Tag: rehabilitation

Hip flexor strengthening exercises

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Hip Flexor Strengthening exercises

Stretching

Quadricep and hip flexor stretch (lying on side):

• Lie on one side, with your legs extended and stacked on top of each other
• Bend your top knee and bring your foot towards your glutes, keeping your bottom leg straight
• Hold this stretch for about 30 seconds and then switch sides

Hip flexors stretch (kneeling):

• Kneel on the floor with one foot in front of the other
• Shift your weight forward, keeping your back straight, until you feel a stretch in your hip flexors
• Hold this stretch for about 30 seconds and then switch sides

Hip flexors stretch (edge of table):

• Stand facing a table or similar surface
• Place one foot up on the table with your knee bent, while keeping the other foot on the floor
• Lean forward into the table until you feel a stretch in your hip flexors
• Hold this stretch for about 30 seconds and then switch sides

Seated butterfly:

• Sit on the floor with the soles of your feet touching each other
• Hold onto your feet and gently press your knees down towards the floor
• Hold this stretch for about 30 seconds

Bridge pose:

• Lie on your back with your knees bent and feet flat on the floor
• Lift your hips up towards the ceiling, keeping your feet and shoulders on the ground
• Hold this position for a few seconds and then slowly lower your hips back down to the floor.

Strengthening

Mountain climbers:

• Get into a push-up position with your hands placed under your shoulders
• Bring one knee up towards your chest while keeping your other leg extended behind you
• Switch legs quickly and repeat the motion, as if you are running in place
• Continue this motion for a specified number of repetitions or for a set amount of time

Lunges/Jump Lunges:

• Stand with your feet hip-width apart
• Step forward with one foot, lowering your body until both knees form a 90-degree angle
• Push back up to the starting position
• For jump lunges, add a jump as you switch legs and land with the opposite foot forward.

Straight leg raises:

• Lie on your back with your legs extended straight up towards the ceiling
• Keeping your legs straight, lower one leg down towards the floor until it is about 6 inches off the ground
• Raise your leg back up to the starting position and repeat with the other leg
• Continue this motion for a specified number of repetitions or for a set amount of time.

Hamstring bridge with banded hip flexion:

• Lie on your back with your knees bent and feet flat on the floor
• Place a resistance band around your thighs, just above your knees
• Push through your heels to lift your hips up towards the ceiling
• While holding this position, bring your knees towards your chest and then straighten them back out

Standing knee flexion with additional weight:

• Attach weight to one feet
• Focusing on holding your core strong, bend the knee to flexed position
• Continue this motion for a specified number of repetitions or for a set amount of time.

Flat Feet

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Flat Feet

Overview

Flat Foot, medically known as Pes planus, is a condition in which the medial longitudinal arch (MLA) which runs the length of the foot is flattened out or lowered. Flatfoot may affect one or both feet, and it can not only increase the load acting on the foot structure, but also interferes with the normal foot function. Therefore, individuals with flat feet experience discomfort while standing for long periods of time and exhibit a distinctive flat-footed gait. Typical flatfoot symptoms include a tenderness of the plantar fascia, a laxity of the ligaments, a rapid tiring of the foot, pain under stress, and instability of the medial side foot structure. Over time, the mechanical overloading resulting from the flattened MLA is transferred to proximal areas such as the knees, hips, and lower back. Flatfoot is recognized as a contributory factor in a wide variety of medical conditions, including lower limb musculoskeletal pathologies such as plantar fasciitis Achilles tendonitis, and patella-femoral joint pain.
Flatfoot deformities are commonly treated using some form of orthotic device. Such devices are designed to provide stability and to realign the foot arch, and have a demonstrable success in alleviating patients’ symptoms

Anatomy

Flatfeet are an anatomical alteration which can occur in one foot or in both feet. The most common structural difference in flatfeet is found to be rear-foot varus which in turn causes excessive pronation of the foot. In addition, deepened navicular cup, widened talus articular surface, proximally faced talus, and higher positioned navicular articular surface can be seen. These alterations cause the MLA to collapse resulting in a loss of arch height. When this loss of arch height is observable in both non-weight bearing and weight bearing positions, it is termed as rigid flatfeet. Contrarily, when a normal MLA height is present in non-weight bearing condition and collapses with weight bearing is identified as flexible flatfeet.

Symptoms

The most identifiable symptoms and characteristics of flat feet are the decrease or lack of arches in the feet (especially when weight bearing) and pain / fatigue along the inner side of the feet and arches.
Some issues caused by flat feet include:
• Inflammation of soft tissue
• Foot, arch, and leg fatigue
• Heel, foot, and ankle pain
• Knee, hip, and lower back pain
• Rolled-in ankles
• Abnormal walking patterns
• Shin splints
• Bunions
• Hammertoe
• Arthritis
• Plantar fasciitis
• Posterior tibial tendon dysfunction (PTTD)

Causes

Flatfeet is not unusual in infants and toddlers, because the foot’s arch hasn’t yet developed. Most people’s arches develop throughout childhood, but some people never develop arches. People without arches may or may not have problems.
Some children have flexible flatfeet, often called flexible flatfoot, in which the arch is visible when the child is sitting or standing on tiptoes but disappears when the child stands. Most children outgrow flexible flatfeet without problems.
People without flatfeet can also develop the condition. Arches can collapse abruptly after an injury. Or the collapse can happen over years of wear and tear. Over time, the tendon that runs along the inside of the ankle and helps support the arch can get weakened or tear. As the severity increases, arthritis may develop in the foot.

Diagnosis

The observation of the feet mechanics from the front and back and also toes stand. The strength test in the ankles and locate the main area of pain. The wear pattern on the shoes also may reveal information about the feet.

Tests

Imaging tests that can be helpful in diagnosing the cause of foot pain may include:
• X-rays. A simple X-ray uses a small amount of radiation to produce images of the bones and joints in the feet. It’s particularly useful in evaluating alignment and detecting arthritis.
• CT scan. This test takes X-rays of the foot from different angles and provides much more detail than a standard X-ray.
• Ultrasound. Ultrasound may be used when a tendon injury is suspected. Ultrasound uses sound waves to produce detailed images of soft tissues within the body.
• MRI. Using radio waves and a strong magnet, MRIs provide excellent detail of both bone and soft tissues.

Treatment

Many people with flat feet don’t have significant problems or need treatment. However, if foot pain, stiffness or other issues occur health provider might recommend nonsurgical treatments. Rarely, people need surgery to fix rigid flat feet or problems with bones or tendons.
Treatments include:
• Nonsteroidal anti-inflammatory drugs (NSAIDs), rest and ice to ease inflammation and pain.
• Physical therapies to stretch and strengthen tight tendons and muscles, improving flexibility and mobility.
• Supportive devices like foot orthotics, foot or leg braces and custom-made shoes.

Exercises

Toes elevations: Start by standing with your feet shoulder-width apart and flat on the ground. Slowly raise your toes off the ground as high as you can, while keeping your heels on the ground. Hold this position for a few seconds, then lower your toes back down to the ground. Repeat for several repetitions.

Toes scrunches: Begin by sitting in a chair with your feet flat on the ground. Scrunch your toes together as tightly as you can, then relax them. Repeat for several repetitions.

Double/Single leg raises: Start by lying on your back with your legs straight out in front of you. For double leg raises, raise both legs off the ground at the same time, keeping them straight. For single leg raises, raise one leg off the ground while keeping the other leg straight and on the ground. Hold the raised leg in the air for a few seconds, then lower it back down to the ground. Repeat for several repetitions on each leg.

Standing single leg balance: Stand on one foot with your knee slightly bent. Hold this position for as long as you can, up to 30 seconds, then switch to the other foot. For a greater challenge, close your eyes or stand on a pillow or unstable surface.

Toes walks: Start by standing with your feet flat on the ground. Slowly walk forward on your toes, keeping your heels off the ground. Walk for a few steps, then lower your heels back down to the ground. Repeat for several repetitions.

Heel walks: Begin by standing with your feet flat on the ground. Slowly walk forward on your heels, keeping your toes off the ground. Walk for a few steps, then lower your toes back down to the ground. Repeat for several repetitions.

Calf muscle stretch: Start by standing facing a wall with your hands on the wall at shoulder height. Take one step back with one foot, keeping your heel on the ground. Bend your front knee, keeping your back leg straight, until you feel a stretch in your calf muscle. Hold this position for 15-30 seconds, then switch legs and repeat.

Prevention

Although flat feet are often hereditary and cannot be completely prevented, there are strategies that can be put in place to help reduce the risk of developing flat feet symptoms. Here are some preventative measures:
Footwear:
Choose supportive footwear with good arch support and cushioning and try to avoid shoes with flat soles.
Consider using orthotic insoles or arch supports that are designed to provide additional support and alignment for the feet.

Foot Exercises:
Perform exercises to strengthen the muscles of the feet and lower legs. This may include toe curls, heel raises, and toe taps. Consult with a healthcare professional or a physical therapist for guidance on appropriate exercises.

Maintain a Healthy Weight:
Excess body weight can contribute to the flattening of the arches. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce stress on the feet.

Avoid Prolonged Standing:
If your job or activities involve prolonged periods of standing, take breaks to rest and stretch your feet. Consider using supportive mats or insoles in areas where you stand for long durations.

Stretching Exercises:
Perform stretching exercises to maintain flexibility in the Achilles tendon and calf muscles. This can help prevent excessive pronation and contribute to better foot alignment.

Avoid High Heels:
Limit the use of high-heeled shoes, as they can contribute to foot misalignment and increase stress on the arches. Opt for shoes with a moderate heel height.

Gradual Changes in Physical Activity:
If you are starting a new physical activity or exercise routine, make changes gradually. Sudden increases in intensity or duration can place additional stress on the feet.

Proper Body Mechanics:
Pay attention to your body mechanics and posture. Maintain good posture while standing and walking and be mindful of how you distribute your weight on your feet.

Consult with a Specialist:
If you have concerns about your foot structure or experience symptoms of flat feet, consult with a podiatrist or orthopaedic specialist. They can provide a thorough evaluation and recommend appropriate interventions, such as orthotics or physical therapy.

Consider Arch-Supporting Activities:
Engage in activities that naturally support the arches, such as swimming or biking. These activities can be less stressful on the feet compared to high-impact sports.
It’s important to note that preventive measures may vary based on individual factors, and what works for one person may not be suitable for another. If you have specific concerns about flat feet or foot health, seeking advice from a healthcare professional is recommended. They can provide personalized recommendations based on your unique circumstances.

The Power of Sports Massage: Performance and Recovery

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The Power of Sports Massage: Enhancing Athletic Performance and Recovery

Whether you’re a professional athlete, a weekend warrior, or just someone who enjoys staying active, sports massage can be a game-changer in your fitness journey. This specialized form of massage therapy offers a wide range of benefits that go far beyond relaxation. In this article, we’ll explore the numerous advantages of sports massage and why it’s a crucial component of many athletes’ training and recovery routines.

1. Enhanced Athletic Performance

One of the most significant benefits of sports massage is its ability to boost athletic performance. By targeting specific muscle groups and alleviating tension, sports massage helps improve flexibility and range of motion. This increased flexibility allows athletes to move more freely and efficiently, which is especially vital in sports that require agility and quick movements. As a result, athletes can perform at their best and reduce the risk of injury.

2. Faster Recovery

The demands of intense physical activity can lead to muscle soreness and fatigue. Sports massage helps in the speedy recovery of fatigued muscles by increasing blood circulation and lymphatic flow. This enhanced circulation assists in the removal of waste products and reduces muscle soreness, allowing athletes to bounce back faster and maintain their training consistency.

3. Injury Prevention

Preventing injuries is a top priority for athletes of all levels. Sports massage is an invaluable tool in injury prevention. By identifying and addressing muscle imbalances and areas of tension, massage therapists can reduce the risk of overuse injuries. They can also spot potential issues before they become more severe, helping athletes make necessary adjustments to their training routines.

4. Stress Reduction

Training and competition can be physically and mentally taxing. Sports massage offers a dual benefit by reducing both physical and mental stress. The soothing touch of massage can have a calming effect, helping athletes manage anxiety and stay focused on their goals.

5. Improved Posture and Body Awareness

A well-trained sports massage therapist can identify and address postural issues and imbalances that may be negatively impacting an athlete’s performance. By focusing on these areas, athletes can improve their posture and overall body awareness, which can lead to better movement and reduced strain on the body.

6. Targeted Rehabilitation

In cases where injuries have already occurred, sports massage can be an integral part of the rehabilitation process. Therapists can work alongside healthcare professionals to design a customized massage plan that aids in the healing and recovery of injured muscles and tissues.

7. Enhanced Immune System Function

Regular sports massage can also strengthen the immune system. The reduction of stress and the improvement in circulation and lymphatic flow can help the body better defend against illnesses, keeping athletes in peak condition.

8. Mental Clarity and Focus

Physical well-being and mental health are intricately connected. Sports massage contributes to mental clarity and focus, helping athletes stay motivated and determined to achieve their goals.

In conclusion, sports massage is not just a luxury; it’s a powerful tool that can significantly impact an athlete’s performance, recovery, and overall well-being. Whether you’re a professional athlete or someone who enjoys an active lifestyle, incorporating sports massage into your routine can help you achieve your fitness objectives and enjoy a more balanced, injury-free life. Consult with a qualified sports massage therapist to discover how this specialized therapy can benefit your athletic journey.

Shin Splints

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Overview

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

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Shin Splint Anatomy

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

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Medial tibial stress syndrome (MTSS)

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

Symptoms

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

Causes

– Muscle imbalance
– Impact
– Change of stress (e.g: shoes, surfaces, intensity)
– Over pronation of the foot[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true” border_sizes_top=”0px” border_sizes_bottom=”0px” border_sizes_left=”0px” border_sizes_right=”0px”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Stress Fractures

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

Symptoms

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

Causes

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

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Compartment Syndrome

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

Symptoms

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

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

Causes

– Post-impact bleeding
– Rapid hypertrophy of compartment muscles
– Inflammation of tendons from repetitive movement or impact
– Reduced flexibility in an adjacent compartment[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true” border_sizes_top=”0px” border_sizes_bottom=”0px” border_sizes_left=”0px” border_sizes_right=”0px”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Diagnosis

Shin splints are usually diagnosed from the patients’ medical history and a physical exam. In some cases, an X-ray or other imaging studies can help identify stress fractures.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true” border_sizes_top=”0px” border_sizes_bottom=”0px” border_sizes_left=”0px” border_sizes_right=”0px”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Treatment

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

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

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

Resume usual activities gradually after your pain is gone.

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Exercises

Standing Gastrocnemius Stretch

Stand facing a wall with your palms flat against it, place your left foot behind you ensuring your toes are facing forward. While keeping your left heel on the ground & your leg straight lean forward to create the stretch in the lower leg. If the stretch isn’t felt move your heel further back. Hold the stretch for 30 seconds before returning back to the starting position. Repeat a minimum of 3 times before changing legs.

Soleus Stretch

Start in the same position as the Gastroc stretch however this time the back leg needs to be bent. Making sure to keep the heel on the ground, the stretch should be felt in the lower as you bend the knee. Hold the stretch for 30 seconds before returning back to the starting position. Repeat a minimum of 3 times before changing legs.

Tibialis Anterior Stretch

Kneel down on the ground, once in this position slowly sit onto your heels. You can place your hands on the ground behind you for balance and you should be able to feel the stretch in the front of your lower leg. To get more of a stretch push down into your heels and slowly lift your knees up off the ground. Make sure to hold the stretch for 30 seconds, repeat 3 times.

Calf Raises

Resisted Dorsiflexion


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Prevention

– Lessen the impact involved with the types of activity you’re doing- e.g: change from road running to softer ground running
– More support, wear more supportive shoes, arch supports
– Avoid too much overload on the shins e.g: too much high impact activity

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Winging Scapula

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Overview

Scapula winging is a condition that affects the shoulder blades, the shoulder blade bones should usually lay flat against the back of the body. Scapula winging occurs when a person suffers with shoulder problems, causing the shoulder blades to stick out abnormally. The condition of scapula winging is quite rare but some individuals may suffer really bad from the condition and need effective treatment.

The main muscle involved in the cause of scapula winging is the serratus anterior. This muscle originates from the ribs 1-8 and attaches to the anterior surface of the scapula, which pulls the muscle against the ribcage. The long thoracic nerve is stimulated by the serratus anterior, when or if this nerve becomes injured the scapula will be affected as it jolts back adding more force onto the arm. Injuries to the shoulder may affect this nerve causing inflammation and added pressure onto the nerve, consequently triggering the onset of scapula winging.

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Anatomy

The scapula more commonly known as the shoulder blade articulates with the humerus at the glenohumeral joint. The scapula has three surfaces: the costal, lateral and posterior.

Costal Surface

The anterior surface of the scapula faces the ribcage. This is where the subscapularis originates (one of the rotator cuff muscles). The coracoid process also originates here which lies underneath the clavicle allowing the pectoralis minor, coracobrachialis and bicep brachii to attach at this region.

Lateral Surface

The lateral surface faces the humerus bone. This is where the glenohumeral joint is situated, the main bones around this area are the glenoid fossa, supraglenoid tubercle and infraglenoid tubercle.

Posterior Surface

The posterior surface of the scapula is the site of the majority of the rotator cuff muscles. These include the Infraspinous fossa and the Supraspinous fossa.

All 3 surfaces of the scapula are important to know to locate the site of pain/ discomfort and understand what is causing the winging.

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Symptoms

Scapula winging symptoms may differ as it depends where the location of the muscle or nerve damage is situated. Scapula winging is commonly presented by the shoulder blade sticking out from the back uncharacteristically. This may affect a person from even doing everyday things such as sitting down on a chair that has a hard back or even carrying bags that have straps.

Common symptoms of scapula winging are shown as:

  • Shoulder blades sticking out
  • Pain into the neck, shoulders and arms
  • Weakened muscles surrounding the shoulder blade
  • Tiredness and exhaustion when performing simple tasks
  • Pain and discomfort around the area
  • Inability to lift arms over the head
  • Sagging of the scapula

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Causes

Scapula winging Is triggered by an individual sustaining a severe injury to any muscles that control the scapula. The serratus anterior is one of the main muscles that enables a person to lift the arm above shoulder level, therefore when this is injured it can cause many problems within the shoulder region.

The main causes of scapula winging are:

  • Nerve damage to the long thoracic nerve
  • Serratus anterior weakness
  • Weakness in the rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis)
  • Compression on the dorsal scapula nerve (controls the Rhomboid muscles)
  • Weakness in the trapezius

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Diagnosis

Firstly, for the diagnosis of scapula winging your doctor will look at the shoulder blades for any clear obvious signs of winging. Some patient’s scapula bone may be more visible than others and have distinct scapula winging. The doctor may also ask you to perform arm/ shoulder movements to examine the range of movement and stability at the joint.

One of the main tests that are used to aid in the diagnosis of scapula winging is the serratus anterior test. This is where the patient is asked to face a wall, standing about two feet from the wall and then push against the wall with flat palms at waist level. This test is carried out to identify if any damage is done to the thoracic nerve causing the scapula to wing.

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Treatment

Treatment for winging scapula is dependent on which muscles or nerve is causing the issue. There are two types of treatment surgical and non-surgical.

Non-surgical treatment (Scapula Winging)

  • Physical therapy/ Rehabilitation
  • Stretching exercises
  • Strengthening exercises given by a physiotherapist
  • Wearing a brace/ sling to support the arm and shoulder
  • Sports massage therapy
  • Muscle relaxants/ anti-inflammatory drugs

Surgical treatment (Scapula Winging)

One surgical treatment for scapula winging is nerve and muscle transfers. This is a process which involves moving a part of the nerve and muscle to a different portion of the body, this mainly focuses on the neck, shoulder, back and chest areas.

Static stabilization is another form of treatment used to prevent scapula winging, however there is a risk with this treatment that it may return. This procedure uses a sling to attach the scapula to the ribs to add extra stability to the shoulder blade.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_2″ type=”1_2″ layout=”1_2″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”false”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Exercises

When performing these exercises aim to do 3 rounds of 15 sets for each exercise. Make sure they are slow and controlled so that it is solely focusing on strengthening the weakened muscles:

  • Scapula retraction
  • External Rotation
  • Horizontal Row
  • Standard press ups
  • Press up on knees (easier version)
  • Angel wings exercise

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Prevention

Prevention for scapula winging may not always be possible, however there are procedures you can complete to reduce the risk:

  • Perform exercises to help with posture
  • Try and maintain correct posture positioning
  • Don’t carry anything to heavy on the shoulders and back
  • Do not lift heavy weights at the gym that could cause more damage to the shoulder
  • Strengthen the muscles in the neck and shoulders
  • Perform rehabilitation exercises given by a physiotherapist or doctor
  • Avoid constant repetitive shoulder/ arm movements
  • Rest when needed

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Achilles Tendinitis

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Overview

Achilles tendinitis may occur when overuse or to much strain is placed onto the tendon in the ankle region. The Achilles tendon is situated at the heel of the foot and connects the lower leg muscles of the calf to the heel bone of the ankle.

This pathology is mainly sustained by people who do a lot of running and high intensity exercises. Individuals who may have amplified the time and intensity of their runs, thus potentially leading to Achilles tendinitis. This injury could also occur with a lot of people who play sports such as tennis, netball or basketball, due to the fast pace and explosive movements, causing added pressure onto the ankle joint. If not treated correctly Achilles tendinitis could lead to further complications such as tendon tears or ruptures, which may require surgical repair.

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Anatomy

The Achilles tendon, also known as the calcaneal tendon is situated at the back of the ankle. It is a hard band of fibrous tissue that attaches the calf muscles to the calcaneus (heel bone of the ankle). The Achilles tendon is also the largest and strongest in the body.

The two calf muscles; the gastrocnemius and soleus form into one band of tissue, which becomes the Achilles tendon at the lowest point of the calf. A bursa (small sac of fluid) covers the Achilles tendon to help support and protect the area.

When we flex the calf muscles the Achilles tendon pulls onto the heel. This enables us to perform day to day movements such as walking, running and standing on our tip toes. So, it is important to be safe when exercising ensuring the area is protected. The tendon has a limited amount of blood supply, so when we place the tendon under strain or tension it can be more susceptible to injury.

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Causes

The main causes for Achilles tendinitis are from repetitive stress and tension placed onto the tendon, it is not usually related to one specific injury cause. Too much pressure on our bodies sometimes can be harmful and extra care should be taken whenever performing any sporting event or exercise activities. Here are some causes of Achilles tendinitis:

  • Tightness in calf muscles
  • Sudden increase in intensity of exercise
  • Longer duration of exercise
  • Unexpected bone growth

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Symptoms

Common signs and symptoms of Achilles tendinitis are as follows:

  • Stiffness at the back of the ankle first thing when you wake up
  • Pain along the back of the tendon
  • Sharp pain along the back of the foot
  • Feels different e.g., thicker or tighter
  • Lack of range of movement
  • Severe pain after exercising
  • Swelling around the tendon

When exercising or walking and you feel or hear a loud popping noise, you should see your doctor immediately. As it is highly likely that you may have torn/ ruptured the tendon and will need medical attention.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

Diagnosis

If you feel you are suffering with Achilles tendinitis, then it is best you go and see your doctor. The health care professional will palpate (feel) the area to determine the site of pain tenderness and swelling. The doctor will also complete a physical examination assessing flexibility, alignment, reflexes and range of movement around the effected area.

Special imaging test may also be used such as:

  • X-Rays
  • Magnetic Resonance imagining (MRI)
  • Ultrasound

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Treatment

Now days there are many treatment theories available for Achilles tendinitis. These could be home treatments, anti-inflammatory medication or surgery.

  • Use the RICE acronym- Rest, Ice, Compress and Elevate the area of injury
  • Reduce physical activity until swelling and pain has reduced
  • Ice the area after exercising when pain has occurred
  • Anti- inflammatory drugs such as aspirin or ibuprofen (however this may just mask the pain)
  • See a sports/ physiotherapist for rehabilitation exercises and stretches
  • Wear protective equipment such as a brace to prevent heel movement

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Exercises

Here are a few exercises which may aid in preventing Achilles tendinitis:

  • Calf raises on floor
  • Single leg calf raises
  • Calf raises on elevated bench
  • Lunge calf stretch
  • Resistance band calf stretch
  • Resisted plantarflexion
  • Walking on tip toes

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Prevention

It may not be possible to full prevent Achilles tendinitis from occurring, however you can incorporate certain measures to reduce the risk factors:

  • Don’t over do exercise, make sure to have rest days and include full warm ups before exercising
  • Increase intensity levels of exercise progressively
  • Make sure you are wearing the correct footwear
  • Stretch daily, and even more importantly before and after exercising
  • Perform specific exercises to strengthen the calf muscles
  • Complete non weight bearing exercise such as swimming to reduce pressure onto the Achilles tendon.

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Is It Tendonitis or Tendinopathy…

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Tendonitis or Tendinopathy?

The Overview

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

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Overview

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.

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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.

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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.

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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.

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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.

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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 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.

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Exercises

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.

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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.

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Tennis Elbow

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Overview

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.

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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.

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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.

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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

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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.

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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 massage on the arm offering STR (Soft Tissue Release) as well as general massage to relax the area and stimulate blood flow can really help to speed up recovery and make you feel better.

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

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

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

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

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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.

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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.

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.

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Sciatica

Posted on

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Overview

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.

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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.

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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.

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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.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ type=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ first=”true” last=”true”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””]

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.

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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. 

Massage can be really beneficial also and this also helps stretch the muscles and really stimulate the nervous system by increasing the blood flow especially in the legs.

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Exercises

Glute Max Stretch

Piriformis Stretch

Hamstring Stretch

Quadricep Stretch

Trigger Point the Piriformis Muscle

Please see some exercises and stretch examples in our video.

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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.
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.

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