Below you will find information on some of the common conditions that we deal with on a regular basis. This is not an exhaustive list - if you are unsure whether we can treat your particular problem, simply contact us and we will be able to advise whether we can help and what the most appropriate treatment is.
Back & Neck
Whiplash injury is most frequently caused by a sudden and rapid movement of the head forwards, backwards or sideways, although forwards is the most common. The head is a relatively heavy body-part and if we are ‘stopped in our tracks’ the forward trajectory tends to propel the head forwards. This movement will be stopped, either by the neck muscles reacting and bringing the head back to a neutral position and/or other soft tissues such as ligaments which act as ‘straps’ holding the individual vertebrae together. Damage to the muscles (a strain), or the ligaments (a sprain) will result when the force is too great and they become damaged.
Neck pain, headaches, ‘pins and needles’, muscle spasm are all possible symptoms which can last for some time depending on the extent of injury.
Treatment options: Must include visiting a hospital or your GP following accidents, or when symptoms appear serious. Painkillers may be prescribed and massage as well as mobility exercises should follow to restore normal function.
A disc may be referred to as ‘slipped’ when it is either prolapsed or herniated. In both instances the disc which sits between each pair of spinal vertebrae will be bulging and putting pressure on a nerve root leaving the spinal cord, or the cord itself. Each intervertebral disc is formed of cartilage and a soft gel centre, and together with 24 mobile vertebrae they facilitate movement and shock absorption throughout the spinal column. Any impingement of a nerve may cause pain, weakness, numbness, tingling, pins and needles, and often radiating to other areas of the body.
Discs may be subject to sudden traumatic events, sometimes initiated by bad lifting, or by degeneration from repetitive activity, or ageing. Slipped discs most commonly affect people between the ages of 30 and 50 and whilst high percentages of people suffer backpain, only a small number of those have ‘slipped discs’.
Treatment options: May include a variety of tests to measure strength, mobility, reflexes, and posture followed by manual therapy and therapeutic exercises aimed at restoring normal function. Severe cases should refer to their GP or hospital.
Sciatica may commonly arise from compression or impingement of the sciatic nerve in one of two areas, the spinal structures in the lumbar region, or a deep group of muscles under the gluteals which are collectively known as the piriformis group. In the latter case, because the sciatic nerve passes underneath the group and surfaces from under the piriformis muscle, or in some people, actually through the belly of the muscle, if the muscle should become tight and inflexible it will compress the sciatic nerve.
Once the sciatic nerve becomes irritated, symptoms may include pain, numbness, ‘pins and needles’ or tingling that radiates anywhere from your lower back or gluteal area to your legs and even your feet. Sometimes the calf and foot muscles may be weak as well and symptoms may range from mild to serious. The condition may be worsened by long periods of sitting, coughing, sneezing, and lifting.
Treatment options: Accurate assessment of this condition is essential to understand the cause and area to be treated. If it is arising from the lumbar spine, further investigation may be necessary including X-Rays and/or MRI scans. Treatment will depend on the location of the problem but will be focused on alleviating pressure on the sciatic nerve.
Acromio-Clavicular (AC) Sprain
An acromio-clavicular sprain is usually caused by driving the shoulder upwards so that the joint between the bones of the shoulder blade and collar bone on top of the shoulder, are forced apart, stretching or tearing the capsule and ligaments that bind the two together. This often starts with landing on an outstretched arm as the person falls – for example, in a rugby tackle, or falling off a bike.
Treatment options: May include a sling, rest, massage, mobility exercises, and ice massage, restoring strength and normal movement patterns.
Rotator Cuff Injury
The rotator cuff group of 4 muscles stabilises the head of the humerus and assists in rotational movements of the arm. They are susceptible to tears and tendonitis problems, primarily from throwing type activities and although all sectors of the population are affected, they are more prevalent in those aged 55+. Inflamed muscles and discomfort when lifting the arm towards horizontal positions are common signs of rotator cuff problems which should be treated quickly to avoid more chronic and serious conditions developing.
Treatment options: May include reducing the activities that aggravate the condition, maintaining flexibility and restoring strength. Engaging in regular overarm actions will maintain mobility and strength in those advancing in years.
Shoulder Pain and Frozen Shoulder
This condition can be quite erratic in its’ nature, and therefore often presents signs and symptoms that can prove difficult to treat. Discomfort or pain and stiffness of the shoulder may have been precipitated by surgery and/or a period of immobility, leading to capsulitis, or inflammation of the capsule that holds the shoulder joint together. Sufferers usually find it difficult or painful to lift their arm above a horizontal position and it therefore affects everyday activities.
The symptoms of pain and lack of mobility usually increase over months, or years, followed by stiffness in the joint. The condition may improve over time and with treatment, but this can sometimes be a quite lengthy period.
Treatment options: May include manual therapy, exercises, painkillers, corticosteroid injections, and sometimes surgery.
Lateral Epicondylitis (Tennis Elbow)
Tennis elbow arises from repetitive action involving gripping, coupled with any movements that extend the wrist, such as backhand in tennis, rowing, or using a screwdriver. This in turn may lead to micro-trauma within the tendon structure and the consequent inflammatory response. If you experience tenderness to the area just below the elbow on the back of the forearm, close to where the common wrist extensor muscles attach to the bone, may be suffering from tennis elbow.
Treatment options: May include massage and stretching to both the forearm extensors and flexors, checking equipment and techniques used in sporting action.
Not sure who to see? Contact us
Medial Epicondylitis (Golfers Elbow)
Similar to tennis elbow, golfers elbow arises from repetitive action involving gripping, coupled with any movements that flex the wrist. This in turn may lead to micro-trauma within the tendon structure and the consequent inflammatory response. If you experience tenderness to the area just below the elbow on the front of the forearm, close to where the common wrist flexor muscles attach to the bone, may be suffering from tennis elbow.
Treatment options: May include massage and stretching to both the forearm flexors and extensors, checking equipment and techniques used in sporting action.
Wrist & Hand
Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a common condition caused by compression of the median nerve, which controls sensation and movement in the hands. The carpal tunnel is formed by a ‘U’ shape of small carpal bones in the wrist through which tendons, nerves, and blood vessels pass to the hand. Across the top of the ‘U’ shape is a tough band of connective tissue that compresses these vessels into a tunnel. If the nerve becomes inflamed, it will continue to be irritated by the swelling in a confined space leading to tingling sensations, ‘pins and needles’, numbness, weakness, and sometimes pain in the hand and fingers. Muscles in the forearm may also ache as well. The condition can develop following prolonged periods of activity such as typing and symptoms are often worse at night.
Treatment options: In some instances, this condition will resolve itself without intervention. Up to 50% of pregnant women may suffer from CTS and again, symptoms will normally disappear within 3 months after a baby is born. Wrist splints and corticosteroid injections are sometimes administered and in other cases surgery will be effective.
Trigger finger is caused by an inflamed tendon that no longer passes smoothly through a tendon sheath so it tends to stick and then continue with a ‘jerky’ action, similar to pulling a trigger.
If the tendon becomes swollen and inflamed it can 'catch' on the tendon sheath making it difficult to move the affected finger or thumb and this can result in a clicking sensation.
The condition can affect one or more fingers and sometimes both hands although more commonly appears to affect the ‘dominant’ limb only. The inflamed tendon will often be uncomfortable and painful when pressed. Severe cases of Trigger Finger may result in the finger becoming stuck in a flexed position, until straightened with the other hand, and in a few cases, this may not be possible.
Treatment options: The exact cause of this condition is unclear but rest and medication is usually recommended. Splinting the affected finger may assist in limiting movement and anti-inflammatory drugs or injections may help.
Hips & Pelvis
Runners Hip (bursitis)
On the outermost part of the leg, close to the hip is a large bony prominence over which lies a connective tissue sheath known as the iliotibial band (ITB). As we walk or run the band glides smoothly over the bony prominence, aided by a bursa which is a fluid-filled sac. Attaching into the sheath are some powerful muscles that aid in our walking and running movements. If these become tight and are not loosened off by stretching, the ITB can start to ‘friction’ over the bone, leading to soreness, irritation, and inflammation.
Shoes, running style, training levels and biomechanics must all be checked to ascertain the reason for the tightness in the ITB.
Treatment options: May include massage to lengthen the ITB, correction of gait, adjustment to exercise regime, and prescribed stretches to help loosen the ITB and associated muscles.
Thigh & Knee
The 3 muscles that form the hamstrings span both the hip and knee joints and are responsible for knee flexion and hip extension when they contract. It is believed they are most vulnerable to injury when they are slowing down the knee during extension as we prepare for ‘heel strike’ when running. At this point the muscles are contracting at the same time as they are lengthening, otherwise known as an eccentric muscle contraction. This combined with opposing the force generated by the quadriceps muscle group may lead to a strain in the hamstrings, and this will be graded according to severity. The injury will often be accompanied by bruising and discomfort.
Treatment options: Initial treatment will usually involve applying ice, and resting until the early stages of healing are established. As the repair process develops, strength and flexibility must be re-established before coordination, speed and a return to sport.
Cruciate Ligament Injury
There are 2 major cruciate ligaments within the knee and the more commonly injured anterior cruciate ligament (ACL) is the larger of the two. They both work to stabilise the knee during movements, in particular flexion, extension and rotation. When either ligament is subject to an aggressive movement they may become stretched, or torn, and the severity of injury will depend on how much the ligament has become loaded. The knee will often respond by swelling and the person will be uncomfortable walking on the affected leg. Assessment may involve applying ‘special tests’ to check the integrity of the ligament and this may be confirmed with MRI scans depending on the level of injury.
Treatment options: Initial aims will be to reduce the swelling allowing for a more accurate diagnosis. The extent of damage to the affected ligament will determine the treatment and rehabilitation which may be conservative, or necessitate surgical intervention to repair, or replace the ligament using tendon tissue from elsewhere.
Foot & Ankle
Plantar Fasciitis is a common foot condition, usually caused by overuse arising from inflammation of the soft tissues which connect to the front of the heel bone. Someone suffering from plantar fasciitis will feel pain on the underside of the thick heel pad towards the front; this will be worse in the mornings, particularly when placing the feet on the floor and taking first steps, or after a period of sitting. For more information on plantar fasciitis, read our Plantar Fasciitis blog post.
Treatment options: May include massage, flexibility and strength exercises, night splints, ice massage, foot orthotics, changing existing footwear and/or activities.
Not sure who to see? Contact us
The Achilles tendon is the largest tendon in the human body and must withstand enormous strain as it forms the link between the two calf muscles and a common attachment into the heel bone, or calcaneum. Tendons are tough, resilient and possess some elastic qualities which allows them to stretch and generate force as they recoil after being stretched. The calf muscles are responsible for plantarflexing the foot which in turn, means raising the entire body weight upwards so both the muscles and their respective tendon are subject to considerable strain on a frequent basis. The tendon may therefore be susceptible to overuse with any increase in activity, but particular those that involve impact such as running on hard surfaces, jumping, etc. This may result in inflammation and soreness to the tendon.
Treatment options: Footwear, biomechanics and training levels must all be examined carefully to try and determine the cause of the problem. Treatment may include releasing tension in the plantar muscles of the foot, the calf muscles, and the hamstrings, plus any necessary adjustment in activity.