Tag Archive for 'physiotherapy'

Consultant Q&A with Mr Fares Haddad- leading knee and hip surgeon

Mr Fares Haddad- leading knee and hip surgeon

Considering having hip or knee surgery?  Make sure you read my interview with top London knee and hip surgeon Mr Fares Haddad.  During Consultant Q&A I ask Fares questions that are on my patients’ minds about his field of hip and knee surgery. If you want to know about latest advances, “lubricating” injections for the knee and more, then please read on.

At BOOST PHYSIO we’ve enjoyed rehabilitating many of Fares’ patients over the years following hip and knee operations and I’ve also had the benefit of watching Fares perform various knee operations-hence we highly recommend him to our patients. If you want to read Fares’ impressive biography and CV follow this link to his website, but in brief Fares Haddad is a Hip and Knee Reconstructive Surgeon at University College Hospitals, The Princess Grace Hospital and the Wellington Hospital.  He is Divisional Clinical Director of Surgical Specialties at UCH, and Director of the Institute of Sport, Exercise and Health at University College London.  Clearly an expert in his field!

Q: Fares, you are well known for being one of a few surgeons to perform key hole surgery for hip problems. Which patients do you find benefit the most from this procedure?
A: 
Hip arthroscopy is a procedure that has expanded dramatically over the last ten years. The indications have become much clearer. The most successful interventions are in cases where there are isolated labral tears or when patients present in the early phases of femorocetabular impingement (FAI) before the joint is irrevocably damaged. FAI is a condition where the bones of the hip joint develop in such a way that the patient can function relatively normally, and often very athletically, but where abnormal contact between the femur and pelvis damages the hip. These are typically in sporting individuals who either suffer an acute injury, the labral tear, or get the insidious onset of symptoms through activity such as running, cycling or football. Plain x-ray imaging and MRI scan gives us most of the information we need although CT scanning is occasionally necessary to look at the bony anatomy. By dealing with the primary bony impingement as well as the problems within joint we decrease symptoms and hopefully also prevent recurrence and further progression of the problem in future. 

Q:  What does the future hold for technological developments in treatments for arthritic hip and knee joints?
A: 
The management of early arthritis of the hip and knee is progressing at an impressive rate. Technical developments will focus in the first instance on prevention thus by replacing the damaged menisci and the damaged joint surface and injured ligaments. The new work on partial resurfacing of joints with novel materials such as Oxinium is very exciting. New work also on customising joint replacement will change the face of the management of arthritis giving us joint replacements that are much more functional and geared to high end activity such as sports. 
 
Q:  Which sports do you believe are suitable for patients following total hip replacement surgery?
A: 
Following a hip replacement operation, we encourage our patients to get back to normal day to day activity within 6 weeks. All non impact sports such as long distance walking, gym exercises, swimming, doubles tennis and golf are encouraged. It is perfectly feasible for patients to play singles tennis or indeed in certain circumstances squash and many of our patients do get back to running but it is important for the patients to realise that there is a tension between the amount of impact activity that they do and the wear that they will cause to their new joint. 

Q:  How effective do you find “lubricating” injections are for arthritic knees?

A:  Our experience of the Hyaluronic acid lubricating injections for knee and hip arthritis has been mixed. There are some patients who have an extremely good response that lasts up to six months. There are others who do not respond at all. It is very difficult to predict. My personal experience is that those patients have dry knees without effusions tend to respond better to Hyaluronic acid therapy whereas those with effusions can respond to aspiration and injection but do so for a shorter period of time.  These are nevertheless interesting therapies which we must continue to pursue both in our athletic population when we often use them after surgery and also in the arthritic population.

I hope that you have found this Consultant Q&A interesting, if you wish to discuss any issues regarding your hip or knee condition with myself or one of my physios, please do not hesitate to contact us, you can call the clinic in Hendon, NW London on 020 82017788 or email us at info@boostphysio.com 

The BOOST Blogger- Steven Berkman

Regards… The Boost Blogger, Steven Berkman

Top 10 Gym Sins?

Sports Injuries caused at gym

Top 10 injuries in the gym

Last week I met with a group of good friends and fellow NW London Physiotherapists and Osteopaths for a delicious Chinese Meal, I mean CPD (Continued Professional Development) event.  Naturally no discussion would be complete without us outlining the top ten gym injuries and BAD exercises … so I thought I’d share it with you…

  1. Dead lifts- why on earth anyone would want to lift a heavy weight with their knees locked and bending from the back is not only beyond me but idiotic!!
  2. Seated Cable Rows ( sitting on floor with feet in front of you)- another lumbar disc injury waiting to happen
  3. Lat Pull downs behind the head- cervical spine injury and disc irritation
  4. Lateral raises with dumbells- impingement syndrome and supraspinatus tendonitis HELLOOOO!!!
  5. Weighted squats- where do we begin with this one ( Lumbar spine, cervico-thoracic junction pain, knee pain, patella femoral pain)
  6. Kettle Bells- the hip in vogue exercise form will do wonders for developing a lumbar disc protrusion or supraspinatus impingement
  7. Vibro-gym / Power Plate- great for aggravating all existing knee conditions, particularly mensicus trouble. Also good if you have a lumbar disc that has almost blown and you really want to speed up the process, do some deep squats while vibrating away at a high frequency
  8.  Step aerobics- that is if you can still find any gym silly enough to still be offering this sure fire way of developing anterior knee pain, patella femoral pain, patella tendonitis or achilles tendonitis
  9. Yoga head and neck stands (Yes I do really think that resting your whole body weight through your neck is  NOT a good idea)
  10. Back Extension machine – do 3 sets of 15reps heavy if  you want to have a lumbar spine facet joint problem and for about 4-6 sessions of physiotherapy

     

Clearly you can see that this is a somewhat glib listing, but please bear in mind that these warnings and concerns are based on actual injuries that I have treated and seen as a direct result of incorrect gym exercises.  If you do have any questions or have an injury related to any of these issues we can certainly help you recover quicker and more fully and prevent any further problems in future.

Call us on 020 8201 7788 or look at our main website www.boostphysio.com

My private physiotherapy clinic is in Hendon, North West London.  And of course we are BUPA and AXA PPP recognised.

Careful gym training- Steven Berkman (The BOOST BLOGGER)

Judo is a dangerous sport- or is it just the pursuit of excellence that’s dangerous?!

Physiotherapy north west london for judo injuries

What allows 1 sports person to escape injury free- and the other to be beset by injury troubles?

A couple of weeks ago I conducted an injury screening for 2 members of the Great Britain Judo team.  I concluded that Judo is a dangerous sport!  This was the week before they were representing GB in a Judo tournament- who knows they may be representing GB at the 2012 Olympics!  How did we come into contact with these Judo players?  Well…

At BOOST PHYSIO we are privileged to be a Talented Athlete Scholarship Scheme  physio clinic (TASS- click here for more info about TASS).  What’s TASS I hear you ask- it is a Government funded programme to support and fast-track young sporting talent, the potential medal winners of the future- and BOOST PHYSIO is one of the clinics looking after these athletes.  Click here to view a Video about TASS.

So during this athlete screening I had to screen 2 female judo players which left me with the philosophical question- why do elite athletes have so many injuries and what leads some to succeed and others not?

One of the girls had broken her arm and her wrist  previously and had a thumb injury, the other had a dislocated thumb – all from Judo.  But these girls were tough- training hard in conjunction with their strength and conditioning coaches.  I wondered to myself- are these injuries simply the consequence of contact sport, or is it something else, perhaps the extreme lengths to which elite sports people push themselves to achieve excellence?  Could an ability to recover better from injury allow one to  to succeed while another fails?

I’ve never seen a 19year old athlete who’s had a steroid injection for an injury before (usually it’s over 30’s and sometimes those in their 20’s), so when I did this hit home and reminded me the extremes to which sports people push their bodies in pursuit of their dreams.

Rafael Nadal’s poor performance at the Australian Open seems to be put down almost entirely to injury from pushing himself too much, some critics even wonder if he’s going to be able to come back in the same way because of his injury problems.  I’ve had to treat injuries of various county level tennis players ranging from 10 to 17 years old.  The one who I think gets pushed the hardest is the 10 year old boy- whether it is him or his mum who does the pushing I am sometimes not too sure- but when kids under 14 come regularly for physio for various injuries one asks the question- is this simply the cost of the pursuit of excellence or is this abnormal.  Furthermore could it be that what dictates whether he will ever make it to Wimbeldon is actually his physical make-up and pre-disposition to injury that may make him miss 1 or 2 critical seasons of training and competition?

A recent article in the Telegraph talks about the mounting concern over the Winter Olympics casualty list and safety of the various sports- it would seem that the sports and events themselves are becoming more extreme, not only the athletes themselves who are pusing the boundaries all the time.  Clearly there is a huge psychological element to why and how athletes push themselves to the extremes.

Enough philosophising- to sum up it is clear to me that to even aspire to elite sporting success requires enormous physical sacrifice and dedication, along with mental tennacity and extreme focus.  But that to succeed in achieving the pinnacle of one’s sport will almost always be dictated by the ability to ward off  serious injury. I firmly believe that those athletes on the winners podium have their genetic code to thank in warding off career stopping injury in what Darwin would call survival of the fittest!

So the reason why I have always achieved sporting mediocrity must be down to my genetic code- it just aint good enough :-)

Icy Winter Injuries- what have we been treating?

Physiotherapy for winter injuries

We've been busy dealing with winter related injuries :-) People who've slipped on the ice and those with winter sports injuries

The icy weather over Christmas and early January led to A+E departments being rushed off their feet with injuries from people and cars slipping on the ice.  Many patients and friends have been asking us what type of injuries have we been treating at BOOST PHYSIO relating to the bad weather… well unfortunately shoulders have born the brunt of these injuries….  here is part of the list:

  • 26 year old man who fell on his shoulder, referred by his GP to see me 4 weeks after slipping and falling on his shoulder (xray was normal).  When I saw him it was immediately apparent that he had a more significant injury than usual, sent him back to GP requesting MRI which has shown an impact fracture to the shoulder and a muscle injury too.
  • A man who fell and dislocated his shoulder (ouch!!)- he is doing well thanks to great treatment by Jolene
  • 2 other men who have fallen onto their shoulders
  • a Snowboarder who has injured his shoulder
  • We have now started having enquiries from patients who broke their ankles or wrists and are coming out of plaster (after 6weeks) so watch this space!

Some of our these experiences have shown how a good musculo-skeletal physio with specialist experience and knowledge will pick up injuries that others will often miss!

Weekend Warriors Watch Out!

Physiotherapy clinic specialising in sports injuries Hendon NW London

Don't be a Weekend Warrior- make sure your fitness level matches your activity level

The key to injury prevention is always in the preparation! The ‘Weekend
Warrior’ patients that we see, are all guilty of doing too little training
during the week and not being adequately fit for playing their sport.

Don’t forget that training should be specific
to your sports, so if you are playing football,
cycling may be helpful but running and
shuttle sprints would be better. The most
common football injuries that are treated at
BOOST PHYSIO are hamstring, calf and groin
muscle injuries.
Most of our patients who have injured
themselves in sport do not warm-up. Spend 10
minutes warming up. Don’t confuse warmingup
with stretching, these are two different
things. Warming up involves aerobic exercise
to raise the heart rate and body temperature
gradually and should include activities specific
to the sport being performed. For sports like
football and netball starting with jogging and
progressing to a faster run for short shuttles
is important. During the last 2 minutes of
the warm up then do specific stretches to
the high risk areas such as the quadriceps,
hamstrings, groin and calf muscles – this
ensures there is sufficient elasticity in
the muscles.
While the research on stretching is
controversial as to whether it actually
reduces the chances of an injury, you will
not find an elite athlete who does not spend
time stretching.