What is Achilles Tendinopathy?
Acute or chronic inflammation and often degeneration of the Achilles tendon. Your Achilles tendon is the largest tendon in your body and attaches from your calf muscles to your heel. Pain occurs above the heel, it is normally tender to touch and you can get localized thickening of the tendon itself. It often aches and is stiff in the morning with some relief from a small amount of activity but worsens with prolonged activity.
How does Achilles Tendinopathy happen?
Achilles Tendinopathy often occurs as either an acute or chronic overuse injury from an increase in activity such as running or jumping. Achilles tendinopathy occurs following abnormal loading. This abnormal loading may be a consequence of overuse or biomechanical abnormality. Once the tendon is loaded abnormally it can become inflamed and cause damage to the structure of the tendon. There are a number of predisposing factors than can contribute to this injury such as an increase in activity, flat feet (over pronation), poor walking or running biomechanics, calf weakness and tightness, muscle imbalances and poor footwear.
What WDC Physiotherapy can do to treat Achilles Tendinopathy:
- Soft tissue release of the muscles that attach and surround the Achilles tendon. Initial gentle stretching of the calf muscles.
- Taping to assist in unloading the tendon and relieving pain.
- Specific exercises and advice on activity modification, cross training and relative rest. Eccentric loading exercises to remodel the tendon and a progressive strengthening program to get you back in action
- Treadmill waking and or running analysis to improve biomechanics and prevent future problems.
Suitable products for this condition:
- Custom-made Orthotics
- Foam roller
Anterior Cruciate Ligament Tear
What is an Anterior Cruicuate Ligament (ACL) Tear?
Your ACL is a ligament in the middle of your knee that provides stability and prevents buckling of the knee. There are three grades of tears with a grade three or complete tear often requiring surgical intervention. If you have a full tear an Orthopaedic surgeon will usually repair it using a graft from either the patella tendon, hamstring tendon or a synthetic ligament (LARS). Rehabilitation is vital to restore tangle of motion, strength and coodination. Poorly rehabilitated ACL reconstructions have a higher re-rupture rate.
How Does an ACL Tear Happen?
The mechanism of an ACL tear usually occurs while playing sport with a pivoting action on a grounded foot. Often a popping or cracking sound occurs at the time of injury. ACL injuries commonly occur alongside other injuries due to the location of the ligament and mechanism of injury, particularly a MCL tear and/or medial meniscal tears.
What WDC Physiotherapy can do to Treat an ACL Tear?
- Oedema management: Advice on swelling management and how to prevent further damage to the ACL and surrounding tissue
- Soft tissue massage to release spasm in muscles restricting knee range of movement
- Joint mobilisations where necessary
- Specific exercises to strengthen the muscles surrounding the knee, to increase stability, increase proprioception (the sense of your joints position in space) and balance. Then we will progress you to sport specific exercises to get you back into your training
- Treadmill running analysis and gait analysis will also be beneficial
Suitable Products for this Injury:
- Custom-made Orthotics
Carpal Tunnel Syndrome
What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome presents as tingling, numbness and burning pain in the thumb, index and middle finger. You may also experience a sense of weakness in the hand. The carpal (wrist) bones form a narrow tunnel on the palmer (front) aspect of your hand. The tendons of the wrist and finger flexor muscles travel through the tunnel and are accompanied by the median nerve. Carpel Tunnel Syndrome is more prevalent in females, people with diabeties, thyroid diseases and during pregnancy.
How Carpal Tunnel Syndrome Happens
Increased swelling in the hand can compress the median nerve causing symptoms in the hands. It is commonly associated with overuse but can also occur secondary to another health conditions. Symptoms can occur at night, when you try to use your hands or grip objects.
What can Jenny Barker at WDC Physiotherapy can do to Treat Carpal Tunnel Syndrome
- Activity modification: We will advise you on how to modify aggravating activities to reduce your symptoms. You may benefit from night splints
- Joint mobilisations: Carpal (wrist) joint mobilizations
- Specific exercises: We will prescribe specific nerve slide exercises to decrease symptoms
- Ergonomic assessment: As this is an overuse condition a full assessment of your biomechanics and ergonomics is needed to prevent further damage
Suitable Products for Carpal Tunnel Syndrome
- Wrist splints
What is Frozen Shoulder?
Also known as adhesive capsulitis. It is an inflammatory condition of the ball and socket joint where the capsule tightens and greatly restricts shoulder range of movement.
How does Frozen Shoulder occur?
The causes for a frozen shoulder are not clearly defined, it often happens spontaneously, occurs in people between the ages of 40-60 and occurs more in women. It can occur after a fracture, surgery or trauma. A frozen shoulder progresses through three stages, usually over one to two years. The initial “Freezing” stage is painful and range of movement starts to become restricted. It’s often painful at night and can stop you from getting a good sleep. In the second or “Frozen” stage your shoulder movement will be very restricted but pain should reduce. In the third and final “Thawing” stage your range of movement will gradually improve. People who have conditions such as diabetes and thyroid disorders are also more likely to get adhesive capsulitis.
What WDC Physiotherapy can do to help fix it!
Unfortunately treatments for frozen shoulder are limted. Physiotherapy aims to minimise pain as well as maintain as much range of motion, strength and function as possible. During the “thawing phase” physiotherapy becomes more important as range of motion and strength needs to be restored.
Specific exercises: Specific stretching to maintain and improve range of movement of the shoulder joint. A progressive strengthening program of muscles surrounding the shoulder and shoulder blade to correct abnormal movement patterns and stop secondary injuries to the tendons.
Soft tissue release: To decrease spasm in the muscles surrounding the shoulder
Joint mobilizations: To increase range of movement and decrease pain in your shoulder
ITB Friction Syndrome
What is ITB Friction Syndrome?
ITB Friction Syndrome (ITBFS) presents as an ache on the outer side of the knee and is commonly seen in distance runners. The pain is often worse when running downhill. It results from rubbing and irritation of the bone underlying the fibrous band like structure that runs between the hip and knee as the knee is repeatedly bent and straightened.
How ITB Friction Syndrome Happens
Several factors can contribute to ITBFS. These include a tight illio-tibiaI band, tight muscles attaching to the illio-tibial band, poor muscle strength and stability at the hip and over-pronation at the feet.
What WDC Physiotherapy Can Do To Treat ITB Friction Syndrome
- Soft tissue massage: to release tight muscles including the hip stabilisers and ITB
- Stretching of the ITB and hip musculature
- Specific Exercises to loosen or stretch tight structures and strengthen weak muscles. In this condition strengthening of the quads and hip stabilizers are particularly important
- Kinesio Tape
- Treadmill running analysis
Suitable Products for ITB Friction Syndrome?
- Foam roller
- Custom-made Orthotics to control excessive pronation and align the lower limb
Lower Back Pain
What is Flexion Related Lower Back Pain?
Flexion Related Lower Back Pain is a a broad term used to describe any lower back pain that is aggraved by flexion movements e.g. bending and sitting. Pain can be localised to the middle of your back or is also commonly felt in the buttocks and thigh. Occaisionally pain can shoot down the leg. This electric shooting type of pain is called radicular pain or is also often refered to as sciatica. It is important that you keep moving and return to work (even if you can only do light duties). Excessive “bed rest” is not effective in managing lower back pain and is even considered detrimental to your rehabilitation.
How Flexion Related Lower Back Pain Happens
Flexion related lower back pain usually occurs with a bending, lifting or twisting movement, or can be a result of prolonged sitting or bending postures. Flexion related lower back pain can be caused by irritation of multiple structures such as an intervertebral disc, facet joint, ligaments or surrounding muscles. As the spine is a complex structure a comprehensive assessment by one of our specialist physiotherapists is essential in getting the correct diagnosis and treatment plan.
What WDC Physiotherapy can do to Treat Flexion Related Lower Back Pain
- Soft tissue massage to decrease muscle spasm and pain
- Joint mobilization: Specific to the affected joint in your back to relieve pain and increase range of movement.
- Specific Exercises: Home exercises to increase your range of movement and decrease pain. Core muscle retraining to increase the strength of the supporting muscles of the back and decrease your risk of re-injuring your back
- Ergonomic advice: ie workstation set up, avoiding loading positions such as proloinged sitting and bending
- Taping can be beneficial in reducing pain in the acute stages of management
- Pilates 1:1 or Class
Products useful for Flexion Related Lower Back Pain
- Lumbar roll
- Foam Roller / Trigger point foam roller
- Lumbar brace in an acute flare up
What is a Meniscus Injury?
There are two menisci in your knee joint, one lateral (outside) and one medial (inside) and they sit side by side on top of your tibia. Their role is to act as shock absorbers and to add stability to the knee joint. When torn the meniscus causes pain, swelling and can often cause your knee to click or lock.
How a Meniscus Injury Happens
An acute meniscal tear usually occurs when the knee is forcefully bent, compressed and then twisted. The person will likely get pain and they may hear a tearing sensation at the time of injury. Degenerative meniscal tears can also occur in the older population and don’t usually have a specific event causing injury. There are many different types of tears that differ in severity. The more severe ones can cause clicking or locking of the knee, restricted range of movement and function. Some of these more severe meniscal injuries may require surgical intervention prior to physiotherapy. The meniscus itself has a poor blood supply, with the outer third having slightly more and therefore a greater chance of small tears healing.
It is very important to get a full physiotherapy assessment to ensure no other structures are damaged. A medial meniscus injury can occur along with an Anterior Cruciate Ligament (ACL) tear and Medial Collateral Ligament (MCL) tear, known as the “unhappy triad”.
What WDC Physiotherapy can do to treat a Meniscus Injury
- Soft tissue massage to release muscle spasm around the knee
- Oedema management and advice on initial swelling
- Specific exercises to increase range of movement and to strengthen the supporting muscles around the knee and hip. Proprioceptive and balance program to enhance function and stability
- Treadmill walking and or running analysis to correct biomechanics
- Arrange referral to a knee orthopaedic specialist as major tears may need arthroscopic surgery to remove or repair the damaged part of the meniscus.
Patello-Femoral Pain Syndrome (Runners Knee)
What is Patello-Femoral Pain Syndrome (PSPS)?
PFPS typically presents as generalised pain at the front of the knee. It commonly occurs with activities involving weight bearing with bending and straightening of the knee. These activities include running, cycling, climbing up and down stairs or weight training. This type of injury generally comes on gradually and is not associated with a twisting mechanism.
How Does PFPS Happen?
Anything that increases the loading on knee cap or changes the way it moves over the knee joint can contribute to patello-femoral pain. Typically a number of biomechanical factors cause the kneecap to be pulled laterally (to the outside). Instead of it sliding nicely in its groove on the femur (thigh bone) it rubs against the outside of the groove producing pain and occasionally a grinding sound known as crepitis. The biomechanical factors include bony varience, foot overpronation, weak quadriceps and hip stabilisers, tight quadriceps or ITB.
What WDC Physiotherapy can do to Treat PFPS
- Soft Tissue Massage to release tight muscles including the hip stabilizers, quads and ITB
- Joint mobilization of the patella to glide it medially (towards the inside)
- Specific Exercises to loosen or stretch tight structures and strengthen weak muscles. In this condition strengthening of the quadricepss and hip stabilizers are particularly important
- Specialist taping techniques to help pull the patella into a better position
Suitable Products for this Condition
- Foam Roller: Used to loosen tight muscles around the hip, knee and calf
- Custom-made Orthotics
What is Plantar Fasciitis?
It is a common inflammatory condition affecting the thick band of connective tissue (fascia) on the sole of the foot. It is often a sharp pain in the heel which is much worse with the first few steps in the morning and occurs with most weight bearing activities. It can become a disabling chronic problem if not treated correctly. It occurs commonly in runners and people who are on their feet for prolonged periods of time. It also occurs more frequently in women and people aged 40-60 years old.
How Does Plantar Fasciitis Happen?
It often starts for no reason and is not normally associated with trauma. A number of factors can contribute to Plantar Fasciitis but typically people with flat feet, poor walking biomechanics and tightness in the calf, hamstring and gluteal regions. There can also be associated crepitis or “rice bubble” sensations when you press on the sole of your foot. It is aggravated by walking, running, dancing and non-supportive footwear.
What WDC Physiotherapy Can Do To Treat Plantar Fasciitis
- Soft tissue release – of the plantar fascia itself, calf muscles, hamstrings and gluteal muscles
- Specific exercises: Advice on using ice to control inflammation, rest and exercise modification to allow structures to heal. You will then need a progressive strengthening and exercise program to get you back up and running
- Taping to provide support for the foot and plantar fascia. Specific stretching exercised to stretch plantar fascia and supporting muscles
- Treadmill running analysis to correct your gait pattern and prevent further episodes
Suitable Products for Plantar Fasciitis
- Spikey Ball/Golf Ball
- Custom-made Orthotics
Postural Neck Pain
What is Postural Neck Pain?
A common condition seen amongst office workers due to the prolonged positions maintained at the desk. It presents as a burning or aching pain across the shoulders and neck and is commonly associated with headache. More severe cases can include symptoms into the arms and hands.
How Postural Neck Pain Happens
Prolonged poor postures with the chin poked forward, rounded back and shoulders increases the tension on the muscles and causes the joints to stiffen resulting in pain. Imagine your head being a bowling ball on a stick. Now imagine the force through the stick as you slowly tilt the stick forward to look at a computer screen.
What WDC Physiotherapy Can Do To Treat Postural Neck Pain
- Soft tissue massage to release muscle tension around the neck and shoulders
- Joint mobilisations to loosen stiff joints and enable better postural alignment when sitting
- Specific exercises to stretch tight muscles, loosen stiff joints and strengthen the postural stabilisers. The postural stabilisers are the muscles responsible for holding you upright in a good posture
- Postural Correction: This involves teaching you how you should be sitting. Sometimes your therapist will use tape to cue your muscles to hold you in a better posture
- Ergonomic assessment: Your therapist can provide you with an information pack that teaches you how to set up your workstation. It may involve you taking a photo of yourself at your workstation. We may even come to your workplace to help you set up your workstation. This includes computer monitor height, desk height and more
- Pilates 1:1 or Classes to help correct your posture and balance out and strengthen your body and posture muscles
Suitable Products for Postural Neck Pain
- Lumbar roll: Stabilizes the lumbar spine which has a positive effect up through both the thoracic spine (upper back) and cervical spine (neck)
What is Shin Splints?
Shin Splints is a generalised term to describe several different conditions that cause pain around varying parts of the shin region. There are several structures which can cause pain in this area so it is very important to get a correct diagnosis from your physiotherapist. Different types of shin splints occur in long distance runners, impact and jumping sports.
What are the causes of shin splints?
- Stress fractures: Whilst not typically referred to as a type of shin splint, stress fractures have been mentioned here as they are a type of that shin pain that must be ruled out as treatment may vary from treatments that are appropriate for other shin splint types. It might be easy to think of stress fractures as a MORE SEVERE form of shin splints. Stress fractures are exactly what the name suggests. Smallcracks or fractures graduallt develop with the bones with excessive stress or loading. You will have very localised pain on one of the bones in the shin. Stress fractures are more commonn the tibia than the fibula so pain is typically felt on the inside of the shin. Stress fractures are a gradual onset, overuse problem and is made worse with exercise, a rapid increase in your training program, incorrect footwear, poor running biomechanics and poor bone density can all be contributing factors. This type of pain will tend to progress with further activity and often aching at night is present.
- Inflammation: at the insertion of the muscles onto the bone, particularly tibialis posterior and soleus muscles in the calf. This presents as quite diffuse pain along themedial tibia (inside of the shin).
- Vascular insufficiency: altered blood flow either into or out of the leg can present as pain in the calf.
- Compartment syndrome: this typically presents as increased aching pain and tightness during exercise, with no pain at rest. Your lower leg has several muscles divided into four compartments separated by thick inelastic fascia. Overuse and inflammation of the muscles can increase the pressure within the compartment and reduce blood flow to the muscles. The pain in this type of injury is described as tightness and settles within minutes of cessation of the aggravating activity. Occasionally patients complain of pins and needles in the feet also.
- Nerve entrapment: less common but can cause pain in the shin.
What we at WDC Physiotherapy can do to treat Shin Splints!
- Specific exercises. An initial period of relative rest will be essential. Relative rest does not necessarily mean a complete cessation of aggravating activity but most certainly a reduction in it. We will advise you on appropriate cross-training exercises to keep up your fitness and not cause pain. You will need a specific strengthening program with a gradual return to running.
- Soft tissue release: Release spasm in the muscles surrounding the calf and shin.
- Kinesio Taping
- Treadmill running analysis: These will be essential to analyze your biomechanics. We can then prescribe custom made orthotics and hip stability exercises to improve your running biomechanics and prevent further damage.
Suitable Products for shin splints include:
- Orthotics: help control excessive pronation and improve lower limb alignment
- Foam roller: used to massage and loosen tight muscles around the calf.
- Kinesio Tape