Common injuries

Pain, injury, posture, surgery: See what we say and how we can help.

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Common injuries that we see

• Ankle sprains

  What is it?

  An ankle sprain is when there has been a sudden unexpected movement and the ligaments and tendons have had to react quickly to speed and force going through them during that movement. A slight tumble down a pivot in Richmond Park or Kew Green would be enough to cause the ligaments to be called into action.

  A ligament is attached to bone and its job is to stop too much movement between two bones. A tendon is attached to muscle and its job is to stop too much movement of that particular muscle. Any activity can result in an ankle sprain; running, walking, tennis, golf, squash.

  They either do a really good job and stop excessive movement or they tear under pressure. Either way they still do a really good job because they are just trying to protect you. This protection may leave them feeling bruised and swollen for a few weeks. Ligaments and tendons will and do heal, they take a bit longer than muscle but give them enough encouragement and they will heal. They will probably want to stay in the protective mode for longer than necessary so it is best to get osteopathy or physiotherapy advice to challenge them out of it.

  Our advice

  Give your ligaments and tendons a bit of gratitude and apply the RICE principle. Rest, ice, compression and elevation for a couple of days. Be sure to move your ankle; wiggle your toes and bend your ankle up an down. Apply heat when safe as this encourages healing, safe could be anything from a couple of days to a couple of weeks. Check with us your physiotherapist and osteopath if you are unsure.

  How we treat ankle sprains

  At Get Strong physiotherapy & osteopathy we test the ligaments and tendons to see if they are still doing their job properly. We will also do some deep tissue massage to allow the muscles to calm down and relax. Strengthening exercises are given to encourage your ankle to come away from the protective mode and back to top form so you can get back to playing your favourite sport.

  Shock absorption is a really important function of the foot and ankle, this function happens by all the little bones in the foot being able to move freely without stiffness or restriction and the muscles being able to relax without being tired, weak or in pain. After an ankle sprain, some of the bones may remain stiff therefore losing the ability to absorb shock resulting in the muscles never being able to relax. This can have a chronic affect on other joints such as the knee, hip and back. We will check these joints in your foot and ensure that they are moving to the best of their ability.

• Arthritis

  What is it?

  Arthritis is a condition that affects the joints; symptoms may include pain, stiffness, swelling, redness and reduced movement. There are many different types of arthritis, the most common are osteoarthritis and rheumatoid arthritis. Both forms are rare. Osteoarthritis normally effects the fingers, knees and hips. Rheumatoid arthritis is an autoimmune disease and often effects the hands and feet.

  Our advice

  Movement is a good way to manage arthritis. Your brain will want to protect you by stopping you from moving and therefore sending pain signals. We recommend that you move to send your brain reassurance that movement is not an aggravating factor.

  How we treat arthritis

  We massage and mobiles your muscles and joints within your pain limits. We teach you how to move and that pain is not a sign of damage. We prescribe exercises to keep you strong.

• Biceps tendonitis

  What is it?

  Biceps tendonitis is inflammation of the tenon at the top of the biceps muscle in the upper arm. There are two tendons that run up and attach to the shoulder blade and the shoulder socket. The one that more commonly gets inflamed is called the long head of biceps tendon. A possible reason is because it runs through a narrow groove before attaching onto the shoulder socket. It can sometimes ‘flick’ out of the groove causing irritation and inflammation. Why this happens is almost always multifactorial, it could happen to someone fit and active or someone who lives a sedentary lifestyle. In our clinic we have seen it happen to runners due to the repetitive nature and movement of the upper arms whilst running. Biceps tendonitis can be extremely painful, it can cause difficulties sleeping and it can cause severe weakness. The good news is it will get better and will probably make 100% recovery but it will take time.

  Our advice

  Pain-killers are needed here, not everyone likes taking them but the inflammation is going to cause pain. Anti-inflammatories, ice and even heat at some point. Seek advice and reassurance from your physiotherapist or osteopath, or your GP if needed. Under the advice of your physio or osteopath stop activities such as running or weights for a short period of time.

  How we treat biceps tendonitis

  At Get Strong physiotherapy & osteopathy our aim is to offer advice to help reduce inflammation so that treatment and movement doesn’t flare it up too much. Your upper back and ribs will be worked on with mobilisations and massage to help with movement around the biceps tendon. Graded weight bearing and movement exercises will be given to get the shoulder moving and feeling strong again. As well as discussing a plan to return to activities and sports, we will offer advice on how to prevent it from happening again.

• Big toe pain

  What is it?

  Not technically an injury but I wanted an excuse to talk about the big toe. Have you given much thought to your big toe lately? I would like you to become more aware of it. Are you aware of how much your toe moves or doesn’t move? Do you know how to strengthen it?
  The big toe plays an important role in everything you do such as, standing, walking, running and jumping. It can be prone to osteoarthritis, stiffness and bunions. The big toe is big for a reason, it has to do most of the work, it needs to be able to bend a lot and be strong enough to propel you forwards.

  Our advice

  Move your toes, don’t wait for stiffness to set in. Tune into your big toes from time to time. Be aware of their movement when you stand, walk and run, feel the ground underneath them. It sounds like a strange thing to do but with this awareness you can keep them moving and strong.

  How we treat the big toe

  We check the range of movement and mobilise it to improve the movement. We will do deep soft tissue massage to reduce any pain and tension. We will teach you to keep them moving and strong.

• Degenerative disc disease

  What is it?

  Degenerative disc disease is when the normal changes in your vertebral disks become painful. It can happen any where along the spine but usually in the lower spine. The vertebral discs are the squishy spongy things between each vertebrae that help make movements smooth rather than clunky. They also act to absorb shock that travels up and down the spine with movements and activities such as, walking; sitting, jumping, and running. The discs have been shown to nourish the bony end plates of the vertebrae themselves. It is fair to say that they have an important job to do. The reason they become degenerative is not fully understood, it can happen at any age and may have a genetic component to it. There is a normal ageing degenerative process where the discs become drier, flatter and less able to absorb shock, this process is usually not painful but stiffness is a common complaint.

  Symptoms of degenerative disc disease can range from severe pain to mild pain to no pain at all. Stiffness is a common complaint especially first thing in the morning. Tying shoe laces can be a struggle as can turning over in bed.

  Our advice

  Try not to worry about it. A large proportion of the population will have degeneration of their spinal discs and may have mild to no symptoms at all.

  If you do suffer with painful symptoms the best thing to do is to manage it as best as you can throughout your life. Learn what works for your body and mind. Practise movements that you haven’t done for a while. The brain will become protective and possibly allow weakness and more stiffness to set in all in the name of protection. Once you learn more about your movements and what works for your body you can also learn when painful movements are just your brain trying to protect you and are therefore not a sign of damage. This means that if you avoid a certain movement for a few days that is fine, but if you have avoided it for a few years that is not so good.

  Movement is not the enemy but movement can give you pain, pain is something to be explored and not feared but it takes practise, lots of practise. Keep going!

  How we treat degenerative disc disease

  Your movements are what we are keen to practise with you. Your pain levels will vary and when they are bad we will try our best to soothe your symptoms. As stated earlier your brain will try to reduce or stop movements in your vertebrae so we will be keen to get them moving and teach you how to keep them moving. Strength exercises will be taught and exercise classes such as yoga and Pilates may be recommended. Check our yoga class details here: Get Strong Yoga.

• General joint stiffness

  What is it?

  Do you wake up in the morning and feel it takes that little bit too long to get moving? That could be down to general stiffness in your joints. It happens to some of us through different times of our lives. It doesn’t mean you have arthritis. It simply means that your joints are a bit stiff and need a bit of time to wake up. The amount of stiffness you perceive to be in your joints can be due to a number of different factors such as, genetics; lifestyle, history of injury, history of pain, your body type. Your body type could play a large part into how your joints feel, some body types are naturally quite stiff, others are not.

  Our advice

  If your body type is naturally stiff, we recommend that you learn how to move more, and differently. Explore your movements and maximise on what they are capable of. You may never be able to touch your toes, and that is ok. You may, however want to move more freely and that’s a lifelong journey of learning and exploration. Speak to us about exploring your movements.

  How we treat joint stiffness

  Whether you have naturally stiff joints and are a bendy person, learning how your body moves and learning what it is capable of is something we can help with. Your movement is your strength! And not just for now but for the rest of your life.

• Headaches

  What is it?

  Headaches are a very uncomfortable pain and pressure in the head often radiating up from the back of the neck and into the scalp. 99% are from a build up of tension called tension headaches. This is where the muscles in the back of the neck have reached their capacity to hold tension and the tension then reaches the head causing headaches.

  Our advice

  Drink plenty of water, your muscles are working hard and need hydrating. Move more, go to thoracic rotation exercises on our 'Your exercises' page and try it.

  How we treat headaches

  We work on the muscles in the scalp, jaw, neck and upper back. They are have the ability to hold a huge amount of tension that can become painful. We also mobilise the joints in the neck.
  Movements are taught to reduce the build up of tension.

• Hip replacements

  What is it?

  Hip replacements are fairly common and can be done for adults of any age, more commonly for ages between 60 and 80 years old. The surgeon removes the old hip and replaces it with a prosthesis, a metal hip.

  Total hip replacements are very successful, the recovery rate is really good. Medication such as, codeine, paracetamol or ibuprofen are often used to reduce pain post surgery. It can be really sore during the first 6 weeks, pain control is important at this stage. You will feel much better post 6 weeks and one day, your strength and movement will return and the soreness will have dropped significantly.

  Our advice

  Be patient for the first 6 weeks, stay positive, rest and keep the pain down. Follow the precautionary advice of not crossing legs or bending more than 90 degrees until after 6 weeks. Time is your best medicine during this time.

  How we treat hip replacements

  Massage and gentle mobilisations are used to reduce pain and improve movement.
  Once you have reached 6 weeks and 1 day progressive strength exercises are given. Mobilisations and massage are used to surrounding areas such as your lower back and other hip.
  If you had a hip replacement months or years ago, we will assess the range of the movement, work on the muscles and help you be stronger.

• Jaw pain

  What is it?

  Do you wake up in the morning with pain in the face and jaw?
  
  If this is the case keep reading…

  Problems with the jaw (temporomandibular joint “TMJ”) can arise from intrinsic structures such as ligaments, muscles or articular meniscus. Problems can also arise from extrinsic structures related to the TMJ anatomically such as the skull, the neck or the shoulders. The nerve supply to the jaw, neck and shoulders are so closely related that it is not surprising when one is effected so can the other.

  What is the TMJ? (temporomandibular joint)

  The TMJ is defined as a highly specialised joint that represents the meeting point between the jaw and the skull. Articulation is in front of the ear (TMJ pain can often be felt around the ear). The jaw is one of the most mobile parts of our body: during the day it can move up to 2000 times!

  The TMJ is responsible for the movements of our jaw, it is fundamental for the articulation of sounds, for chewing and consequently swallowing - but not only that: it is responsible for breathing, and making facial expressions (that's why when we have TMJ pain we may seem "impassive").

  Here is a list of symptoms that may explain why so many of the complains you have or have had recently may be related to the jaw:
  - Continuous joint pain
  - Noises such as the "bolt" of the jaw or rubbing, but also a sort of click when the jaw is opened
  - Annoyance when yawning, swallowing or even while talking
  - Headaches
  - Dizziness
  - Stiffness in the face
  - Tensions in the cervical area
  - Pain and fatigue of the facial muscles
  - Pain and stiffness in the neck (cervicalgia), but also in the back and shoulders
  - Earache or feeling of having clogged ears

  Related issues

  As well as being related to TMJ issues, these symptoms can also be related to bruxism (teeth grinding), to arthritis, to a malocclusion of the jaw, and posture.

  How can the osteopath help?

  The osteopath will look at muscular imbalances within the jaw, cranium, neck and shoulders as well as assessing globally and holistically.
  First of all, the osteopath tries to understand if the closure and the opening of the jaw affects movements of the skull and the cervical spine. Through cranial osteopathy: techniques on the cervical spine; techniques on the ligaments of the jaw; techniques of detention of the masticatory muscles; the osteopath tries to bring comfort to the cranio-mandibular structures.

• Knee pain

  What is knee pain

  There are many causes for knee pain. Knee injuries we see at Get Strong physiotherapy & osteopathy can vary from traumatic injuries such as ligament sprains and cartilage damage, to knee issues that can creep on over time such as arthritis or repetitive strain injuries.

  A common knee issues that I see as an Osteopath, is patellofemoral pain syndrome also known as ‘runners knee’. This is pain caused by overuse resulting in tendons around the knee tightening and your kneecap not gliding properly on the femur (thigh bone). Pain is normally felt at the front of the knee under and around the kneecap. The most common cause for this issue is doing too much of something without enough rest or strength work. It’s a chicken and egg thing where we’re not sure if it starts as weakness in the gluteal muscles or tightness in the quadriceps, which can cause the kneecap to be pulled so it doesn’t glide smoothly in the groove it sits in on the femur. Commonly patients who are runners, cyclists, or basketball players performing repetitive jumping movements, who increase their training time, distance and intensity quite quickly present with this issue.

  Other issues that can cause similar pain around the front of the knee include patella tendonitis and bursitis.

  Patella tendonitis is where the tendon that runs from the bottom knee to the shinbone, can become inflamed and very painful, especially when bending the knee or putting load through such as going up and down stairs and squatting.

  There are approximately 13 bursae around the knee joint that are fluid filled sacs that help to reduce friction. However, these bursae can become irritated and inflamed themselves (called bursitis) causing the knee to look very puffy and tender to touch.
  All three knee problems: patella tendonitis, bursitis, and patellofemoral pain syndrome can be caused by similar issues including, gluteal muscle weakness, poor movement in the lower back, or in the ankle, and overuse.

  How we help

  At Get Strong physiotherapy & osteopathy we can help identify areas of the body that may not be moving well, or may not be strong enough and as a result causing stress to the knee. Through treatment we can help to improve function of these areas through soft tissue massage, joint mobilisation and articulation, as well as prescribe tailored exercises for your particular issue to help get you out of pain. We will reassure you that the pain you are feeling does not mean something is damaged and that you will be able to return to your favourite sport or even be able to go up and downstairs pain free.

• Lower back pain

  What is it?

  Likewise, with the ankle, the lower back has the same structures; ligaments, muscles, nerves and tendons. Any one of these structures can become reactive to different forces placed upon them. This reaction can result in pain, muscle spasm and restricted movements. Do not worry, it will get better. It is very rare that lower back pain becomes serious enough to warrant surgical intervention. Once the muscle spasm calms down everything will feel much better.

  The way lower back pain tends to happen is that sometimes a person can bend forward to empty the dish washer or to pick up a pencil and their back ‘goes’, resulting in muscle spasm and very painful movements. This pain is a sign that your back is trying to protect you, the way we get protection is by two ways, one is to give us pain, and the other is to stop us from moving. These protective mechanisms are important and helpful so we must remember to be grateful. It is our/your job to gradually re-introduce movement even if it is still a bit painful, and to improve strength. We see many people with lower back pain at Get Strong physiotherapy & osteopathy. Physio and osteopathy treatment works really well to get the lower back moving again.

  Our advice

  Let your back calm down for a day or two. Put some heat and or ice on. Rest and avoid sports for a few days at least and speak to us or your physio or osteopath for advice on returning to sport.

  How we treat lower back pain

  We recognise where and how your back will try to compensate and continue to protect you, we will encourage these areas to move with a number of different physiotherapy and osteopathy treatment techniques. We will teach movements and strength exercises. Get in touch if you would like more advice and treatment in the Kew and Richmond area.

• Muscle strains

  What is it?

  Muscle strains are a common presentation we see at Get Strong physiotherapy & osteopathy. Muscle strains have varying severity, from a minor strain which involves a muscle being over stretched to major strains, which involve sever tears of muscle, and could require surgery. Don’t panic the muscle will get better and get strong again, it will need to heal and then we need to work out why it happened.

  Muscle strains normally occur when an area of the body is not functioning optimally and a certain muscle has to work harder than it should be. This can lead to it fatiguing, tightening, weakening and therefore being predisposed to being over stretched.

  At Get Strong physio, the osteopath or physiotherapist you see will assess the extent of the strain and give advice on what you should do to aid in its recovery. Rest, ice, compression and elevation are normal recommendations in the initial stages, with heat and gentle exercise being the advices once the site of the strain progresses in its recovery.

  Our advice

  If you have suffered with a muscle strain or muscle pain book in to see us.

  How we treat muscle strains

  Soft tissue and articulation techniques will help to maintain and improve mechanics of surrounding areas of the injured site, which will help to reduce stress put on the strained muscle. Identifying muscle imbalances or areas of weakness are key to help prevent reoccurrence of a strain. Our aim is to address the underlying cause to get you back doing what you love doing!

• Neck pain

  What is it?

  Many of our patients tend to have one of two complaints when it comes to neck pain; one is they woke in the morning and were unable to turn their head, the other is a build up of tension usually due to stress or too much time sitting at the desk. Occasionally it can be one of the most uncomfortable pains resulting in headaches and nausea, most often it is a mild background pain. Neck muscles are really strong, they work hard all day every day, only resting when you lay down at night to sleep. As with most muscles they can tire and fatigue resulting in pain and weakness.

  Our advice

  Movement and strengthening will help. Raise your arms above your head and stick your chest out a few times a day. This helps the upper ribs to move which will feed the muscles on top of them with blood increasing the oxygen and nutrient supply. Don't be afraid to strengthen your neck muscles, we can advise on some good physiotherapy and osteopathy neck exercises.

  How we treat neck pain

  Your neck joints will be check and mobilised if needed, pressure will be applied to the deep muscles in the neck to relieve the pain. We will also treat your upper back as stiffness in this area can affect the neck. Exercises and movements are given to teach you how to keep that part of your body moving and strong so that you able to do deskwork for long periods of time painfree.

• Neck tension

  What is it?

  Neck tension is something we hear a lot from our patients here at Get Strong physiotherapy & osteopathy. It occurs a lot especially amongst desk workers. A build up of tension happens across the shoulders, upper back and into the neck and sometimes into the head causing tension headaches. It can range from feeling uncomfortable to feeling very painful, where whatever you do to try to relieve it doesn’t seem to effect it.

  Why does it happen?

  Tension is a normal and necessary thing to happen, our neck is structured in a way to receive tension from other parts of the body. The neck will hold onto some of the tension is receives and also get rid of some. The muscles needs a certain amount of tension in order to get rid of the excess. This may sound strange but tension can come in many different forms, it can come in the form of movement, in the form of strength, in the form of sustained posture, and in the form of bursts of shock from jumping or running.

  If your neck is not coping with the amount of tension it receives and it is therefore unable to get rid of the excess, it may be due to not having enough tension to begin with. If this is the case your neck muscles will fatigue, get weak and become painful.

  Our advice

  Let’s give your neck more tension! How? Basically it means doing a lot of things that your neck doesn’t like doing such as moving it, strengthening it and putting some forceful bursts of shock through it with activities such as running and jumping. The key thing to take away is that tension is normal, it is your neck doing a perfectly good job and what it is designed to do, it’s good to give it some gratitude. So the next time you get an uncomfortable build up of tension in your neck be aware that tension is normal and needed. It may be a sign that your neck needs a bit more tension in the form of movement and strengthening.

  How we treat neck tension

  Osteopathy treatment will help help reduce the fatigue and get rid of the pain with massage and joint mobilisations and show you how to put movement and strength in your neck so you get less uncomfortable tension. Check our exercise page for exercise ideas. Please seek professional advice before doing them.

• Plantar fasciitis

  What is it?

  Plantar fasciitis is when the tendon in the base of your foot becomes inflamed and painful. It is a really thick tendon that help; the springing part of your foot when you take a step and the shock absorption part when your weight is on your foot during standing. Plantar fasciitis is not a sign of damage, your foot will recover but you will need to be proactive to get it better.

  Like any other muscle and tendon in the body it can get overused and under paid. The under paid bit is a lack of strength. Overuse can come in the form of walking, running and doing your normal activity. The feet are highly specialised parts of the human body and need to be taken care of.

  Our advice

  Ice, heat, strengthen and get treatment by someone who knows how to treat it sooner rather than later. Many people tend to leave it for months before seeking treatment, it's better to get it treated as soon as possible.

  How we treat plantar fasciitis

  At Get Strong physiotherapy & osteopathy we mobilise all the joints in the foot and ankle, there are 33 joints in that small space, we make sure they are all moving. We check how much movement there is in your big toe, this is a key part to the health of the plantar fascia. We check how strong your big toe and plantar fascia is and then help to strengthen them. Deep soft tissue massage helps a lot to reduce the tension and pain.

  Check out the video below, this is a patient of ours in Kew. Can you spot the weakness? This is a year long plantar fasciitis after running a half marathon. It is on the left side and the plantar fascia and calf muscle are weak. It is time to get strong with heel raises, squats, toe yoga, downward dogs, jumps, hops and running.

• Postpartum discomforts

  Postnatal osteopathy

  The birth, and the period after the birth, can have a significant impact on your body. The woman uses her body overcoming the structural limits to which she was accustomed throughout pregnancy. The physiological, and structural demands on the body during Childbirth can be compared with that of a sporting performance of a high-level sportsperson.
  
  Given all of these demands, changes and adaptions the body faces a demanding job to find its own balance. An extremely important recovery phase must follow and it is worthy of attention.
  Osteopathy in the postpartum and breastfeeding periods can help speed up this recovery and reduce aches and pain that can often appear during this delicate phase.

  What does the osteopath do?

  Osteopathy treatment will take into consideration the different physiological effects to the viscera, circulatory and lymphatic systems that pregnancy and childbirth has on the body. Treatment has the overall aim to rebalance the musculoskeletal system including the pelvic floor and urinary disorders. Breastfeeding and different stages of this will play a part on how the mother is feeling. Treatment will aim to reduce discomfort but work alongside the amazing process the female body undergoes.

  Another point on which the osteopath works with particular attention is the diaphragm, that has been working hard and well but has also been compressed by the growth of the belly. The manipulations and massage of the diaphragm allows a better respiratory functionality, fundamental during the birth to help the mother to release the physical and emotional tensions. A diaphragm that has more movement will support contractions; alleviate pain, oxygenate the whole organism, therefore allowing the whole system to work in a more effective way.

  It has often been observed that gynaecological problems (endometriosis, ovulatory pain or pelvic infections of various kinds) can present as pains in the pelvis and vertebral column as the main complaint by the patient.

  This is due to the "viscero-somatic reflexes" that involve the spinal segments responsible for the innervation of the viscera and also the muscles in the spine and pelvis. Osteopaths will work on the symptomatic muscles and joints in the spine and pelvis in order to reduce somatic dysfunctions deriving from the visceral-somatic reflexes. This makes the osteopathic approach a unique advantage for medical practice in the management of patients with gynaecological and obstetric problems.

  When to make the first osteopathic treatment? 

  The first meeting takes place after the third month of pregnancy when the placenta is installed.
  During the first trimester I recommend a first cognitive meeting that aims to: illustrate to the expectant mother the Osteopathic path she will choose to undertake, inform and resolve doubts, provide the first useful tools to master the first postural changes.
  During the first meeting the presence of any imbalances is evaluated and the first treatment is carried out. The second takes place at a distance of about 10-15 days, and then evaluates how far to organise the subsequent sessions based on the individual response.
  The classic process that I recommend, to do a complete job, is characterised by 5 “base” meetings, and subsequent “reminders” that will be distributed one month apart from the other.
  For example, if the first 5 treatments take place (ideal situation) between the fourth and fifth month, the following meetings will be: one during the sixth month, one during the seventh, one during the eighth, one during the ninth.
  Clearly, we must consider that every woman is different from the other, and consequently also the adaptations that the future mother feels during the gestation period, which is why there is no real scheme of sessions and treatments.
  The route will therefore be customised according to the patient's needs. 

• Prenatal discomforts

  Discomforts during pregnancy

  Did you know osteopathy is useful during pregnancy?

  Osteopathy as complementary manual medicine can help during the preparation for childbirth, it can provide support during pregnancy and improve postpartum imbalances.
  Osteopathy can help support the body through the changes that occur both during pregnancy and after childbirth.

  Prenantal osteopathy

  During pregnancy the woman's body undergoes profound structural and functional changes.
  These changes require continuous adaptations to the body, a normal consequence of those adaptations can be fatigue, aches and pains. Aches and pains that can be listened to, understood and addressed, reducing the effects they have on the wellbeing of the expectant mother.

  Some of the normal and natural changes that allow a woman to adapt to the child's growth are:
  Sudden and important hormonal changes  this may cause the joints to become increasingly mobile in preparation for growth and delivery of the foetus.

  Other changes include:
  • Increased water retention;
  • Increase in body weight;
  • Physiological increase of the spinal curves (in particular the lumbar and cervical curve is accentuated in the last few months);
  • Morphological changes in the pelvis and lower limbs;
  • Increased lumbosacral load;
  • The viscera are pushed by the growth of the uterus;
  • The rib cage adapts to increased abdominal volume and changes in curves.

  The female body has an incredible ability to adapt to these changes and as pregnancy progresses, these changes may effect daily activities.

  Osteopathy in pregnancy can act globally on the body of the future mother, recognising what is adapting well and what areas are struggling to cope. Under these extra demands, muscles can fatigue and joints can become sore, osteopathy helps to promote movement, strength and overall wellness.

  One of the main purposes of osteopathic medicine is to promote the best possible expression of health for the person. Therefore, it is important that obstetric, gynaecologist and osteopathy is taken into consideration to maintain health and wellbeing.

  Some common disorders that osteopathy can help the symptoms of during pregnancy are:

  • Lumbosciatica
  • Pelvic pain
  • Neck pain
  • Headaches
  • Swelling
  • Nausea
  • Carpal tunnel disorder

  What does the osteopath do?

  Using gentle techniques, and sometimes deep tissue massage, osteopathy helps the muscles and joints to move, increase blood supply, and improve movement and strength. Resulting in reduced pain and better movement, with the overall aim of you feeling better.

  This new comfort will have a double advantage:

  It will remind the body of its capabilities in adapting to the extra demands of pregnancy.
  It will have a relaxing effect on both the mother and baby.

• Rotator cuff injuries

  What is it?

  The rotator cuff muscles are a collection of four muscles that wrap around the head of the humerus (the bone of the upper arm). They help to stabilise the joint of the shoulder where the humerus and the scapular (shoulder blade) meet.
  Common causes of rotator cuff injuries are repetitive overhead movements either due to work or sport. Commonly these injuries occur due to poor shoulder mechanics, either through muscle imbalance or due to postural changes.

  Our advice

  Initial avoidance of painful movements will normally be advised, and use of ice and/or heat may be suggested. We will endeavour to help you find ways to allow you to continue doing most things, however occasionally it may be needed for you to take a short period off of working/playing sport if it is likely to lead to further injury!

  How we treat rotator cuff injuries

  We will work on the muscle strain or tendon injury with massage, stretching and mobilisations. Your upper back will be worked on to improve mobility and we will keep the muscles and joints around the injury working properly to aid recovery time. Rehabilitation exercises will be given tailored to your injury with your lifestyle taken into account. The shoulders are demanding, they need a lot of movement but they also need stability and strength, without these factors they can become troublesome. Look after your shoulders.

• Running injuries

  What is it?

  We see a lot of running injuries; calf tears, plantar fasciitis, hip and even shoulder injuries. Whether you are a weekly Park Run participant or an avid marathon runner, injury can sometimes be apart of running. We encourage you not to take this as a sign to stop but to explore what your body is telling you and try to change it.

  Our advice

  Listen to your body and this doesn’t necessarily mean stop running. Try to work out what it’s telling you and what it needs to feel better. Remember pain doesn’t mean damage but it can result in injury if ignored.

  How we treat running injuries

  We check your movements from your big toe to the base of your skull. Every part of you body is involved in running, we make sure that every part is participating. We pay particular attention to your big toe and calves as they do the bulk of the work. We will coach you to understand what your body is saying and why.

• Shoulder pain

  What is it?

  Shoulder pain can be caused by a multitude of different things. Most common causes of shoulder pain we see are muscle strains and tendonitis, rotator cuff injuries, Ligament sprains and shoulder impingement.
  Pain can also be felt around the shoulder but is not caused by something in the shoulder itself and rather be referral pain from the neck or upper back.

  Our advice

  Initially will suggest to either ice and/or heat the shoulder and to refrain from painful movements until the acute stage of the injury has passed. Keeping the shoulder moving with in a pain free range will help recovery and prevent too many compensatory movements happening.

  How we treat shoulder pain

  At Get strong physiotherapy & osteopathy treatment will be tailored depending on the cause of the pain. We commonly use hands-on treatment as well as prescribed rehabilitation exercises to help strengthen the shoulder and aid good flexibility. By achieving this it will help with recovery of an injury, alongside preventing future injury.

• Sports injuries

  What is it?

  Sports injuries usually occur when there is an unexpected force going through either; bone, ligaments, tendons or muscles.
  They can range from meniscal injuries in the knee from playing football or tendonitis in the elbow from playing tennis.

  Our advice

  If you have sustained an injury whilst playing sport the best thing to do is to is apply the RICE principle. Rest, ice, compress it if necessary and elevate.

  How we treat sports injuries

  Our aim is to get you back playing your sport as soon as possible. If necessary and with your permission a referral will be made for the appropriate scan. Once we are sure that the ligaments and tendons are intact we will get the injured part moving and stronger.

• Stress

  Stress

  Stress is one of the most underestimated causes of pain. It doesn’t have to be a major stressful life event but it can be normal day-to-day routine stress. Pain can range from headaches, neck and shoulder pain to lower back pain. We all need a certain amount of stress in our lives to get us out of bed in the morning. It is therefore a constant tug-of-war of finding the right balance. You can guaranteed that the balance will tip one way or the other at some point. The tipping of balance can be what causes the increased tension in your neck or shoulders or your lower back.

  Our advice

  Do many different things to help; meditation, running, yoga, a hot bath with a glass of wine. The brain perceives all of these things as therapy. Therapy is just way of finding ways to be kind to yourself and not just to yourself but to your muscles that are doing an amazing job for you day in and day out.

  How we can help

  Your muscles and joints need movement, power, oxygen and nutrients to keep up with all the different pressures and tension they receive every day. Massage, mobilisations, movement and strength exercises will be used. Once you have the awareness to be grateful to your muscles and joints the more likely you are to be kind to them. Book in and find ways to move your muscles and joints today.

• Tennis elbow

  What is it?

  Tennis elbow is when the tendon in the elbow becomes inflamed and painful. This can happen for many reasons, the most common being overuse. Many manual workers such as builders, plasterers and mechanics can suffer with it.

  The tendon is linked to the muscles in the hand actions such as gripping, pouring the kettle and shaking hands can aggravate it.

  Similarly to plantar fasciitis, it can last for a long time if not treated. The tendon gets into a vicious cycle; inflammation causes pain, pain causes weakness, weakness contributes to more inflammation and pain. There is very little risk to actual damage to the tendon even if it has been going on for months and months.

  Our advice

  Don’t live with it, seek treatment sooner rather than later. Put ice on it, strengthen it. Explore the pain a bit without pushing it too much, don’t necessarily avoid painful movements. Remember it is highly unlikely to cause actual damage.

  How we treat tennis elbow

  We work on the hand and wrist to get the joints moving. We will massage the elbow tendons and possibly do acupuncture if appropriate. Your neck and upper back will be worked on and we will teach strength exercises.

  Case study

  A patient of ours has his own plastering business and over time has overused his elbow tendon resulting in painful, stiff and weak hand and arm. We worked on the whole chain from his hand to his shoulder and upper back. Strengthening exercises and advice on not avoiding certain movements were given. The patient no longer has tennis elbow and now understands the way his brain and body reposnds to certain activities and more importantly what he can do to help it.

• Wear and tear

  What is it?

  The reason I have included wear and tear is because many people blame wear and tear for their pain and struggle with certain activities. The truth is we don’t get pain from general wear and tear, otherwise we would be in pain from an early age. We do get pain from our reaction to wear and tear, this means our tendons may tighten up to try to reduce our full range of movement. Once we have this awareness we can re-educate the tendons to move in a different way that will encourage movement and strength.

  Wear and tear is a normal process and yes it will be more prevalent in some joints than others depending on your lifestyle. A little awareness and movement education can steer you away from a pattern of restricted movement and pain.

  Our advice

  Pain does not mean damage, if you feel pain try to explore it a bit and see what it is trying to tell you rather than shy away from that movement or activity.

  How we treat wear and tear

  We get things moving and challenge tendons outside of their comfort zone so that they discover new movements and more strength.

• Your feet and pain

  Your feet

  Connect with your feet. What are they doing right now? Some fun facts about your feet: 1)There are 26 bones in each of your feet. 2) There are 33 joints that articulate to keep you stable and to move you. 3) A quarter of all of your body's bones are in your feet! Whaaat?! 4) The big toe is 4 times bigger than your other toes because it does 4 times the amount of work (or at least it should be!) 5) Your brain is highly protective of the big toe and will therefore send more pain signals and may allow it to stiffen and weaken, all in the hope of protecting it.

  You can keep your feet and toes moving just by being aware of them more on a daily basis.

  Our advice

  Check out our exercise and movement page on our website for some ideas: https://www.getstrongphysio.com/exercises/