Conditions

Here in our Mend Library, we have some of the most common injuries by body region.  Read more about the pain you may be suffering and how Mend can help.

Click on the drop-down tabs for more information.

Ankle Pain
Ankle Sprain
A sprained ankle occurs when your ankle ligaments are overstretched. Ankle sprains vary in their severity, from mild "twisted ankle" or "rolled ankle" sprain through to severe complete ligament ruptures, avulsion fractures or broken bones.
 What are the Symptoms of a Sprained Ankle?
A history of your ankle rolling is the key ingredient to suspecting a sprained ankle. At the time of the injury, you may hear a popping or cracking sound and will notice swelling, bruising and ankle pain. Lateral or medial ligament sprains are usually acutely tender over the injured ligament. Depending on the severity of your ankle sprain, you may have trouble walking or standing on your foot.  In more severe cases, there may be sharp pain deep in the ankle joint associated with a talar dome fracture or pain between your lower shin bones, which may be a syndesmosis or high ankle sprain.
Which Ankle Ligaments are Commonly Sprained?
Your ankle joint, known as the talocrural joint, is made up of three bones: the tibia (shin bone - inside ankle bone), fibula (outer lower leg - outside ankle bone) and talus (deep ankle bone). Underneath the talocrural joint lies the subtalar joint, which is the articulation between the talus and the calcaneus (heel bone). Your ankle ligaments attach from bone to bone and passively limit the motion available at each joint. On the outside of the ankle lie the lateral ligaments, which are the most frequently injured in an ankle sprain. These include the:
  • Anterior talofibular ligament (ATFL)
  • Calcaneofibular ligament (CFL)
  • Posterior talofibular ligament (PTFL)
The main medial (inside of ankle) ligament is the much stronger deltoid ligament.  High ankle sprains involve the inferior tibiofibular ligament and syndesmosis. These are more disabling ankle injuries and are often misdiagnosed as the more simple sprained ankle.
Treatment for Sprained Ankle
A sprained ankle can increase your risk of re-injury as much as 40-70%, but the correct post-injury rehabilitation exercises significantly decrease the risk.
Physiotherapy Treatment Aims
  • Injury Protection, Pain Relief & Control Inflammation
  • Regain Full Range of Motion
  • Strengthen your Ankle and Calf Muscles
  • Restore Joint Proprioception & Balance
  • Restore Normal Function
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Arm Pain

Arm pain and arm injuries are very common. Arm pain can occur due to a sudden trauma or repetitive overuse. They are often related to sports or work injuries, and everyday arm use.

Arm pain can be a local musculoskeletal or could even be referred from nerves of joints in your neck (cervical radiculopathy). Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury eg: your neck joints.  A skilled physiotherapist can diagnose both spinal-origin and local origin (muscle and joint) injuries.

Common causes of Arm Pain

Shoulder pain is most commonly caused by your rotator cuff or frozen shoulder.

Elbow pain is most commonly caused by tennis elbow or golfers elbow.

Wrist & hand pain can be related to carpal tunnel, wrist arthritis or even a thumb tendon condition known as de Quervain's tenosynovitis.

Arm pain and injury normally respond very well to medical or physiotherapy when early assessment and treatment is sought.

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Back Pain
Lower Back Pain

Lower Back Pain is the most common form of back pain. At least 80% of people will experience lower back pain at some stage of their life. Most back pain is caused by musculoskeletal conditions and can be treated successfully. Lower back pain can be avoided with a little back education and lower back exercises.

90-95% of lower back pain can be successfully managed without the need for surgery. Most improve within two to six weeks. They can be managed with pain relief and physiotherapy techniques such as manual therapy and back exercises. The causes are usually due to either a sudden traumatic or sustained overstress injuries.

Traumatic Injury: This is often something as simple as bending awkwardly to lift something heavy, or jarring the lower back.

Sustained Overstress Injury (poor posture): This is usually more common and easier to prevent. Normally positional stress or postural fatigue creates an accumulated microtrauma that overloads your lower back structures over an extended period of time to cause injury and back pain.

Early diagnosis and specific individual treatment is the easiest way to recover quickly from lower back pain and to prevent a recurrence.

Types of Back Pain

There are many forms of back pain including, Muscle, Bone, Disc, Nerve and Pelvis related injuries, Pregnancy and Systemic Diseases.

Some of the highest frequency causes of lower back pain are:

Muscle Strains through muscle fatigue, excessive and poor lifting posture techniques.  Inefficient back muscles can lead to poor joint stabilisation and subsequent injury.

Ligament Sprains: Ligaments are the strong fibrous bands that limit the amount of movement available at each spinal level. Stretching ligaments too far or too quickly will tear them with subsequent bleeding into the surrounding tissues, causing swelling and pain.  The main cause of ligament sprains can be sports injuries and motor vehicle accidents.  Physiotherapy can help the healing process and relieve the pain.

Bulging Disc Injury: This is a common spine injury sustained to your spine's intervertebral disc. Spinal discs are the shock-absorbing rings of fibrocartilage and glycoprotein that separate your bony vertebral bodies while allowing movement at each spinal level, and enough room for the major spinal nerves to exit from the spinal canal and travel to your limbs. The annulus is the outer section of the spinal disc, consisting of several layers of multi-directional fibrocartilaginous fibres all densely packed to create a wall around the glycoprotein filled jelly-like disc nucleus. A disc bulge (commonly referred to as a slipped disc), can potentially press against or irritate the nerve where it exits from the spine. This nerve pinch can cause back pain, spasms, cramping, numbness, pins and needles, or pain in your legs.

Bone Injuries: You can fracture your spine if the force involved is highly traumatic or you have a low bone density (eg osteoporosis).

Poor Posture: Excessive sitting, standing and lifting can place unnecessary stress on your spine. Muscles fatigue, ligaments overstretch, discs stretch can all place the spinal joints and nerves under pressure.

Mend Physio can assist you with a prompt diagnosis, and provide you with a long-term self-management, and back pain prevention strategies specific to your back pain.

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Elbow Pain

Elbow pain is often caused by overuse. Many sports, hobbies and jobs require repetitive hand, wrist or arm movements. Elbow pain may occasionally be due to arthritis, but in general, your elbow joint is much less prone to wear-and-tear damage than are many other joints.

Diagnosing the source of your elbow pain can be complicated as elbow pain can be caused by many different sources. These may be local structures, referred structures and other systemic conditions.

Local elbow pain is commonly caused by a local muscle, tendon or joint injury. Alternatively, elbow pain can be referred from your neck joints.
The most common source of elbow pain that presents clinically is lateral epicondylalgia (lateral elbow pain). This is also the medical term to describe Tennis Elbow.

Medial epicondylalgia (medial elbow pain) is a similar condition on the inner aspect of your elbow and is commonly known as golfers elbow.

Common causes of elbow pain include:

  • Broken Arm
  • Bursitis (joint inflammation)
  • Dislocated elbow
  • Golfer’s elbow
  • Osteoarthritis (disease causing the breakdown of joints)
  • Osteochondritis dissecans
  • Rheumatoid arthritis (inflammatory joint disease)
  • Sprains and strains
  • Stress fractures
  • Tendinitis
  • Tennis elbow
  • Throwing injuries
  • Trapped Nerves

 

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Golfers Elbow

Golfer's elbow is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain might spread into your forearm and wrist.

Golfer's elbow is similar to tennis elbow, which occurs on the outside of the elbow. It's not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer's elbow.

The pain of golfer's elbow doesn't have to keep you off the course or away from your favourite activities. Rest and appropriate treatment can get you back into the swing of things.

Symptoms

Pain and tenderness on the inner side of your elbow. Sometimes the pain extends along the inner side of your forearm. Pain typically worsens with certain movements.

Stiffness - Your elbow may feel stiff, and it may hurt to make a fist.

Weakness - You may have weakness in your hands and wrists.

Numbness or tingling - These sensations might radiate into one or more fingers — usually the ring and little fingers.

The pain of golfer's elbow can come on suddenly or gradually.

The pain might worsen when you:

  • Swing a golf club or racket
  • Squeeze or pitch a ball
  • Shake hands
  • Turn a doorknob
  • Lift weights
  • Pick up something with your palm down
  • Flex your wrist

Golfer's elbow, also known as medial epicondylitis, is caused by damage to the muscles and tendons that control your wrist and fingers. The damage is typically related to excess or repeated stress especially forceful wrist and finger motions. Improper lifting, throwing or hitting, as well as too little warm-up or poor conditioning, also can contribute to golfer's elbow.

Many activities can lead to golfer's elbow, including:

Golf - Gripping or swinging clubs incorrectly or too forcefully can take a toll on your muscles and tendons.

Racket sports - Excessive topspin can hurt your elbow. Using a racket that's too small or heavy also can lead to injury.

Throwing sports - Improper pitching technique in baseball or softball can be another culprit. Football, archery and javelin throwing also can cause golfer's elbow.

Weight training - Lifting weights using the improper technique, such as curling the wrists during a biceps exercise, can overload the elbow muscles and tendons.

In addition, any activity that requires repeatedly bending and straightening your elbow can cause golfer's elbow. This includes painting, raking, hammering, chopping wood, using a computer, doing assembly-line work and cooking.  The activity generally needs to be done for more than an hour a day on many days to cause a problem.

You could be at higher risk of developing golfer's elbow if you're:

  • Age 40 or older
  • Performing repetitive activity at least two hours a day
  • Obese
  • A smoker

Left untreated, golfer's elbow can cause:

  • Chronic elbow pain
  • Limited range of motion
  • A lasting, fixed bend (contracture) in your elbow

You can take steps to prevent golfer's elbow:

Strengthen your forearm muscles - Use light weights or squeeze a tennis ball. Even simple exercises can help your muscles absorb the energy of sudden physical stress.

Stretch before your activity - Walk or jog for a few minutes to warm up your muscles. Then do gentle stretches before you begin your game.
Fix your form. Whatever your sport, ask an instructor to check your form to avoid overload on muscles.

Use the right equipment - If you're using older golfing irons, consider upgrading to lighter graphite clubs. If you play tennis, a racket with a small grip or a heavy head may increase the risk of elbow problems.

Lift properly - When lifting anything, including free weights keep your wrist rigid and stable to reduce the force to your elbow.

Know when to rest. Try not to overuse your elbow. At the first sign of elbow pain, take a break.

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Tennis Elbow
Tennis Elbow

Acute Tennis Elbow is an injury to the muscles that extend the wrist and fingers. The site of injury is typically the lateral epicondyle, a bony bump on the outside of the elbow where these muscles attach. Tennis Elbow symptoms that have lasted more than 6 weeks are considered to be sub-acute and beyond three months, as chronic tennis elbow.

Tennis Elbow Symptoms?

Tennis Elbow sufferers will experience pain when performing gripping tasks or resisted wrist/finger extension. They will also experience pain when the muscles are stretched. There will be tenderness directly over the bony epicondyle, and there may be trigger points in the wrist muscles. Often sufferers will experience neck tenderness and stiffness and there could be signs of nerve irritation. Most elbow movements will be pain-free, despite that being the area of pain.

Why do you get Tennis Elbow?

Acute Tennis Elbow is caused by damaged muscle tissue at the point it anchors to the arm bone at the elbow. It occurs when more force is applied to an area than the normal healthy tissues can handle.

Common causes include:

  • Unaccustomed hand use. eg painting a fence, hammering, lots of typing.
  • Excessive gripping or wringing activities
  • Poor forearm muscle strength or tight muscles
  • Poor technique (this may be a poor tennis shot)

In some cases such as Chronic Tennis Elbow, this can occur due to the soft tissues being in poor health, which are easily injured. Inflammation follows the injury, which leads to swelling and elbow pain.

Where did Tennis Elbow get its name?

It is known that 40% of tennis players will experience tennis elbow - hence it's name. 15% of manual workers also experience tennis elbow. This condition can be experienced at any age, however, generally, they are between the ages of 35 - 50.

How Physio can help

Physiotherapy is very effective in the short and long-term management of tennis elbow.

Physiotherapy helps with:

  •  Reduction of elbow pain.
  • Facilitation of tissue repair.
  • Restoration of the normal joint range of motion and function.
  • Restoration of normal muscle length, strength and movement patterns.
  • The normalisation of your upper limb neurodynamics.
  • The normalisation of cervical joint function.

There are many ways to achieve these and, following a thorough assessment of your elbow, arm and neck.

 

Mend Physio can diagnose and discuss the best strategy for you to use based on your symptoms and your lifestyle.

Physiotherapy treatment can include gentle mobilisation of your neck and elbow joints, electrotherapy, elbow Kinesio taping, muscle stretches, neural mobilisations, massage and strengthening.

 

Call 01868 340690 for an appointment now
Foot Pain

Foot pain and injuries are extremely common. Foot pain can be sourced from local structures such as muscles, ligaments, bones and joints, or it can be referred from other sources including your lower back and other systemic diseases.

Because foot pain can have so many causes it is very important to have foot pain assessed by a health professional with an expertise in the management of foot pain. Only then can you be confident that your foot pain treatment is managing the "right" cause of your foot pain.

Common sources of foot pain include Plantar Fasciitis, Bunion, Heel Pain, Heel Spur and Ankle Injuries.

Achilles Tendonitis

Achilles Tendonitis is an inflammation of the Achilles tendon or its covering. It is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may occur in other activities that requires the same repetitive action.

What Causes Achilles Tendonitis?

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or ageing. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time.

Common Causes of Achilles Tendonitis include:

  • Over-training or unaccustomed use – “too much too soon”
  • A sudden change in training surface – e.g. grass to bitumen
  • Flat (overpronated) feet
  • High foot arch with tight Achilles tendon
  • Tight hamstring (back of thigh) and calf muscles
  • Toe walking (or constantly wearing high heels)
  • Poorly supportive footwear
  • Hill running.
  • Poor eccentric strength
Symptoms of Achilles Tendonitis?

Achilles tendonitis may be felt as a burning pain at the beginning of an activity, which gets less during activity and then worsens following activity. The tendon may feel stiffness first thing in the morning or at the beginning of some exercise.

  • Achilles tendonitis usually causes pain, stiffness, and loss of strength in the affected area.
  • The pain may get worse when you use your Achilles tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.
  • Achilles tendons will often have a painful and prominent lump within the tendon.

Achilles Tendon Rupture

When your Achilles tendon snaps it is known as Achilles tendon rupture.  Often an Achilles rupture can occur spontaneously without any prodromal symptoms. Unfortunately the first "pop" or "snap" that you experience is your Achilles tendon rupture.

Achilles tendon rupture most commonly occurs in the middle-aged male athlete. Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are tennis, racquetball, squash, basketball, soccer, softball and badminton.

It does appear that previous history of Achilles tendonitis results in a degenerative tendon, which can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics) can also increase the risk of rupture.

Treatment of a ruptured Achilles tendon is usually conservative (non-operative) in a Controlled Motion Ankle (CAM) Boot or it may require surgery.  Achilles tendon surgery is usually considered if your Achilles has re-ruptured or there is a delay of two weeks between the rupture and the diagnosis and commencement of conservative bracing and treatment.

Post-Surgical Physiotherapy

Most surgeons will recommend that you commence physiotherapy about one-week post-op. It is important to not over-stress your Achilles tendon repair.

Plantar Fasciitis

Plantar Fasciitis is one of the most common sources of heel pain. Your plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes. Your plantar fascia acts as a passive limitation to the over flattening of your arch. When your plantar fascia develops micro tears or becomes inflamed it is known as plantar fasciitis.

Symptoms of Plantar Fasciitis

First, you will notice early plantar fasciitis pain under your heel or in your foot arch in the morning or after resting.  Your heel pain will be worse with the first steps and improves activity as it warms up.  As plantar fasciitis deteriorates, the pain will be present more often. You can determine what stage you are in using the following guidelines:

  • No Heel Pain - Normal!
  • Heel pain after exercise.
  • Heel pain before and after exercise.
  • Heel pain before, during and after exercise.
  • Heel pain all the time. Including at rest!
  • This symptom progression is consistent with the four stages of a typical overuse injury.

If left further trauma and delayed healing will result in the formation of calcium (bone) within the plantar fascia. When this occurs adjacent to the heel bone it is known as heel spurs, which have a longer rehabilitation period. Plantar fasciitis is one of those injuries that magically seems to appear for no apparent reason. However, plantar fasciitis is caused by one of two methods. They are either traction or compression injuries.  Plantar fasciitis is most often associated with impact and running sports, especially those that involve toe running rather than heel running styles.

It is also commonly diagnosed in individuals with poor foot biomechanics that stress the plantar fascia. Flat feet or weak foot arch control muscles are two common causes of plantar fasciitis.

Traction Plantar Fasciitis

Plantar fasciitis symptoms are usually exacerbated via "traction" (or stretching) forces on the plantar fascia. In simple terms, your plantar fascia is repeatedly overstretched. The most common reason for the overstretching is an elongated arch due to either poor foot biomechanics (eg overpronation) or weakness of your foot arch muscles.

Compression Plantar Fasciitis

Compression type plantar fascia injuries have a traumatic history. Landing on a sharp object that bruises your plantar fascia is your most likely trauma. The location of plantar fasciitis pain will be further under your arch than under your heel, which is more likely to be a fat pad contusion if a single trauma caused your pain. The compression type of plantar fasciitis can be confused with a fat pad contusion that is often described as a "stone bruise".

Plantar Fasciitis Diagnosed?

Plantar fasciitis is usually diagnosed by your physiotherapist on your symptoms, history and clinical examination.  After confirming your plantar fasciitis they will investigate why you are likely to be predisposed to plantar fasciitis and develop a treatment plan to decrease your chance of future bouts.

  • X-rays may show calcification within the plantar fascia or at its insertion into the calcaneus, which is known as a calcaneal or heel spur.
  • Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification.
  • Pathology tests (including screening for HLA B27 antigen) may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
You are more likely to develop plantar fasciitis if you are:
  • Active - Sports that place excessive stress on the heel bone and attached tissue, especially if you have tight calf muscles or a stiff ankle from a previous ankle sprain, which limits ankle movement eg. Running, ballet dancing and aerobics.
  • Overweight - Carrying around extra weight increases the strain and stress on your plantar fascia.
  • Pregnant – The weight gain and swelling associated with pregnancy can cause ligaments to become more relaxed, which can lead to mechanical problems and inflammation.
  • On your feet – Having a job that requires a lot of walking or standing on hard surfaces ie factory workers, teachers and waitresses.
  • Flat Feet or High Foot Arches – Changes in the arch of your foot changes the shock absorption ability and can stretch and strain the plantar fascia, which then has to absorb the additional force.
  • Middle-Aged or Older – With ageing the arch of your foot may begin to sag – putting extra stress on the plantar fascia.
  • Wearing shoes with poor support.
  • Weak Foot Arch Muscles. Muscle fatigue allows your plantar fascia to overstress and cause injury.
  • Arthritis. Some types of arthritis can cause inflammation in the tendons in the bottom of your foot, which may lead to plantar fasciitis.
  • Diabetes. Although doctors don't know why plantar fasciitis occurs more often in people with diabetes.

The good news is that plantar fasciitis is reversible when treated. About 90 percent of people with plantar fasciitis improve significantly within two months of initial treatment.

Poor foot biomechanics is often the primary cause of your plantar fasciitis so it is vital to thoroughly assess and correct your foot and leg biomechanics to prevent future plantar fasciitis episodes or the development of a heel spur.  We may recommend that you seek the advice of a podiatrist, who is an expert in the prescription on passive foot devices such as orthotics.

With accurate assessment and early treatment, most foot pain responds extremely quickly to physiotherapy allowing you to quickly resume pain-free and normal activities of daily living.

Please ask Mend Physio for their professional treatment advice.

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Hip Pain

Hip pain is very common in all age groups. The hip joint and it’s integration with your pelvis, SIJ and lumbar spine (lower back) make it a complex region to correctly analyse and assess any dysfunction.

The Older Hip

The older population are more vulnerable to age-related hip issues such as hip arthritis, trochanteric bursitis and GTPS (Greater Trochanteric Pain Syndrome). Functional limitations could include simply walking, sit to stand, single leg standing, stairs or even sleeping in severe cases.

Hip pain can also be associated with reduced balance so a thorough balance assessment may be required to predict a falls risk. Your Physio may give you fall prevention exercises to address any individual deficits. They may even advise you to use a walking assistance device such as a walking stick, crutches or a walking frame.

The Sporting Hip

Younger sports-related hip issues may come on after prolonged running, jumping or landing activities.  Specific sporting hip conditions can be discussed and thoroughly by Mend Physio.

Groin Pain


Groin pain is one of the most common symptoms associated with hip joint pathologies such as hip osteoarthritis and hip labral injury. There are also many other causes of groin pain that need to be excluded by a health professional.

Only after a thorough hip assessment will your hip pain be effectively rehabilitated to relieve your current hip pain and joint dysfunction, plus prevent the return of any future hip pain.

Hip Pain Assessment

The successful treatment of your hip pain requires a thorough and accurate assessment of your:

  • entire lower limb (foot, ankle, knee, hip, groin)
  • lumbar spine
  • pelvis and SIJ function and alignment
  • deep hip muscle control and activation patterns
  • middle and superficial hip muscle control, strength and function
  • deep abdominal, core and pelvic floor muscle control
  • upper thigh muscle length and strength (e.g. quadriceps, adductors, hamstrings, and ITB)
  • neural tissue extensibility e.g. sciatic and femoral nerve
  • hip joint biomechanics.

Your assessment should include a functional assessment of your knee, foot and ankle joints, plus your thigh and calf muscles.  They all contribute to your hip function. Hip pain is often related to your whole lower limb biomechanics and function.

Hip Pain Causes

Hip Joint Pain, Lateral Hip Pain, Adductor-related Groin Pain, Pubic-related Groin Pain, Inguinal-related Groin Pain, Iliopsoas-related Groin Pain and other muscle-related Pain.

There are also Systemic diseases such as Rheumatoid Arthritis, Fibromyalgia and Osteoporosis. Referred Sources such as Sacroiliac Joint Pain (SLJ), Sciatica, Lower Back Pain and a Pinched Nerve.

Hip Pain Treatment

Hip joint conditions are often treated with short-term cures, such as cortisone injections or painkillers. This is inadequate, especially for recurring hip pain.

A thorough analysis of why you are having hip pain is important to solve the problem, to prevent recurrence and improve your performance, especially on the sports field.

Hip pain education should also include teaching you about activity modification, individualised exercises, weight-loss advice (if required), and methods to unload any arthritic joints. We recommend a thorough hip assessment so your hip treatment can progress quickly and get you pain-free sooner.

Trochanteric Bursitis

Trochanteric bursitis is the most common bursitis of the hip. It is also a common cause of Greater Trochanteric Pain Syndrome.

Trochanteric bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur).

The superficial trochanteric bursa is located over the greater trochanter. This is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases.

Trochanteric Bursitis Symptoms?

One or more of the following symptoms may be experienced:

  • Pain and swelling occurring on the side of the hip
  • Referred pain that travels down the outside thigh and may continue down to the knee
  • Pain when sleeping on your side; especially the affected hip
  • Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car)
  • Pain when climbing stairs
  • Pain in sitting with the legs crossed
  • Increased pain when walking, cycling or standing for long periods of time
Causes of Trochanteric Bursitis?

The trochanteric bursa may be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone. This injury can occur traumatically from a fall or a sport-related impact contusion.

It can also be a case of gradual onset via a repetitive trauma to the bursa from such activities as running (with poor muscles control or technique), walking into fatigue, or cycling, especially when the bicycle seat is too high.

It is also a secondary injury associated with chronic conditions such as:

  • Scoliosis - curvature of the spine
  • Unequal leg length
  • Weak hip muscles
  • Osteoarthritis (degenerative joint disease) of the hips or lower back
  • Calcium deposition in the gluteal tendons that run over the bursa
  • Rheumatoid arthritis.

A traumatic injury such as a car accident or fall can also cause bursitis. Acute compression of your bursa causes an inflammatory healing reaction that results in swelling within the bursa, or bursitis. Once the bursa is inflamed, normal movements and activities can become painful from either the pain-sensitive chemical reaction within the bursa or the swollen bursa can provide additional frictional forces in the subsequent movements.

Mend Physio can provide you with an assessment based on your medical history and a physical examination of your hip, pelvis and back.

For specific advice regarding your hip pain, ask Mend Physio for advice on hip pain and related injuries.

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Knee Pain

Knee pain or knee injuries are extremely common, and there are many causes.

It is important to make an accurate diagnosis of your knee pain as the treatment can vary considerably. Treatment can involve simple knee mobilisation techniques, massage, taping, stretches or strengthening exercises all the way through to a thorough rehabilitation protocol post knee reconstruction or knee replacement.

 

Knee pain can arise from soft tissue injuries such as ligament sprains and muscle strains. It could also be a bone condition such as knee arthritis, Osgood Schlatters.

Biomechanical dysfunction such as Patellofemoral Syndrome can often cause knee pain and it may also be linked to your Sciatica!

It is always best to consult your physiotherapist or doctor for the most accurate diagnosis and best treatment for your knee pain.

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Neck Pain

There are many causes of neck pain or a stiff neck. The inability to move your head, sharp neck pain, headache or muscular aches can be very painful. However, often it is simple to fix to rectify in the most cases.

Types of neck pain

Neck Joint Injuries, Muscle-related Injuries, Bone-related Injuries, Disc-related Injuries, Nerve-related / Referred Pain, Vertigo-related, Headaches/Migraine related and Systemic Diseases.

Neck Joints and Muscles

Often the neck joints (cervical spine) become stiff or locked and cause protective muscle spasms in some neck and shoulder muscles. The longer this is left, the harder it is to reverse. Your neck posture changes, which puts a strain on adjacent joints and muscles, and the condition deteriorates, leaving you with a sore neck.

Usually, a combination of the neck joint, muscle stretching, massage, strength exercise and postural techniques are required to reverse the condition before poor habits become established.

Neck Pain Treatment

The human body is very clever and will adjust itself so that other joints or muscles will work harder than they should to try and heal the pain. While this can result in a short-term fix, in the long term it can cause long-term neck pain. The result can be chronic neck pain, neck stiffness, headaches, wry neck or even a tension-type migraine.

Research has shown that a combination of neck joint and muscle treatment performed by your physiotherapist and some specific strengthening exercises are an effective way to eliminate your neck pain, stiffness and headaches.

Mend Physio will be able to diagnosis and apply a treatment of mechanical neck pain.  Contact Mend Physio for advice on your neck pain.

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Osteoarthritis

Osteoarthritis is one of the most common forms of arthritis.

This form of arthritis is caused by everyday wear and tear damage to your joints. Joint cartilage becomes thin, extra bony spurs grow in response to joint stress, and joint motion lessens. In advanced stages, osteoarthritis is painful and functionally is limiting and depressing.

Is there a cure?

There is no cure for osteoarthritis. However, there are many ways to manage osteoarthritis and slow the degeneration process. Physiotherapy is a very important part of making your life living with osteoarthritis less painful and comfier.  Research has shown Physiotherapy is especially successful with knee osteoarthritis.

Your Osteoarthritis Diagnosis

An experienced physiotherapist will have a very good idea of whether you have osteoarthritis when they examine you. X-rays are the most successful way to confirm osteoarthritis.

Osteoarthritis and the older generation

As you age, most people develop some degree of osteoarthritis. Wear and tear of our joints may occur due to ageing, injury, prolonged micro-trauma, overuse of joints, or excess weight. Permanent bony changes occur and will exist even when there are no painful symptoms.

Some people may be symptom-free while others may suffer continuous disabling pain. The most common is mild or intermittent pain provoked by episodes of increased use or minor trauma.

The most commonly affected joints are the weight-bearing joints: hip, knee, ankle, feet and spine. However, osteoarthritis is also very common in hands and shoulders. Severe cases may require surgical treatment but most will respond very well to physiotherapy and medication prescribed by your doctor.

Osteoarthritis Symptoms

  • Joint pain or tenderness that intermittently returns
  • Stiffness, particularly early morning stiffness
  • Joint swelling or deformity
  • Obvious joint heat and redness
  • Joint movement is difficult

Mend Physio can help you diagnose and manage your osteoarthritis.  Contact Mend Physio with any questions you may have.

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Osteoporosis 

Osteoporosis is a condition where your bones weaken and become thin, fragile and brittle, leading to a higher risk of fractures (breaks or cracks) than in normal bones. It develops slowly over several years and is often diagnosed when someone has a minor fall or sudden impact causing a bone fracture.

What Causes Osteoporosis?

There is no real cause for osteoporosis. Your bones are constantly being renewed in a process where old bone is broken down and new bone is produced to replace the old. This process occurs throughout our life and is usually in balance. However, due to a number of reasons, it can get out of balance and thinning of the bones can occur.

As we grow older our ability to lay down new bone lessens and if we become increasingly less active, we are increasing our risk of developing osteoporosis. Osteoporosis isn’t usually painful until a fracture occurs

Risk Factors for Osteoporosis

A number of risk factors have been identified that can increase your inability to lay down dense bone, these include:

  • Lack of Weight-Bearing Exercise
  • Menopause
  • Rheumatoid Arthritis, Ankylosing Spondylitis
  • Overactive thyroid or parathyroid glands
  • Coeliac disease and other chronic stomach conditions
  • Chronic liver or kidney disease
  • Type 1 diabetes
  • Some Cancers
  • Smoking
  • Excessive alcohol consumption
  • Diet lacking in calcium
  • Lack of sunlight exposure, which may cause vitamin D deficiency

One of the most important factors is thought to be a lack of bone stress stimulating exercise. Exercise, especially weight-bearing and resistance exercises, help you to stimulate the production of new bone when you are younger and limits the loss of bone when we are older.

How is Osteoporosis Diagnosed?

Osteoporosis is diagnosed with a special scan called a bone densitometry scan. This is usually done of the lumbar spine or the upper thigh bone, takes about 15 minutes and lets you know how dense the bone is compared to people of your age.

Osteoporosis Treatment

The treatment of osteoporosis involves reducing any of the factors contributing to poor bone health. Your doctor may advise you to embark on an exercise regime, review your medications or review current lifestyle factors that predispose you to osteoporosis. Your doctor may also advise you to increase your:

  • Calcium intake via your diet or with supplements. Calcium is used to build and maintain bone health.
  • Vitamin D intake via supplements or exposure to low levels of sunlight. Vitamin D is used to absorb calcium in the bone and to regulate calcium in the blood.

Preventing Osteoporosis

If you are at risk of developing osteoporosis, you should take steps to help keep your bones healthy. This may include:

  • Taking regular exercise
  • Healthy eating (including foods rich in calcium and vitamin D
  • Taking supplements (vitamin D & Calcium)
  • Making lifestyle changes - give up smoking and reduce alcohol consumption

Mend Physio can help with your osteoporosis by giving you exercises and physio to help with the pain and strengthen your body.

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Pilates

Pilates is a form of exercise which concentrates on strengthening the body with an emphasis on core strength. This helps to improve general fitness and overall well-being.

Developed by a man called Joseph Pilates in Germany, who he was a carpenter and gymnast. He invented Pilates as an exercise program for injured dancers and soldiers while living in the UK. Joseph Pilates believed that physical and mental health were closely connected.

It is very similar to Yoga, as it concentrates on posture, balance and flexibility. In Pilates, the chance of injury is much lower than with other more strenuous forms of exercise.

Pilates also focuses on the mind-body connection. While doing the various exercises your mind needs to be constantly aware of your breathing and the way your body moves.

Because Pilates can be modified to provide either a gentle strength training program or a challenging workout, most people would have no problem with this form of exercise. It is suitable both for beginners and for people who already exercise regularly.

Many beginners will start with basic exercises and then once you’ve mastered those, you can work on the more advanced moves. It’s a good idea when you’re just starting out in Pilates to go to Pilates exercise classes or have a private instructor. This way the instructor can make sure that you are doing the exercises correctly to avoid any injury.

Pilates may not be recommended if you have the following conditions:

  • Unstable blood pressure.
  • A herniated disk.
  • Severe osteoporosis.
  • A risk of blood clots.

Pilates focuses on core strength, posture and flexibility the health benefits include:

Good posture – Pilates will teach you to gain and maintain good posture. The exercises require that your body is always in alignment. This is especially beneficial if you suffer from lower back pain.

 

Muscle Tone – Pilates exercises concentrate on muscles that you may not use on a daily basis. After a short period of time, you’ll find that your muscles will be much more toned. This especially benefits older people who are not so active in their daily life, and as a result muscle tone is usually lost.

 

Flexibility – As we get older we tend to lose the flexibility we had when we were young. Pilates will gently help you restore your flexibility. You’ll be amazed at how flexible your body will become. This especially benefits you from avoiding injuries from falls.

 

Flat abdominal muscles – Because Pilates focuses on strengthening your core which includes your abdominal muscles, you’ll find that one of the benefits of Pilates is that it will result in a flat stomach.

 

Balance – Pilates teaches you how to become more aware of how your body moves and performs through mind and body connection. Pilates not only improves your physical balance through correct posture but will also restore your mind-body balance.

 

Reduces stress – When doing the exercises, you’ll be totally engrossed and will forget about all those responsibilities that weigh you down on a day to day life. You’ll be so focused on your breathing and on the moves that you are making with your body. This is an excellent way to relieve stress.

 

Well-Being – Because Pilates focuses on providing a balance between your mind and body it gives you an overall sense of well-being.

Key areas of benefit

Pilates works mainly on your core which includes your abdominal area and your spinal area. This is why Pilates can be extremely beneficial for people who suffer from lower back pain.

Other areas of your body that are strengthened and toned through Pilates include your legs, especially your upper thighs, and your buttocks.

Pilates has also proved beneficial for arthritis sufferers as it helps to keep your joints flexible. Because Pilates strengthens the thigh muscles it can be particularly successful in preventing arthritis and knee injuries.

Pilates and Rehabilitation

Here at Mend Physio, we work with Pilates as part of our rehabilitation and wellness program. Research has shown that Pilates can be an effective treatment for injuries and illnesses such as:

  • Chronic neck and back pain.
  • Hip or knee replacements.
  • Multiple sclerosis.
  • Fibromyalgia.
  • Scoliosis.

It is also excellent for athletes, dancers and other sports professionals who have had some kind of injury and need rehabilitation to get back into top form.

As Pilates is a low-impact exercise, it can be tailored to work on certain areas of your body as long as you have a trained and qualified instructor.

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Post Natal

Motherhood is a wonderful time of your life but it does take its toll on our bodies during pregnancy, labour now that we’re caring for every need of the new addition to the family. If this isn’t your first baby then there’s even more demand on you! Everyone gets told after childbirth to ‘do your pelvic floor exercises.’ Let's be honest, most of us do initially but once our bodies are virtually back to normal we tend to give up because life is so busy and our minds are always running wild trying to juggle a million different things.

How your body changes while Pregnant?

Abdominal muscles stretch massively during pregnancy and do not snap back into place immediately (although for some lucky women, they do appear to). Two-thirds of women will experience a split in their rectus abdominis (the external abdominal muscle – six-pack muscle), for some this will return to its original position with no additional effort required. For others, it requires careful progressions through a well-designed exercise programme to bring the sides of the muscles back together. Some women’s split will not completely zip up, this can be due to having a wide split in the first place, exercising too early at a relatively high intensity or simply due to lower elasticity in the muscles.

The pelvic floor will go through big changes and can take time to recover. Ideally, women need to do pelvic floor exercises during pregnancy, and as soon as able after birth to help it get back into place.

Pain in the pelvis during pregnancy can still remain after giving birth as the hormone relaxin continues to circulate around the body for several months after birth. In addition to all of this, there can be added complications if the woman has had a c-section or stitches!

Don’t worry many of these problems can be resolved within weeks of giving birth! However, full re-modelling of the tissues can take up to 18 months.

Pilates can help with all of these problems and is also a relaxing way to get back into exercise postnatally.

Pilates is a wonderful way to exercise our pelvic floor, core, gluteals and even our upper body and neck, which suffer from stiffness caused by the strains of motherhood. Not only will Pilates give your body back the strength and control it needs (whether this is the last time you plan on having a baby or if you’re planning on having more children), it will aim to improve your muscle tone getting rid of the dreaded ‘Mummy Tummy.’

Read more on Pilates

Mummy Tummy Programme

My name’s Kate and I gave birth to my first child in April 2017. I’m a Physiotherapist and a qualified Pilates instructor, having completed a specific course on Ante and Post Natal Pilates. My son was a big baby weighing in at 8 pounds 11 ounces and we’ve had a busy year but being a Mummy is the best job in the world. I did, however, ensure that I made time for myself to get my pelvic floor and core back into shape, I was lucky enough to know exactly how to get these muscles working again and the importance of this to my body. I want to help you achieve your goals, feel proud of your body and get the strength back that you deserve.

The ‘Mummy Tummy Programme’ is a brand new programme that we’re offering at Mend Physio. It comprises of 2, one to one sessions where we go through a thorough history and introduce you to Pilates and some of the basic exercises.

The last 4 sessions are group sessions with a maximum of 5 clients in the group whereby we work through a Pilates class at each session, directed at Post Natal needs.

Take advantage of this brand new programme and the introductory rate that we are offering.

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Shoulder Pain

The shoulder is the most mobile of all your joints so shoulder pain and injury are common. The reason for this movement is a very small joint contact zone. Substantially this means that your shoulder is quite unstable. That is why your shoulder muscles are so vital to a normally functioning shoulder.

Often when you are suffering shoulder pain it is because your muscles are simply not strong enough or they are uncoordinated. Both of these dysfunctions can usually be corrected with a quality assessment and injury-specific exercises.

Common Shoulder Pain & Injury Conditions

Rotator Cuff, Adhesive Capsulitis, Shoulder Bursitis, Shoulder Instability, Acromioclavicular Joint, Bone Injuries, Muscle Conditions, Systemic Conditions and Referred Pain.

Shoulder Treatment

Managing your shoulder injury with physiotherapy is usually successful.

There are usually two options with shoulder pain: non-operative or a surgical approach. Depending on your condition Mend Physio will advise which option is best for you. Non-operative care is also referred to as conservative rehabilitation.

If shoulder surgery is required, then your physiotherapist will recommend pre-operative rehabilitation; to either try a physiotherapy treatment approach first or to condition and prepare your body for a surgical procedure.

They will then recommend post-operative physiotherapy to help regain your range of movement, strength, speed and function back to normal.

Mend Physio will provide you with both conservative and operative rehabilitation options to ensure that you will attain the best outcome for your shoulder injury.

Shoulder Arthritis

Shoulder Arthritis (Osteoarthritis) is a very common source of shoulder pain as you age. Basically, everyday wear and tear damage your shoulder joints. The chances of you suffering shoulder arthritis are increased if your shoulder has been overworked or injured.

As with all arthritis, researchers have confirmed that exercise is the best way of controlling arthritic pain, strengthening your muscles or keeping and improving your joint and muscle flexibility.

Exercises will improve both your pain and ability to move about every day. Exercises for shoulder arthritis should be commenced gently and carefully.

Mend Physio can guide you through what exercises are best for you and your stage of arthritis.

Rotator Cuff Tear

A rotator cuff tear is quite simply a tear in your shoulder’s rotator cuff tendons. A rotator cuff tear can occur in two ways, trauma, and repeated microtrauma.

Traumatic rotator cuff tears occur quickly or under heavy load eg a fall or lifting a heavy-weight. However, the most common cause of a rotator cuff tear is repeated microtrauma, which can occur over several weeks, months or years.

Repeated rotator cuff injury from straining or pinching the rotator cuff tendons will injure the soft tissue resulting in bruising or swelling. Since there are only a few millimetres separating your rotator cuff tendons from a bony hood (acromion), the additional swelling causes a quicker impingement, catching or squeezing of the rotator cuff tendons.

What is the Rotator Cuff?

Your shoulder’s rotator cuff is a very important group of four small shoulder muscles that stabilise, control and move your shoulder joint. When your rotator cuff muscles work in isolation they exhibit rotational motion at the glenohumeral (shoulder) joint, which is why they are termed the rotator cuff.

Your subscapularis, supraspinatus, infraspinatus and teres minor muscles are the four muscles collectively known as the rotator cuff.

Rotator Cuff Tear Symptoms?

Your rotator cuff tears may be partial or full thickness tears. You will notice that your shoulder pain and weakness increases with the severity of your rotator cuff tear.

Partial rotator cuff tear may only present with mild shoulder pain, clicking during shoulder elevation and mild shoulder weakness lifting your hand above shoulder height or reaching behind your back.

Full thickness rotator cuff tear will normally present with severe shoulder pain and an inability to lift your elbow away from your body. However, in some cases, the rotator cuff tear is so severe that a significant number of your pain fibres are also torn, which can make them less painful but very weak.

Mend Physio can diagnose a suspected rotator cuff tear based on your clinical history and the findings from a series of clinical tests.

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Sciatic Pain

Sciatic pain is felt along the sciatic nerve, which runs from your lower back, down through the buttock, hamstrings and into the lower leg. The sciatic nerve is the longest nerve in the body.

Sciatica is often misdiagnosed, which can result in slow or non-responsive treatment. Leg pain can have various sources. It can be a local leg injury or it may even be referred from your lower back. The main nerve that travels from your lower back to your leg is your sciatic nerve. Irritation or pinching of your sciatic nerve can cause severe leg pain known as sciatica.

Main Causes of Sciatica

Joint inflammation, compression of the nerve from bony arthritic growths or a locked facet joint in the lower spine can commonly cause sciatica. Another common cause is pressure on the sciatic nerve from a herniated disc.

An injury that irritates or pinches your sciatic nerve can cause severe leg pain known as sciatica. You're most likely to get sciatica when you're 30 to 50 years old. It may happen due to the effects of general wear and tear, plus any sudden pressure on the discs that cushion the vertebrae of your lower (lumbar) spine, such as lifting or sneezing.  While there are many causes of sciatic pain the main ones tend to be:

  • Lumbar bulging disc
  • Spine degeneration
  • Facet joint injuries
  • Sciatica Symptoms

Sciatic pain usually begins in the lower back and spreads through the buttock, leg, calf and, occasionally, the foot. The pain can vary between dull, aching or burning sensations and sharp, shooting pains.

Sciatica can also cause tingling, numbness or muscle weakness in the affected leg. It is very important to seek medical attention in these situations as long-term nerve compression can permanently damage the nerve and its function. In these cases, your symptoms may become permanent.

One or more of the following sensations may occur because of Sciatica:

  • Pain in the rear or leg that is worse when sitting
  • Burning or tingling in the leg
  • Weakness, numbness or difficulty moving the leg or foot
  • A constant pain on one side of the rear calf
  • A shooting pain that makes it difficult to stand up
Diagnosing Sciatica

Sciatica diagnosis is based on your symptom description, the behaviour of your pain and a thorough physical examination. This could be reasonably simple, however, the primary cause of your sciatica may require further investigations to eliminate or confirm its origin. It is also important to determine how significant your sciatic nerve has been compressed.

Mend Physio will examine you, paying special attention to your spine and legs, and will ask you if you have low back pain that spreads to the leg and calf. They will test you for muscle weakness, sensation deficits and altered reflexes in your leg or foot.

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Sports Injury

We all know that participating in sport is good for your body and mind. However, one of the downsides of participating in sport is the chance of sports injury. Fortunately, sports injury occurs relatively infrequently, so the health and psychological benefits of participating in sports far outweigh the potential temporary downside of a sports injury.

Sports injuries can be caused by:

  • an accident – such as a fall or heavy blow
  • not warming up properly before exercising
  • using inappropriate equipment or poor technique
  • pushing yourself too hard

Almost any part of the body can be injured, including the muscles, bones, joints and connective tissues (tendons and ligaments). The ankles and knees are particularly prone to injury.

If you've injured yourself more than likely you will feel immediate pain, tenderness, swelling, bruising, and restricted movement or stiffness in the affected area. Sometimes, these symptoms may only be noticeable several hours after exercising or playing sports.

If you feel pain, stop exercising. Continuing to exercise while injured may cause further damage and slow your recovery. Often you will be able to treat minor injuries at home with ice packs, resting and over the counter painkillers.

If you experience a serious injury such as a head injury, broken bone or dislocation then you will need to go to your nearest A&E department. More serious injuries will require specialist treatment and sports physiotherapy to help the recovery process.

Preventing sports injuries by:

  • warming up properly before exercise
  • not pushing your body beyond your current fitness level
  • using the right equipment – for example, wearing running shoes for running, shin guards for football, and a gum shield for rugby
  • receiving coaching to learn correct techniques

When starting a new sport or activity, seek advice and training from a qualified fitness trainer or sports coach.

Mend Physio can accurately diagnose and manage your sports injury in the shortest possible time.

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