How alcohol and dehydration can slow down your injury rehab

Let’s face it, the Christmas and New Year period is one where Australians overindulge in lots of the things that aren’t necessarily great for our bodies. Alcohol, cigarettes and endless plates of delicious leftovers are more likely to find themselves on the menu and on top of leaving you with a crook guts, these things can also hamper your rehab efforts.

What are the effects of alcohol on rehabilitation?

According to recent research from the Australian National University, during COVID-19, 1 in 5 Aussies increased their alcohol intake over the lockdown months. Going by ABS data, this means that in 2020 Australians have spent an average of $1891 on alcohol – up $270 on 2019.

That’s the equivalent of at least 2 gym memberships on alcohol.

Alcohol can have many effects on physical and mental performance;

  • Decreasing reaction time and
  • Hand-eye coordination
  • Speeds up dehydration
  • Increases blood pressure (Do not consume alcohol before a workout)
  • Slows down muscle recovery
  • Blood glucose levels can be affected, leading to hypoglycaemia

Imagine you’ve just come off the backyard cricket pitch injured with a side strain, there is some swelling and your shoulder is feeling very sore.

You notice there are drinks in the esky and you decide to have a few. Maybe a few more.

It is known that alcohol – no matter how much you indulge in – increases the bleeding and swelling around injured soft tissue. The alcohol is thinning your blood which makes the blood run faster to the injured area, increasing the swelling and the amount of toxins that will stay around the injured site which in turn will significantly delay healing.

This small injury that could have been looked after in a week or two with the R.I.C.E method and some physio, could now take four to five weeks due to alcohol and poor injury management.

The alcohol will also likely mask the pain you are feeling at the moment, increasing the chances of you standing or dancing on the injured area which again will increase the bleeding and swelling around the site.

If you are not sure whether or not your injury is “that bad” then it is best to be on the safe side and seek the advice of a musculoskeletal physio any way.

What are the effects of dehydration on injuries and rehab?

Alcohol consumption and the hot Aussie summer is a recipe for dehydration. Dehydration can contribute to several issues which have a negative effect on sports injuries, including:

  • Slower rate of nutrient absorption
  • a build-up of waste products such as lactic acid
  • thickening of the blood
  • impaired ability to regulate your body temperature

These dehydration effects mean that the body will not be able to get rid of toxins effectively and will not be able to get the body’s healing nutrients to the injured area fast, delaying the healing phase of your injury and causing you to spend more time out of action.

We’re not telling you not to drink, just remember that your injury is being affected by the alcohol you are consuming along with dehydration. It may add extra rehab to that healing time-frame your Physio gave you originally though…

If you have an injury that is not healing at the rate you would expect don’t hesitate to book in to see one of our Fixio physios.


AC joint injuries and how physiotherapy treats them

Your acromioclavicular joint (or AC Joint) is located at the top of your shoulder between your clavicle (collarbone) and your scapula (shoulder blade) and is essential in allowing overhead and across your body shoulder movements.

What are the types of AC joint injury?

AC joint disorders can be classified into acute injuries, repetitive strain injuries and degenerative conditions. The diagnosis of an acute AC joint injury (sometimes referred to as a sprain or “separated” shoulder) is often straightforward due to the presence of tenderness, swelling, and deformity.

AC joint disorders from overuse, inflammation, or chronic degeneration can be more difficult to diagnose, particularly if other shoulder problems exist.

Overuse injuries — The AC joint is subject to inflammation from repetitive motion and stress, particularly activities involving an outstretched arm moving across the body.

Acute injuries – Acute AC joint injuries are most common in people younger than 35, with males sustaining more traumatic AC joint injuries than females.

Because younger athletes are more likely to participate in high-risk and collision activities, such as rugby league, biking, and snow sports traumatic AC joint injuries occur most often in this population.

AC joint injuries can be caused by:

  • Falling directly on the outside of the shoulder
  • Colliding with another player in a contact sport
  • Falling onto an outstretched hand
  • Lifting heavy weights overhead

A traumatic impact can push the top of the shoulder blade underneath the end of the collarbone, damaging the capsule surrounding the AC joint and the ligaments which support the joint.

What are the symptoms of an AC joint injury?

AC joint ligament damage can vary from a mild strain of one or more of the surrounding ligaments to complete ligament tears and deformity. The first sensation felt when the AC joint is injured is pain on the top of the shoulder. After this, you may also have a mix of:

  • A visible bump above the shoulder
  • Swelling and tenderness over the AC joint
  • Loss of shoulder strength
  • Loss of shoulder motion
  • A popping sound or catching sensation with movement of the shoulder
  • Discomfort with daily activities that stress the AC joint, like lifting objects overhead, reaching across your body, or carrying heavy objects at your side

AC joint injuries can be identified and effectively treated by a physiotherapist. 
It is advised that all AC joint injuries are fully assessed by a physio in order to prevent ongoing shoulder pain and an increased risk of re-injury when you return to normal activities.

Your Fixio physio will examine your shoulder and assess your sensation, motion, strength, flexibility, tenderness, and swelling. They will then perform several tests and may also ask you to briefly demonstrate the activities or positions that cause your pain.

Your neck and upper back will also be examined to determine whether they, too, might be contributing to your shoulder condition through referred pain processes.

How can physiotherapy help treat an AC joint injury?

Physiotherapy for an AC joint injury is very important. Once an injury to the AC joint is diagnosed, your physio will work with you to develop a bespoke plan tailored to your specific shoulder condition and your goals. There are many physio treatments that have been shown to be effective in rehabilitating AC joint injuries, including:

  • Range of Motion –  An injury to the AC joint often causes swelling and stiffness, causing loss of normal motion.
  • Strength Training –  After an AC joint injury, your physiotherapist will design a bespoke exercise program to strengthen the muscles around the shoulder, so that each muscle is able to properly do its job.
  • Manual Therapy – Physiotherapists are trained in hands-on therapy and will gently move and mobilise your shoulder joint and surrounding muscles as needed to improve their motion, flexibility, and strength.

If you have any questions regarding your AC joint injury (or any other condition), please contact your Fixio physio to discuss and organise an appointment to get your recovery on track.


De Quervain’s Tenosynovitis

De Quervain’s tendinopathy is a mouthful of a condition that causes pain along the thumb side of the wrist, swelling, decreased grip strength, and restricted thumb movements.

It inflames the sheath (the synovium) that surrounds the two tendons that are involved in moving your thumb and can be very painful if left untreated.

What causes Tenosynovitis?

In 1892, the 13th edition of Gray’s Anatomy first described this tenosynovitis as “wrist sprain of washerwomen”. A Swiss surgeon, Fritz de Quervain went further in 1895 and published a report on five cases of first dorsal compartment tenosynovitis and the condition has taken his name ever since.

While the exact causes are long and debated, repetitive activities requiring sideways movement of the wrist while gripping the thumb and modern handheld electronics have been shown to cause De Quervain’s tenosynovitis.

Who is most at risk?

De Quervain’s tenosynovitis occurs most often in individuals between 30 and 50 years of age and is at least 5 times more common in women. It commonly occurs in mothers with young infants due to a combination of overuse and hormone-related tendon swelling, and those in sports and jobs with repetitive movements.

What are the signs and symptoms?

Symptoms are typically of gradual onset, but may develop suddenly and pain located over the thumb side of the wrist, radiating up to the forearm and swelling is common. It is worse with use of the hand and thumb, especially forceful grasping, pinching and twisting. There may be swelling at the site of pain and “snapping” when the thumb is moved. Due to pain and swelling, thumb movement may be reduced.

How is De Quervain’s tenosynovitis diagnosed?

The Finkelstein test is a simple way physiotherapists diagnose De Quervain’s. It is performed by placing your thumb down into the palm of the same hand, making a fist around it and then bending the wrist towards your little finger. If this exacerbates the pain at the base of your thumb, this is considered a positive test and likely that you have De Quervain’s. X-rays are not usually required for diagnosis.

What is the treatment for De Quervain’s?

Injuries of the hand and thumb can be challenging, since we use them in our daily lives, healing time can take a little longer. Typical physical therapy management of de Quervain’s disease and other wrist disorders consists of:

Rest – As best as possible, try and limit the movements that aggravate symptoms and give it some time to settle down

Splinting – An off the shelf or custom made splint can help your thumb to rest by limiting its movement

Physiotherapy for De Quervain’s

First of all, your Fixio physio is going to check the way you do your work or sports tasks to try to reduce or eliminate the irritation on the thumb tendons. Your physiotherapist may suggest alternative techniques or ways of doing things to ensure healthy body alignment and wrist positions. Part of your bespoke rehab plan for De Quervain’s tenosynovitis supports helpful exercises, and tips on how to prevent future flare-ups.

As you progress, you’ll begin doing active movements and range-of-motion exercises as your physio gives you at-home exercises to help strengthen and stabilise the muscles and joints in the hand and thumb.

For specific advice regarding your wrist pain, please consult your Fixio Physiotherapist. We can create your personalised recovery plan straight away and get you back to doing the things you love, pain free.


Lisfranc Joint injuries

The year is 1815 and French surgeon, Jacques Lisfranc de St. Martin is looking for the best place to make an amputation on his patient’s foot. This joint is at the junction between the midfoot and forefoot. The tarsometatarsal joint he chose now bears his name, and refers to an injury involving a break and possible dislocation of your metatarsal and tarsal bones in your foot.

Lisfranc injuries can be difficult to diagnose and treat, but if not detected and appropriately managed by a musculoskeletal physio they can cause long-term problems.

What causes a Lisfranc injury?
Lisfranc injuries can be caused by either direct or indirect trauma.

Extreme force applied to the midfoot, usually following a car accident or a fall from height and crush injuries such as dropping heavy objects onto your foot or your foot being run over are the most common ways of sustaining a Lisfranc injury.[1]

In terms of indirect trauma, injury can occur from plantarward bending associated with rotational stress along with mechanisms where the forefoot is suddenly adducted relative to a fixed hindfoot. This type of injury occurs in equestrians during a fall from a horse when their foot remains in the stirrup.[2]

Sports where your foot is held in position, for example; horse riders, cyclists, snowboarders, kitesurfers and windsurfers are more at risk of a Lisfranc injury. If a fall happens, the foot often is not removed from its placings, resulting in extreme force being applied to the midfoot region causing a dislocation or fracture.

What does a Lisfranc injury feel and look like?

A Lisfranc injury will usually present with:

  • Swelling of the foot and/or ankle
  • Bruising of the foot and/or ankle
  • Pain usually in the middle part of the foot
  • Widening of the midfoot area
  • Large bump on the top midfoot area
  • Not being able to put any weight on the injured foot

What Lisfranc injury symptoms can physiotherapy help with?

Physiotherapy improves the healing process allowing you to return to normal life as quickly as possible following a Lisfranc injury. After a Lisfranc fracture, your foot and ankle will likely be immobilised in a cast or walking boot.
Fixio Physiotherapy treatment provides many benefits following a Lisfranc fracture. These include:

  • Decreased pain
  • Decreased swelling
  • Gait (walking) education without the use of aids
  • Increase in muscle strength
  • Increase in range of movement
  • Increase in function

What does physiotherapy treatment for Lisfranc involve?              

There are various treatment techniques that our physiotherapists will utilise depending on your presenting symptoms. Physiotherapy treatment should begin shortly after immobilisation and may include:

  • Soft tissue massages to decrease swelling
  • Calf stretches to regain the flexibility in the calves
  • Range of motion exercises: Plantarflexion, dorsiflexion, inversion and eversion
  • Toe and midfoot arch flexibility stretches:
  • Ankle and foot strengthening exercises
  • Balance exercises
  • Plyometrics and jumping exercises: Jumping and landing, single leg hops
  • Strengthening to address post immobilisation weakness
  • Gait training

A bespoke rehab program will be designed when weight bearing has been commenced. This is to further develop strength, range of movement and flexibility.

You may benefit from the services of a musculoskeletal physio if you have suffered a Lisfranc injury. Your Fixio physio can assess your condition and offer treatments to help decrease your pain and improve your range of motion (ROM), strength, and overall functional mobility.

[1] Haapamaki V, Kiuru M, Koskinen S. Lisfranc fracture-dislocation in patients with multiple trauma: diagnosis with multidetector computed tomography. Foot Ankle Int. 2004 Sep;25(9):614–9.

[2] Wiley JJ. The mechanism of tarso-metatarsal joint injuries. J Bone Joint Surg Br. 1971 Aug;53(3):474–82.


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