Monday, March 31, 2014

Pes Anserine Bursitis, or "My knee hurts!"

Knee and back pain are kinda like a really good steak: everyone has experienced it, or at least knows someone who has. The types with flashy names like "runner's knee" (patellofemoral pain) or "lumbago" (lower back pain) get all sorts of attention, but what about poor old "hurt goose's foot"?! An awkward way of describing for anserine bursitis, it doesn't really tell you what's going with your knee, does it? Not to worry, that's what we're here for.

Because it often pops up right alongside other knee problems (MCL tear anyone?), this injury is often overlooked. The "goose's foot" refers to the pes anserinus, the conjoined leg tendons that connect to your tibia, just below your knee cap, on the inner side of your lower leg. They're most there to flex the knee, but also stabilize it side-to-side.

Guess it's not surprising then that pes anserine injuries are found most commonly in young individuals playing sports with lots of side-to-side movement. Risk is also increased in people with tight hamstrings, who overpronate when running, or who are obese. Pain normally creeps in when going from sitting to standing or climbing up stairs, but walking along a flat surface feels just fine. Especially when the injury is due to some feat of athletics, the pain can occur when stretching the hamstrings or reproduced with some stretches by your physiotherapist.

Not a young buck but still struggling with knee pain you think might fit that description? Pes anserine bursitis also occurs in older patients with articular cartilage damage. It often coincides with osteoarthritis of the knee, increasing the severity of pain and functional limitations.

So, hurty knees, what are you going to do? No matter the knee pain, it's important to have it diagnosed, since there are SO many different things that could be going on. If it is pes anserine bursitis the first thing you'll likely be prescribed is rest. Anti-inflammatory medications will help with swelling and pain, but won't fix the problem. Physiotherapy is what you'll need to correct the biomechanics that lead to your injury, and ultrasound or electrical stimulation will also help reduce inflammation.  Take action now and count your lucky stars: the need for surgical intervention is rare for this injury!

Wednesday, March 19, 2014

Thumbs...down. Skier's thumb is no fun.

Winter just. won't. end. Good! That means you're all still skiing, and today's post is still relevant. 

Kidding! Of course this post is relevant, it's about an injury commonly know as skier's thumb, but it doesn't actually discriminate. We're referring to a tear of the ulnar collateral ligament in the thumb after an extreme force pulls the thumb away from the palm of the hand. That extreme force could be you hurtling down a mountainside with a ski-pole in hand, bailing, and falling while holding onto the aforementioned pole. Or you could've been rock climbing, or you might've caught a ball funny, or were playing a ridiculously violent game of rock-paper-scissors. Doesn't matter how it went down, we're going to talk about your sore thumb.

About that thumb, it's sore, yeah? Feels weak when you pinch or pick things up? See a bit of bruising around the joint? Run your other hand along it and maybe feel a little bump? Take a deep breath, and don't panic. Our physiotherapists know just what to do.

If it's a minor tear and you get in right away, you'll probably be right as rain after a few physiotherapy sessions. You may need to immobilize your thumb with sports tape when doing activities, and your physiotherapist can give you some guidance. If your injury is more serious, you may need to immobilize the thumb with a "thumb spica" cast for a few weeks. Immobilization is important to let the ligament heal, and then treatment to help get your strength and range of motion back can begin.

Think you've got a case of skier's thumb? Give any of our clinics a call to see a physiotherapist. Otherwise, thumbs up for a few more days of skiing!