Ankle sprain:

Missing a step, stepping into a pothole – Next thing you see your ankle swells up, blue and black below the ankle. A trained physiotherapist is able to provide a proper diagnosis of soft tissues injuries you sustain from ankle sprain and advise if you need an X-ray to diagnose an ankle fracture.

Recovery time: Everyone will ask ‘do I need an X-ray after an ankle sprain?’ The answer is if you’re able to bear weight, taking more than 4~5 steps, you do not have an ankle fracture, so X-ray is not needed. After sustaining a minor ankle sprain, you can start your physiotherapy immediately after your sprain and it will take 6~12 weeks to return to sports.

Why Rehab: Because early weight bearing is encouraged for minor ankle sprains, complete rest is not the best treatment, get the soft tissue injuries diagnosed and treated, which allows you to regain confidence in your ankle’s ability and to generate higher level of force needed for your sports demand.

Treatment Approach:

• Acute ankle sprain – The patient should be treated from day 1 of the injuries and gets treated daily for the first 2 weeks, a few minutes of deep friction is ample, more than 2 weeks of deep friction treatment is seldom needed.
• Chronic ankle sprain
• Taping technique

Ankle/Foot Fracure:

A fracture is an interruption of the continuity of bone. Ankle fractures almost always occur following a traumatic event. Automobile accidents, falls, sports injuries and even a sprain can all lead to ankle fractures. Common signs of an ankle fracture include pain, swelling, bruising, and an inability to bear weight on the broken ankle even for a few steps.

Recovery time: Most patients with an ankle or foot fracture require 6 weeks of immobilisation depending on the fracture type/severity. Patients with an initially non-displaced fracture or who were treated surgically will generally require 4 weeks of non-weight bearing in a short-leg cast or removable walking boot, followed by 2 weeks in a walking cast or boot.

Why Rehab:
Wolff’s law states that bone grows and remodels in response to the stress that is placed upon it. Therefore, applying the right stress in the correct direction can help to ensure that maximal bone healing occurs and that your fractured ankle will function properly

Treatment Approach:
Soft tissue manipulation to reduce the chances of heterotopic ossification which is the process whereby bone tissue forms outside the skeleton.

Joint mobilisation for adjacent joints such as toe and knee joint can help to maintain range of movement and prevent joint stiffness 

Electrotherapy and also exercise therapy aimed to prevent muscle wasting by strengthening lower limb muscles 

Taping to support the injured ankle 

Aircast walking boot is used to immobilise the fracture, and to allow injured soft tissues to heal in the shortened position rather than a stretched position.  

Back Pain:

Wake up with back pain, pain can travel down into the leg, and you feel more pain when bending forward to wear pants, to put on your socks, these are the signs and symptoms recognized as lumbar nerve impingement.

 Lumbar Impingement  Recovery time: Back pain can be associated with sciatica of the lower limb, where the lumbar disc and nerve
root are inflamed. 3~4 sessions of manual therapy in the first 2 weeks should be able to improve the symptoms and allow you to bend forward with better range. Next, back strength exercises and motor control can be the interventions to minimize risk of recurrence of your back pain.

Why Rehab: Because we can combat this inflammation with lumbar spine mobilization and nerve sliding technique by increasing mobility of the nerve itself hence desensitizing the nerve which helps to disperse inflammation around the nerve and get you out of back pain.

Treatment Approach: Lumbar spine PA glide | Lumbar rotation stretch | Lumbar spine mobilization | Sciatic nerve flossing | Dry needling

Bunion:

Bunion is also known as a Hallux valgus, is one of the most common forefoot deformities. It often becomes red and painful and can disrupt daily activities. Bunion happens when proximal phalanx pronates and deviates laterally, while the first metatarsal head deviates medially. If correctly identified and treated, the symptoms will vastly improve.

Recovery time: If surgery is indicated, bunion require 6-12 weeks of post-op rehabilitation, scar mobilisation, wound healing regime, foot muscle work out are implemented to regain optimal foot function again.

Why Rehab: Controlling the extrinsic factors such as wider shoes, orthotics, night splinting and also exercise therapy will be the first option. If conservative treatment proves ineffective, bunionectomy or bunion correction surgery is the next recommended course of action. Physiotherapy rehabilitation after surgery is equally important.

Treatment Approach: Bunion Corrective Exercise | Flat foot corrective exercises | Post Operative Scar and Joint Mobilization | Ultrasound Therapy

Flat Foot:

Flexible flat foot is the most common. You can see the arches in the feet when you aren’t standing. The arches disappear when you put weight on the feet. When you extend your big toe, the arch appears in that position therefore indicates strengthening of foot intrinsic muscles could be effective in correcting your flat foot. A person with rigid flat foot has no arch when standing (putting weight on the feet) or sitting (no weight on the feet). There is a missing arch upon extension of the big toe, therefore indicating insole fitting in the footwear might be needed to provide some support to your foot arch.


Recovery time: For a flexible flat foot, you will need to consistently work on your foot strengthening to rebuild your foot arch. Whereas for a rigid flat foot, once you start wearing your insole, you will be taking 2 weeks to 3 months time to get used to the insole, and get your foot assessed every 6 monthly for adjustment if needed.


Why Rehab:
Because Excessive Pronation flattens the foot arch and potentially causes:

• Plantar fasciitis
• Achilles tendonitis
• Morton’s Neuroma
• Posterior tendon tendinopathy
• Hallux Valgus

Treatment Approach:
Flat foot exercise:

• Posterior tibialis strengthening
• Foot intrinsic muscle strengthening
• Big toe extension exercise

Insole assessment:

• Resting Calcaneal Stance position (RCSP)
• Neutral Calcaneal Stance Position (NCSP)
• Leg Length Difference
• Tip Toe Test

Hamstrings Strain / Tear Injury：

Sprinting with / without the ball is the most common mechanism of Hamstrings Strain Injury. Hamstrings Strain Injury often occurs from quick acceleration / decelerations that badminton players must do during the strokes.

Recovery time: (A) Short-tau inversion recovery (STIR) image of the initial injury showing extensive increased signal intensity at the musculotendinous junction of the musculus biceps femoris (arrow). (B) T1-weighted image of the same initial injury showing no abnormality. (C) T1-weighted image at return to play showing an increased area of low-signal intensity at the site of the injury, indicating fibrous tissue formation.

Why Rehab: We cannot change how much time you spend in high speed running, how much aggressiveness involves accelerating / decelerating of the sports you play. However, we can rehab the hamstrings strain to adapt the athlete to sustain those types of loads and demands without incurring injury risk.

Treatment Approach: Taping | Dry Needling | Exercise Therapy

Neck Pain:

Wake up with neck pain, pain can travel down into the arm, and you feel more pain when rotating your head to the painful side, not able to rotate your head all the way into the painful side, you are then recognized to have cervical nerve impingement and it’s treatable with physiotherapy.

Recovery time: Cervical nerve impingement recovery time, it’s essentially the sciatica of the upper limb, by which your cervical disc and cervical nerve root are inflamed. 3~4 sessions of manual therapy in the first 2 weeks should be able to get you out of pain largely, and allow you to rotate your head to the symptomatic side. Next, neck strength exercises and motor control can be the interventions to minimize risk of recurrence of your neck pain.

Why Rehab: Because we can combat this inflammation with cervical spine mobilization and nerve sliding technique by increasing mobility of the nerve itself hence desensitizing the nerve which helps to disperse inflammation around the nerve and get you out of neck pain. Also, a successful cervical impingement treatment leaves you less chance to develop arthritis osteophytes which lead to future nerve root irritation.

Treatment approach: Cervical traction | Lateral glide | Cervical facet joint upglide | Nerve slider

Plantar Fasciitis:

Plantar fasciitis is a common condition that causes pain in the heel or the bottom of the foot. Plantar fasciitis is most commonly seen in middle-aged people, but it can occur at any age. Plantar fasciitis is most commonly seen in middle-aged people, but it can occur at any age. Half of the heel spurs are not painful/asymptomatic, therefore this is a finding, not a diagnosis.

Recovery time: The recovery time for plantar fasciitis can vary depending on the severity of the condition and the individual’s response to treatment. In most cases, plantar fasciitis can be successfully treated with conservative measures and the pain will gradually improve over time. However, it may take several weeks to several months for the symptoms to fully resolve.

Why Rehab: Because wearing insole/taping technique and combined with slow heavy resistance training have shown to have greater odds of recovery. Slow heavy resistance training coupled with appropriate return to running programs enable to improve capacity of the tissue to handle load, and also there is no inflammation found sin the chronic Plantar fasciitis so NSAIDs is not helping in this case, we shall stop targeting the inflammation.

Treatment Approach: Taping technique | Shockwave therapy | Slow heavy resistance training | Return to running protocol

Scoliosis:

Scoliosis is a complex three-dimensional deformity affecting the spine and the trunk. Scoliosis occurs in functional and possible structural changes in the three planes of the body. Therefore, to interrupt the circular process of scoliosis progression, the main therapeutic aspect is to reduce the asymmetric loading on the spine and its effects for the body statics and the postural and structural adaptations before the end of skeletal maturity.

Recovery time: Treatment also includes teaching and planning scoliosis specific exercises and breathing techniques following the principles of Schroth Posture Variations to enable and encourage patients to perform a home-exercise program and achieve postural changes in activities of daily living. The intensity of the treatment program has to be individually tailored to the exercise capacity of the patients and the inherent risk of progression. Motivation, compliance, commitment, and discipline of the patients are following a deep understanding and the recognition of the main focus on long term postural changes. Therapists should be able to accompany patients sometimes for months, years even lifelong.

Why Rehab: Conservative scoliosis treatment is targeting towards deceleration or prevention of progression to avoid bracing in cases with a low risk of progression and most important preventing surgery. Most impactful goal is to restore trunk symmetry and hence improve the patient’s cosmetic appearance and self-confidence.

Treatment Approach: Schroth postural training | Schroth exercises | Schroth manual techniques

Tennis Elbow:

Tennis Elbow also known as lateral epicondylitis, is a painful condition that occurs when the tendons that connect the muscles of the forearm to the elbow become inflamed or damaged. Undersized, too heavy racket, excessive gripping can result in tennis elbow.

Everyday uses: Typing, meal prep, knitting, playing an instrument can also result in Tennis Elbow.

Recovery time: Recovery time for tennis elbow can range from a few weeks to several months or longer. It’s important to work closely with your physiotherapist to develop a treatment plan that is tailored to your individual needs and goals.

Why Rehab: The strongest evidence we have to date is that a progressive exercise approach which has been shown to not only increase pain free grip strength but also pressure pain thresholds combined with use of mobilization with movement.

Treatment Approach: Cross friction massage | Dry needling | Mulligan technique | Diamond tape of the elbow | Exercise therapy