Seddon Physiotherapy

07/08/2025

Arthritis:
• Arth = Joint
Itis = Inflammation
• There are more than 100 types of arthritis, but not all are inflammatory
• Affects bones, muscle and joints
• Incidence – F:M = 2:1
• One of the major health initiatives of the Government and affects more kids than CP and diabetes

Role of the Physiotherapist in Arthritis Management:
• Aim – To regain and/or maintain mobility and function
• What the Physio can treat in a patient with arthritis:
o Contractures
o Decreased ROM
o Instability
o Decreased proprioception
o Altered gait patterns and poor posture
o Pain
o Swelling
o Muscle weakness
• Role of the Physio:
o Treat specific problems as necessary
o Assist with goal setting
o Monitor (using objective measures over time) the patient’s progress
o Develop an appropriate exercise plan
o Advise the patient regarding progression
o Ensure the patient performs the exercises correctly
o Keep tasks functional
o Increase compliance with supervision
o Encourage exercise options outside of Physio programs

04/08/2025

ACL rehab
• 8-12 weeks = Muscle strength phase:
o Strengthen calf and hamstrings
o Proprioception exercises
o Water exercise
o Commence running (on treadmill) if there’s no anterior knee pain, painfree lunge and hop and no effusion
• 3-6 months = Sports specific jumping, plyometrics and agility training phase:
o Agility and speed drills (specific to the sport the patient wants to do)
o Jogging/sprinting
o Cutting
o Landing control
o Functional activities of sport

31/07/2025

• 2-5 weeks = Early conditioning phase:
o FWB
o Ice
o PFJ mobilisation
o Muscle stimulation
o EMG (especially with VMO dysfunction)
o Sustained mobilisations to increase ROM (aim for 0°-100°)
o Stretch calf and hamstrings
o Strengthen LL (e.g. use theraband, gym equipment)
o Closed chain exercises (e.g. fitball, stepper, bike)
o Calf raises
o Proprioception exercises (e.g. SLS on different surfaces)
o Hydrotherapy
• 5-8 weeks = Progressive muscle control, beginning dynamic stability phase:
o FWB
o Electrotherapy
o Exercise bike, stair master
o PFJ mobilisation
o Passive mobilisations
o Stretches
o Half squats (fitball against wall altering foot position)
o Calf raises
o Step ups (with weights) or step downs
o Strengthening exercises for hamstrings and calf (e.g. leg presses on machine)
o Proprioception exercises (e.g. rockerboard, foam)
o Water exercise

24/07/2025

ACL Reconstruction Rehabilitation Guidelines:
• 0-2 weeks = Early post-op phase:
o PWB
o Zimmer splint (?)
o Ice
o PFJ mobilisation
o ROM exercises:
 Passive extension exercises:
- EMG
- Leg press-type action into an exercise ball
- In long-sitting, hands underneath and squash quads
- In sitting on an exercise ball, sitting squats
 Passive/active flexion exercises
o Exercises to regain control of hamstrings and quadriceps
o Increase proprioception

17/07/2025

Why is there a fracture in my knee after ACL?
When the knee hyper extends or twists suddenly the femur and tibia bones hit each other and can cause a fracture in the cartilage and/or bone.

Usually this requires no management and will heal on its own.

10/07/2025

26/06/2025

Do you know what the most common muscular injury is?
80% or more of people will at least once injure their back in their life.

How can you help prevent back pain?
1. Strengthen your back
2. Stretch your back
3. Be mindful of postures that place more stress on your back
4. Lift and move correctly. Use your legs to lift.

19/06/2025

Neck tight and sore?
Grab a Heat pack $30.

18/06/2025

Foam Roller- Great for releasing muscle tension. $26
Exercise bands- strengthen those glutes. 5 pack $25

09/06/2025

Treatment principles for PFPS (Knee pain):
• Multifactorial treatment (as it’s a multifactorial problem)
• Careful assessment is required
• The PFJ needs to be treated as part of a kinematic chain (i.e. look at the joints above and below)
• Address training factors
• Consider behavioural aspects (i.e. compliance, fear-avoidance, hypochondria, anxiety)
• Conservative treatment is successful in ~90% of cases
Treatment of PFPS using the McConnell approach:
• Taping
• Muscle retraining
• Soft tissue stretching
• Correction of lower limb biomechanics

03/06/2025

Training factors in Knee pain:
• Overloading
• Too much, too soon in terms of:
o Rate
o Intensity
o Duration
• Problematic during growth spurts (as changes take a while to stabilise), due to:
o Increased weight
o Decreased relative strength
o Decreased flexibility
• Changing biomechanical environments (e.g. changing surfaces, footwear etc)

29/05/2025

Patellofemoral Pain Syndrome (PFPS):
• Describes diffuse (i.e. scattered) pain around the anterior or retro patella
• Results from changes to the PFJ
• Aggravated by activities that load the PFJ (e.g. stairs, squats, prolonged sitting, running)
• Onset – Insidious (or can be preceded by an acute traumatic event)
• Prevalence:
o Girls > boys (36% of 14 year old girls)
o Common during adolescent growth spurts
• Causes – Unclear (i.e. articular cartilage? subchondral bone? synovium? medial/lateral retinaculum? fat pad? muscular trigger points?)
• Predisposing factors:
o Abnormal biomechanics:
 Increased Q angle
 Patella alta/baja
o Soft tissue tightness (i.e. gastrocs, hamis, quads, ITB, lateral retinaculum)
o Muscle dysfunction (i.e. VMO, gluteals, abdominal stabilisers, foot supinators)
o Training factors