Low Level Laser (LLL)
Low level laser (LLL) is completely non-invasive and painless light wave therapy. It acts to relieve pain, reduces swelling, and stimulates collagen production which is essential for healing. How does it do this? Photobiostimulation. Photobiostimulation improves circulation, reduces inflammation and bio stimulates the body’s cells which stimulates the healing process. Low level laser has over 30 years of high-level published evidence-based research including hundreds of randomised clinical trials and studies. This makes low level laser the ideal application for a broad range of both acute and chronic conditions including acute sporting injuries such as ankle sprains, ligament ruptures, and fractures. Knee injuries such as meniscus tears and ligament tears can also benefit by including LLL in the rehabilitation plan. Improved healing times on overuse injuries such as tennis elbo and shin splints, and reduction of the inflammation associated with bursiitis (both in the shoulder and also the hip). Used in conjunction with other manual therapy approaches, it has minimal contraindications, minimal side effects and little down time, making it a great option to speed recovery and get patients back on their feet sooner.
Therapeutic ultrasound involves the application of high-frequency sound waves to soft tissues via an applicato over the surface of the skin with the aid of a conductor gel. Ultrasound works by creating a thermal effect. When the sound waves pass through the treated area, it causes a vibration of the skin, resulting in a deep heating effect that decreases pain and improves circulation or blood flow to the tissues. Ultrasound therapy has a proven track record of being effective for a multitude of chronic conditions and injuries. Some of the benefits involved are: improving the overall relaxation of soft tissues, decreasing chronic pain, increasing blood flow and circulation, reducing swelling and inflammation and enhancing the breakdown of scar tissue which is very important when an injury has been around for a while. Some of the applications of the ultrasound technology include chronic hamstring tendinopathies and rotator cuff tendinopathies which require increased blood flow to speed the healing process.
This is an older technology, however still relevant and combines well with other physical therapy applications and rehab protocols.
Radial Shockwave therapy is a high powered ultrasound, which is a well studied, evidence-based application for musculoskeletal conditions. It is clinically proven that pressure waves, when applied to injured tissues, stimulate metabolic reactions. Shockwave therapy reduces pain felt by nerve fibres, increases circulation in the surrounding soft tissues and stimulates the healing process triggered by stem cell activation. Shockwave therapy applied weekly (usually for up to 6 sessions) is effective for chronic conditions such as Plantar fascitis, achilles pain, shin splints, hip pain, multiple forms of tendiopathy, entesopathy, faciopathy, muscle tear, trigger points, or spasms. Shockwave therapy is used in the management of chronic injuries where fibrotic scar tissues have formed, the injury is either unresolved or remains adhesed by this resultant scar tissue such as old hamstring tears and rotator cuff tendinopathies.
The results of the Shockwave therapy can be enhanced in combination with LLL , physical therapy and rehabilitation protocols. The shockwave machine of choice at our clinics is the EMS Doloclast which is the Gold Standard in terms of evidence based practice with over 30 level 1 clinical trails supporting its efficacy.
NMES (Neuro Muscular Electrical Stimulation) is a device that sends electrical impulses to nerves causing muscles to contract. It is an incredibly safe and well researched treatment option which is an effective adjunct to exercise-based therapy and uses surface electrodes to deliver a low-amplitude current to stimulate affected muscles. These muscles may be weakened or inactive due to injury, post surgical or following a period of immobility. . This device is used in functional recovery following surgery, to prevent disuse atrophy, reduce ROM dysfunction and improve motor control in patients with strength deficits.
During a normal voluntary muscle contraction, type 1 muscle fibres are recruited before type 2 fibres. The NMES performs this recruitment in the reverse order. Its function is unique in stimulating the larger and more superficial type 2 motor units first as they offer a lower resistance to electrical stimulation which can accelerate strengthening and shorten rehab times. This makes the NMES an excellent addition to your management plan for those who want to get back to doing what they love in a fraction of the time.
Since the inclusion of NMES at the clinic, we have found the neuromuscular electrical stimulation very effective rehabilitation of acute sporting injuries and post-operative orthopaedic injuries that have been immobilized, with excellent results showing improved muscle strength testing following its use.
This is our Chattanooga Triton Traction table. Traction is viable option that can be used in to relieve pain and reduce pressure on intevertebral discs associated with various spinal injuries and pathologies. The techinque of traction applies a longitudinal force to the spine and the associated structures, assisting the nucleus pulposus to retract back into the disc, with the aim of relieving compression and irritation of the exiting nerves, helping to relieve symptoms like peripheral nerve pain, sciatica and lower back pain. Traction can be used for many injuries such as protruding discs, discs bulges, herniated discs and degenerative disc disease. The Triton traction has the facility to accommodate both lower spine traction or neck traction with a specialised attachment.
This is a very safe and gentle approach to the application of traction which is applied in a specific measured protocol to suit our individual patient’s needs.
The Traction can be used in combination with other treatment approaches such as the LLL which has proven to be a very effective protocol for disc management, and can form part of a rehabilitation protocol and management plan.
We support our patients rehabilitation with all forms of Osteopathic manual therapy, including deep tissue release, myofascial trigger points, soft tissue mobilization, muscle energy techniques (MET), stretching and manipulation. Some or all of these techniques can be combined with other applications for the best results for our patients.
Specifically, manipulation or High Velocity Low Amplitude (HVLA) manipulation which patients often refer to as ‘cracking’ or ‘clicking’ is a fast and painless technique which adjusts a joint to instantly correct the position. This can provide immediate relief at the joint and also surrounding muscles by optimizing the nerve supply and relaxing muscles which attach to that joint.
Common presentations such as neck pain and headaches can benefit from deep tissue release combined with dry needling and manipulation for instant relief and optimal lasting results. Our patients love these synergistic benefits, which single applications may not be able to provide in isolation.
Other presentations which benefit from this approach, include lower back pain, ergonomic over-use injuries, chronic sporting injuries, stress related pain and tension, and injury prevention for professional athletes and sportspersons.
Trigger Point Dry Needling is active needling which uses an acupuncture needle to target myofascial trigger points (which are often tender points) in the muscle fibres. Dry needling activates a neuromuscular “twitch” reflex which releases tension almost instantaneously. The technique of ‘feathering’ the needle enhances this mechanism to more effectively release muscle fibres via this activated twitch response. A tingling or twitching effect can be felt during the needling which is often an unfamiliar sensation, but rarely painful.
We find dry needling to be one of the single most effective methods of releasing deep tension for our athletes (and non-athletes alike!), which may have failed to respond to other conservative methods or manual therapies. Areas which respond well to dry needling include the traps muscles and the shoulder region, muscles of the neck, lower back muscles, deep calves and quads, IT bands for lateral knee pain, forearms for tennis elbo and everything in between!
Modern myofascial cupping is a painless cupping method, used to decompress and release fascia (connective tissue) which has become adhered (stuck together) and not allowing free flow of movement. The cups are placed on the skin surface with gentle negative pressure (vacuum) to the underlying fascia which is affected by gliding the cups while maintaining the pressure. The cupping can be very effective for generalized lower back tension, athletes with tight calves and hamstrings or runners with IT band tension. The cups are particularly beneficial for our patients with scar tissue resulting from injury or post-surgical incisions when the acute healing phase is resolved. Gliding the cups over the scar tissue can untether some of the fibrous scarring and allow more free movement. Eg scar tissue due to a chronic hamstring tear can experience improved range of motion post myofascial cupping.
Sports Taping and Bracing
The effective use of both rigid and sports (kinesio) taping are an important part of acute injury management. We include deloading tape regimes for injuries such as hamstring tears, rotator cuff injuries, acute lower back spasms, knee pain and rib strains. This assists to both support and off-load the effected area until the acute stage has resolved. The rigid taping applications are reserved for injuries involving ligaments, such as acute ankle sprains and collateral ligament injuries of the knee and elbo to support and limit the painful range.
Our patients also benefit from the regular prescription of corrective bracing which is included as an adjunct to exercises and regular physical therapy.
Technical bracing is prescribed for injuries such as acute and chronic knee injuries, tennis elbo, lower back and chronic postural weakness. Our prescribed postural supports are supplied by our partners PostureFit (posturefit.com.au) which can also be fitted by friendly reception staff and do not require an appointment with our Osteopaths.
Bracing and taping can provide positive bio-feedback to restore function and correct muscle engagement eg postural bracing, as well as enhance proprioception (positional awareness) which effects balance and stability eg ankle bracing.
Compression sleeves and socks are also often prescribed as part of our rehabilitation protocols.
Research-based exercise rehabilitation is included as part of the management plan for our patients to ensure complete recovery from acute sporting injuries and chronic conditions. Exercises involving therabands, swiss balls, free weights, resistance bands and the pilates reformer may be incorporated into each session. Mobility, Strengthening and Stability are key to achieving the best outcomes for all our patients. We aim to empower our patients with this knowledge and the ability to effectively rehabilitate, manage and prevent further injuries in the future with appropriate exercise prescription.
We support our patients participation in a wide variety of sports such as golf, swimming, soccer, martial arts, running, triathlons, gymnastics, cross fit, surf boat rowing, surfing, boxing at both professional and also social levels. Common acute sporting injuries sustained by our patients include hamstring tears, ankle sprains, knee injuries,rotator cuff tears, rib strains, calf tears and IT band pain, acute fractures, strains, pains and everything in between . We also rehabilitate chronic and recurrent presentations such as plantar fasciitis, tennis elbo, rotator cuff tendinopathies, hamstring strains, core instability, muscle weakness and imbalances, growth related conditions and also specialised post surgical rehabilitation protocols. Each management plan is created to support the individual patient needs, expediting the recovery process and return to activity as soon as possible.
Words and gratitude can’t explain how relived I was to find these amazing guys. I can honestly say I was broken when I walked in 8 months ago and now I have my working body back. From the beautiful Mel at the front counter to Brodie my amazing sounding board and osteo and James who has the best mirror to fix my make up and hair. Love you guys. My Osteo family. Also thank you to Tracey who started my osteo journey. X