and how they can help you stay active:

Assessment: Physiotherapists begin by comprehensively assessing the patient’s condition. This involves evaluating their physical function, range of motion, strength, posture, and pain or discomfort. The goal is to identify the underlying issues that may be causing the patient’s problems.
Diagnosis: Based on the assessment, physiotherapists diagnose the underlying causes of the patient’s symptoms. They determine the root of the issue, whether it’s a specific injury, a musculoskeletal problem, a neurological condition, or a combination of factors.
Treatment Planning: Physiotherapists create personalized treatment plans tailored to the patient’s needs, goals, and condition. These plans often include a combination of various therapeutic techniques and exercises designed to address the identified issues.
Exercise Prescription: Physiotherapists prescribe specific exercises and therapeutic activities that target the patient’s condition. These exercises strengthen weak muscles, improve flexibility, enhance balance, and address movement abnormalities.
Patient Education: Educating the patient about their condition, proper body mechanics, injury prevention, and self-management techniques is a significant part of a physiotherapist’s role. Patients are empowered to participate in their recovery and long-term health actively.
Rehabilitation: Physiotherapists play a crucial role in the rehabilitation process after surgeries, accidents, or injuries. They help patients regain strength, flexibility, and function, guiding them through a structured recovery program.
Monitoring Progress: Throughout the treatment process, physiotherapists continually assess the patient’s progress and adjust the treatment plan as needed to ensure optimal results.

Top 5 reasons why physiotherapy is essential for active individuals

Active lifestyles put increased stress on our bodies, making them more susceptible to overuse injuries, muscle imbalances, and joint problems. Physiotherapists at Opus Biological specialize in identifying and addressing these issues before they escalate, thus reducing the risk of injuries. They design personalized exercise plans to strengthen weak areas, improve flexibility, and optimize biomechanics, improving performance and efficiency in sports and activities. Moreover, as individuals age, physiotherapy ensures that they can adapt their exercise routines to maintain mobility, balance, and function, allowing them to enjoy an active lifestyle for life. Here are the top 5 reasons to choose physiotherapy to maintain an active lifestyle:

Injury Prevention: Active individuals often engage in high-impact activities that put a strain on muscles, joints, and ligaments. Physiotherapy helps identify areas of weakness, imbalance, or poor biomechanics. Through targeted exercises and corrective techniques, physiotherapists can prevent injuries by strengthening these vulnerable areas, reducing the risk of overuse injuries, strains, and sprains.

Improved Performance: Physiotherapy isn’t just about preventing injuries; it’s also about optimizing performance. Physiotherapists can analyse an individual’s movement patterns, identify inefficiencies, and provide tailored exercises to improve form, strength, and flexibility. This optimization leads to better athletic performance and increased endurance.

Faster Recovery: If an active individual does experience an injury, physiotherapy is essential for a swift and effective recovery. Physiotherapists employ manual therapy, targeted exercises, and modalities like ultrasound or electrical stimulation to speed up the healing process, restoring function and reducing the risk of complications.

Personalized Guidance: Physiotherapy at Opus Biological offers individualized care that aligns with your needs, goals, and physical condition. This personalized approach ensures that active individuals receive tailored advice, exercises, and strategies that address their unique challenges, helping them achieve their fitness objectives while minimizing the risk of setbacks.

Staying Active for Life: Physiotherapy helps adapt exercise routines to address age-related changes, such as reduced joint flexibility or muscle strength. This ensures active individuals can continue enjoying their preferred activities as they age, promoting overall health and well-being.

Managing Injuries Better with Physiotherapy

Photo by Sincerely Media on Unsplash

Preventing injuries is always better than treating them, and that’s where physiotherapy shines. A physiotherapist is a healthcare professional trained to assess and address musculoskeletal issues, identify potential problems, and design personalized prevention plans. By identifying weak areas, poor movement patterns, or imbalances, a physiotherapist can create exercises and strategies to address these issues, reducing the risk of injury.

For active individuals, this proactive approach is a game-changer. It allows you to identify and correct small issues before they become significant problems. It’s like giving your body a regular check-up, ensuring every joint, muscle, and ligament functions optimally. By investing time in physiotherapy, you’re investing in your body’s longevity.

Individualized Care Matters

Photo by Sincerely Media on Unsplash

One of the significant advantages of physiotherapy at Opus Biological is its personalized approach. Every person is unique, and their needs, goals, and physical conditions are distinct. Our physiotherapists work closely with you to understand your specific conditions and design a customized plan that addresses your concerns.

Whether recovering from a sports injury, looking to improve your athletic performance, or seeking guidance on maintaining an active lifestyle as you age, our physiotherapists can provide the tailored care you require. The individualized attention you receive ensures that you’re on the right path, with exercises and strategies that align with your goals, ultimately helping you achieve desired results.

Final Thoughts

Staying active is a beautiful way to maintain your health and enjoy life to the fullest. However, taking a proactive approach is essential to ensure that you can continue being active without unnecessary setbacks. Physiotherapy offers a comprehensive solution, focusing on prevention, performance enhancement, and longevity in your active lifestyle.

By investing in regular physiotherapy sessions at Opus Biological, you’re investing in your body’s well-being. You’re taking steps to prevent injuries, optimize your performance, and adapt your approach to physical activity as you age. With the guidance of a skilled physiotherapist, you can ensure that you’re staying active and healthy for years to come, enabling you to enjoy the activities you love and lead a fulfilling, active life. So, make physiotherapy an integral part of your active lifestyle – your body will thank you for it.

Why exercise is good for your joints

Apr 29, 2024

Photo by Towfiqu barbhuiya on Unsplash

It comes as no surprise that exercise has an endless list of benefits for our body; it reduces the risk of heart diseases, helps maintain your blood sugar and insulin levels, improves your mental health and mood, and increases strength and flexibility whilst reducing pains and combatting fatigue. However, the benefits of exercise for our joints is often overlooked.

The most common example of the advantages of exercise for our joints is in people with arthritis. Let’s look at this in more detail.

Arthritis is a common condition that results in substantial pain and inflammation to the joints, with over ten million people in the UK alone suffering from this condition. It can affect people of all ages and is categorised into different types depending on the location of the inflammation. The most prevalently discussed types of arthritis are osteoarthritis and rheumatoid arthritis, both of which we provide treatment for at Opus. We discuss the types of arthritis in more detail here.

During exercise, people with arthritis and joint pain describe a significant reduction in their pain alongside a notable increase in their range of motion. But how does physical activity exert these effects? Below are five benefits that exercise yields and how this is advantageous to the joints:

Synovial fluid lubricates the joint. Each joint in the body is surrounded by soft tissue, also known as the synovial membrane, that is capable of producing fluid. This fluid acts as a lubricant, enabling the bones at each joint to slide past one another in a smooth motion. During exercise, the circulation of this fluid is increased and, therefore, reduces any pain at the joint.
Blood flow increases. During physical activity, our heart increases at a much faster pace. This results in an increase in blood circulation throughout the body, including at the joints. This exposes the synovial membrane to an increased and steady supply of both oxygen and nutrients.
Joint-repair genes are switched on. This is a relatively unresearched area; however, studies have shown that genes play a significant role in joint repair, with these being activated by physical activity and joint movement.
Cellular waste is removed. During exercise, a process called autophagy is triggered. Autophagy refers to the biological process in which damaged cells are broken down and removed. The build-up of these cells at the joint can often cause severe pain and limits movement; therefore, ensuring these are removed can instantly decrease the pain experienced.
Increase in muscle mass. It is no surprise that exercise strengthens muscles, ligaments, and tendons in the body; this includes those surrounding the joints. When these elements are strong, they behave like a brace, protecting the join from harm. Moreover, physical activity also increases your overall range of motion, enabling your joints to withstand more pressure.

At Opus, we can assess the root cause of your joint pain and recommend specific sports medicine-backed exercises to lessen this discomfort. Beyond this, we also provide regenerative treatments that may provide long-term pain relief. Get in touch to discuss how we can assist you on your journey.

Why are injuries so common in athletes?

Apr 25, 2024

Photo by Jonathan Chng on Unsplash

Sports injuries are extremely common, with figures estimating that amongst the younger population alone, over 3.5 million children and teens are injured each year as part of organised sports or physical activity. This does not even account for unreported injuries. Given their prevalence, it is important that we understand why injuries are more common amongst athletes and those that regularly participate in sporting activities so that we can prevent and treat these accordingly.

A sports injury can occur as a result of several scenarios, including accidents, impact, insufficient training, improper equipment, lack of conditioning, or poor warming up and stretching, to name a few.

Although joint injuries represent the most common site of damage, accounting for both sprains and strains, any part of your body can get injured during physical activity. When we exercise, a significant number of our muscles and tendons are involved; therefore, the chances of developing an injury are much greater.

Moreover, especially during competitive sporting activities, we tend to stretch our bodies and push ourselves farther than we usually would, resulting in us moving in ways that we often wouldn’t. Although this can be harmless, in some instances, this leaves our muscles and tendons torn, damaged, and in pain.

In athletes, the above factors are exacerbated, with the most common sports injuries amongst this population being:

Strains: A strain is defined as an injury to either a muscle or a tendon that primarily results from overuse, force, or stretching. The severity of the injury depends on the nature of its cause, with strains ranging from a simple overstretching of the muscle or tendon to a partial or complete tear.
Sprains: Alongside strains, sprains represent the most common type of injury across all sports, being especially common amongst athletes. A sprain is characterised by a torn muscle or ligament that results from overuse or excessive force, whether that be a collision, a fall, or other causes.
Knee injuries: Damage to the knee joint is most common in contact sports and is usually caused by a sprain, strain or tendonitis. There are a vast number of different conditions that may result from an injury to the knee, including ACL tears, MCL/LCL ruptures, runner’s knee, IT band syndrome and jumper’s knee, anterior knee pain, and patella-femoral maltracking.
Fractures: The most prevalent fractures seen amongst athletes are fractured wrists, hands, collarbones, and bones in the ankle and feet. The highest rate of fractures is seen in contact sports, such as football and rugby.
Tennis elbow: If you experience persistent pain around the outside of your elbow, you may be suffering from tennis elbow. This injury primarily results from overuse of the forearm due to a repetitive or strenuous activity; however, it may sometimes occur following force to the elbow.
Plantar fasciitis: Do you have pain in the bottom of your foot? Or around your heel and arch? This may be plantar fasciitis. Plantar fasciitis is one of the most common causes of heel pain and arises following inflammation of the thick band of tissue that runs across the bottom of your foot, connecting the heel bone to the toes. This injury is most common in endurance athletes, such as runners
Back injuries: It is estimated that 80% of UK adults experience back pain at some point during their lives. Back pain is most common in athletes that participate in sports that have frequent hypertension of the lumbar spine, including gymnastics and football. The primary issue with back injuries is that athletes can cause strain to other parts of their bodies if they change their techniques to reduce the pain experienced.
Concussion: Injuries to the head and neck represent the most frequent catastrophic sports injury, with concussion being the most common athletic head injury. In the UK, an estimated 8.5% of all concussion-related hospital admissions are of sporting origin.

At Opus, we treat a range of sports injuries with our novel techniques, including elbow, hand and wrist sports injuries, shoulder injuries, foot and ankle damage, knee injuries, shin splints and stress fractures, hip sports injuries, neck and back pain, and sprains and strains. Contact us today to discuss your needs and how we can assist you on your journey.

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