Category: Physio

Physiotherapy articles where our team discusses issues around injuries, rehabilitation, exercises and stretches.

Golfers Elbow

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Golfers elbow, clinically known as medial epicondylitis, is a condition that causes pain around the inside of the elbow joint. Often occurring after repetitive overuse of the forearm muscles and tendons used for moving the wrist and hand. Due to the constant strain of the wrist flexors on the insertion (attachment) point, inflammation or micro tears can occur.

Golfers elbow is a musculoskeletal condition usually seen in people aged 40 – 60, whose daily activities include repetitive wrist flexion. Despite generally being diagnosed in golfer’s, the injury can occur in several other professions or sporting activities.

The level of pain associated with the pathology can vary from a mild niggle to a severe ache. Fortunately there are many different treatments available to help, with more than 80% of people recovering with basic treatment.

Anatomy

Your elbow joint is a joint consisting of 3 bones. The first is in your upper arm and known as the Humerus. The other 2 bones are in your forearm and known as the Radius and Ulna bones. At the bottom of the humerus there are small bony prominences called epicondyles, where muscles within the forearm attach. The bony prominence located on the inside side of the elbow is called the medial epicondyle.

Muscles, ligaments, and tendons play a huge role in holding the elbow joint in position with strength but also flexibility to move.

Medial epicondylitis, or Golfer’s elbow, is a condition that affects the muscles and tendons of your forearm which attach onto the medial epicondyle. Research suggests that the flexor carpi radialis (FCR) and the pronator teres are the muscles most commonly affected.

Symptoms

The symptoms of golfer’s elbow usually develop over a long period of time. In the vast majority of cases the pain can be minor and more of a side note but can worsen over time. In most cases there is no specific mechanism of injury associated with the condition, it is usually due to repetitive overuse.

Common signs and symptoms of tennis elbow include:

  • Pain or burning on the inner part of your elbow
  • Weakness or pain when gripping, lifting or twisting objects
  • Pain when straightening the arm
  • Sometimes, pain at night

The symptoms are often worse when the forearm is being used in activities that can be as simple as pouring water into a cup, using a screw driver even shaking hands.

Causes

Overuse – As mentioned previously the underlying cause of Golfer’s elbow is overuse, causing the tendons of the muscles to become inflamed. Overtime this inflammation can lead to small tears within the tendon or muscle. Recent studies have shown that particular muscles when damaged can play a large part in the cause of Golfer’s Elbow. These muscles are located in the forearm, known as the flexor carpi radialis (FCR) and the pronator teres. When these muscles become injured or weak from overuse they can get very tight causing the muscles to shorten and pull on the tendons at the insertion point. This constant pull on the tendons is what then causes the inflammation and micro tears, resulting in pain.

Activities – Activities play a large part in the cause of Golfer’s Elbow (Medial epicondylitis). As you would expect Golf and other sports are a factor in the case of Golfer’s Elbow (hence the name) however, anyone can get it and it could even be down to work related overuse. Professionals such as Plumbers, Electricians, Carpenters, Factory Workers and Office Workers can get this condition, any work where grip and wrist strength is important.

Age – Anyone can get Golfer’s Elbow at any stage in their life depending on the activities they are doing and how they are using their arm. That said, the majority of cases we see can range between the ages of 40 and 60.

Diagnosis

When discussing this issue with your doctor, they will take into consideration a number if factors before making a diagnosis. These will include how your symptoms developed, your work and your hobbies etc.

The Doctor will discuss how and when the symptoms occur and are more severe and where on the arm the pain / symptoms are materialising. You will need to make sure you inform your doctor of any underlying health issues such as Arthritis (RA or Osteo), you you have injured your elbow in the past or any other medical issues that has a baring on your elbow.

There are a number of tests the doctors can and should perform during your examination such as asking you to try straighten your wrist and fingers with the doctor providing resistance with your arm straight.

Your doctor may recommend additional tests such as X-rays, Magnetic resonance imaging (MRI) scan or an Electromyography (EMG) – this will be to rule out nerve compression.

Golfers Elbow Treatment

Golfer’s elbow is a condition that will eventually get better over time, the length of time will be determined by how much you are using the arm in the way in which it was damaged in the first place. This may mean you will need to stay off certain activities indefinitely for a period of around 6-8 weeks. This could be shorter or longer depending on what state the injury is in.

However, there are treatments that can be used to speed up your recovery and ultimately help alleviate symptoms while you recover.

The first stage in any recover is

REST. It is important you rest your injured arm and stop doing the activity that’s caused the problem in the first instance.

ICE – Apply a cold compress to the injured arm, such as a bag of frozen peas or a sports ice pack / gel pack for a few minutes several times a day, this will reduce inflammation and ease the pain. Some people have great success with contrast bathing the area so for example, icing the joint itself (the bony / tendonous areas) and using heat on the muscular areas such as Forearm to relax the muscles and speed up recover.

PAINKILLERS – Taking Paracetamol to ease the pain and Non-Steroidal Anti-Inflammatory’s such as Ibuprofen to reduce the inflammation can help greatly whilst in recovery.

MASSAGE – Asking your personal Sports Massage Therapist / Massage Therapist to perform massage on the arm offering STR (Soft Tissue Release) as well as general massage to relax the area and stimulate blood flow can really help to speed up recovery and make you feel better.

PHYSIOTHERAPY – Physiotherapy should be considered with other conservative treatment options especially for more severe and persistent cases.

A good rehabilitation plan with those elements mentioned above has seen great results and improved recovery time as well as reduced inflammation, reduced pain and improvement to the range of movement in your arm.

SURGERY – may be an option if the issue persists and you have gone through a considered and tailored physiotherapy and massage program as a last resort to remove the damaged part of the tendon.

Exercises

 

  1. Wrist Flexor Stretch
  1. Start Position: Extend your arm straight in front of you with your palm facing up.
  2. Movement: Use your other hand to gently pull back on the fingers of the extended hand, bending the wrist downward.
  3. Action: Hold the stretch when you feel a gentle pull along the inside of your forearm.
  4. Hold: Maintain this position for 15-30 seconds.
  5. Switch: Repeat on the opposite arm.
  1. Wrist Extensor Stretch
  1. Start Position: Extend your arm straight in front of you with your palm facing down.
  2. Movement: Use your other hand to gently pull the fingers of the extended hand back towards your body.
  3. Action: Hold the stretch when you feel a gentle pull along the top of your forearm.
  4. Hold: Maintain this position for 15-30 seconds.
  5. Switch: Repeat on the opposite arm.
  1. Wrist Flexor Strengthening (with a Dumbbell)
  1. Start Position: Sit on a chair and rest your forearm on your thigh, holding a light dumbbell (1-3 lbs) in your hand with your palm facing up.
  2. Movement: Slowly curl the dumbbell upwards by flexing your wrist.
  3. Action: Lower the dumbbell back down in a controlled manner.
  4. Repetitions: Perform 10-15 repetitions for 2-3 sets.
  5. Switch: Repeat with the opposite arm.
  1. Reverse Tyler Twist (Using a Flex Bar)
  1. Start Position: Hold a Flex Bar vertically with your injured arm at the bottom, palm facing inward.
  2. Movement: With your other hand, grasp the top of the Flex Bar and twist it downward.
  3. Action: Slowly extend your injured arm while keeping the twist in the Flex Bar.
  4. Repetitions: Perform 10-15 repetitions for 2-3 sets.
  5. Switch: Repeat on the opposite arm if necessary.

There are a number of exercises you can perform to help in the Recovery of Golfers Elbow but also to help strengthen the area to help in the prevention moving forward. We have put together a video of some of the popular and most effective exercises / rehabilitation programs for this condition.

Prevention

It’s not easy to avoid getting golfers elbow as it can be very minor issues that cause it. However a dynamic and considered training program with a qualified strength and conditioning coach can really help. Further to this if your injury was caused through overuse then looking at reducing that particular activity until you have strengthen the area or looking at other ways to do the task in question will help.

The video above is not just to help rehabilitate the area it will also help in strengthening the area and again you should seek professional advice for this.

If you need any help with your rehabilitation of this particular issue our sports therapy specialits and physiotherapy specialists can help. Please contact us today.

Sciatica

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Sciatica is a specific type of pain that radiates down the sciatic nerve. Which extends from your lower back, into the glutes and down the back of the legs, however sciatica generally takes place down one side of your body. The main cause of this happening is when a herniated disk, which is bone spur on the spine, compresses part of the nerve. This can cause numbness and pain in the legs and also inflammation. Generally this is not considered as anything serious and in most cases will goes away after a few weeks. On rare occasions a patient may need surgery but this is only a result if there is a significant weakness in the legs.

Anatomy

The sciatic nerve is the biggest and longest nerve in the human body, starting at the base of the spine, into the gluteal region and running down the back of the leg into the toes. The sciatic nerve is formed in the lower spine by the combination of motor and sensory fibers from spinal nerves L4 to S3. These spinal nerves belong to a larger group of nerves in the lower spine called the lumbosacral plexus.This long, thick, nerve then divides into the Peroneal and Tibial nerves which innervate different parts of the lower leg, foot and toes.

Symptoms

Pain that forms and travels through your legs up via your glute and into your back is the biggest and most common sign that you may have sciatica. Discomfort can be felt almost anywhere but this is more apparent through the nerve pathway through the areas stated above. Feelings such as burning pain can be felt through sciatica and this may be mild or severe. This can sometimes feel worse or be more painful when you sneeze or cough, additionally sitting for a long period of time can also aggravate this more. Another main symptom is numbness or tingling, this is commonly known as the phrase pins and needles. Muscles can also tighten and become weak in the leg and foot.

Causes

Sciatica occurs when an overgrown bone is on your vertebrae/ herniated disk in your spine and results in the sciatic nerve getting pinched. 

Some factors such as age can not prolong sciatica. There is sometimes nothing you can do to stop this. Obesity can also be a factor as this puts stress on your spine and the extra weight can cause spinal changes leading to sciatica. Your job can also play part as a factor, for example if you have a heavy lifting job or a job that requires you sitting down for long periods of times like driving long distances. Diabetes can also enhance sciatica because of the way your body uses blood sugar, and increases your risk of nerve damage. Finally not being active can also trigger sciatica.

Diagnosis

Sciatica is commonly diagnosed through the patients history taking and physical screening. By definition patients mentioning the radiating pain in the leg will spark the sciatica diagnosis. They may be asked to report the distribution of the pain and whether it radiates below the knee and drawings may be used to evaluate the distribution. Sciatica is characterised by radiating pain that follows a dermatomal pattern.Physical examination largely depends on neurological testing. The most applied investigation is the straight leg raising test.

Treatment

As stated before sciatica can go on its own so in most cases you won’t have to do an awful lot however some cases are worse than others and there are various things that you can do to help treat this. Easy things like making sure that you stretch regularly can help massively. This allows you to keep your muscles stretched out and start to stimulate the nervous system. 

A qualified soft tissue specialist providing Sports Massage can be really beneficial with techniques such as Soft Tissue Release and also Nueromuscular therapy. This also helps stretch the muscles and really stimulate the nervous system by increasing the blood flow especially in the legs.

It is also important if this persists to seek help from a qualified sports therapist or physiotherapist who can work with you on a rehabilitation plan that will involve exercises and stretches.

Exercises

Glute Max Stretch

  1. Start Position: Lie on your back with your knees bent and feet flat on the floor.
  2. Movement: Cross your right ankle over your left knee, forming a “figure 4” shape with your legs.
  3. Action: Reach your hands through your legs and pull your left thigh towards your chest.
  4. Hold: Maintain this position for 20-30 seconds while feeling a stretch in your right gluteus maximus.
  5. Switch: Repeat on the opposite side.

 

Piriformis Stretch

  1. Start Position: Sit on the floor with your legs extended straight in front of you.
  2. Movement: Cross your right leg over your left leg, placing your right foot flat on the floor next to your left knee.
  3. Action: Twist your torso to the right and use your left elbow to gently press against the outside of your right knee.
  4. Hold: Hold this position for 20-30 seconds, feeling a stretch in the right piriformis muscle.
  5. Switch: Repeat on the opposite side.

 

Hamstring Stretch

  1. Start Position: Sit on the floor with one leg extended straight in front of you and the other leg bent with the sole of your foot against your inner thigh.
  2. Movement: Reach forward towards your toes of the extended leg while keeping your back straight.
  3. Action: Lean forward from your hips until you feel a gentle stretch along the back of your thigh.
  4. Hold: Hold this stretch for 20-30 seconds.
  5. Switch: Repeat with the opposite leg.

 

Quadricep Stretch

  1. Start Position: Stand upright, holding onto a wall or chair for balance if needed.
  2. Movement: Bend your right knee and bring your heel towards your buttocks.
  3. Action: Grab your ankle with your right hand and gently pull it closer to your buttocks.
  4. Hold: Hold this position for 20-30 seconds, feeling the stretch in the front of your thigh.
  5. Switch: Repeat on the opposite side.

 

Trigger Point the Piriformis Muscle

  1. Start Position: Sit on the floor with your knees bent and feet flat on the ground.
  2. Equipment: Use a foam roller or a small, firm ball.
  3. Placement: Position the foam roller or ball under your right buttock, near the area where you feel tension or discomfort.
  4. Action: Slowly roll your body over the roller or ball, applying pressure to the piriformis muscle. You can adjust your body angle to target different areas.
  5. Duration: Spend about 1-2 minutes working on each side, focusing on areas of tightness or tenderness.
  6. Switch: Repeat on the opposite side.

Please see some exercises and stretch examples in our video provided or alternatively contact one of our personal trainers who can talk you through these exercises.

Prevention

As Sciatic can be idiopathic it is not easy to prevent its occurrence. If possible avoid repetitive activities, when unavoidable take time to perform stretches and take regular breaks. Be aware of the first signs of symptoms developing, the earlier you start treatments the quicker it can be resolved.

If you are suffering with Sciatica

Understanding Spinal Manipulation

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Spinal manipulation, a therapeutic intervention involving the manual adjustment of the spine, is widely used to address various musculoskeletal issues, particularly back pain. This technique, often associated with chiropractic care or osteopathy, can also be effectively administered by massage therapists, soft tissue specialists, sports therapists, and physiotherapists. These professionals play a crucial role in the holistic management of spine-related conditions, ensuring comprehensive care through their specialised skills and expertise.

What is Spinal Manipulation?

Spinal manipulation, also known as spinal adjustment, involves applying controlled force to a specific joint in the spine. This technique aims to improve spinal motion, alleviate pain, and enhance the body’s overall function. The adjustment often results in a noticeable “cracking” sound, which is the release of gas bubbles from the joint spaces, a phenomenon called cavitation.

The Role of Soft Tissue Specialists

Soft tissue specialists focus on the muscles, tendons, and ligaments surrounding the spine. Their expertise lies in understanding how these tissues interact with the skeletal system. Through techniques such as deep tissue massage, myofascial release, and trigger point therapy, they help relieve muscle tension and improve circulation. By addressing the soft tissues, these specialists can reduce the stress on the spine, enhance the effectiveness of spinal manipulations, and provide lasting pain relief.

For instance, in cases of chronic back pain, a soft tissue specialist might identify and treat muscle imbalances or adhesions that contribute to spinal misalignment. This integrated approach not only supports the spinal manipulation process but also helps prevent the recurrence of issues by ensuring that the surrounding soft tissues are healthy and flexible.

Sports Therapists and Spinal Health

Sports therapists, trained in the prevention, diagnosis, and treatment of sports-related injuries, bring a unique perspective to spinal manipulation. Their focus on functional movement and performance optimization makes them adept at addressing spinal issues that affect athletes and active individuals.

Incorporating spinal manipulation into sports therapy can significantly enhance an athlete’s performance and recovery. For example, a sports therapist might use spinal adjustments to improve an athlete’s range of motion, reduce pain, and prevent injuries. By combining spinal manipulation with other modalities such as corrective exercises, strength training, and biomechanical assessments, sports therapists can create a comprehensive treatment plan that addresses the root cause of spinal issues and promotes overall spinal health.

Physiotherapists: Comprehensive Spinal Care

Physiotherapists, or physical therapists, are healthcare professionals who specialise in restoring and maintaining physical function. They employ a range of techniques, including spinal manipulation, to treat various conditions affecting the spine. Physiotherapists are particularly skilled at integrating spinal manipulation into a broader rehabilitation program.

When dealing with spinal issues, physiotherapists conduct thorough assessments to identify the underlying causes of pain and dysfunction. They may use spinal manipulation to restore proper alignment and mobility, followed by targeted exercises to strengthen the core muscles that support the spine. Additionally, physiotherapists educate patients on posture, ergonomics, and lifestyle modifications to prevent future problems.

Collaborative Care for Optimal Outcomes

The synergy between soft tissue specialists, sports therapists, and physiotherapists ensures a holistic approach to spinal care. By combining their expertise, these professionals can provide comprehensive treatment plans tailored to each patient’s unique needs.

For instance, a patient with chronic lower back pain might start with a soft tissue specialist to address muscle tension, move on to spinal manipulation with a sports therapist to improve spinal alignment and mobility, and finally work with a physiotherapist on strengthening exercises and long-term rehabilitation strategies. This collaborative approach maximises the benefits of spinal manipulation and supports sustained spinal health.

In conclusion, spinal manipulation is a powerful tool in the management of spine-related conditions. When performed by skilled soft tissue specialists, sports therapists, and physiotherapists, it can lead to significant improvements in pain relief, mobility, and overall function. Their integrated approach ensures that patients receive comprehensive care that addresses not only the symptoms but also the underlying causes of spinal issues, promoting long-term wellness and quality of life.

If you feel you are in need of spinal manipulation or articulation then please contact us today or make a booking with one of our professionals.

The healing power of cupping therapy

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Cupping therapy, a form of alternative medicine with roots tracing back to ancient Egyptian, Chinese, and Middle Eastern cultures, has gained considerable popularity in contemporary health and wellness circles. This practice involves placing cups on the skin to create suction, which is believed to enhance blood flow, reduce muscle tension, and promote healing and relaxation. Despite its ancient origins, cupping has found a place in modern therapy, offering a holistic approach to health that complements conventional medical treatments.

The History and Techniques of Cupping Therapy

Cupping therapy dates back thousands of years. Historical records suggest that the ancient Egyptians used it as early as 1550 B.C., as documented in the Ebers Papyrus. The technique also features prominently in traditional Chinese medicine (TCM) and has been practised by various cultures worldwide for centuries.

There are two main types of cupping: dry cupping and wet cupping.

  • Dry cupping involves placing cups on the skin to create a vacuum. This can be achieved either by heating the air inside the cup and then placing it on the skin, causing the air to cool and form a vacuum, or by using a pump to create the suction.
  • Wet cupping, also known as hijama, involves a similar process, but after the suction, the therapist makes small incisions on the skin to draw out a small quantity of blood. This is believed to help remove toxins from the body.

Cups can be made from various materials, including glass, bamboo, earthenware, and silicone. The type of material and method used can vary depending on the practitioner’s approach and the specific needs of the patient.

The Mechanisms and Benefits of Cupping Therapy

The primary mechanism behind cupping therapy is the creation of a vacuum that draws blood to the surface of the skin. This process is thought to improve blood circulation, relieve muscle tension, and promote cell repair. By enhancing the flow of blood and lymphatic fluid, cupping may help in removing toxins and reducing inflammation.

Key Benefits of Cupping Therapy:

  1. Pain Relief: One of the most significant benefits of cupping therapy is its ability to alleviate pain. The increased blood flow to the affected area can help reduce muscle soreness, stiffness, and overall pain, making it a popular choice for athletes and individuals with chronic pain conditions.
  2. Improved Blood Circulation: Cupping therapy stimulates blood flow, which can enhance the delivery of oxygen and nutrients to tissues and promote healing. This improved circulation can also help reduce the appearance of cellulite and varicose veins.
  3. Muscle Relaxation: The suction and negative pressure created by cupping can loosen muscles, encourage blood flow, and sedate the nervous system, which makes it an effective treatment for high blood pressure.
  4. Detoxification: Wet cupping, in particular, is believed to draw out toxins from the body, helping to cleanse the blood and boost the immune system.
  5. Stress Reduction: By promoting relaxation and reducing muscle tension, cupping therapy can help alleviate stress and anxiety, contributing to overall mental well-being.
  6. Enhanced Skin Health: The increased blood flow and detoxification effects of cupping can improve skin health, reducing conditions like acne, eczema, and inflammation.

Modern Applications and Considerations

Today, cupping therapy is widely used by healthcare professionals, including medical acupuncturists, massage therapists, sports therapists and physiotherapists. Its integration into modern health practices underscores its efficacy and adaptability.

However, it is essential to approach cupping with caution. While generally safe when performed by trained practitioners, cupping can cause side effects such as skin discoloration, bruising, and, in rare cases, burns or infections. Individuals interested in cupping therapy should consult with a healthcare provider to ensure it is appropriate for their specific health needs.

In conclusion, cupping therapy offers a compelling blend of ancient wisdom and modern application. Its ability to provide pain relief, improve circulation, promote detoxification, and reduce stress makes it a valuable addition to contemporary wellness practices. As more people seek holistic and non-invasive treatments, the popularity of cupping therapy is likely to continue its resurgence, bridging the gap between traditional healing and modern health care.

If you are interested in making a booking with one of our cupping practitioners, then please use our booking system or contact us directly.

Can Meniscus Tears Heal Without Surgery

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The meniscus is a crucial structure within the knee joint, consisting of two C-shaped pieces of cartilage located between the femur and tibia bones. Acting as shock absorbers, the menisci play a vital role in distributing weight, reducing friction, and stabilizing the knee during movement. These rubbery, wedge-shaped tissues are prone to injury, with tears being one of the most common knee injuries, particularly among athletes and older adults. A meniscus tear can occur due to sudden twisting or rotation of the knee, or as a result of degenerative changes over time.

Can Meniscus Tears Heal Without Surgery?

Whether a meniscus tear requires surgical intervention depends on various factors, including the severity, location, and type of tear, as well as the individual’s age, activity level, and overall health. In many cases, small tears located in the outer edge of the meniscus, where blood supply is more robust, have the potential to heal on their own without surgery. Conservative treatment options such as rest, ice, compression, and elevation (RICE), along with physical therapy exercises focused on strengthening the surrounding muscles and improving range of motion, may be sufficient to rehabilitate a minor meniscus tear. Additionally, corticosteroid injections or platelet-rich plasma (PRP) therapy may be recommended to reduce inflammation and promote healing.

Recovery Timeline for Meniscus Tears Without Surgery:

The healing timeline for a meniscus tear treated without surgery can vary depending on several factors, including the extent of the injury, the individual’s age and overall health, and adherence to the prescribed treatment plan. In general, minor meniscus tears may take approximately four to eight weeks to heal with conservative management, while larger or more complex tears may require a longer recovery period. Physical therapy plays a crucial role in the rehabilitation process, helping to restore strength, flexibility, and stability to the knee joint. It is essential for individuals recovering from a meniscus tear to follow their healthcare provider’s recommendations closely and to avoid activities that place excessive stress on the knee during the healing process. While some meniscus tears may resolve without the need for surgery, others may require surgical repair or partial meniscectomy to alleviate symptoms and restore function to the knee joint.

Rehabilitation of a Meniscus Tear

A meniscus tear can significantly impact knee function and mobility, requiring a structured rehabilitation program to facilitate healing, restore strength and flexibility, and prevent future injuries.

Here’s a comprehensive rehabilitation plan tailored for a meniscus tear, however we would always advise personally seeing a sports therapist or physiotherapist to design a tailored plan:

Phase 1: Immediate Post-Injury (Weeks 1-2)

Goals:

  • Reduce pain and inflammation
  • Protect the injured knee
  • Restore range of motion

Treatment:

  1. Rest: Avoid activities that aggravate symptoms, and use crutches if necessary to offload weight from the affected knee.
  2. Ice: Apply ice packs to the knee for 15-20 minutes, 3-4 times a day, to reduce swelling and pain.
  3. Compression: Use a compression bandage or knee sleeve to control swelling and provide support.
  4. Elevation: Elevate the injured leg above heart level when resting to reduce swelling.
  5. Pain management: Take over-the-counter pain medications as prescribed by a healthcare professional.

Phase 2: Recovery and Mobility (Weeks 3-6)

Goals:

  • Improve knee range of motion
  • Begin gentle strengthening exercises
  • Enhance proprioception and balance

Treatment:

  1. Physical therapy: Start a supervised rehabilitation program focusing on gentle knee mobilization exercises, such as heel slides, passive and active knee flexion, and extension exercises.
  2. Strengthening exercises: Initiate low-impact exercises to strengthen the quadriceps, hamstrings, and calf muscles, including straight leg raises, hamstring curls, and calf raises.
  3. Proprioception training: Perform balance and stability exercises, such as single-leg stance and mini-squats, to improve joint proprioception and reduce the risk of re-injury.
  4. Cardiovascular exercise: Engage in non-weight-bearing activities like swimming, stationary cycling, or aqua jogging to maintain cardiovascular fitness without stressing the injured knee.

Phase 3: Functional Rehabilitation (Weeks 7-12)

Goals:

  • Restore normal knee function and strength
  • Improve flexibility and proprioception
  • Gradually return to sport-specific activities

Treatment:

  1. Progressive strengthening: Advance to more challenging strengthening exercises, including lunges, step-ups, and resistance training using bands or weights.
  2. Flexibility exercises: Incorporate stretching exercises to improve flexibility and mobility in the knee joint and surrounding muscles.
  3. Plyometric training: Introduce controlled jumping and hopping exercises to enhance lower limb power and agility.
  4. Sport-specific drills: Gradually reintroduce sport-specific movements and activities, focusing on proper technique and biomechanics.
  5. Functional testing: Assess readiness to return to sport or high-impact activities through functional tests, such as single-leg hop tests and agility drills.

Phase 4: Return to Activity (Weeks 13 and beyond)

Goals:

  • Full recovery and return to previous activity level
  • Prevent recurrence of injury

Treatment:

  1. Gradual return to sport: Resume full participation in sports or physical activities, starting with low-intensity drills and gradually increasing intensity and duration.
  2. Maintenance program: Continue with a maintenance program of strength, flexibility, and proprioception exercises to prevent future injuries and maintain optimal knee function.
  3. Regular monitoring: Attend follow-up appointments with a physical therapist or healthcare provider for ongoing assessment and monitoring of knee health and function.

In conclusion, understanding the nature of meniscus tears and their potential for healing without surgery is essential for individuals navigating treatment options for knee injuries. While conservative management strategies may be effective for some meniscus tears, others may require surgical intervention to achieve optimal outcomes. Consulting with a healthcare provider to determine the most appropriate course of treatment based on the specific characteristics of the injury is crucial for promoting successful recovery and restoring function to the knee joint.

If you would like help and advice on rehabilitation of a meniscus tear, please contact our team for further information.

Understanding the Meniscus: An Essential Component of Knee Health

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Understanding the Meniscus: An Essential Component of Knee Health

The meniscus, often referred to as the “shock absorber” of the knee, is a vital structure that plays a crucial role in maintaining knee stability and function. Composed of two C-shaped pieces of cartilage nestled between the femur and tibia bones, the menisci act as cushions, distributing weight evenly across the knee joint and providing stability during movement.

Anatomy and Function

Located within the knee joint, the menisci are tough, rubbery tissues that help to absorb shock and reduce friction between the femur and tibia bones. They also serve to stabilise the knee, preventing excessive movement and providing support during activities such as walking, running, and jumping.

The menisci have a crescent shape, with the larger medial meniscus on the inner side of the knee and the smaller lateral meniscus on the outer side. Each meniscus is attached to the joint capsule and ligaments of the knee, ensuring proper positioning and function.

Common Injuries

Despite their resilience, the menisci are susceptible to injury, particularly during activities that involve twisting, pivoting, or sudden changes in direction. Meniscus tears are among the most common knee injuries, occurring as a result of traumatic injury or degenerative changes associated with ageing or repetitive stress.

Symptoms of a Meniscus Injury

Meniscus injuries can cause a range of symptoms, including:

  1. Pain, especially along the joint line of the knee
  2. Swelling and stiffness
  3. Difficulty fully straightening or bending the knee
  4. Popping or clicking sensations
  5. Feeling of instability or “giving way” in the knee

Diagnosis and Treatment

Diagnosing a meniscus injury typically involves a thorough physical examination, along with imaging tests such as MRI or X-ray to confirm the diagnosis and assess the extent of the injury. Treatment options for meniscus injuries depend on several factors, including the severity and location of the tear, the individual’s age and activity level, and the presence of any underlying knee conditions.

Conservative treatment measures such as rest, ice, compression, and elevation (RICE), along with non-steroidal anti-inflammatory medications (NSAIDs) and physical therapy, may be recommended for minor meniscus tears or for individuals who are not good candidates for surgery.

Surgical options may be considered for larger or complex tears, particularly those that interfere with knee function or cause persistent symptoms. Surgical procedures for meniscus tears may include arthroscopic repair, partial meniscectomy (removal of the torn portion of the meniscus), or meniscus transplant for irreparable tears.

Conclusion

The meniscus plays a crucial role in knee health and function, serving as a vital component of the joint’s stability and shock absorption mechanism. Understanding the anatomy of the meniscus, common injuries, and treatment options is essential for maintaining knee health and preventing long-term complications associated with meniscus injuries. Prompt diagnosis and appropriate treatment can help individuals recover from meniscus injuries and return to their normal activities with improved function and reduced risk of future injury.

 

If you feel you are struggling with a meniscus issue, our highly qualified sports therapists and physiotherapists can help design a robust rehabilitation plan. Contact us for more information.

Tennis Elbow

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Tennis elbow is a condition that causes pain around the outside of the elbow joint, the clinical name for this condition is known as lateral epicondylitis. It usually occurs after strenuous overuse of the muscles and tendons of the forearm. It is a very common musculoskeletal condition with an estimated 1 in 3 people having Tennis Elbow at any one time. The condition is more common in adults and across the age demographic of 30-50 years of age. Both Men and women are equally affected by this condition. Not surprisingly, and as the name suggests, playing tennis or other racquet sports can and is a big factor in the cause of this condition. However, several other sporting activities and non sporting activities can also put you at risk. Tennis elbow can be because of inflammation or, in some cases, small tears of the tendons that join the forearm muscles to the bone (epicondyle of the humerus) on the outside of the elbow.

Anatomy

Your elbow joint is a joint consisting of 3 bones. The first is in your upper arm and known as the Humerus. The other 2 bones are in your forearm and known as the Radius and Ulna bones. At the bottom of the humerus there are small bony prominences called epicondyles, where muscles within the forearm attach. The bony prominence located on the later side of the elbow (outside) is called the lateral epicondyle.

Muscles, ligaments, and tendons play a huge role in holding the elbow joint in position with strength but also flexibility to move.

Lateral epicondylitis, or tennis elbow, is a condition that affects the muscles and tendons of your forearm however extensive research has shown one particular muscle can play a large part in Tennis Elbow which is the Extensor Carpi Radialis Brevis (ECRB) muscle. The muscles associated with Tennis Elbow are responsible for the extension of your wrist and fingers.

Symptoms

The symptoms of tennis elbow usually develop over a long period of time. In the vast majority of tennis elbow cases the pain can just be minor and more of a side note but can worsen over time. In most cases there is no specific injury associated with the condition, it is usually a repetitive overuse injury but not in all cases.

Common signs and symptoms of tennis elbow include:

  • Pain or burning on the outer part of your elbow
  • Pain when lifting, twisting or bending your arm (with or without objects)
  • Weak grip strength
  • Sometimes, pain at night on the outside of your upper forearm, just below the elbow.
  • You may also find it difficult to fully extend your arm.
  • The symptoms are often worse when the forearm is being used in activities that can be as simple as pouring water into a cup, using a screw driver even shaking hands.

Causes

Overuse – Recent studies have show that a particular muscle, when damaged can play a large part in the cause of Tennis Elbow. This muscle, located in the forearm, is known as the extensor carpi radialis brevis (ECRB). It is a muscle that helps in stabilizing the wrist when the elbow is straight.

When the ECRB is injured / weakened from overuse or a specific incident, small tears appear in the tendon where it attaches to the lateral epicondyle (bony prominence). This of course then leads to inflammation and the resulting pain.

Studies also show, the ECRB could be at a greater risk of damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.

Activities – Activities play a large part in the cause of Tennis Elbow (Lateral epicondylitis). As you would expect Tennis and other racket sports are a factor in the case of Tennis Elbow (hence the name) however anyone can get it and it could even be down to work related overuse. Professionals such as Plumbers, Electricians, Carpenters, Factory Workers, Cooks and Butchers can get this condition based on how they are using their arm such as the use of screw drivers with the twisting actions etc

Age – Anyone can get Tennis Elbow at any stage in their life depending on the activities they are doing and how they are using their arm. That said, the majority of cases we see can range between the ages of 30 and 50.

Unknown – Tennis Elbow (Lateral epicondylitis) has been known to occur even without any particular reason such as repetitive over use etc. If this happens, it is called “idiopathic” or in layman’s terms, of an unknown cause.

Pain that occurs on the inner side of the elbow is often known as golfer’s elbow

Diagnosis

When discussing this issue with your doctor, they will take into consideration a number if factors before making a diagnosis. These will include how your symptoms developed, your work and your hobbies etc.

The Doctor will discuss how and when the symptoms occur and are more severe and where on the arm the pain / symptoms are materialising. You will need to make sure you inform your doctor of any underlying health issues such as Arthritis (RA or Osteo), you you have injured your elbow in the past or any other medical issues that has a baring on your elbow.

There are a number of tests the doctors can and should perform during your examination such as asking you to try straighten your wrist and fingers with the doctor providing resistance with your arm straight.

Your doctor may recommend additional tests such as X-rays, Magnetic resonance imaging (MRI) scan or an Electromyography (EMG) – this will be to rule out nerve compression.

Treatment

Tennis elbow is a condition that will eventually get better over time, the length of time will be determined by how much you are using the arm in the way in which it was damaged in the first place. This may mean you will need to stay off certain activities indefinitely for a period of around 6-8 weeks. This could be shorter or longer depending on what state the injury is in.

However, there are treatments that can be used to speed up your recovery and ultimately help alleviate symptoms while you recover.

The first stage in any recover is REST. It is important you rest your injured arm and stop doing the activity that’s caused the problem in the first instance.

ICE – Apply a cold compress to the injured arm, such as a bag of frozen peas or a sports ice pack / gel pack for a few minutes several times a day, this will reduce inflammation and ease the pain. Some people have great success with contrast bathing the area so for example, icing the joint itself (the bony / tendinous areas) and using heat on the muscular areas such as Forearm to relax the muscles and speed up recover.

PAINKILLERS – Taking Paracetamol to ease the pain and Non-Steroidal Anti-Inflammatory’s such as Ibuprofen to reduce the inflammation can help greatly whilst in recovery.

MASSAGE – Asking your personal Sports Therapist / Massage Therapist to perform a sports massage on the arm offering STR (Soft Tissue Release) as well as general massage to relax the area and stimulate blood flow can really help to speed up recovery and make you feel better.

PHYSIOTHERAPY – Physiotherapy should be considered with other conservative treatment options especially for more severe and persistent cases.

A good rehabilitation plan with those elements mentioned above has seen great results and improved recovery time as well as reduced inflammation, reduced pain and improvement to the range of movement in your arm.

SURGERY may be an option if the issue persists and you have gone through a considered and tailored physiotherapy and massage program as a last resort to remove the damaged part of the tendon.

Depending on the severity of your Tennis Elbow, recovery can take anything from a couple of months through to 2 years in the most extreme cases. Getting over such an injury should not be considered quick or with a magic treatment, recovery and repair takes time, getting the rehabilitation right is also a very important thing to consider to stop this reoccurring.

Exercises

There are a number of exercises you can perform to help in the recovery of Tennis Elbow but also to help strengthen the area to help in the preventing moving forward. We have put together a video of some of the popular and most effective exercises / rehabilitation programs for this condition. Alternatively you can consult one of our personal trainers or strength & conditioning coaches.

Prevention

It’s not easy to avoid getting tennis elbow as it can be very minor issues that cause it. However a dynamic and considered training program with a qualified strength and conditioning coach can really help. Further to this if your injury was caused through overuse then looking at reducing that particular activity until you have strengthen the area or looking at other ways to do the task in question will help.

Should you need any further information or help, please contact a member of our team. Alternatively you can book one of our Sports Therapists or Physiotherapists through our online booking system.

Tennis Elbow Main Image for article

Shin Splints

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Shin splints is a generic term used to describe several conditions of the lower leg such as:
– Medial tibial stress syndrome (MTSS)
– Stress Fractures
– Compartment Syndrome

Throughout this article will we discuss the signs & symptoms for each condition.

Anatomy

The function of the tibialis anterior muscle is to dorsiflex the foot (bringing your toes towards the shin). Not a lot of strength is required to perform this movement and as a result the TA tends to be quite small. As the muscle contracts to perform dorsiflexion, the plantarflexors relax to allow the foot to raise. Plantarflexors are muscles that create the opposing movement of the foot, meaning they bring your toes down towards the ground. If the plantarflexors fail to relax, then the TA needs to overcome both the weight of the foot and the intrinsic resistance of these antagonistic muscles. This extra effort causes overload on the TA, resulting pain and discomfort.

Medial tibial stress syndrome (MTSS)

MTSS is inflammation of the periosteum, usually occurring on the posterior and medial surfaces of the tibia. The inflammation results in scar tissue which can stick or ‘splint’ the affected muscles (gastrocnemius and soleus) to the bone, making it difficult for them to lengthen, which would allow the tibialis anterior (TA) muscle to function.

Symptoms

– Pain and discomfort in the front and medial side of the shin, especially when walking or running uphill since the ROM required increases.
– inflammation along tibia
– persistent discomfort during activity, increases with walking or uphill running
– limited dorsiflexion (tight calf musculature)
– pain on palpation of medial tibial border
– pain on full contraction or stretch
– foot in a pronated position

Causes

– Muscle imbalance
– Impact
– Change of stress (e.g: shoes, surfaces, intensity)
– Over pronation of the foot

Stress Fractures

Continued microtrauma caused by repetitive impact can lead to small cracks developing in the tibia. The fractures often occur on the anterior tibia where the impact force is focussed.

Symptoms

– Pain felt on anterior and posterior tibia
– Increased pain with activity (particularly impact)
– Pain on palpation on anterior tibia
– Nodules along anterior tibia may be felt in more chronic stages

Causes

– Muscle imbalance
– Poor posture
– Over pronation during walking, jogging or running gait
– Overuse and excessive repetition
– Too much too soon

Compartment Syndrome

Compartment syndrome results in an increase in pressure in any of the four compartments of the lower leg

Symptoms

Symptoms are similar to those of deep vein thrombosis (DVT), so the healthcare professional should be confident that DVT is not a possibility before progressing with any treatment.

– Pain and swelling of lower limb
– Pain and discomfort increasing with activity
– Symptoms relieved shortly after activity stops
– Pain on palpation of affected compartment
– Pain on contraction of affected muscles
– Reduced ROM relating to movements of the muscles in the affected compartment
– Neurological symptoms distal to the compartment (numbness, tingling)
– Reduced pulse quality of the affected foot

Causes

– Post-impact bleeding
– Rapid hypertrophy of compartment muscles
– Inflammation of tendons from repetitive movement or impact
– Reduced flexibility in an adjacent compartment

Diagnosis of Shin Splints

Shin splints are usually diagnosed from the patients’ medical history and a physical exam. In some cases, an X-ray or other imaging studies can help identify stress fractures.

Treatment

Rest – Avoid activities that cause pain or discomfort but don’t give up all physical activity. While you’re healing, perform low-impact exercises, such as swimming, bicycling or water running.

Ice – Apply ice packs to the affected shin for 15 to 20 minutes at a time, every 2-3 hours for several days. To protect your skin, wrap the ice packs in a thin towel.

Take an over-the-counter pain reliever. Try ibuprofen to reduce pain.

Resume usual activities gradually after your pain is gone.

Alternative therapies

As soft tissue specialists in some cases Shin Splints can be confused with a tightness in the Tibialis Anterior muscle and as such a sports massage or deep tissue massage can relieve the issue. That said even if you have shine splints, maintaining good blood flow to the area and keeping your muscles relaxed and the lymphatic fluid drained can also be achieved through hands on soft tissue massage and lymphatic drainage techniques. Other therapies like medical acupuncture has also shown to be effective in the management of pain and symptoms.

Exercises

Standing Gastrocnemius Stretch

Primary muscles stretched: Gastrocnemius (calf muscle)

  1. Starting Position: Stand facing a wall or sturdy object, about arm’s length away. Place your hands flat against the wall at shoulder height for support. Keep your feet hip-width apart and both feet flat on the ground.
  2. Step Back: Take a step back with one foot, keeping it flat on the ground and extending it behind you. Your back leg should be straight, with your heel firmly planted on the ground and your toes pointing directly forward.
  3. Bend Front Knee: Bend your front knee, shifting your weight slightly forward while keeping your back leg straight. You should feel a gentle stretch in the calf muscle of your back leg.
  4. Adjust Position: If you don’t feel a stretch, you can adjust your stance by stepping farther back or bending your front knee slightly more. Ensure that your back heel remains in contact with the ground throughout the stretch.
  5. Hold and Breathe: Hold the stretch for 20-30 seconds, focusing on deep, steady breaths. Relax into the stretch, allowing the tension in your calf muscle to gradually release.
  6. Switch Sides: After holding the stretch on one side, release and switch legs, stepping back with the opposite foot. Repeat the stretch on the other side, following the same steps.
  7. Repeat: Perform the stretch 2-3 times on each leg, aiming to deepen the stretch slightly with each repetition. Listen to your body and avoid pushing into pain or discomfort.

Soleus Stretch

Primary muscles stretched: Soleus (calf muscle)

  1. Starting Position: Sit on the floor with your legs extended in front of you. Keep your back straight and your feet flexed, pointing towards the ceiling.
  2. Bend Knee: Bend one knee and cross it over the opposite leg, placing your foot flat on the floor on the outside of your opposite knee. Your bent knee should be pointing towards the ceiling.
  3. Foot Positioning: Keep your foot on the floor relaxed, with your toes pointing slightly outward and the sole of your foot in contact with the ground.
  4. Lean Back: Slowly lean back, using your hands for support behind you. Keep your back straight and your chest lifted as you lower your upper body towards the floor.
  5. Feel the Stretch: You should feel a gentle stretch in the calf muscle of your extended leg. This stretch primarily targets the soleus muscle, located deeper within the calf.
  6. Hold and Breathe: Hold the stretch for 20-30 seconds, focusing on deep, steady breaths. Relax into the stretch, allowing the tension in your calf muscle to gradually release.
  7. Switch Sides: Release the stretch and switch legs, crossing the opposite knee over the other leg and repeating the stretch on the opposite side.
  8. Repeat: Perform the stretch 2-3 times on each leg, aiming to deepen the stretch slightly with each repetition. Listen to your body and avoid pushing into pain or discomfort.

Tibialis Anterior Stretch

Primary muscles stretched: Tibialis anterior (front of shin)

  1. Starting Position: Sit on the floor with your legs extended in front of you. Keep your back straight and your feet flexed, pointing towards the ceiling.
  2. Cross Ankle: Cross one ankle over the opposite knee, placing your foot flat on the floor beside your opposite knee. Your crossed leg should form a figure-four shape.
  3. Lean Back: Slowly lean back, using your hands for support behind you. Keep your back straight and your chest lifted as you lower your upper body towards the floor.
  4. Point Toes: Point your toes of the crossed leg towards the ceiling. This movement will target the tibialis anterior muscle, located on the front of your shin.
  5. Feel the Stretch: You should feel a gentle stretch along the front of your shin and ankle of the crossed leg.
  6. Hold and Breathe: Hold the stretch for 20-30 seconds, focusing on deep, steady breaths. Relax into the stretch, allowing the tension in your tibialis anterior muscle to gradually release.
  7. Switch Sides: Release the stretch and switch legs, crossing the opposite ankle over the other knee and repeating the stretch on the opposite side.
  8. Repeat: Perform the stretch 2-3 times on each leg, aiming to deepen the stretch slightly with each repetition. Listen to your body and avoid pushing into pain or discomfort.

Calf Raises

Muscles targeted: Gastrocnemius (calf muscle), Soleus

  1. Starting Position: Stand tall with your feet hip-width apart, ensuring your weight is evenly distributed between both feet. Keep your shoulders relaxed and your abdominal muscles engaged for stability.
  2. Lift: Slowly rise up onto the balls of your feet by lifting your heels off the ground. Focus on using your calf muscles to initiate the movement. Keep your core tight to maintain balance.
  3. Peak Contraction: Once you’ve reached the highest point of the movement where you feel a strong contraction in your calf muscles, pause briefly. Ensure that you maintain control throughout the exercise to prevent any jerky movements.
  4. Lowering Phase: Slowly lower your heels back down to the starting position, allowing your heels to gently touch the ground. Resist the urge to drop your heels quickly, as this reduces the effectiveness of the exercise.
  5. Repeat: Perform the desired number of repetitions, aiming for 10-15 repetitions to start with. As you become more comfortable with the exercise, you can gradually increase the number of repetitions or add additional resistance by holding onto dumbbells or using a calf raise machine.

Resisted Dorsiflexion

Muscles targeted: Tibialis anterior

  1. Starting Position: Sit on a chair or bench with your feet flat on the floor, hip-width apart. Place a resistance band around the top of your foot, securing the other end to a stable object in front of you, such as a table leg or heavy piece of furniture.
  2. Ankle Positioning: Sit up straight with your shoulders relaxed and your abdominal muscles engaged. Your knees should be bent at a 90-degree angle, with your thighs parallel to the ground. Ensure that the resistance band is positioned securely around the top of your foot, just below your toes.
  3. Dorsiflexion: Keeping your heel planted firmly on the ground, slowly pull your toes towards your shins against the resistance of the band. Focus on contracting the muscles on the front of your shin (tibialis anterior) to lift your foot upwards, bringing your toes closer to your body.
  4. Peak Contraction: Hold the top position for a moment, feeling the muscles on the front of your shin working hard. Maintain control throughout the movement to maximize muscle engagement and prevent any jerky motions.
  5. Lowering Phase: Slowly release the tension on the resistance band as you lower your foot back down to the starting position, allowing your toes to point away from your body. Avoid letting the resistance band snap back quickly, as this can strain your ankle joint.
  6. Repeat: Perform the desired number of repetitions, aiming for 10-15 repetitions to start with. As you become more familiar with the exercise and your strength improves, you can gradually increase the number of repetitions or adjust the resistance level of the band.

If you believe you have shin splints and would like to have an evaluation done and possibly some treatment by some of our physiotherapists or sports therapists, then please contact us or alternatively make a booking online.

Iliotibial Band Syndrome (ITB Syndrome)

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Iliotibial Band (ITB) syndrome is a condition that often causes pain in the outside of the knee. The ITB itself is a thick connective tissue that originates at the hip and inserts into the knee; it is composed of the tendinous portions of the Tensor Fascia Latae and Gluteal muscles. The ITB’s purpose is to stabilise the knee joint and assist with movement

Anatomy

The ITB is a large thick band of fasia, that originates at the anterolateral iliac tubercle of the exernal lip of the iliac crest & inserts into the lateral condyle of the tibia at the Gerdy’s tubercle. Meaning it begins at the top part of your pelvis, runs down the lateral side of the thigh & attaches at the top of the shinbone, just under the knee cap. It is composed from the Tensor Fascia Lata & Gluteal muscles, then becomes proportionately thickened before attaching into the knee. This thick fibrous sheath then helps to stabilize the lateral side of the knee during flexion & extension, as well as aiding with hip abduction. When the knee is in a flexed position, the ITB is behind the lateral epicondyle, as you start to straighten the leg the ITB then travels forward across the epicondyle.

Causes

ITB syndrome is an overuse injury that usually presents as pain in the lateral aspect of the knee due to inflammation of a portion of the band, most commonly near the knee. It is most common in runners due to the repetitive knee flexion and extension (bending and straightening) of the knee required.

When the knee repetitively bends and straightens, the band slides of the lateral femoral condyle of the knee, causing excessive friction and thus inflaming the band, resulting in pain. It has been found that individuals diagnosed with ITB syndrome often have thickening of the band itself, which inflames the space between the ITB and femoral condyle.

A number of training factors have been suggested to be risk factors for ITB syndrome:

  • Excessive running in the same direction on a track
  • Increased running mileage
  • Downhill running
  • Wearing worn out shoes with improper support

Symptoms

If you are suffering from ITB Syndrome you may notice;

  • Sharp pain, particularly on the outside of the knee
  • Pain when the knee is bent to approximately 30 degrees
  • Tightness and reduced flexibility
  • Tenderness on the outside of the knee
  • Pain when running or cycling.

If you suffer with any of these symptoms and suspect you may have ITB syndrome, contact your GP or local Sports Therapist/ Physiotherapist who can complete a thorough assessment to determine a clear diagnosis.

Diagnosis

If you suspect you have ITB syndrome, it’s crucial to seek professional assessment from a qualified healthcare provider, such as a physiotherapist or sports medicine doctor. They will conduct a comprehensive evaluation, which may include:

  • Medical History: This involves discussing your symptoms, their onset, and any activities that exacerbate or alleviate the pain. Your doctor will also inquire about your training habits, previous injuries, and overall health status.
  • Physical Examination: The doctor will examine your knee, assessing for tenderness, swelling, and range of motion. They may also perform specific tests, such as the Noble Compression Test or Ober’s Test, to further evaluate the ITB.
  • Imaging Studies: In some cases, imaging studies like ultrasound or MRI may be recommended to rule out other potential causes of knee pain or to assess the severity of the ITB inflammation.

Differential Diagnosis

It’s important to note that other conditions can mimic the symptoms of ITB syndrome, such as:

  • Lateral meniscus tear: This involves damage to the cartilage cushion on the outer side of the knee, causing pain, swelling, and locking sensations.
  • Biceps femoris tendinopathy: This condition involves inflammation or irritation of the hamstring tendons, leading to pain in the back of the thigh or knee.
  • Patellofemoral pain syndrome: Also known as runner’s knee, this condition causes pain around the kneecap due to overuse or misalignment.

A thorough evaluation by a healthcare professional is essential to rule out these other conditions and confirm the diagnosis of ITB syndrome.

Treatment

Physical therapy (Physiotherapy) plays a crucial role in ITB syndrome treatment. A qualified therapist will develop a personalised plan that may include:

  • Stretching Exercises: Specific stretches targeting the ITB, hip muscles, and gluteal muscles can help improve flexibility and reduce tension.
  • Strengthening Exercises: Strengthening the hip abductors, gluteal muscles, and core can improve stability and reduce stress on the ITB.
  • Manual Therapy: Techniques such as sports massage, medical acupuncture, myofascial release, and trigger point therapy can help alleviate pain and improve tissue mobility.

Pain Management

Over-the-counter pain relievers like ibuprofen or naproxen can help reduce pain and inflammation. In some cases, your doctor may prescribe stronger pain medications or corticosteroid injections for short-term relief.

Addressing Underlying Causes

ITB syndrome often stems from biomechanical imbalances or training errors. A thorough assessment by a healthcare professional can identify underlying issues, such as:

  • Muscle weakness or tightness: Imbalances in muscle strength or flexibility can contribute to ITB syndrome. A qualified personal trainer or sports therapist can address these issues through targeted exercises.
  • Training errors: Overtraining, sudden increases in mileage or intensity, or running on uneven surfaces can all contribute to ITB syndrome. Adjusting your training plan and incorporating proper warm-up and cool-down routines can help prevent future flare-ups.
  • Footwear or orthotics: Improper footwear or underlying biomechanical issues may require orthotics or shoe modifications to correct foot mechanics and reduce stress on the ITB.

Exercises

ITB Syndrome Stretches:

  1. IT Band Stretch (Standing):

    • Stand with your feet shoulder-width apart.
    • Cross the affected leg behind the other leg.
    • Lean your torso away from the affected side until you feel a stretch along the outer thigh.
    • Hold for 30 seconds, then repeat on the other side.

  2. IT Band Stretch (Lying):

    • Lie on your side with the affected leg on top.
    • Bend the top knee and reach back with your hand to grasp your foot or ankle.
    • Gently pull your heel towards your buttock until you feel a stretch in the front of your hip and thigh.
    • Hold for 30 seconds, then repeat on the other side.

  3. Hip Flexor Stretch:

    • Kneel on one knee with the other foot flat on the floor in front of you.
    • Lean forward, keeping your back straight, until you feel a stretch in the front of the hip of the kneeling leg.
    • Hold for 30 seconds, then repeat on the other side.

  4. Glute Stretch (Pigeon Pose):

    • Start in a push-up position.
    • Bring one knee forward and place it on the floor just behind your wrist, with your foot angled outwards.
    • Extend the other leg straight behind you.
    • Lean forward over the front leg until you feel a stretch in the outer hip and buttock of the front leg.
    • Hold for 30 seconds, then repeat on the other side.

ITB Syndrome Exercises:

  1. Clamshells:

    • Lie on your side with knees bent and feet stacked.
    • Keeping your feet together, lift your top knee open like a clamshell.
    • Slowly lower back down.
    • Repeat for 10-15 repetitions on each side.

  2. Side-Lying Leg Raises:

    • Lie on your side with legs extended.
    • Lift your top leg up towards the ceiling, keeping your hips stacked and core engaged.
    • Slowly lower back down.
    • Repeat for 10-15 repetitions on each side.

  3. Foam Rolling:

    • Place a foam roller under the outer thigh of the affected leg.
    • Slowly roll back and forth over the IT band from hip to knee.
    • Hold on tender spots for 30 seconds.

  4. Single Leg Squats:

    • Stand on one leg with your knee slightly bent.
    • Slowly lower yourself down as far as comfortable, keeping your knee aligned with your toes.
    • Push back up to the starting position.
    • Repeat for 10-15 repetitions on each leg.

Important Considerations:

  • Consult a healthcare professional before starting any new exercise or stretching routine, especially if you have any underlying medical conditions.
  • Perform stretches and exercises gently and gradually increase the intensity and duration as tolerated.
  • Listen to your body and stop any activity that causes pain.

Remember, consistency is key! Regular stretching and strengthening exercises can help prevent ITB syndrome from recurring and keep you moving pain-free.

Please see some exercise examples in our video.

Coming Soon..

 

If you feel like you are experiencing issues with your IT Band and would like to speak to one of our professional physiotherapists or sports therapists then our team can help. We have specialists covering a number of locations in the UK such as Birmingham, Manchester, Liverpool, Gloucester, Leeds, Wolverhampton, Derby, Nottingham, Leicester, Colchester, Maidstone and London. For more information you can contact us via our contact page.

Gluteus Muscle Stretches

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Benefits of glutes stretching

• Relieve Pain: Stretching tight glutes can help relieve low back pain, buttocks pain, pelvic pain, tight hips, tight hamstrings, and in some cases, knee pain.
• Improve Flexibility: Regular glute stretching can help increase flexibility in your muscles, allowing you to move more freely.
• Enhance Range of Motion: By stretching your glutes, you can improve your range of motion, making it easier to perform daily activities with ease.
• Reduce Injury Risk: Tight glutes can lead to poor posture and gait, putting you at a higher risk of injury. Regular stretching can help reduce the risk of injury by maintaining muscle balance and flexibility.
• Improve Mobility: Regular glute stretching can help improve overall mobility and performance by reducing tension and promoting relaxation in your muscles.

Exercises

Step 1: Start in a seated position with both legs extended straight in front of you.
Step 2: Bend your right knee and bring the right ankle over your left knee so that your right shin is perpendicular to the floor.
Step 3: Bend your left knee and use your left hand to grasp your left ankle or shin.
Step 4: Hold for 30 seconds to 1 minute, then release and repeat on the other side.

Half Pigeon Variation

Step 1: Start on your hands and knees with your hands directly below your shoulders and your knees directly below your hips.
Step 2: Bring your right knee forward to the outside of your right hand and extend your right leg behind you so that your ankle is in line with your left hip.
Step 3: Place your right hand on the floor in front of you and slowly begin to lower your body down, resting your right forearm on the floor.
Step 4: Hold for 30 seconds to 1 minute, then release and repeat on the other side.

Half Lord of the Fishes

Step 1: Start in a seated position with both legs extended straight in front of you.
Step 2: Bend your right knee and bring your foot to the outside of your left hip.
Step 3: Twist your torso to the right and place your right hand behind you for support.
Step 4: Place your left elbow on the outside of your right knee and hold onto your right foot with your left hand.
Step 5: Hold for 30 seconds to 1 minute, then release and repeat on the other side.

90-90

Step 1: Start in a seated position with your legs straight out in front of you.
Step 2: Flex your right foot and bend your right knee, bringing it towards your chest. Place your arms around your shin to support the stretch.
Bonus: To deepen the stretch, gently pull your right knee towards your right armpit while maintaining a straight back. Hold this position for 1-2 minutes, then repeat on the other side. This is one repetition.

Recline Knee To Chest

Step 1: Lie on your back, legs extended.
Step 2: Flex left knee, grab shin & pull it to chest.
Step 3 (Optional): To deepen, pull left knee towards left armpit, keeping low back on mat. Hold 1-2 min. Repeat on right side.

Downward-Facing Dog

Step 1: Begin in a push-up position, with your hands placed shoulder-width apart and legs together.
Step 2: Straighten your body and engage your core muscles.
Step 3: Move your hips back and up, forming an inverted “V” shape with your body.
Step 4: Slight bend your knees and bring your head between your shoulders, aligning it with your spine.
Step 5: Reach your heels towards the floor, keeping them slightly raised.
Step 6: Hold the pose for 20 seconds and then return to the starting position.
To provide extra wrist support, you can place each hand on a yoga block.
If needed, bend your knees to help straighten your back, making sure your body stays in an inverted “V” shape.

Foam Rolling

Step 1: Sit on foam roller, hands on floor behind
Step 2: Turn out right ankle to rest on left knee, tilt hips to right.
Step 3: Roll along length of right glute, focusing on tight spots
Repeat on left side.

When performing any of these exercises it is advised you consult a personal trainer or strength and conditioning coach, or part of your local gym fitness team, to make sure your form is correct. If done incorrectly, injuries may occur. If you have any more questions about whether there is anything else you can do to support your muscle growth, you can get in contact with one of our exercise professionals through our email info@livewellhealth.co.uk or give s a call on 0330 043 2501. Alternatively visit our contact page and fill in the contact form.

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