The majority of people who experience “tennis elbow” don’t actually play tennis. Tennis elbow is a condition where a tendon attachment at the elbow becomes injured due to a change in load or activity that the tendon is unaccustomed to eg: using a mattock, screwdriver or crow bar etc. Many times, people cannot even recall any activity that resulted in the onset of their symptoms.
Aggravating activities usually include gripping, shaking hands, picking up a cup or water bottle, turning taps etc.
There are a myriad of treatment options available for tennis elbow ranging from PRP (platelet rich plasma) and cortisone injections, shockwave therapy, dry needling, bracing, manual therapy and exercise therapy. Unfortunately, there is no such thing as a “quick fix”. Results from clinical trials researching the effects of shockwave therapy vs placebo is mixed. Many people experience immediate, short term relief following a cortisone injection however, over time, their symptoms return. Solid evidence supports the use of manual and exercise therapy for pain relief and conditioning of the tendon to be able to cope with daily activities.
Your physiotherapist can evaluate your elbow symptoms to determine if the diagnosis is actually tennis elbow or pain resulting from another condition. Home exercise programmes are not recipe based and need to be prescribed based on the severity/irritability of your condition and life/sporting/work goals.
Whether it be reaching up into a cupboard, taking off a shirt, sleeping or lifting weights, shoulder pain can significantly impact upon many of our day-to-day activities.
Not all shoulder pain is the result of a rotator cuff tear. Shoulder pain can also originate from the neck, acromioclavicular joint, heart and other internal shoulder joint pathology.
It is quite common to develop rotator cuff tears as we age and the prevalence increases as we get older: 12-13% in our 50’s, 15-20% in our 60’s, 26-31% in our 70’s and 37-51% in our 80’s. The interesting point is that 65% of rotator cuff tears are asymptomatic. A tear may have been present for years before it becomes painful. If so, then why?
Scapular position, altered muscle length (long or short), reduced strength, poor joint mobility and habitual postures can all contribute towards why a shoulder may become painful. It is important to determine the source of your symptoms in order to implement the most effective treatment.
Following a thorough evaluation, your physiotherapist will decide which manual therapy techniques, exercise programme and advice/education will be required to address your shoulder symptoms and get you back to pain free function.
NECK PAIN & HEADACHES
Many people suffer from neck pain and/or headaches at some point in their lives. For those that experience neck pain more frequently however, it can interfere with their participation and enjoyment of activities of daily living.
People often wonder why they have neck pain when they haven’t sustained a particular injury or incident eg: a fall or motor vehicle accident. Neck pain can also result due to prolonged, inappropriate loading secondary to poor habitual postures and muscle recruitment patterns.
There are many muscles that attach from our spine, ribs and shoulder blades to our neck. If these muscles are continually overworking, they can develop painful trigger points, reduce in length, restrict joint motion and increase compressive loading at neck joints. This can contribute towards the aching and tightness experienced in people’s necks. A small percentage of headaches derive solely from the upper neck segments and can occur in combination with tension-type headaches and migraines.
Manual therapy such as joint mobilisations and massage can help improve people’s symptoms, however contributing factors such as poor postures, general activity levels, muscle recruitment, strength and length issues, need to be addressed for improved longer-term outcomes.
Following a thorough assessment, therapy, possible taping and graded exercise, your physio can get you back to doing the things you love, pain free.
A PAIN IN THE SIDE….
Pain occurring in the side of the hip, +/- down the side of the thigh, can be referred from your lower back or be the result of buttock muscle dysfunction, particularly the gluteus medius muscle. The gluteus medius and minimus tendons attach onto the greater trochanter of your hip bone. One of their functions is to provide functional stability to your hip joint when standing on one leg.
For various reasons, such as age/sex, weakness, certain postures and reduced flexibility, the gluteal tendons can develop increased wear, tear and compressive load at their attachment site on the greater trochanter. Painful activities can include walking, running, stairs, sit-to-stand and lying on your side. This condition is often called “bursitis” of the hip however advanced imaging and surgical procedures have revealed a primary pathology of the gluteus medius and minimus tendons.
One treatment option for gluteus medius tendinopathy is a corticosteroid injection, which can result in a significant reduction in symptoms for approximately 70-75% of people one month post-injection. Unfortunately, these effects can be short-lived, with symptoms often recurring 3-4 months later. Underlying causative factors, such as weakness or reduced flexibility, need to be addressed for long term resolution of symptoms.
Your physiotherapist will perform a thorough assessment to determine the source of your symptoms (lower back or gluteal tendon) and establish which exercises, taping techniques and manual therapy are appropriate for you and the stage of your gluteal tendinopathy. Close monitoring, adjustment and progression of your exercise programme is required throughout the rehabilitation process.
Ankle sprains are common injuries. Being common does not however equate to being trivial. Over the years, I have noted that many people do not consider seeking treatment for their sprained ankle. They possibly apply ice and then let nature take its course. As a result, I usually see people months after their injury with ongoing problems.
There is much more to recovering from an injury than just the damaged structure healing. A sprained ligament may heal however frequent issues are persisting swelling, pain with stairs and running, “feeling unstable” and reduced range of motion.
Following a thorough history and physical examination, your physiotherapist will determine what management plan is required to reduce pain, restore function and return to your usual sporting and lifestyle activities.
The sooner you seek treatment following a sprain, the greater the likelihood of a speedier recovery without ongoing pain and dysfunction.
There are many reasons why we can develop knee pain. Today’s focus will be on pain experienced in the front of the knee around the knee cap. People may recall a specific incident that brought on their knee symptoms or their pain may have developed gradually for no apparent reason.
Aggravating activities often include climbing stairs, squatting, running, twisting, jumping and kneeling. People with pain at the front of the knee often have reduced quadriceps and gluteal muscle function and/or limited flexibility of the thigh muscles and connective tissues. There is no recipe for the management of knee pain, treatment varies depending on the diagnosis and severity of symptoms.
Your physiotherapist will perform a thorough assessment to determine the correct diagnosis and administer specific treatment and exercises.
Getting you back to symptom-free sporting or daily activities is always our goal.