We offer treatment for all musculoskeletal problems, a list of these is given below:
- Any sports injury, ligament, muscle or joint problems
- Ligament injuries
- Knee injuries such as patello-femoral tendonitis, cartilage tear
- Chronic and acute soft tissue injuries
- Tennis or golfers elbow
- Repetitive strain injuries
- Arthritis, lower back pain, neck and shoulder pain
- Whiplash injuries, spinal disorders
- Back pain
- Core stability training and post-surgery rehabilitation
- Post-surgery rehabilitation
- Hamstring/Calf strain or tear
- Iliotibial band
Sport injury: can be either traumatic, as in a high velocity impact causing serious damage or something that is caused by overuse. In each case a sports injury can result in many different types of injury to many different areas of the body. There can be either a fracture of a bone, dislocation of a joint, complete or partial tear of a muscle belly, ligament or tendon.
Sports injuries can be either chronic or acute. your injury has become chronic if it has been more than 6 weeks since your injury. Acute injuries can be any injury up to 6 weeks. There are important healing implications with the chronicity of your injury, if your injury is chronic then treatment may take a little longer to settle your symptoms. If your injury is acute then it should respond well to rest, ice, elevation and sometimes compression.
The ligaments in the knee hold the two bones (femur and tibia) together. The ligaments in the knee are called collateral ligaments, these take time to heal as the blood supply there is poor. Other ligaments commonly injured are those in the ankle. Usually the anterior talo-fibular ligament on the outside of the ankle which holds the talus and the fibula together. Ligaments are tough and fibrous and very strong and because of this, sometimes in sports injury the ligament is pulled but doesn’t tear at all which causes a bit of the bone to be pulled off instead – this is called an avulsion fracture.
There are several injuries that can occur around the knee and the mechanism of the injury can often be very telling and give the therapist the right diagnosis. Knee injuries such as patello-femoral tendonitis is the Inflammation of the tendon over the top of the knee joint that attaches onto the tibial tuberosity which is a bony lump on the top of the tibia bone in the lower leg, this can be aggravated by kneeling and moving from sitting to standing.
Cartilage or a meniscal tear of the knee is commonly injured in sports. You may tear a meniscus by a forced twisting movement whilst you are weight bearing on that leg. How serious the injury is depends on how much is torn and the exact site of the tear, there are many different degrees and types of tear that occur.
Meniscal tears may also occur insidiously without any direct trauma. On occasions a tear develops due to repeated stresses to the cartilage causing tiny stress tears or caused by a degeneration of the joint (wear and tear) often occurring in early to middle age. Due to poor blood supply, cartilage does not heal very well once it is torn. Smaller tears may heal in time however larger tears do not heal as well and may need surgical trimming or repair. There are other cartilage tears that occur in the shoulder or the hip joint.
Tennis or golfers elbow
Tennis Elbow (Lateral Epicondylitis) is a common cause of elbow pain and not always as a result of playing Tennis! pain on the outside of the elbow can radiate also down the forearm from the outer side of the elbow and wrist and hand activities can cause further pain at the elbow. This condition is often caused by certain gripping activities or repetitive wrist movements. There is usually inflammation of the tendons that attach to a bony point, the lateral epicondyle of the elbow. The muscles that lift your fingers and wrist up extend all the way up to the elbow and any repetitive wrist movements such as playing tennis, flicking the wrist or turning the forearm can aggravate and inflame the tendons of these muscles. There is also pain if the elbow is straight and the hand is moved forward and back at the wrist. Golfers elbow is less common and is the inflammation of the tendons running along the forearm that bend the wrist downwards. As with any tendon injury sometimes a course of non-steroidal anti-inflammatory drugs ( NSAIDs ) prescribed by a doctor and a period of rest from aggravating activities is advisable.
Elbow supports are useful and can relieve stress and offload tension on the inflamed tendon. Ice is excellent for relieving the pain of Tennis Elbow by massaging an ice cube over the affected area. Acupuncture as an adjunct to conventional treatment is excellent for providing pain relief and once your symptoms have subsided strengthening and stretching exercises of the nerves and forearm muscles can minimise any future re-occurence.
Repetitive Strain Injuries
Repetitive strain injuries (RSI) an umbrella term for the inflammation of any tendon, muscle, ligament or nerve that is usually caused by repetitive actions, occupational vibration or overuse. RSI can cause pain and swelling over the affected area requiring local anti-inflammatory treatment, stretches and strengthening. The following conditions are all caused by repetitive strain:
- Carpal Tunnel Syndrome
- Cubital tunnel syndrome
- DeQuervain’s syndrome
Unfortunately repetitive strain injuries are becoming more common with an increased computer and mobile phone use. RSI conditions may be due to an activity where the body will be required to perform repetitive tasks. Some people are more susceptible to repetitive strain injuries and this risk can increase especially in office workers if the correct body posture or position of equipment is not adopted.
RSI is also known as an occupational overuse syndrome. There are preventative measures you can take that may help with repetitive strain injuries Many occupational health departments now offer an indepth ergonomic assessment of your workstation if your injury is desk/computer related. This is useful and ensures that you adopt the correct posture to minimise injury. In addition specialist adapted equipment can be used to prevent RSI. Office workers are always advised to get appropriate ergonomic assessment of their work station regularly. Manual workers using vibrating equipment are also in a high risk group of developing a condition known as Hand arm vibrationsyndrome.
This type of injury to the neck is sustained by a road traffic accident in which the neck is thrusted forwards and backwards or sideways causing damage and over-strain of the muscles and ligaments in the neck. Whiplash can cause pain and stiffness where it is difficult to even turn the head and may even cause headaches and pain referring down the back of the spine or down into the arms. Physiotherapy for an acute whiplash injury is essential in order to maintain full movement of the neck.
Lower Back pain
Lower back pain can be central to the lumbar spine and be due to poor posture or weak core stability. Daily postural stresses that we put our backs under for example sitting slouched and generally not looking after the back by lifting things that are too heavy on a regular basis all contribute to back pain. These daily stresses to the lower back can cause the tissue that holds the disc in place to weaken and sometimes the disc can become irritated and inflamed. At times the disc can bulge out pressing on the surrounding nerves that descend into the leg, this is called referred pain. It is very important to seek treatment early to prevent this type of referred pain as if not seen quickly this may develop into a more chronic problem that is difficult to settle. There are many types of physiotherapy techniques that can help to treat back pain and once this has been settled by your physio a comprehensive core stability program can be introduced in order to strengthen the back to help minimise any further problems in the future.
Core Stability Training
This is so important if you are prone to back pain. The muscles of the abdomen are in layers and the deepest layer is close to the spine and can provide good spinal stability. Building up core stability correctly can take time however if you make this a priority it may minimise the number of episodes of back pain or injury you experience.
There are two forms of arthritis – Rheumatoid Arthritis which is an inflammatory condition caused by the immune system or Osteoarthritis which is a degenerative condition which is basically general wear and tear of the joint caused by age. Osteoarthritis, is the most common form of arthritis can cause pain, stiffness and loss of function at any joint. This could be the neck, hips, the back, the shoulders or knees. The wrist, thumb joints and elbows can also be affected. Osteoarthritis may develop earlier due to injury or overuse.
When you have osteoarthritis the cartilage that covers each surface of the bone to enable smooth articulation can wear down. This can affect the function of the joint, cracks may appear in the cartilage or it may become frayed and synovial fluid inside the joint may seep out causing cysts. Cartilage may even wear away completely which causes the normal gap between the bones may become smaller until the joint space is lost and the bones grind over each other. Areas of cartilage may become detached as is common in the knee causing locking or giving way in the joint. These fragments of bone or cartilage may float in the joint space, causing further damage and pain. If you suffer from Osteoarthritis then you may experience stiffness of the joint in the morning, pain when you move, pain when you have been still for a while, redness or swelling around the joint.
Whether you have had a knee arthroscopy, an ACL repair or a hip replacement, post surgery rehabilitation is extremely important for its full recovery. It is very important to continue with the exercises advised by your hospital however these often need progressing in order to build strength, balance and endurance in the long term.
Hamstring/Calf strain or tear
This is where, usually a sporting injury, there is a tear or a separation of the muscle fibres in the back of the lower leg. These usually heal very well with treatment however some larger tears may need surgical repair. Treatment can be beneficial in breaking down fibrous scar tissue that has built up which may be restricting the optimum function of the muscle, and stretches and strengthening are important after this injury in order to return to sporting activities fully.
Iliotibial band (ITB)
This is a fibrous band of fascia that runs along the lateral side of the leg from the hip to the knee. Many muscles attach and insert into this band and provides an essential anchor the leg muscles. Sometimes this band can become very tight and may cause hip or knee pain. Myofascial release, where slow deep strokes with the point of the elbow along the whole lateral side of the leg, is very effective in easing this pain.