Our Services

Orthotics

Orthotic therapy is a form of podiatry treatment that uses specially designed devices that are worn inside the shoe to control abnormal foot function and improve lower limb alignment. The idea being that this alteration can help eliminate lower limb pain and possibly enhance performance through improved gait efficiencies.

Orthotic Uses :

• Metatarsalgia or other foot pain
• Plantar fasciitis [[]]
• Morton’s Neuroma
• Flat feet
• High arches
• Knee pain
• Hip pain
• Low back pain
• SIJ dysfunction
• Degenerative Disc Disease
• Scoliosis
• Osteoarthritis in the knees, hips, pelvis or low back
• Patellofemoral pain syndrome
• Femoral acetabular impingment
• Iliotibial band friction syndrome
• Bursitis in the ankle, knee or hip
• Chronic ankle sprains
• Piriformis syndrome
• Achilles tendonopathy
• Patellar tendonopathy
• Snapping Psoas 
• Gluteal tendonopathy
• Hamstring tendonopathy
• Recurrent Calf Strains

 

What type of orthotics do we have?

For complex foot problems, our podiatrists may recommend a custom-made orthotic (usually with a thermoplastic material) made in a laboratory from a plaster cast moulding or a 3D scan of your foot. For less complex problems, we have a range of heat-moulded orthotics that may suffice. Making quality orthotics takes years of experience and in many ways is considered an art form. Our podiatrists have these skills and can supply quality orthotics to suit your needs.

All of our orthotics are supplied with a full length cover meaning you get an ideal fit that doesn’t move around in the shoe. Your feet are like no other and this is why our orthotics are all custom made to fit your particular foot type.

 

 

 

 

Exercise Therapy

Exercises are instrumental tool in keeping us healthy. Just like your car, our bodies need regular maintenance to perform optimally. Physical therapy improves strength, balance, mobility, and overall fitness as well as injury prevention and treatment. Physical therapists help you restore and improve motion to achieve long-term quality of life.

Manual Therapy:

Manual therapy (sometimes called bodywork) is a general term for treatment performed mostly with the hands. The goals of manual therapy include relaxation, decreased pain, and increased flexibility.Manual therapy can include:

 Pressure is applied to the soft tissues of the body, such as the muscles. Massage can help relax muscles, increase circulation, and ease pain in the soft tissues.

  • Mobilization. Slow, measured movements are used to twist, pull, or push bones and joints into position. This can help loosen tight tissues around a joint and help with flexibility and alignment.
  • Manipulation. Pressure is applied to a joint. It can be done with the hands or a special device. The careful, controlled force used on the joint can range from gentle to strong and from slow to rapid.

The Physiotherapist assists the patient in the movement restoration. His tasks include the following:

  1. Muscle strength evaluation and quantification.
  2. Physiotherapy exercises to maintain and increase joint range of motion.
  3. Evaluate and train sitting and standing balance.
  4. Physical therapy exercises to increase strength,endurance and coordination for other specific muscle groups or the entire body.
  5. Use various physical therapy modalities such as both superficial and deep heat and cold as well as hydrotherapy techniques, electrical stimulation, traction and massage for pain relief.
  6. Aid in home evaluation to make the environment barrier free and accessible.
  7. Assess the patient's wheelchair needs, including maintenance and assist with individualized wheelchair prescriptions.
  8. Progressive gait training with or without amubulatory aids.
  9. Exercises to reduce spasticity.

 

 

Kinesiology Tape

It is a thin, stretchy, elastic cotton strip with an acrylic adhesive. Therapeutic kinesiology tape that can benefit a wide variety of musculoskeletal and sports injuries, plus inflammatory conditions.

Kinesiology tape is almost identical to human skin in both thickness and elasticity, which allows kinesio tape to be worn without binding, constricting or restriction of your movement.

Kinesiology tape is an that is used for treating athletic injuries and a variety of physical disorders. For the first decade after its introduction practitioners in Japan were the main users of the therapeutic kinesiology tape. By 1988 the tape had been adopted by Japanese Olympic and professional athletes before spreading across the world.

Benefits of Kinesiology Taping

Kinesiology tape is a flexible elastic tape that moves with your body. This provides supports to your body parts without the tape slipping.

By supporting your body part kinesiology tape is able to provide you with pain reief and muscular support to help control body parts affected by muscle inhibition.

Muscle Support

As previously mentioned, your muscle strength may be assisted by kinesiology tape via physical assistance and tactile feedback through the skin. This phenomenon may assist both the able bodied athlete to enhance their performance and hypotonic eg children with low muscle tone.

Swelling Reduction

Kinesiology provides a passive lift to your skin via its elastic properties. This vacuum effect allows your lymphatic and venous drainage systems to drain and swollen or bruised tissue quicker than without the kinesiology tape.

It is also thought that this same principle can assist the removal of exercise byproducts like lactic acid that may contribute to post-exercise soreness eg delayed onset muscle soreness (DOMS).

Mulligan Therapy

 

The Physiotherapy treatment of musculoskeletal injuries has progressed from its foundation in remedial gymnastics and active exercise to therapist-applied passive physiological movements and on to therapist-applied accessory techniques. Brian Mulligan’s concept of mobilizations with movement (MWMS) in the extremities and sustained natural apophyseal glides (SNAGS) in the spine are the logical continuance of this evolution with the concurrent application of both therapist applied accessory and patient generated active physiological movements.

Principles of Treatment

In the application of manual therapy techniques, Physiotherapists acknowledge that contraindications to treatment exist and should be respected at all times. Although always guided by the basic rule of never causing pain, therapist choosing to make use of SNAGS in the spine and MWMs in the extremities must still know and abide by the basic rules of application of manual therapy techniques.

 

Specific to the application of MWM and SNAGS in clinical practice are:

  1. During assessment the therapist will identify one or more comparable signs as described by Maitland. These signs may be a loss of joint movement, pain associated with movement, or pain associated with specific functional activities (i.e., lateral elbow pain with resisted wrist extension, adverse neural tension).
  2. A passive accessory joint mobilisation is applied following the principles of Kaltenborn (i.e., parallel or perpendicular to the joint plane). This accessory glide must itself be pain free.
  3. The therapist must continuously monitor the patient’s reaction to ensure no pain is recreated. Utilising his/her knowledge of joint arthrology, a well-developed sense of tissue tension and clinical reasoning, the therapist investigates various combinations of parallel or perpendicular glides to find the correct treatment plane and grade of movement.
  4. While sustaining the accessory glide, the patient is requested to perform the comparable sign. The comparable sign should now be significantly improved (i.e., increased range of motion, and a significantly decreased or better yet, absence of the original pain).
  5. Failure to improve the comparable sign would indicate that the therapist has not found the correct contact point, treatment plane, grade or direction of mobilisation, spinal segment or that the technique is not indicated.
  6. The previously restricted and/or painful motion or activity is repeated by the patient while the therapist continues to maintain the appropriate accessory glide. Further gains are expected with repetition during a treatment session typically involving three sets of ten repetitions.
  7. Further gains may be realised through the application of passive overpressure at the end of available range. It is expected that this overpressure is again, pain-free.

 

CPM Therapy

 

Knee CPM Machine

knee CPM machine

Our knee CPM machines are designed to provide reliable, safe, continuous passive motion therapy to a wide range of patients, including children and bariatric patients. 

CPM, or Continuous  Passive Motion, is a postoperative procedure designed to aid in recovery after joint surgery. After extensive joint surgery, if a patient fails to move their joint tissue around, the joint will become stiff and scar tissue will form, resulting in a joint with limited range of motion, which often takes months of physical therapy to recover. 

Shoulder CPM machine

Our shoulder CPM machines are designed to provide reliable, safe, and comfortable continuous passive motion therapy to patients

CPM, or Continuous  Passive Motion, is a postoperative procedure designed to aid in recovery after joint surgery. After extensive joint surgery, if a patient fails to move their joint tissue around, the joint will become stiff and scar tissue will form, resulting in a joint with limited range of motion, which often takes months of physical therapy to recover. 

Passive range of motion means that the joint is moved without the patient's muscles being used. Continuous passive motion devices are used after surgery, both in the hospital and in the home.  The motorized CPM device gradually moves the affected joint through a prescribed arc of motion for an extended period of time.

Compression Therapy

Compression therapy means wearing socks or stockings that are specially designed to support your veins and increase circulation in your legs. The socks or stockings are normally worn in the morning upon arising, and removed at night. Throughout the day the compression they provide prevents blood from pooling in leg veins, thereby helping overall circulation and diminishing any leg swelling you may have.

How compression therapy stockings work? 

Compression stockings improve the signs and symptoms of various conditions of venous disease by providing graduated compression therapy to help control leg swelling and discomfort.  They are designed to provide support to the legs and veins, assist with circulation, and minimize swelling. The compression is graduated, with the strongest support starting at the ankles and gradually decreasing towards the top of the garment. This gradual support works in conjunction with the pumping action of the calf muscles, which also assist with circulation. 

How do I get compression stockings? 

Talk to your health care provider to find out if graduated compression stockings are right for you. If they are,  your healthcare provider can tell you what pressure grade you should buy. Additionally, your healthcare provider may be able to recommend an authorized vendor that can measure and fit you for the stockings and can provide education regarding compression therapy.  Since all legs are different in length and circumferences, before a stocking is dispensed the medical supply personnel will measure the intended leg to ensure maximum therapeutic effects from the stockings.

 

Galvanic, Faradic, Russian and microcurrents

 

There is a degree of confusion with regards this intervention, mostly caused by there being several 'names' or descriptions for the same intervention.

Essentially, this type of electrical stimulation employs what is referred to as a medium frequency alternating current (in the low kHz range - thousands of cycles a second), which is delivered in a pulsed (or burst or interrupted) output. The pulsing or bursting is at a 'low' frequency, and as a result, nerves will respond. It is primarily employed as a means to generating a motor response, though as will be seen (below), it has also been investigated as an electro-analgesia type intervention.

Russian Stimulation was probably the earliest name for this stimulation type. Several multi-modal stimulation devices include it as one of their options. Burst Mode Alternating Current (BMAC) is a more generic and more recently employed term, which is probably preferable. Aussie Stimulation (see below) is a play on the original Russian Stimulation, and is not especially insightful as a descriptor. BMAC is probably the term that could be used and should persist.

Primo Stimulation Multidyne 970

 

The Primo Multidyne 970 provides all low and medium frequency outputs from one unit. Stimulation therapy is used for rehabilitation purposes, preventing muscle atrophy caused by musculoskeletal injuries, such as damage to bones, joints, muscles, ligaments and tendons.

Ordering information:

Primo Multidyne 970 stimulation therapy unit 2/4 pole patient lead, four medium (100x70mm) rubber electrodes, four medium sponge covers, four electrode connection cables ( blue and yellow) and two stretch bandages (1200x75mm) – scroll down for accessories

 

 

TENS Machine

TENS Machine

What is a TENS Machine?

TENS is an abbreviation of Transcutaneous Electrical Nerve Stimulation.

Transcutaneous means "across the skin". In simple terms, a tens machine stimulates your nerves via an electrical current through your skin.

A TENS machine is an electronic medical device. A TENS machine may assist you in modest short-term pain relief.

The use of a TENS machine should be as one part of a  program under the guidance of your doctor or healthcare practitioner. Your health practitioner should always be consulted before using a TENS machine.

How does a TENS Machine provide Short-term Pain Relief?

Pain is thought to be controlled by TENS in one of two ways:

Sensory Level Stimulation - The Gate Control theory of pain means that the electrical input of the TENS machine interferes with the transmission of pain signals, by blocking the neural “gate” through which the pain travels.

Motor Level Stimulation - The goal of motor level stimulation is to cause the release of the body’s own opiate-like substances to achieve pain relief.

IMPORTANT

Use only as directed. A TENS machine and EMS machine are electronic medical devices.  Always read the label and instruction manual. A TENS machine may assist you in modest short-term pain relief. Consult your doctor/healthcare professional prior to use and if symptoms persist.

Interferential Therapy

 

The basic principle of Interferential Therapy (IFT) is to utilise the strong physiologicaportable iftl effects of low frequency (<250pps) electrical stimulation of nerves without the associated painful and somewhat unpleasant side effects sometimes associated with low frequency stim.

To produce low frequency effects at sufficient intensity at depth, patients can experience considerable discomfort in the superficial tissues (i.e. the skin). This is due to the impedance of the skin being inversely proportional to the frequency of the stimulation. In other words, the lower the stimulation frequency, the greater the impedance to the passage of the current & so, more discomfort is experienced as the current is ‘pushed’ into the tissues against this barrier. The skin impedance at 50Hz is approximately 3200* whilst at 4000Hz it is reduced to approximately 40*. The result of applying a higher frequency is that it will pass more easily through the skin, requiring less electrical energy input to reach the deeper tissues & giving rise to less discomfort.

The effects of tissue stimulation with these 'medium frequency' currents (medium frequency in electromedical terms is usually considered to be 1KHz-100KHz) has yet to be established. It is unlikely to do nothing at all, but in terms of current practice, little is known of its physiological effects. It is not capable of direct stimulation of nerve in the common context of such stimulation.

Interferential therapy utilises two of these medium frequency currents, passed through the tissues simultaneously, where they are set up so that their paths cross & they literally interfere with each other. This interference gives rise to an interference (beat frequency) which has the characteristics of low frequency stimulation – in effect the interference mimics a low frequency stimulation.

The exact frequency of the resultant beat frequency can be controlled by the input frequencies. If for example, one current was at 4000Hz and its companion current at 3900Hz, the resultant beat frequency would be at 100Hz, carried on a medium frequency 3950Hz amplitude modulated current.

By careful manipulation of the input currents it is possible to achieve any beat frequency that you might wish to use clinically. Modern machines usually offer frequencies of 1-150Hz, though some offer a choice of up to 250Hz or more. To a greater extent, the therapist does not have to concern themselves with the input frequencies, but simply with the appropriate beat frequency which is selected directly from the machine.

Ultrasonic Therapy

 

ultrasound

Therapeutic ultrasound is a modality that has been used by physiotherapists since the 1940s. Ultrasound is applied using the head of an ultrasound probe that is placed in direct contact with your skin via a transmission coupling gel. 

Therapeutic ultrasound has been shown to cause increases in:

  1. healing rates
  2. tissue relaxation
  3. tissue heating
  4. local blood flow
  5. scar tissue breakdown.

How Can Ultrasound Help You?

The effect of ultrasound via an increase in local blood flow can be used to help reduce local swelling and chronic inflammation, and, according to some studies, promote bone fracture healing. The intensity or power density of the ultrasound can be adjusted depending on the desired effect. A greater power density (measured in watt/cm2) is often used in cases where scar tissue breakdown is the goal.

Ultrasound can also be used to achieve phonophoresis. This is a non-invasive way of administering medications to tissues below the skin; perfect for patients who are uncomfortable with injections. With this technique, the ultrasonic energy forces the medication through the skin. Cortisone, used to reduce inflammation, is one of the more commonly used substances delivered in this way.

The most common conditions treated with ultrasound include soft tissue injuries such as tendonitis (or tendinitis if you prefer), non-acute joint swelling and muscle spasm. Most muscle and ligament injuries can benefit from therapeutic ultrasound.

Laser Therapy

Laser Therapy treatment is a non-invasive therapy that makes use of intense beams of light of specific wavelengths to help reduce pain related to your injury. LASER stands for ‘Light Amplification by Stimulated Emission of Radiation.’

When it comes to therapeutic use, lasers are often referred to as Cold Lasers, Low-Level Laser Therapy (LLLT) or High Power Laser Therapy (HPLT). The Low-Level Laser Therapy utilizes red (and close to red) infrared light on areas of injury or wounds in order to mend the soft tissue and also to give relief from acute and chronic pain.

When the lights of specific wavelengths are targeted to a particular area of body, physiological changes take place in the cells. This process is known as photobiomodulation. In contrast to surgical lasers, the therapeutic lasers gently pass through your skin without breaking the skin or causing discomfort. Laser therapy is considered by many professionals and patients to be a very effective tool in improving injury condition.

 

Laser Treatments are becoming increasingly popular for patients seeking alternative pain management techniques. Laser Therapy can:

  • Reduced therapy time – quicken the reproduction of cells and their growth.
  • Safely treat pain – influences and increases the metabolic activity of the cells.
  • Effective for pain relief – reduces swelling from bruising or inflammation.
  • Helps to increase circulation to damaged cell sites.
  • Minimizes scar formation from surgery, cuts, burns, etc.

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