Osteoporosis – an ageing issue!

It is estimated that 137 million women and 21 million men have high osteoporotic fracture risk globally.

Over three million people in the UK are living with osteoporosis with the prevalence expected to double in the next 40 years.

Fractures of the hip and spine can lead to loss of independence, disability and reduced life expectancy.

Vertebral fractures are associated with long-term back pain and other physical and psychological symptoms, whereas hip fractures are associated with increased morbidity and mortality.

Current approaches to reduce risk of fracture include identifying people with significant fracture risk and prescribing pharmaceutical treatment, using education and support to promote adherence to medication, and developing falls prevention strategies especially for those who are older and frailer.

Additional strategies include healthy eating with adequate calcium and vitamin D, not smoking or consuming excessive alcohol and being physically active in adolescence and young adulthood to maximise peak bone mass.

Epidemiological and intervention studies provide evidence of a strong relationship between physical activity, exercise and bone health, with regular exercisers having a lower incidence of fracture.

Research now encourages people with osteoporosis to undertake resistance and impact exercise to maximise bone strength and should take part in activities to improve strength and balance to reduce falls and undertake spinal extension exercise to improve posture, and potentially reduce pain levels caused by vertebral fractures, risk of falls and vertebral fracture.

If you have, or are at risk of having osteoporosis, you could book here to have an assessment with one of our specialist South Cambridgeshire physios at Penn Farm Physio.

Please click here to be forwarded to the Osteoporosis Society for more information.

Managing Osteoarthritis

How can Physiotherapy help with Osteoarthritis?

Physiotherapy is a rehabilitation profession that helps people with a range of conditions, including osteoarthritis, to maximise their physical potential – often through exercise and physical activity.

Exercise and physical activity are safe and evidence-based first line management strategies for osteoarthritis

Exercise and physical activity are safe and effective for people with osteoarthritis and play a key role in improving and maintaining movement and function. Exercise can even reduce pain and in some cases delay or prevent a joint replacement.

Physiotherapists play a vital role in reducing the burden of this disease by not only helping people manage osteoarthritis but also in educating on the benefits of exercise and pain relief.

Please click here for further facts about osteoarthritis and here for how physio can help.

Here at Penn Farm Physio, in South Cambridgeshire, we can help you manage your arthritis and optimise your quality of life. Click here to book an appointment.

Flat feet in Children – is this an issue?

Best evidence suggests most children’s flat feet will be fine

A recent article in The Conversation raised unnecessary alarm about children’s flat feet.

The article isn’t supported by the best evidence and may have worried parents.

The most recent evidence confirms it’s normal for young, healthy and active children to have flexible flat feet, and these flat feet will get less flat over time.

Flat feet require assessment if they hurt, look different left and right, or if they occur in older children, with few requiring treatment.

Children’s flat feet reduce as they grow

Approximately 15-20% of healthy children have flexible flat feet.

Studies have consistently shown a higher prevalence of flat feet in younger children, fewer flat feet in older children, and a return towards flatter feet in older adults.

2019 study looked at over 3,000 children’s feet. It found the normal foot posture across childhood is flat (also known as “pronated”) and children’s flat feet tend to get less flat as they get older.

Another study published in 2018 followed more than 1,000 healthy children for three years. It shows foot posture does “straighten” with time, so there are fewer flat feet in older children.

This study also found high arch feet (the opposite of flat feet) are unusual. So, children with high arch feet are the ones to watch.

See the following link for more info: https://theconversation.com/best-evidence-suggests-most-childrens-flat-feet-will-be-fine-176673?utm_source=newsletters&utm_medium=email&utm_campaign=ttt-issue69-22mar2022


LISS or HITT training – which is best?
South Cambridge Physiotherapy Blog. The first thing to know about HIIT or LISS training is that they are not training programmes, in that they don’t have a specific number of sets, repetitions or even specific exercises that have to be included. What they are, are different approaches to exercise. HIIT training stands for High Intensity Interval Training and as the name suggests involves short intervals of training performed at a high intensity with short breaks in between. LISS stands for Low Intensity Steady State and is defined as being the opposite of HIIT training in that it involves exercises performed at a much lower intensity over a longer period of time with minimal rest. It is important to note that there is no one magic exercise or even approach to exercise that will guarantee perfect results. Generally, when choosing exercises or training, the best approach is to choose one that you are going to enjoy because studies have shown that the more you enjoy an exercise the more likely you are going to keep it up in the long term. That being said, both HITT and LISS have their own drawbacks and benefits these can make all the difference when choosing which type of training is right for you. Some things to bear in mind when choosing a training method is what is your end goal? Cardiovascular health, weight loss, injury recovery/prevention, training for a specific sport or event, or even just general health, wellbeing and enjoyment. HIIT and LISS impact these goals in different ways and should affect your decision making. Cambridge Physiotherapy Blog cont.

What Are The Benefits Of HIIT Training?

Time Efficient: Generally training takes only 15-20 minutes Fat Loss: Burns more calories in a short amount of time and causes you to continue burning calories even after you stop Fitness: Has been shown to lead to improved increases in both aerobic and anaerobic fitness when compared to LISS training. See link for more info on HITT: https://www.livestrong.com/article/13716442-hiit-for-beginners-6-tips-to-jump-start-your-workouts/

What Are The Benefits Of LISS Training?

Beginner Friendly: LISS is the more approachable of the two training methods and is perhaps easier on someone who is just starting out their fitness journey, recovering from injury or even the more elderly or frail Less Taxing: Because its less intense you need less time to recover between session and can therefore be done more often. You’re Probably Already Doing It: Walking for 1 hour per day is the most common form of LISS training, https://www.byrdie.com/liss Physiotherapy blog cont.

What Are The Drawbacks Of HIIT Training?

Demanding: Due the intense nature of the training it can be demanding both physically and mentally and is therefore not the most approachable form of training to exercise novices or those recovering from illness or injury Risk: With increased demands on the body there is always an increased risk of injury although relatively minor if done correctly

What Are The Drawbacks Of LISS Training?

Time: By its very nature LISS training requires more time to complete and can therefore be less appealing to those who already have many demands on their time Fitness: Although is easier to perform the drawback is that it will probably take longer for you to see any improvements in your fitness or skill levels

Which Type Of Training Should I Choose?

So with all that in mind, which type of training should you choose: HIIT or LISS? As I said above no one exercise or training programme is inherently better than any other. What does make the difference is what your end goal is and choosing the right training method for you to achieve that goal make all the difference If you’re relatively experienced when it comes to exercise, want to see results in a short amount of time and not afraid of a bit of hard work HIIT training might be the way to go. If you’re new to training and exercise, have a bit of time to spare and are recovering from illness or injury LISS training could be for you. Before starting any new exercise or training programme speak to a healthcare professional such as a physiotherapist who can give you some guidance on choosing the right training method for your goals.

Frozen shoulder and hydrodistention injection.

Shoulder Hydrodistention

What is it I here you ask!

Its fundamentally a treatment for persistent contracted frozen shoulders.  Also known as Arthrographic Distension it was first reported back in 1965 but has been generally poorly researched. It’s basically an injection of a local anaesthetic, cortisone and saline (enough to try and stretch the joint capsule) into the shoulder joint with a contrast, which allows the procedure to show up on an imaging device. The injected fluid can be seen to expand the joint which is thought to disrupt adhesions of the shoulder capsule or even burst it.

How does this improve your pain and movement?

It is proposed that its benefits are derived from a combination of the anti‐inflammatory effect of cortisone with the mechanical effect of joint distension, thereby reducing the stretch on pain receptors in the glenohumeral joint capsule and its attachements.

The great thing about this procedure is it takes 15-20 minutes to perform and is very little risk.


Whats the evidence for this procedure.

Leonard Funk (consultant physiotherapist) reports the following outcomes from one of his studies:

  • 75% patients report a good or excellent overall response and 95% report reduced pain scores and improved movement.
  • 100% reduced medication use and15% have the injection repeated depending on the symptoms

Most of the research is of a poor standard with small sample size, poor methodology and significant heterogeneity.

Cochrane Review 2008 included 5 RCTs and concluded that…

  • Hydrodilatation does no harm
  • At best it reduces disability over the short term and might improve pain levels
  • However, lower quality evidence does provide support for this technique
Shoulder pain

Initial conservative treatment is definitely recommended prior to such an injection. This includes physiotherapy (exercises and manual therapy) analgesia and a steroid injection (if pain is significant). If your symptoms of pain and stiffness persist then a hydrodistention injection might be an option for you to consider.