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Physio Solutions We provide Physiotherapy services at the clinic, at home, or online.

TREAT YOUR OWN BACK.ROBIN McKENZIE CNZM, OBE, FCSP (Hon), FNZSP (Hon), Dip MDT, Dip MT.Soft copy available.If you want c...
14/02/2026

TREAT YOUR OWN BACK.

ROBIN McKENZIE CNZM, OBE, FCSP (Hon), FNZSP (Hon), Dip MDT, Dip MT.

Soft copy available.
If you want comment with email address or text on Whatsapp.

Kegel exercise for womenKegel exercise, also known as pelvic-floor exercise, involves repeatedly contracting and relaxin...
14/02/2026

Kegel exercise for women

Kegel exercise, also known as pelvic-floor exercise, involves repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles".

♿Aim:

Kegel exercises aim to strengthen the pelvic floor muscles. These muscles have many functions within the human body.

🙎Women:

In women, they are responsible for:
➡️ holding up the human bladder.
➡️ preventing urinary stress incontinence
(especially after childbirth).
➡️vaginal and uterine prolapse.

🧔Men:

In men, these muscles are responsible for:
➡️urinary continence.
➡️fecal continence
➡️ejaculation.

Note:
Several tools exist to help with these exercises, although various studies debate the relative effectiveness of different tools versus traditional exercises.





All about frozen shoulder
13/02/2026

All about frozen shoulder

After a long time back to social media.
13/02/2026

After a long time back to social media.

Priformis Syndromes🗣️Relationship bw Piriformis Muscle and Sciatic Nerve:👉The sciatic nerve generally exits the pelvis b...
22/01/2025

Priformis Syndromes

🗣️Relationship bw Piriformis Muscle and Sciatic Nerve:

👉The sciatic nerve generally exits the pelvis below the belly of the muscle, however many congenital variations may exist.

✍️The relationships between the Piriformis Muscle and sciatic nerve have been classified by Beaton and Anson using a six category classification system.

🗣️Variations in the relationship of the sciatic nerve to the piriformis muscle shown on the diagram below:

🏋️Type A:
The sciatic nerve exiting the greater sciatic foramen along the inferior surface of the piriformis muscle; the sciatic nerve splitting as it passes through the piriformis muscle with the tibial branch passing.

🏋️Type B:
Inferiorly.

🏋️Type C:
Superiorly.

🏋️Type D:
The entire sciatic nerve passing through the muscle belly.

🏋️Type E:
The sciatic nerve exiting the greater sciatic foramen along the superior surface of the piriformis muscle. The nerve may also divide proximally, where the nerve or a division of the nerve may pass through the belly of the muscle, through its tendons or between the part of a congenitally bifid muscle.

🏋️Type F:
Diagram showing an unreported additional B-type variation consisting of a smaller accessory piriformis (AP) with its own separate tendon. SN sciatic nerve, P piriformis muscle, SG superior gemellus muscle.

Piriformis syndrome🗣️ExaminationA complete neurological history and physical assessment of the patient is essential for ...
20/01/2025

Piriformis syndrome

🗣️Examination

A complete neurological history and physical assessment of the patient is essential for an accurate diagnosis.

The physical assessment should include the following points:

👉an osteopathic structural examination with special attention to the lumbar spine, pelvis and sacrum, as well as any leg length discrepancies.
👉diagnostic tests.
👉deep-tendon reflex testing, strength and sensory testing.

🗣️Palpation

👉The patient reports sensitivity during palpation at the greater sciatic notch, in the region of sacroiliac joint or over the piriformis muscle belly. It is possible to detect the spasm of the PM by careful, deep palpation.

👉With deep digital palpation in the gluteal and retro-trochanteric area, there may be tenderness and pain with an exacerbation of tightness and leg numbness.

🗣️Observation:

👉Patients with piriformis syndrome may also present with gluteal atrophy, as well as shortening of the limb on the affected side.In chronic cases, muscle hypotrophy is present in the affected extremity.

🗣️Special test:

👉Lasèque sign / Straight Leg Raise Test.
👉FAIR test.
👉Hughes test.
👉Hip Abduction Test.
👉Trendelenburg Test.
👉Beatty’s Manoeuver
👉Freiberg Sign
👉Pace sign



Piriformis syndrome🗣️Physical Therapy Management:According to Tonley et al , the most commonly reported physical therapy...
19/01/2025

Piriformis syndrome

🗣️Physical Therapy Management:

According to Tonley et al , the most commonly reported physical therapy interventions include:

👉ultrasound thepray
👉soft tissue mobilization
👉piriformis stretching
👉 hot packs or cold spray
👉various lumbar spine treatments.

In addition, Tonley et al. describe an alternative treatment approach for piriformis syndrome.

The intervention focused on functional exercises Therapy Exercises for the Hip aimed at strengthening the hip extensors, abductors and external rotators, as well as correction of faulty movement patterns.

To achieve a 60 – 70% improvement, the patient usually follows 2 – 3 treatments weekly for 2-3 months.

➡️Ultrasound therapy:

First of all, the patient must be placed in the contralateral decubitus and FAIR position (Flexed Adducted Internally Rotated). Start with an ultrasound treatment: 2.0-2.5 W/cm2, for 10-14 minutes. Apply the ultrasound gel in broad strokes longitudinally along the piriformis muscle from the conjoint tendon to the lateral edge of the greater sciatic foramen.

➡️Hot or Cold Pack:

Before stretching the piriformis muscle, treat the same location with hot packs or cold pack or spray for 10 minutes. The use of hot and cold before stretching is very useful to decrease pain.

➡️Stretching:

1️⃣: After that, begin with stretching of the piriformis which can be executed in a variety of ways. Stretch the piriformis muscle by applying manual pressure to the muscle’s inferior border. It is important not to press downward, rather directing pressure tangentially, toward the ipsilateral shoulder. When pressing downward, the sciatic nerve will compress against the tendinous edge of the gemellus superior. However, when applying tangential pressure, the muscle’s grip will weaken on the nerve and relieve the pain of the syndrome.

2️⃣: Another way to stretch this muscle is in the FAIR position. The patient lies in a supine position with the hip flexed, adducted and internally rotated. Then the patient brings his foot of the involved side across and over the knee of the uninvolved leg. We can enhance the stretch, by letting the physical therapist perform a muscle–energy technique. This technique involves the patient abducting his limb against light resistance, which is provided by the therapist for 5-7 seconds, with 5-7 repetitions.

➡️Myofascial Release:

After stretching, continue with myofascial release at the lumbosacral paraspinal muscles and McKenzie exercises. When the patient lies in the FAIR position, the lumbosacral corset can be used.

➡️Hip Muscles strengthening:

PS is caused when the tight piriformis is forced to do the work of other large muscles (like the gluteus maximus, the gluteus medius), An alternative treatment approach for piriformis syndrome using a hip muscle strengthening program especially of the weak gluteal musculature with movement re-education can help in pain relief.

➡️Patient Education:

The therapist can also give several tips to avoid an aggravation of the symptoms. This includes:

♿Avoid sitting for a long period; stand and walk every 20 minutes,
♿Make frequent stops when driving to stand and stretch.
♿Prevent trauma to the gluteal region and avoid further offending activities.
♿Daily stretching is recommended to avoid the recurrence of the piriformis syndrome.

➡️Home exercises:

The patient can also perform several exercises and treatments at home including:

✴️Rolling side to side with flexion and extension of the knees while lying on each side.
✴️Rotate side to side while standing with the arms relaxed for 1 minute every few hours.
✴️Take a warm bath.
✴️Lie flat on the back and raise the hips with your hands and pedal with the legs like you are riding a bicycle.
✴️Knee bends, with as many as 6 repetitions every few hours.

All About Piriformis Muscle
18/01/2025

All About Piriformis Muscle

Piriformis Muscle➡️An OverviewThe piriformis muscle is a small, flat, pear-shaped skeletal muscle that resides in the de...
18/01/2025

Piriformis Muscle

➡️An Overview

The piriformis muscle is a small, flat, pear-shaped skeletal muscle that resides in the deep gluteal region of the pelvis. It is part of the group of six external rotator muscles of the hip. This muscle plays a critical role in lower limb movement, hip joint stability, and overall biomechanics by facilitating coordinated movements of the pelvis and femur.

➡️Anatomy

Location:

The piriformis is situated deep in the buttock, beneath the large gluteus maximus muscle.
It is found in the posterior pelvic region, connecting the lower spine (sacrum) to the upper femur (thigh bone).
The muscle passes through the greater sciatic foramen, one of the primary openings in the pelvis.

Origin:

The muscle originates from:
The anterior (front) surface of the sacrum: Specifically, it arises from the second to fourth sacral vertebrae (S2–S4).
The sacrotuberous ligament, a fibrous band connecting the sacrum to the ischial tuberosity (sitting bone).

Insertion:

The muscle tapers and inserts into the greater trochanter of the femur, the prominent bony projection on the lateral (outer) side of the thigh.

Innervation:

The piriformis is innervated by the nerve to piriformis, which arises from the sacral plexus and is composed of nerve roots from:
L5, S1, and S2 spinal levels.

Blood Supply:

The blood supply to the piriformis muscle is extensive, ensuring proper oxygenation and function:
Superior gluteal artery: Supplies the upper portion of the muscle.
Inferior gluteal artery: Supplies the lower portion.
Internal pudendal artery: Contributes smaller branches for additional perfusion.

Structural Relationships:

The sciatic nerve (largest nerve in the body) passes close to or through the piriformis muscle in most individuals, making the muscle clinically significant in cases of sciatic nerve compression.
Other neurovascular structures, such as the inferior gluteal nerve and pudendal nerve, also run near the piriformis.

Functions

1. External Rotation:
The piriformis is a key external rotator of the hip joint.
When the hip is in an extended position, the muscle rotates the thigh laterally (outward). This function is essential for stabilizing the pelvis and orienting the lower limb.
2. Abduction:
During hip flexion (e.g., while sitting, climbing stairs, or running), the piriformis assists in abducting the thigh.
Abduction is the lateral movement of the thigh away from the midline of the body.
3. Hip Stabilization:
The piriformis stabilizes the hip joint during dynamic movements such as walking, running, or standing on one leg.
It helps maintain proper alignment of the femoral head in the acetabulum (hip socket), preventing hip instability.
4. Proprioception:
Like other muscles, the piriformis contributes to proprioceptive awareness, providing sensory feedback to help coordinate movement and balance.

Frozen Shoulder⚛️Definition/Description:Adhesive capsulitis (AC), often referred to as Frozen Shoulder, is characterized...
14/11/2024

Frozen Shoulder

⚛️Definition/Description:

Adhesive capsulitis (AC), often referred to as Frozen Shoulder, is characterized by initially painful and later progressively restricted active and passive glenohumeral (GH) joint range of motion with spontaneous complete or nearly-complete recovery over a varied period of time.

♿Common names for AC include:

➡️Frozen Shoulder
➡️Painful stiff shoulder
➡️Periarthritis

🛐Causes of Frozen Shoulder:

1️⃣. Insidious:

This means the condition occurs for no apparent reason at all. You may simply wake up with pain and limited motion. I have seen this many times in my clinical experience, and it is hard to understand why it comes on. You will see markedly limited motion within a few weeks. There is some evidence to indicate a genetic link to this condition as well.

2️⃣. Trauma :

In this scenario, a person often experiences significant trauma related to a fall, motor vehicle accident or other blunt trauma to the shoulder. I once worked with a patient who was knocked down by a wall of water in the ocean and subsequently developed adhesive capsulitis.

3️⃣.Diabetes:

Research has shown that people with Diabetes are 2-5x as likely to develop this condition and more likely to have it in both shoulders. The condition is often more severe in these situations as well.

4️⃣. Inflammation coupled with immobilization:

This case may involve someone who suffers an injury or is recovering from a surgery and is placed in a sling. Subsequently, the individual avoids moving the affected arm because of pain and spasm. Over time, the capsule becomes shortened and tightens up. I have seen this with patients following shoulder dislocations, humerus fractures, severe tendonitis and rotator cuff surgery. However, immobilization alone does not cause this condition.

5️⃣. Autoimmune reaction :

In some cases it appears tendon degeneration may trigger a response by your own body in which the capsular tissue becomes thickened and fibrotic (hardened). Some feel this explains why most people affected are older (between the ages of 40 and 60).

🗣️Frozen shoulder is more prevalent in women than in men and typically affects the nondominant arm.

Frozen Shoulder⚛️Definition/Description:Adhesive capsulitis (AC), often referred to as Frozen Shoulder, is characterized...
12/11/2024

Frozen Shoulder

⚛️Definition/Description:

Adhesive capsulitis (AC), often referred to as Frozen Shoulder, is characterized by initially painful and later progressively restricted active and passive glenohumeral (GH) joint range of motion with spontaneous complete or nearly-complete recovery over a varied period of time.

♿Common names for AC include:

➡️Frozen Shoulder
➡️Painful stiff shoulder
➡️Periarthritis

🛐Causes of Frozen Shoulder:

1️⃣. Insidious:

This means the condition occurs for no apparent reason at all. You may simply wake up with pain and limited motion. I have seen this many times in my clinical experience, and it is hard to understand why it comes on. You will see markedly limited motion within a few weeks. There is some evidence to indicate a genetic link to this condition as well.

2️⃣. Trauma :

In this scenario, a person often experiences significant trauma related to a fall, motor vehicle accident or other blunt trauma to the shoulder. I once worked with a patient who was knocked down by a wall of water in the ocean and subsequently developed adhesive capsulitis.

3️⃣.Diabetes:

Research has shown that people with Diabetes are 2-5x as likely to develop this condition and more likely to have it in both shoulders. The condition is often more severe in these situations as well.

4️⃣. Inflammation coupled with immobilization:

This case may involve someone who suffers an injury or is recovering from a surgery and is placed in a sling. Subsequently, the individual avoids moving the affected arm because of pain and spasm. Over time, the capsule becomes shortened and tightens up. I have seen this with patients following shoulder dislocations, humerus fractures, severe tendonitis and rotator cuff surgery. However, immobilization alone does not cause this condition.

5️⃣. Autoimmune reaction :

In some cases it appears tendon degeneration may trigger a response by your own body in which the capsular tissue becomes thickened and fibrotic (hardened). Some feel this explains why most people affected are older (between the ages of 40 and 60).

🗣️Frozen shoulder is more prevalent in women than in men and typically affects the nondominant arm. It may take anywhere form 6 months to 2-3 years to completely resolve, but it will eventually go away on its own. Physical therapy is often prescribed and may have limited results based on the individual.


⚛️WHAT IS MALLET FINGER?Mallet finger, also known as baseball finger, is a tear in one of the tendons in your hand. Tend...
03/11/2024

⚛️WHAT IS MALLET FINGER?

Mallet finger, also known as baseball finger, is a tear in one of the tendons in your hand. Tendons are strong bands of tissue that connect muscle to bones.

The tendon that usually tears is called an extensor tendon, which attaches muscles in your hand to the bone near the tip of your finger. Extensor tendons are used to extend or straighten your fingers.

♿WHAT IS THE CAUSE?

Mallet finger is usually caused by a jamming injury to the tip of the finger. This can happen with any activity where there is a blow to the tips of your outstretched fingers, such as catching a ball in baseball, basketball, or volleyball. The stress of the injury can pull the tendon off the bone, tear a small piece of bone off the finger, or tear the tendon itself.

✴️WHAT ARE THE SYMPTOMS?

You may have pain and swelling at the tip of the finger. You may not be able to straighten the tip of your finger. If you don’t get medical care for within a week or two after the injury, you may permanently lose the ability to straighten your finger.

👀HOW IS IT DIAGNOSED?

Your healthcare provider will examine you and ask about your symptoms, activities, and medical history. You may have X-rays or other scans.

➡️HOW IS IT TREATED?

Your healthcare provider will straighten your finger and put it in a splint for 6 to 12 weeks. This will allow the tendon to reattach to your finger bone or, if a piece of bone has been pulled off, to allow the bone to heal.

Your provider may recommend stretching and strengthening exercises to help you heal after the splint is no longer needed.

If the injury is severe, you may need surgery to repair the tendon or reset the bone.

🏋️HOW CAN I TAKE CARE OF MYSELF?

To reduce swelling and pain for the first few days after the injury:

Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth, on the area every 3 to 4 hours for up to 20 minutes at a time.
Keep your hand up on a pillow when you sit or lie down.
Take pain medicine, such as acetaminophen, ibuprofen, or other medicine as directed by your provider.
Follow your healthcare provider's instructions, including any exercises recommended by your provider.

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