Our Kwun Tong clinic has been relocated to Room C, 25/F, Legend Tower, 7 Shing Yip Street, Kwun Tong (Kwun Tong MTR Exit B2)

Our Po Lam clinic has been relocated to Shop G33, G/F, Metro City Plaza, Phase 3, Tseung Kwan O (Po Lam MTR Exit C)

我們的寶琳診所已於2018年7月25日遷往新界將軍澳貿業路8號新都城中心第三期商場地下 G33 號舖。

新診所不論環境與設備都有所提升, 而且還新增了不同種類的運動訓練班, 針對不同病人的需要, 所有運動訓練班都由專業復康教練鍾浩然先生任教, 確保每位參加者都可以得到最安全而有效的指導。

本診所希望病人在復康路上可以得到更加完善及全面的照顧。

Workplace health issues

The use of computer is more and more common no matter in work or daily life. Prolonged use of computer has adverse impact on health, leading to degeneration and pain in the neck and back, carpal tunnel syndrome, tennis elbow, tendinitis in the hand or forearm etc.

Get to know the knee joint

The knee joint is the largest and most complicated joint in our body. It is made up of the femur on top, tibia at the bottom, and the patella at the front.

Cause of knee injuries

The knee joint undergoes large stress in turning or sudden stops to absorb shock and stabilize the body. The accomplishment of these functions requires contribution from the joint cartilage, meniscus, ligaments and muscles. Damage to any of these structures can lead to knee pain and functional impairments.

Meniscus injury

Meniscus may split under large torsional stress in turning. Joint stiffness and swelling may occur as well as clicking and locking. The swelling may progress to a chronic stage due to accumulation of fluid inside the joint.

Tendinitis and bursitis

Inflammation of tendon and bursa may develop due to overuse, which often arises from excessive use or inadequate warm-up. The inflamed area is often tender. Serious bursitis may lead to swelling of the whole joint.

Ligament sprain

Trauma, road accident or intensive exercise may lead to ligament sprain or torn. Most commonly affected are the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). One third of the patients hear a popping sound during the injury. Most ACL tear will lead to hemarthrosis, which is bleeding inside the joint. Pain is experienced deep inside the joint and movements are unstable.

Degenerative arthritis

With the aging process, the muscles in the thigh are not strong enough to support the knee joint, thus speeding up the wear and tear on the cartilage. Over time, the subchondral bone underlying the cartilage is exposed. The subchondral bone is innervated by nerve, while the cartilage is not. With compression directly onto the subchondral bone, the nerves are irritated, thus leading to pain. Besides, degenerative arthritis is often accompanied by synovitis. Acute onset of synovitis gives rise to joint swelling, making walking very difficult.

 

Muscle imbalance

Trauma, overuse or poor posture can lead to mal-alignment in the lumbar spine or pelvis, leading to increased muscle tension in anterior and inner thigh. The balance of muscle pull on the patella is then disturbed, speeding up degeneration.

Physiotherapy for knee pain

Ice therapy
Ice therapy can be used to decrease pain and swelling.

Electrotherapy
Electrotherapies such as ultrasound and interferential therapy (IFT) can increase blood circulation around the affected joint thus help to decrease pain and inflammation.

Exercise therapy
Exercise is usually used to strengthen the muscles at the front of the thigh as well as to increase flexibility.

 

Manual therapy
Stiff joints need to be mobilized so as to gain more range of movement. Mal-alignment of the pelvis or lumbar spine need to be corrected so as to reduce the stress on the knee and minimize the referral pain from the spine or pelvis.

 

Corrective insole
Corrective insole can improve the alignment of the foot, ankle and knee and provide more support, so that overuse can be reduced.

 

Prevention and maintenance

1. When the joint is swollen, walking up or down stairs or slopes should be avoided
2. Decrease stress on the knee: avoid squatting, kneeling; overweight patients need to decrease body weight
3. Avoid wearing slippers or high heels for long distance walking
4. Popping sounds from the joint during movement is a sign of degeneration. Medical advice should be sought if it is accompanied with pain.

Ankle sprain

Symptoms

• Pain
• Swelling and bruising
• Instability of the ankle
• Decreased ankle range of motion
• Difficulty in walking

Diagnosis

Diagnosis need to be made after examination by doctor or physiotherapist. X-ray is used to confirm a fracture.

Principles of management

• Acute stage (first 24 hours): RICE – rest, ice, compression, elevation
• Sub-acute stage (24-72 hours): Compression with bandage

Physiotherapy for ankle sprain

• Ultrasound therapy – facilitates the metabolism of the cells, decreases pain and improves circulation.
• Electrotherapy – helps to relieve pain
• Muscle strengthening – strengthening muscles around the ankle can prevent further ankle sprains
• Manual therapy – releases muscles and joints

Onset of neck pain

Ms. Chan is a 30-year-old office worker who uses computer for 5-6 hours every day.
Ms. Chan lives a healthy lifestyle. She goes to gym three days a week. Her neck pain has been present for some time, but the condition was not serious. However the pain increased mildly after doing exercise in the gym last week. Ms. Chan took it as normal muscle soreness, but pain increased gradually and by the night, she was not able to rotate the neck. Ms. Chan went to the emergency department at the hospital. X-Ray findings were normal. She was referred for physiotherapy.

Onset of frozen shoulder

Mrs. Wong is a 40-year-old housewife. Half a year ago, she noticed pain in the left shoulder when waking up, and she had problem elevating the left arm. Pain is tolerable when shoulder elevation is avoided. Therefore Mrs. Wong did not take it seriously. However, the left shoulder gradually became stiff and the range of motion became more and more limited. It was not until half a year later did Mrs. Wong attend doctor. A referral for physiotherapy was made.

The structure of the shoulder joint

The shoulder joint is the most mobile joint in human body. Directly outside of the joint is a joint capsule. The shoulder is stabilized by a group of four muscles, called the rotator cuff.

The development of a frozen shoulder

Patients with frozen shoulder are usually around 40-50 years old, though the condition may also develop in people as young as 30 years old.
The cause of frozen shoulder is unknown. Adhesion develops within the capsule of the joint, leading to a decrease in range of movement. In early stage, pain will be the most prominent symptom, which may affect sleep quality. Months after onset, the pain may gradually decrease and replaced by severe stiffness. Patient may have difficulty wearing clothes or washing hair. In the end the stiffness may gradually resolve. The whole process may take more than one year if left untreated.

Physiotherapy for frozen shoulder

Physiotherapy can relieve pain and increase the range of movement. However serious conditions will take longer to recover.
The therapist will apply different treatment according to the individual condition of each patient. General treatments include:

Manual therapy

Manual therapy is used to relieve the tension in soft tissues, mobilize the stiff joints and increase blood circulation in the affected regions.

Electrotherapy

Different kinds of electrotherapy, such as ultrasound, transcutaneous electrical nerve stimulation (TENS), interferential therapy (IFT), may be applied for pain relief and improving circulation.

Exercise therapy

For patients with frozen shoulder, appropriate exercise is very important to maintain the effect of treatment.
The condition of Mrs. Wong was relatively serious. Her shoulder joint was already very stiff when she attended physiotherapy. Range of movement was very limited. It took three months for Mrs. Wong’s shoulder to return to normal range of motion. Mrs. Wong needs to keep doing exercise to strengthen the shoulder muscles and maintain range of motion.

Get to know sciatica

Mr. Cheung is 45-year-old office worker living a sedentary lifestyle. Two weeks ago, he helped with some housework at home. There was no discomfort during the work, but lower back pain developed the next morning, spreading to the right lower leg gradually and became more and more intolerable. Mr. Cheung attended doctor and was diagnosed of sciatica. A referral for physiotherapy was made.

Sciatica is a common disease. According to statistics, 90% of the general population experience at least one episode of lower back pain in their life. The lumbar spine, which is the part of the spine in the lower back region, is made up of five vertebrae. Between the vertebrae are the intervertebral discs. Many ligaments, muscles and tendons connect the vertebrae together. All these tissues can contribute to lower back pain.

The common cause of sciatica is the protrusion of intervertebral discs. The protruded disc may irritate or compress on the surrounding nerves. In less serious conditions, pain may be experienced in the legs. In more serious conditions, the function of the nerves can be severely affected, leading to weakness and numbness in the affected lower limb.

Possible symptoms of sciatica

Pain in the lower back region
Pain may radiate to the hip, thigh, lower leg, or even foot
Pain may increase with coughing and sneezing and forceful back movements
Numbness, pins and needles or burning sensations along the back of the affected lower limb
Weakness in the lower limb muscles

High risk groups

Elderly
Manual workers
Pregnant women
People with obesity
People with scoliosis
People with sedentary lifestyle
People with prolonged poor postures

Poor postures

Poor postures in lifting heavy objects may lead to prolapsed intervertebral discs. When lifting heavy objects, the back should be kept erect. Squatting through the lower limbs to pick up the object rather than bending through the back.Poor standing posture can lead to an increased stress on the joints and muscles in the lower back, leading to overuse and thus pain.

Physiotherapy for sciatica

Physiotherapy can decrease lower back pain in 70-80% patients. Different treatment techniques may be applied according to the individual conditions of each patient. Common treatments include:

Manual therapy

Manual therapy is used to relieve the tension in soft tissues, mobilize the stiff joints and increase blood circulation in the affected regions.

Electrotherapy

Different kinds of electrotherapy, such as ultrasound, transcutaneous electrical nerve stimulation (TENS), interferential therapy (IFT), may be applied for pain relief and improving circulation.

Lumbar traction

Lumbar traction relieves the stress on intervertebral discs and surrounding nerves.

Postural education

Correct postures will be suggested by the physiotherapist. Exercise will be taught to maintain the effect of treatment and prevent recurrence.

Mr. Cheung made an appointment for physiotherapy. According to his condition, the therapist conducted manual therapy, lumbar traction and electrotherapy. The lower back pain and radiation in the lower limbs disappeared after two weeks of treatment. The therapist also taught Mr. Cheung to do self-maintenance exercises and adopt correct postures in daily life to prevent recurrence.

Tips for dealing with lower back pain

Adequate rest and sleep helps to decrease discomfort and assist recovery
Bed rest on relatively hard matrix
Hot pack helps to relax muscles and decrease pain
Avoid bending over or handling heavy objects
Avoid sitting in sofa or on low seats