Lower back pain
Lower back pain can be very debilitating and there are many, many causes. Your back problem may not be the same as your mate at work even if it is in the same area as his was! It is important to seek correct medical advice via your chartered physiotherapist or GP if you experience prolonged or recurrent episodes of lower back pain.
Some hints and tips to avoid back pain.
This will help the supporting muscles stronger. Choose an activity that you feel confidant doing. If you have not been active for some time and have any concerns please see your chartered physiotherapist before embarking on a new regime. They will be able to advise you what level of activity may be suitable.
Coughing and sneezing!
If you have to cough and sneeze when suffering with back pain it can be agony! To help reduce this pain try standing up straight with your hands in the small of you back to support the back when you sneeze or cough.
Watch your posture!
Ensure when working at your desk that you are sitting supported and the desk and chair are at the correct heights. If you are standing do not slouch. Try to imagine a plumb line passing through your ear, shoulder, hip and ankle joints. Be aware of the trunk , buttock and leg muscles working to hold you.
Change position frequently!
This sounds simple but many of us spend far too much time sitting still! Try to move every 30 minutes if working at your desk, even if it just a stretch in the seat or stand up and sit down again.
Avoid repetitive bending!
( especially if lifting heavy loads ).
Bending repeatedly places increased forces through the intervertebral discs and over time can lead to weakness within the outer wall of the disc. This can lead to a "slipped disc" which occurs when the material inside the disc protrudes through this weakness and creates pressure on the nerves leading to pain either in the area or referred pain which can be felt in the buttocks, legs, stomach or perineum.
What to do if you have back pain
If you suffer with a severe episode of back pain that affects your waterworks or your normal bowel habit please seek advice immediately from your doctor.
For more common lower back pain problems it is important to rest the back for a period of 24 -48 hours after injury. Avoid sitting and bending. Take painkillers such as paracetamol ( if you are not sure what medication to take seek advice from your pharmacist ).
If you can find a comfortable supported position lying this will help offload the spine and relax the back to allow spasm to settle. Sometimes you feel you have to change this position and that is perfectly ok.
Use an ice pack or heat bag to ease the pain. Be careful to avoid burns by ensuring a towel is wrapped around the pack and not directly applied over the skin.
Moving can help restore normal muscle activation and ease pain. Avoid prolonged static positions such as standing in queues or going to a football match!
Exercise is good for you! Gentle exercise carried out correctly can aid in recovery of back pain. It is important to perform the right exercises and you should see your physiotherapist to be advised which ones are most suitable for you. If you do exercise and it worsens your pain then stop!
Medial Tibial Stress Syndrome ( shin splints)
This condition is more commonly known as shin splints and is a painful injury that can significantly reduce an athletes performance.
How is it caused?
It is primarily an overuse injury. When you run the lower leg and foot absorb forces on impact. The muscles in the foot and lower leg have to adapt to the stress on your shin bone and the membrane surrounding it. If your shin bones don’t adapt structurally in line with your training, this can lead to pain and cause a traction periostitis which basically means an "inflammation of the periosteum" due to excess or abnormal force being applied. This can be a particular problem amongst adolescents, though it affects all age groups.
Other possible factors influencing MTSS include
MTSS can be helped by addressing some or all of the factors mentioned above.
In the early stages it is sensible to rest and apply ice regularly if affected.
Do not try to train or run through the pain as this may lead to worsening the condition and you may need longer time off sport .
It is also often helpful to see a podiatrist who can assess the lower limb and foot and use specific equipment to analyse your foot during the phases of gait cycle ( heel strike, stance phase, swing phase and push off. it may be appropriate to use specially made orthotics which are used in your footwear to help the foot and lower leg cope better when distributing the loads as you run.
Physiotherapy can be very effective in helping manage MTSS. In our clinic the physios and podiatrists can work together to analyse gait and we also use the optogait system to help us do this.
Physiotherapy will often involve using soft tissue techniques such as massage and mobilisation of the affected as well as associated muscles. Exercises to help strengthen and improve flexibility of the foot and leg may also be given.
Don't be surprised if your physiotherapist assesses the pelvis, back or hips when you present with MTSS. It is important to address muscle imbalances that could contribute to causing the problem.
When should I return to sport?
This all depends on your symptoms but you can continue to train cardiovascularly by working in the pool, aqua jogging is hard work! You can also cycle.
Remember to return to sport gradually. I usually suggest that you speak with your coach and develop a return to training, or return to competition program that enables a steady and painless return. There is nothing worse than rushing back and re-injuring.
There are some excellent products on the market to help support the foot and lower leg.
Please take a look at our on-line shop or visit the clinic for more advice about the specific services we can offer.
There are many different causes of shoulder pain. Being the most mobile and complex joint in the body it is prone to lots of different stresses and strains.
How did I injure my shoulder?
You can sustain an obvious injury to the shoulder such as a disclocation or a break (fracture). Both are common injuries associated with falling or contact sports such as rugby. Often the shoulder is immobilised initially then it is role of the physiotherapist to help get the shoulder moving again. Similarly you can strain or tear one of the main shoulder muscles known as the Rotator Cuff . These sorts of injuries can be treated successfully with physiotherapy rehabilitation, dependent on the size of the tear.
You may need a referral onto a specialist shoulder Consultant for a scan and in some cases surgery.
We can help with this process. (www.shoulderdoc.co.uk is a great site to find out loads of information and we refer the majority of our shoulder patients to Professor Funk if a consultant opinion is required).
Most shoulder pain is due to some sort of restriction of the normal movements of the shoulder. Arthritis (normal aging “wear & tear”) of the shoulder joints and Adhesive Capsulitis commonly known as a “frozen shoulder” can significantly limit shoulder mobility.
Did you know?
In order for the shoulder to move normally, 70% of rotation at the shoulder is needed. If you do not have this amount of movement, activities involving lifting the arm above the head puts undue stress on the Rotator Cuff . This produces “shoulder impingement” problems often seen in people who work or play sport involving repetitive actions for example painters/decorators, teachers writing on the board, tennis players and swimmers. Physiotherapy manual (“hands on”) therapy and specific exercises are essential in helping restore your normal shoulder range of movement.
Shoulder pain is often caused by poor postures, typically seen in people whose job or hobby involves sitting at a desk using a computer for long periods. We can advise on ergonomics – how your posture fits with your environment. Sometimes the pain you feel in the shoulder and arm is not coming from the shoulder at all, but is referred from the neck!
It is necessary for the physiotherapists to take a detailed history of your shoulder pain and carry out a full assessment in order to diagnose the cause of your shoulder pain. Shoulder problems respond well to physiotherapy treatment including manual therapy, taping, acupuncture, electrotherapy and an individual exercise regime to mobilise and strengthen.
And did you know?
Injuries of the lower limb past or present can have a direct affect on shoulder function so don't be surprised if the physio starts asking to look at your legs when you've come with a shoulder complaint!
Anterior Knee pain