Neck pain and headaches

Neck pain is very common and may occur due to injury, sustained poor posture such as prolonged computer use or general wear and tear. Sometimes the pain may be referred into the arm or hand due to irritation of the nerves in the neck. Headaches can also be due to stiffness or increased muscle tension in the neck and upper back. During your first physiotherapy appointment we can identify the tissues causing your pain and plan appropriate treatment.

Whiplash injury

Whiplash is caused by a sudden uncontrolled movement of the head, neck and upper body. It usually occurs during a road traffic accident (RTA) but can also be caused by falls or sporting injury. Permanent damage is rare and the long-term outlook is good. Whiplash injuries can be very painful but are usually not serious. Symptoms of pain and stiffness can occur in the neck and back and usually develop a day or two after the accident or injury. Headaches are common after whiplash and may be due to associated muscle tension. Other symptoms may include dizziness, tinnitus and nausea.
The severe pain usually improves within the first few weeks after the injury. Your doctor may initially prescribe painkillers and anti-inflammatories to help your symptoms. A return to active movement and normal function is advised as soon as possible. Physiotherapy techniques such as gentle mobilisation, specific exercises and acupuncture can help to reduce pain and restore function.

Shoulder pain

The shoulder is a complex but mobile joint comprised of the upper arm (humerus), shoulder blade (scapula) and collar bone (clavicle). Because it is a flexible joint, the muscles and other soft tissues around the shoulder are very important in maintaining stability and function. Problems may arise if there is damage or inflammation to any of the structures. Rotator cuff pathology, tendinopathy, impingement syndrome, frozen shoulder (adhesive capsulitis), osteoarthritis and fractures or surgery can all cause pain, stiffness and reduced function. Shoulder pain can also be referred pain from the neck. Physiotherapy plays a crucial role in diagnosing and rehabilitating shoulder problems.

Elbow, wrist and hand problems

‘Tennis elbow’ and ‘golfers elbow’ are both painful elbow conditions that are regularly treated by physiotherapy. Golfers elbow causes pain on the inside of the elbow while tennis elbow affects the outer part of the elbow. They are usually due to overuse of the forearm muscles during tasks that include gripping or repetitive movement such as keyboard or mouse use. Symptoms may include pain, stiffness, swelling, weakness and an inability to grip.

Physiotherapy treatment and advice can dramatically reduce the painful symptoms of golfers and tennis elbow. Treatment may include mobilisation of joints and soft tissues, electrotherapy or acupuncture. A progressive eccentric strengthening programme can be very effective.

Back pain and sciatica

Back pain is very common and is not usually a sign of a serious medical condition. There are many structures in the spine such as vertebrae (bones), discs, ligaments and muscles which can cause pain. Early assessment and treatment is important to promote prompt recovery and return to normal activities. Back pain responds well to regular exercise and staying active. As well as treating your symptoms your physiotherapist will advise you on the most appropriate types of exercise and activity for you.

Back pain may sometimes be associated with referred pain into your leg(s). This pain may be felt anywhere in the leg from your buttock to your toes.

Other symptoms of sciatica may include tingling or numbness in the leg or foot. Sciatica is due to irritation of the sciatic nerve. If you lose bladder or bowel control, please see your doctor urgently.

Core stability problems

Core stability refers to the ability of the muscles in your trunk (abdominal and back muscles, pelvic floor and diaphragm) to provide stability in your body while you are moving. Weakness, tight muscles, injury or periods of inactivity may contribute to an ‘imbalance’ in the trunk or pelvis which can in turn lead to pain. Physiotherapists are able to effectively assess any imbalance and help you address this. Pilates is an excellent way of improving flexibility, muscle strength, and endurance and puts emphasis on spinal and pelvic alignment, breathing, coordination and balance.

Hip and groin pain

Hip and groin pain can have a significant impact on your daily life affecting activities like walking, going up and down stairs, putting on socks and shoes and sleep as well as limiting your exercise or sporting ability. There are a vast range of conditions affecting the hip and groin for example, osteoarthritis, femoroacetabular impingement, bursitis, adductor muscle strains and hernias. Your Physiotherapist can help you address the cause as well as providing treatment and advice on improving mobility and strength of the hip and core stability.

Knee ligament injury

Ligament injuries are graded between grade I (minor strain) to grade IV (large tear). By undertaking a thorough history and a full examination of the knee the physiotherapist is able to assess the degree of damage to these stabilising ligaments. Physiotherapy treatment is guided by the degree of the strain/tear and is aimed at regaining stability and reducing pain. The physiotherapist will advise on an individualised rehabilitation schedule to suit your sporting and daily activity levels. If the injury is severe a referral to an orthopaedic specialist may be required.

ACL reconstructionn

An anterior cruciate ligament repair is a surgical procedure usually carried out as a result of a rupture to the ligament caused by injury. A contact injury usually results in multi ligament injury. An ACL reconstruction is carried out to replace the torn ligament usually using part of your own hamstring tendon. Following the surgery physiotherapy is aimed at reducing swelling, restoring movement and strengthening the muscles around the knee and trunk in order to regain full function, weight bearing and mobility.

Physiotherapy lasts for between 6 and 10 weeks. You will be advised on a self management programme including gym exercise when appropriate. Active return to sport is usually around 6-12 months after the surgery. Physiotherapy is key to achieving your functional goals.

Knee meniscus injuries

The menisci (cartilage) in the knee joint sit between the femur (thigh) and tibia (shin). The menisci are integral to knee joint health. Their function includes transmitting loads across the knee joint, providing stability to the knee, shock absorption and joint lubrication and nutrition.
Injuries to a meniscus are usually the result of a high force trauma, but may also follow a low force trauma although this is more likely to happen in a meniscus that already has undergone some degenerative change. During the injury a popping sensation may be felt. Symptoms of a meniscal tear include pain, swelling, inability to fully straighten the knee, loss of movement, locking, catching, the knee giving way and weakness.
Surgical techniques focus on preservation of the cartilage and repair if possible. This is usually done through an arthroscopy – keyhole surgery. Not all meniscal injuries require surgery.
Recovery after the surgery is highly dependent on the specific procedure used. In general if the damaged cartilage is removed the recovery time is quicker than if the cartilage is repaired – healing time for a repair is longer. Physiotherapy is an important part of the post-surgery rehabilitation and is aimed at regaining movement, strength, function, balance and stability.

Foot and ankle pains and sprains

he foot and ankle are made up of a complex structure of bones supported by ligaments, tendons and muscles. While foot and ankle injuries are common in sports people they may also be sustained during relatively minor trips or falls or through repetitive action. Sprains, tendinitis, bursitis and plantar fasciitis are all conditions which can be treated with physiotherapy as well as rehabilitation following fractures, surgery or periods of immobilisation.

Following fractures

Most fractures need a period of immobilisation to allow the bones to heal. However side effects from this include stiffness, loss of muscle strength, pain, loss of co-ordination or balance, decrease in physical activity levels and over-use of the uninjured limb or joints. Physiotherapy is aimed at addressing your specific limitations to regain movement and function as soon as possible.