Rehabilitation | LiveWell Health

Meniscus Tear

Posted on June 3, 2024

This is one of the most common knee injuries, which can be sustained while participating in a number or sports or day to day activities. The severity of the injury can vary greatly from mild, where the injury will resolve on its own given time to heal, to severe, where surgery is often advised.

Anatomy

The meniscus is a ‘C’ shaped piece of cartilage that acts like a cushion between your femur (thigh bone) and tibia (shin bone). It acts to stabilize the joint and prevent wear and tear on the joint surfaces. As the name suggests, a this injury occurs when the meniscus cartilage tears.

Symptoms

The following symptoms could indicate a torn meniscus:

A popping sensation in your knee
Swelling or stiffness
Pain, in particular when twisting or rotating your knee
Difficult to straighten your knee
A feeling of the knee being locked in to place
Feeling like your knee could give way

Causes

A meniscus tear can occur as a result of any activity which requires the forceful twist or rotation of the knee- particularly when that knee is taking full body weight. Aggressive pivoting, sudden stops and turning actions carry a higher risk of injury. It is also possible to tear a meniscus while kneeling, deep squatting or heavy lifting.

Diagnosis

Your doctor my be able to identify a torn meniscus by performing a physical exam, assessing your range of motion, gait and ability to carry out certain movements. They may also use one or more of the following:

X-ray: this will not identify a torn meniscus but may be used to rule out other injuries.

MRI: this will produce and image of the hard and soft tissues in your knee and is considered the best imaging to identify a torn meniscus.

Arthroscopy: this uses a small instrument which is inserted through a tiny incision near your knee. It uses a light and camera to provide an image of your knee, then other surgical tool scan be inserted and used to trim or repair the tear.

Treatment

Treatment generally starts conservatively, depending on the severity of your injury.

Rest – You may be advised to avoid activities which aggravate the pain or involve any twisting, rotating or pivoting. If the pain is severe using crutches can rest your knee and give the injury time to heal.
Ice – This can be used to reduce pain and swelling. Generally it is advisable to apply a cold pack (wrapped in a towel) to your knee for 15 minutes while it is elevated. This can be repeated every 4-6 hours.
Medication – Over the counter pain relievers (often NSAID’s like ibuprofen) can be used to alleviate the pain.
Therapy – Physiotherapy or Sports Massage can help to stabilize and support the knee joint while strengthening the muscles surrounding it.
Surgery – If the injury is still painful after conservative treatment surgery may be advised to repair or trim the meniscus. In the case of severe degenerative arthritis a total knee replacement could be recommended.

Exercises

Once your knee is in recovery there are many exercises that can support your body as it heals. Remember for this type of injury it is not advisable to ‘push through the pain’. Pain is a warning sign from your body that you are asking more than it is capable of at the moment. Under advice from a soft tissue specialist your exercises are likely to proceed through the following stages:

Improve Range of Motion- flexing and extending your knee as far as possible without pain.
Stretches- reducing excess tension in your leg muscles.
Basic Exercises- e.g. straight leg raises and calf raises.
Advanced Exercises- e.g. squats, weighted leg strengthening and advanced stretching.

Prevention

As they are normally caused by an accident, meniscus tears can be difficult to prevent, however the following precautions can lower the risk:

Strengthen your Quadriceps, Hamstring, Adductor and Abductor muscles of the upper leg (thigh muscles) with regular exercise.
Always warm up with light activities and active stretching.
Rest between workouts to allow your body to repair.
Wear shoes that fit well and provide support.
Stretch regularly to maintain flexibility.
Make changed to the intensity of your activity gradually.

If you have any issues around meniscus tears then our team can help diagnose but also and more importantly help you rehabilite the injury. Our specialists physiotherapists and sports therapists deal with issues like this frequency. Contact us today or make a booking.

Carpal Tunnel Syndrome

Posted on June 3, 2024

Carpal Tunnel Syndrome (CTS) is a form of repetitive strain injury (RSI) which occurs as a result of damage to soft tissue structures (such as tendons) and in some cases bones of the wrist. Women are three times more likely to develop CTS than men, with approximately 3 to 6 percent of adults in the general population being affected. The condition is particularly common in people who use their hands repetitively, for example individuals working on computers or assembly lines. It is quite common to develop CTS in both hands, however symptoms tend to be worse in the side of the dominant hand.

Anatomy

The Carpal Tunnel is a narrow passage made up of ligaments and bones at the base of the hand. The Median Nerve and tendons responsible for bending your fingers passes through this passage. The median nerve is the receptor (provides feeling and feedback) for the palm side of your thumb, index, middle and part of your ring fingers.

CTS develops when swelling or damage to the structures of your wrist creates pressure on the median nerve. In addition to swelling due to soft tissue injury inflammation any swelling can develop as a result of medical conditions such as diabetes and arthritis. It can develop during pregnancy, in this case it will probably disappear after delivery.

Symptoms

Symptoms tend to develop gradually over time, beginning with slight discomfort and deteriorating progressively if left untreated. Initially symptoms usually appear in one or both hands during the night. As symptoms get worse, tingling may be felt during the day, especially with repetitive activities such as typing or using a mouse.

Common signs and symptoms of CTS include:

Pain, tingling and numbness in your hand, wrist and also your thumb and fingers.
Fingers may feel and/or appear swollen.
Hand weakness and difficulty gripping.
Partial loss of sensation in the affected thumb and fingers.
In severe cases, where left untreated, muscle wastage of the muscles at the base of the thumb can occur

Causes

CTS is often a combination of many factors which increase pressure on the median nerve rather than a problem with the nerve itself.

Recent studies indicate that CTS can be idiopathic (no identifiable direct cause) and that there may be a genetic component which increases the possibility that an individual develops CTS.

Activities considered high risk for CTS include any which involve repetitive and/or forceful use of one or both hands. In terms of sports this can include gymnastics, weightlifting (Olympic style in particular), racquet sports, cycling, rowing, baseball and golf. CTS also has a high incidence in individuals who regularly use vibrating hand tools (e.g. hammer drill).

Research has shown that certain conditions can increase the risk of developing CTS by causing fluid obstruction in the carpal tunnel. These include:

Pregnancy
Menopause
Obesity
Renal failure/haemodialysis
Hypothyroidism
Use of oral contraceptives
Congestive heart failure
Tumours
Autoimmune disease (eg, rheumatoid arthritis)
Wrist fracture/dislocation/deformity
Age – The majority of those affected are in range 40 to 60 years old, CTS usually only occurs in adults.

Diagnosis

To determine the cause of your CTS your doctor may conduct a physical examination of hands, arms, shoulders and neck. This can help them to decide if the condition is being caused by daily activities, an underlying disorder, or if it is a condition which presents similar symptoms to CTS. They will look for abnormalities in wrist tenderness, swelling, warmth and colour. Your doctor will probably conduct nerve testing to establish sensation in each thumb and finger any check for muscle atrophy (wasting).

You should inform your doctor of any history of fractures, arthritis or diabetes. It will also be helpful if you can provide them with an insight in to your daily activities and hobbies. They will discuss when your symptoms occur, improve or get worse.

They may ask you to have and X-Ray (to check for fractures or arthritis), an ultrasound (which can show if the median nerve is an abnormal size) or an MRI (to check the wrist anatomy).

Treatment

It is important not to ignore the symptoms of CTS. You can often treat it yourself, but it can take months to get better. Leaving the condition untreated can lengthen recovery time considerably.

REST – Where possible stop any activities which make your symptoms worse. Ask an occupational health advisor how you can modify your work station and/ or the activities that cause the pain.

ICE – Applying an ice pack for 5-10 minutes every 1-2 hours in the early stages of the pain/numbness may help reduce swelling and the pressure on the nerve.

SUPPORT – A wrist splint will help limit movement of your wrist which may help reduce the pain and risk of further swelling.

ELEVATION – Try and keep your wrist elevated to reduce the potential for swelling in your wrist. When you lie down this may mean resting your hand on pillows.

MASSAGE – A Sports Massage Therapist can help to relive the pressure in your carpal tunnel by encouraging the proper flow and drainage of fluids to and from your wrist. They may use Soft Tissue Release (STR) to lengthen and normalize the muscles from your wrist in some cases up to your neck. These muscles often become very tight when performing repetitive tasks, this tension can exacerbated the symptoms of CTS. If your therapist is trained in the use of Kinesiology taping they can also use this to create space in the carpal tunnel and support the soft tissue structures of your wrist. Because the problem may be caused, or made worse, by structures as far up as the neck, your therapist will be keen to address these problems as well as the ones at your wrist. Treating the cause of a problem is always more effective than treating the symptoms alone if the condition is to be resolved.

PHYSIOTHERAPY – Consider seeing a Physiotherapist if other treatment have not improved the symptoms.

CTS can be resolved without invasive procedures, following treatments such as those outlined above has been shown to reduce symptoms effectively if properly followed. It is important to be consistent with treatments for CTS as it may take a number of moths for the issue to resolve.

STEROID INJECTION – A medical professional may suggest a treatment involving a steroid injection to reduce inflammation.

SURGERY – In some cases surgery may be necessary but only after all non-surgical methods have been tried.

Exercises:

Wrist Flexor Stretch

Start Position: Extend your arm straight in front of you with your palm facing up.
Movement: Use your other hand to gently pull back on the fingers of the extended hand, bending the wrist downward.
Action: Hold the stretch when you feel a gentle pull along the inside of your forearm.
Hold: Maintain this position for 15-30 seconds.
Switch: Repeat on the opposite arm.

Wrist Extensor Stretch

Start Position: Extend your arm straight in front of you with your palm facing down.
Movement: Use your other hand to gently pull the fingers of the extended hand back towards your body.
Action: Hold the stretch when you feel a gentle pull along the top of your forearm.
Hold: Maintain this position for 15-30 seconds.
Switch: Repeat on the opposite arm.

Tendon Gliding Exercises

Start Position: Hold your hand up with your fingers straight and close together.
Movement:
- Start by bending your fingers at the knuckles to form a hook fist, keeping your thumb straight.
- Next, make a full fist, curling your fingers into your palm.
- Then, return to the hook fist position.
- Finally, straighten your fingers back to the starting position.
Action: Move through each position slowly and smoothly.
Repetitions: Perform 5-10 repetitions, 2-3 times a day.

Median Nerve Glide

Start Position: Extend your arm straight out to the side, parallel to the ground, with your palm facing down.
Movement: Bend your wrist so that your fingers point down towards the ground.
Action:
- Slowly tilt your head away from the outstretched arm.
- You should feel a gentle stretch along your arm and hand.
Hold: Maintain this position for 15-30 seconds.
Switch: Repeat on the opposite arm.

Make sure you are pain-free at all times and take care not to progress too quickly. Where possible stop any activities which make your symptoms worse. We have given suggested sets and repetitions, but everyone is different so your practitioner may give guidance that is more specific to you. It is important to perform the exercises correctly and at the frequency prescribed in order to reach a successful outcome.

Prevention

As CTS 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.

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.

For more infomation or to make a booking with one of our team to help with your Carpal Tunnel Syndrome then please contact us today.

Is It Tendonitis or Tendinopathy…

Posted on June 3, 2024

Tendonitis and Tendinopathy are often used interchangeably as they both present very similar symptoms however the conditions are very different.

Tendonitis: Tendonitis is when a tendon (attachment point of muscles) becomes swollen / inflamed. This can be because of a number of issues such as overuse or a specific injury / movement. The inflamed tendon can become stiff and can cause joint pain as it will be affected in the way it functions. Usually, but not always tendonitis is presented once you finish an exercise or immediately after you have rested it for a period of time and can go away during exercise or use. However it can also present as a dull ache more frequently.

Tendinopathy: Tendinopathy, also referred to as tendinosis, is the breakdown / de-generation of collagen in the tendon. This causes burning pain as well as reduced functionality of the tendon, flexibility and range of movement. While tendinopathy can of course affect any tendon, it’s more common in the Achilles tendon, rotator cuff tendons, patellar tendon and hamstring tendons.

Some suggest that tendinitis precedes tendinopathy (tendinosis) however the fact that a healthy tendon can be up to twice as strong as the muscle is true. This would in turn make the body of the tendon unlikely to tear, unless the tendon is already weakened by degenerative change.

So the very idea that tendinitis is the initial stage of tendinopathy as it will presume micro-tears and inflammation precedes collagen degeneration is wrong. Recent research shows that torn fibres, scar tissue, and calcification are only found in conjunction with tendinosis some of the time, and inflammation are rarely found in tendinosis, which would support the idea that tendinitis occurs secondarily to tendinosis

Symptoms

The symptoms of tendonitis and tendinopathy are very much similar at will present itself at the insertion point where the tendon meets the muscle. The symptoms typically include:

Pain often described as a dull ache, especially when moving the affected limb or joint
Tenderness to touch
Swelling
Pain or Stiffness in the morning
Pain or stiffness after long periods of rest

Causes

Although tendinitis / tendinopathy can happen through a sudden injury or event the condition is much more likely to appear over a long period of time due to overuse or repetitive movements.

Treatment

Tendonitis and Tendinopathy can both be treated in the same way. In more cases Tendonitis will be more effectively treated through conservative methods of rehabilitation as well as rest. The initial advice would be to rest of area that is causing pain, so for example if you are running and that is causing pain to the Achilles tendon then we would advise you to stop that activity an rest usually for around 3-6 weeks depending on the severity. Through this rest period there will be exercises to do in order to strengthen the tendon in question but also by offering stretching techniques and massage to the affected area / muscle attachment.

Tendinopathy can be treated as above however in some more severe cases surgery can be recommended and can also be very effective in providing around 90-95% range of movement and great results.

Golfers Elbow

Posted on June 3, 2024

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

Wrist Flexor Stretch

Start Position: Extend your arm straight in front of you with your palm facing up.
Movement: Use your other hand to gently pull back on the fingers of the extended hand, bending the wrist downward.
Action: Hold the stretch when you feel a gentle pull along the inside of your forearm.
Hold: Maintain this position for 15-30 seconds.
Switch: Repeat on the opposite arm.

Wrist Extensor Stretch

Start Position: Extend your arm straight in front of you with your palm facing down.
Movement: Use your other hand to gently pull the fingers of the extended hand back towards your body.
Action: Hold the stretch when you feel a gentle pull along the top of your forearm.
Hold: Maintain this position for 15-30 seconds.
Switch: Repeat on the opposite arm.

Wrist Flexor Strengthening (with a Dumbbell)

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.
Movement: Slowly curl the dumbbell upwards by flexing your wrist.
Action: Lower the dumbbell back down in a controlled manner.
Repetitions: Perform 10-15 repetitions for 2-3 sets.
Switch: Repeat with the opposite arm.

Reverse Tyler Twist (Using a Flex Bar)

Start Position: Hold a Flex Bar vertically with your injured arm at the bottom, palm facing inward.
Movement: With your other hand, grasp the top of the Flex Bar and twist it downward.
Action: Slowly extend your injured arm while keeping the twist in the Flex Bar.
Repetitions: Perform 10-15 repetitions for 2-3 sets.
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

Posted on May 31, 2024

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

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

Piriformis Stretch

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

Hamstring Stretch

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.
Movement: Reach forward towards your toes of the extended leg while keeping your back straight.
Action: Lean forward from your hips until you feel a gentle stretch along the back of your thigh.
Hold: Hold this stretch for 20-30 seconds.
Switch: Repeat with the opposite leg.

Quadricep Stretch

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

Trigger Point the Piriformis Muscle

Start Position: Sit on the floor with your knees bent and feet flat on the ground.
Equipment: Use a foam roller or a small, firm ball.
Placement: Position the foam roller or ball under your right buttock, near the area where you feel tension or discomfort.
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.
Duration: Spend about 1-2 minutes working on each side, focusing on areas of tightness or tenderness.
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

Posted on May 27, 2024

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

Posted on May 27, 2024

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:

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.
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.
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.
Detoxification: Wet cupping, in particular, is believed to draw out toxins from the body, helping to cleanse the blood and boost the immune system.
Stress Reduction: By promoting relaxation and reducing muscle tension, cupping therapy can help alleviate stress and anxiety, contributing to overall mental well-being.
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

Posted on May 15, 2024

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:

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

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.
Strengthening exercises: Initiate low-impact exercises to strengthen the quadriceps, hamstrings, and calf muscles, including straight leg raises, hamstring curls, and calf raises.
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.
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:

Progressive strengthening: Advance to more challenging strengthening exercises, including lunges, step-ups, and resistance training using bands or weights.
Flexibility exercises: Incorporate stretching exercises to improve flexibility and mobility in the knee joint and surrounding muscles.
Plyometric training: Introduce controlled jumping and hopping exercises to enhance lower limb power and agility.
Sport-specific drills: Gradually reintroduce sport-specific movements and activities, focusing on proper technique and biomechanics.
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:

Gradual return to sport: Resume full participation in sports or physical activities, starting with low-intensity drills and gradually increasing intensity and duration.
Maintenance program: Continue with a maintenance program of strength, flexibility, and proprioception exercises to prevent future injuries and maintain optimal knee function.
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

Posted on May 15, 2024

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:

Pain, especially along the joint line of the knee
Swelling and stiffness
Difficulty fully straightening or bending the knee
Popping or clicking sensations
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

Posted on May 3, 2024

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

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.

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.

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