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0118 969 2299
11 Headley Road
Woodley
Reading
Berkshire RG5 4JB
appts@3way-healthcare.co.uk
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Spotlight on

Conditions

Our Results Focused Method combined with our multidisciplinary team is what makes our Award Winning business model unique in the healthcare market. Unlike the majority of private clinics our staff is employed, rather than contracted, which means that you will be working with the members of the team most experienced and capable of getting you the results you deserve.

On this page you will find a wealth of information regarding more long term and common conditions that we see in our clients.

Upper Limb

Frozen Shoulder

Up to five out of 100 people will get a frozen shoulder at some point in their life. You’re more likely to get frozen shoulder if you’re aged between 40 and 60, and it’s slightly more common among women. People with certain medical conditions are more likely to get a frozen shoulder, including diabetes, an underactive thyroid, an overactive thyroid and heart disease.

The main symptoms of frozen shoulder are pain, progressive stiffness of the shoulder and reduced function. The time frame for frozen shoulder to improve is between 1 and 3 years.

There are 3 phases associated with frozen shoulder and treatment varies depending on the phase you are in.

Phase 1 (freezing) is characterised by mainly pain and inflammation and injection therapy, manual therapy, acupuncture and exercises are the treatments of choice.

Phase 2 (frozen) is characterised mainly by stiffness and a lack of function. In order to help with the stiffness manual therapy, focused shockwave therapy combined with rehabilitation is the treatment of choice. Focused shockwave therapy is a low intensity shockwave treatment to promote and accelerate tissue repair and healing. It has regenerative abilities therefore restoring the tissue back to it’s formal non painful state.

Phase 3 (thawing) is mainly characterised by ongoing stiffness and lack of function rather than pain and manual therapy combined with rehabilitation is recommended.

All these treatments are very safe and have been done to millions of people with no side effects apart from some transient discomfort.

Our treatment programmes can improve the journey of you suffering with frozen shoulder and help towards a full resolution of the problem. Often it is regarded as ‘self-limiting’ however research evidence suggests that only 39% of patients fully recover with 11% reporting ongoing functional limitation.

As this is a very common shoulder complaint our team is well placed and highly experienced to assist in accelerating your recovery, reduce pain and restore normal function.

Tennis & Golfer's Elbow

Tennis elbow and Golfer’s elbow are everyday terms for elbow pain.

Tennis and golfer’s elbow (also called epicondylitis) is pain from the tendons that join the forearm muscles to the elbow. Tennis elbow is on the outside of the elbow (lateral) and golfer’s elbow the inside (medial).

Despite their sport names, the most common causes for tennis and golfer’s elbow are day to day activities such as repetitive desk work or mobile phone use for tennis elbow or DIY, gardening and heavy lifting for golfer’s elbow. It is most common in those between 30-50 years of age, but this can vary hugely depending on the activity levels of the person. People who are sedentary are also at high risk of developing these conditions due to underuse of the affected structures.

The pain isn’t always where you expect it to be. In lower limb tendinopathies, tendon pain is very well localised and does not spread up or down. However, in upper limb tendinopathies, the close proximity of nerves makes it quite likely that the pain will be more spread out.

This nerve involvement complicates both diagnosis and treatment, as pain has the potential to spread up and down from the actual site of the pathology and can create additional unpleasant symptoms such as tingling and numbness.

Pain is what causes most people to notice they have developed tennis or golfer’s elbow, but a loss of grip strength usually precedes the onset of pain.

Physiotherapy is well suited to treating tennis elbow and golfer’s elbow. As Physiotherapists, we take a deep look as to why you are in pain, whether that be a movement issue or something else. Once we have found out what exactly is causing your pain, we can formulate a treatment plan to fix the problem. Some of the techniques for tennis elbow treatment include:

  • Acupuncture
  • Shockwave Therapy
  • Electro Magnetic Transduction Therapy
  • Joint Mobilisations
  • Taping
  • Massage
  • Exercise
  • Injection therapy

Treatment for tennis elbow and golfer’s elbow involves lifestyle changes and prolonged rehabilitation to restore the muscles to their normal strength and prevent recurrence.

Shoulder Osteoarthritis

What is osteoarthritis?

Arthritis means inflammation of the joints. Osteoarthritis (OA) is the most common form ofarthritis in the UK. OA mainly affects the joint cartilage and the bone tissue next to the cartilage.

What causes osteoarthritis?

All normal joints and joint tissues are constantly undergoing some form of repair due to damage to the joint and surrounding tissues through stress and force that is placed on them in our daily activities. However, in some people, it seems that this repair process becomes faulty or delayed in some way and OA develops. In joints with OA, the joint cartilage becomes damaged and worn. The bone tissue next to the cartilage can also be affected and bony growths can develop around the joint edges. These growths are called osteophytes and may be seen on X-rays. The joints and the surrounding tissues can also become inflamed. This inflammation is called synovitis.

Factors that may play a role in the development of OA include:

  • Age: OA becomes more common with increasing age. By the age of 65, at least half of people will have some OA in some joint(s).
  • Genetics: There may be some inherited tendency for OA to develop in some people.
  • Obesity: Shoulder OA is more likely to develop, or be more severe, if you use your arms
  • for weight-bearing e.g. pushing up from a chair or using walking aids.
  • Your sex: Women are more likely to develop OA than men.
  • Previous joint injury, damage or deformity: This may include previous joint infection, a
  • previous fracture (break in the bone) around a joint, or a previous ligament injury that caused a joint to become unstable.
  • Occupation/Sport: Shoulder issues are more prevalent with people who use their arms
  • above shoulder height in a repetitive or sustained way, especially when heavier loads are
  • involved.
  • Posture: Becoming stooped and round shouldered puts more stress on the shoulder joint when performing normal movements.

What are the symptoms of osteoarthritis?

  • In some cases no symptoms may occur. Quite a number of people can have X-ray changes that indicate some degree of OA but have no, or only very mild, symptoms.
  • Pain, stiffness, and limitation in full movement of the joint are typical. The stiffness tends to be worse first thing in the morning but tends to loosen up after half an hour or so.
  • Swelling and inflammation of an affected joint can sometimes occur.
  • An affected joint tends to look a little larger than normal. This is due to overgrowth of the bone next to damaged cartilage.
  • If you have bad OA that affects your shoulder, you may have difficulty in putting your clothes on, and using the arm above shoulder height
  • Pain at night may be an increasing problem with advancing OA

Do I need any tests?

Osteoarthritis can often be diagnosed based on your age, your typical symptoms and examination of your affected joints. Tests such as X-rays or blood tests are usually not needed.

What is the outlook for people with osteoarthritis?

The severity of symptoms can vary. In many people, OA is mild and does not make you anymore disabled than expected for your age. However, in some people, the severity of OA andthe disability it causes is out of proportion to your age.

What are the aims of physiotherapy?

The aim of physiotherapy is to increase joint mobility, improve muscle strength and try and relieve pain.

  • Pain relief:
    • Acupuncture and Dry Needling
    • Soft Tissue Massage
    • Shockwave Therapy
    • EMTT
  • Longer term rehab:
    • Education
    • Exercise prescription (home exercises, hydrotherapy, gym rehab)

In the most severe cases shoulder surgery is required.   We offer a specialist service with regards to the long term rehabilitation following any surgery that is required.

Post-surgical physical therapy varies based on the procedure performed. It may include:

  • Ensuring your safety as you heal.  You will perform specific activities and exercises at the correct time to allow for optimal healing. Restorative and reconstructive options may take several months to heal, with longer precautions.
  • Aiding motion of the shoulder. After surgery, your shoulder will be sore and swollen, and you may not feel like moving your arm. However, gentle motion is often recommended. Our experience and close working with many orthopaedic surgeons mean that we can choose the best options for recovery and guide you through the process.
  • Strengthening the shoulder. Due to prior disuse or postoperative pain, your muscles may not be as strong as normal. If the muscle was repaired during surgery, you will have to let it heal for a period of time, and we can let you know what activity is safe to help the healing along.
  • Relieving your pain. Using hands-on therapies and other modalities, we can help reduce your pain during exercise and daily activities.
  • Getting back to work and activities of daily living. Returning to work and daily activities may be slow, and your physio will guide you through the process to achieve the best results.

Spine & Pelvis

Sciatica

Overview
Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.

Sciatica most commonly occurs when spinal nerve roots get sensitised which can be caused mainly by compression or stretching of the nerve or inflammation in the surrounding area.

Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments.

Symptoms
Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You might feel the discomfort almost anywhere along the nerve pathway, but it’s especially likely to follow a path from your lower back to your buttock and the back of your thigh and calf.

The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.

Some people also have numbness, tingling or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part.

Risk factors
Risk factors for sciatica include:

  • Age
  • Obesity
  • Occupation
  • Prolonged sitting
  • Diabetes

Management
The key goals for management are:

  • Pain control
  • Restoration of range of motion
  • Restoring normal function
  • Improve fitness and strength

Our team has dealt with thousands of clients suffering with sciatica and our success rates are above 80%. All our clients are dealt with individually as they will all have individual goals and needs so we apply our tried and tested results based 3 step system to provide the outcome you deserve.

Neck Pain

If you’re suffering from neck pain, it can be very tempting to hope that it will go away on its own and that time will heal. In many cases, simple neck problems will heal with a little bit of time, keeping active and doing some simple exercises.

However, in some cases that minor ache doesn’t settle quickly, but in fact worsens or persists. Pain that started in your neck may spread into the shoulder and even start affecting the arm. When a stiff neck becomes more painful and you find you’re struggling to sleep, struggling to work and maybe even start developing headaches, it’s maybe time to seek some expert help.

If this is what’s happening to you, you’re no alone. Neck Pain is one of the commonest problems we see.

What Should You Do If Your Neck Pain is Not Improving?

So you’ve tried rest, painkillers, and some exercises you found on YouTube. Unfortunately your neck pain is still not improving and maybe it’s even worsening. Here’s our best advice on what to do next…. 

The most important thing is to make a Decision about getting expert help. So many people put off the decision for far too long hoping that it “will just go away”.

Work Together with your Physio to start easing your pain, strengthen your muscles and get back to doing what you love. 

What Can You Expect When You Book a Neck Pain Assessment

  • We’ll take time to listen, hear Your story and make sure we fully understand the problems you’ve been having
  • We’ll do a thorough Physical Examination, and afterwards explain in plain English what the problem is
  • We’ll develop an Action Plan to achieve the best possible result.

Neck Pain Treatment

Treatment for neck pain can include a wide range of treatments that we have at The Physiotherapy Centre, including:

  • Manual therapy, such as Mobilisation
  • Massage
  • Acupuncture
  • Shockwave Therapy
  • EMTT
  • Taping
  • Prescriptive exercise programme

Pelvic Girdle Pain

Pelvic girdle pain (PGP) is pain which is felt around the pelvis, lower back, hips and thighs.

It can vary from mild to severe. The symptoms can be different for each woman.

Symptoms

The symptoms of PGP can vary for different people, both in terms of severity and presentation. The most commonly experienced symptoms are:

pain in the front centre of your pubic bone
pain in your lower back on one or both sides
pain in your perineum, the area between the anus and vagina

The pain sometimes travels to your thighs, and you might also hear or feel a grinding or clicking sound in your pelvis.

The pain is often more obvious when you’re:

  • walking
  • using stairs
  • putting your weight on one leg
  • turning over in your bed

It might also be challenging to widen your legs. This can make daily tasks such as getting out of bed, getting dressed, or getting in and out of a car difficult.

Causes

The most common cause of pelvic girdle pain is pregnancy. It’s thought that PGP affects up to 1 in 4 pregnant women to some extent.

During pregnancy, hormones such as relaxin are released to loosen the ligaments and muscles in your:

  • hips
  • stomach
  • pelvic floor
  • pelvis

This loosening is intended to increase your range of motion in order to help you give birth, but it also means that your joints can become unbalanced and more mobile than they usually would be. This can cause discomfort or pain.

Although this slackening is intended to help with birth, sometimes you can start producing these hormones in early pregnancy. You may experience the symptoms of PGP long before it’s time to give birth.

The baby’s weight and position are also thought to affect pelvic pain. The symptoms of PGP tend to worsen as the pregnancy progresses.

It’s much less common for PGP to occur outside of pregnancy, but it does happen. Other causes of pelvic girdle pain range from pelvic injuries to conditions like osteoarthritis. In some cases, there’s no known cause.

Diagnosis

Early diagnosis can be really helpful in managing PGP. The diagnosis is mainly made through taking a history and physical examination. Imaging is often not required and frequently does not show anything. Our Specialist MSK and Women’s Health Physiotherapists are well placed to assess and identify the source of your PGP.

Can it lead to pregnancy complications?

Pelvic girdle pain isn’t medically harmful to your baby and there are lots of things that can be done to minimise your pain. That’s why it’s important to seek help from a specialist physiotherapist.

The Pelvic, Obstetric and Gynaecological Physiotherapy group from the U.K. suggests that you try to avoid the following activities if you’re experiencing PGP:

  • putting your weight on only one leg
  • twisting and bending while lifting
  • carrying a child on your hip
  • crossing your legs
  • sitting on the floor
  • sitting in a twisted position
  • standing or sitting for long periods of time
  • lifting heavy loads, such as wet laundry, shopping bags, or a toddler
  • vacuuming
  • pushing heavy objects, such as a shopping cart
  • carrying anything in only one hand

How can physiotherapy help me?

Physiotherapy is the first line of treatment for PGP. We can advise and help you to:

  • minimise your pain
  • improve your muscle function
  • improve your pelvic joint stability and position

It can be good to see someone who has specialises in women’s health, however all MSK physiotherapists will be able to give help and advice.

What are the therapies available and how can they help?

Manual therapies include ‘hands-on’ treatments such as soft-tissue massage and joint mobilisation, which are highly effective for Pelvic Girdle Pain.

Hydrotherapy may be recommended, where you do the exercises in the water. Being in the water can take the stress off your joints and allow you to move more easily.

Education, advice and suggestions on comfortable positions for sex, labour, and birth can help with your overall management and reduce anxiety and pain.

In some cases of PGP, a course of acupuncture or electroacupuncture with our women’s health acupuncturist, Angela, may be prescribed.

You may also be provided with supportive equipment such as crutches or pelvic support belts.

Lower Limb

Greater Trochanteric Pain Syndrome

Greater Trochanteric Pain Syndrome (GTPS) is a painful and debilitating condition, affecting the outer thigh and hip area.
It happens when the tissues that lie over the bone at the top of the thigh (greater trochanter) become irritated. These tissues can include tendons, muscles or fluid-filled sacs (bursae) that help smooth movement between muscles, tendons and the hip bone.
This irritation might happen for a number of reasons. We typically see 2 subgroups of women with GTPS. The first group is young athletic women (mainly runners) who through overload on the tissues develop GTPS, the second group are women over the age of 45 where overload accounts for 25% of the cause and hormonal (menopause) and metabolic changes account for 75% of the cause.
You will usually not need scans to diagnose GTPS. It is diagnosed through taking a medical history, and doing specific tests of the hip during a physical examination.

Symptoms of GTPS

  • Pain in your outer thigh and hip area. This might feel like an aching or burning pain.
  • The pain might be worse when you are lying on your side, especially at night.
  • The pain might be worse with exercise.
  • You might walk with a limp.

Cause of GTPS

GTPS is most common in adult women. The exact cause is not fully understood. There are many factors that can contribute to it.

  • A direct fall on the outside edge of your hip.
  • Excessive load, for example prolonged walking or running. Poor running style can also lead to increased load on this area of the hip.
  • Prolonged or excessive pressure to your hip area can make GTPS worse. For example, sleeping on your affected side or crossing your legs whilst sitting.
  • Weakness of the muscles surrounding the hip.
  • Hormonal changes (menopause)

How do we treat GTPS?
Our 3 step results-focussed-system includes shockwave therapy combined with rehabilitation in our hydropool or gym.

How effective is our treatment?
Our unique 3 step system for GTPS is 85% successful.

How long does it take to get better?
Everybody will improve differently. For most people it will take 6 to 9 months to make a return to full activities without pain.

It is normal to have some periods of increased pain, or flare-ups, during your recovery. Our team will be working closely with you to manage these flare-ups so they don’t interfere with the long term result.

Plantar Fasciitis & Heel Pain

Nothing can disrupt normal daily living quite as much as pain that keeps you from moving around.

If you’re experiencing pain in the bottom of your heel, it may be worth getting it checked out. Your plantar fascia ligament may be inflamed, which could be causing your pain.

What is plantar fasciitis?

Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thick, weblike ligament that connects your heel to the front of your foot. It acts as a shock absorber and supports the arch of your foot, helping you walk.

Plantar fasciitis is one of the most common orthopaedic complaints. The plantar fascia can become painful as a result of excessive load, incorrect footwear, a foot injury, prolonged rest for instance after a fracture of the lower limb or through progressive failure of the tissue in itself. The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.

What are the primary symptoms of plantar fasciitis?

The major complaint of those with plantar fasciitis is pain at the bottom of the heel or sometimes at the bottom mid-foot area. It usually affects just one foot, but it can affect both feet.

Pain from plantar fasciitis develops gradually over time. The pain can be dull or sharp. Some people feel a burning or ache on the bottom of the foot extending outward from the heel.

The pain is usually worse in the morning when you take your first steps out of bed, or if you’ve been sitting or lying down for a while. Climbing stairs can be very difficult due to heel stiffness.

After prolonged activity, the pain can flare up due to increased irritation or inflammation. People with plantar fasciitis don’t usually feel pain during the activity, but rather just after stopping.

What causes plantar fasciitis and who gets it?

Plantar fasciitis tends to develop as a result of overstretching or overuse of this ligament, although a tear or small tears in the fascia tissue can also cause the pain. Your foot structure can also predispose you to developing plantar fasciitis.

Active men and women between the ages of 40 and 70 are at the highest risk for developing plantar fasciitis. It’s also slightly more common in women than men. Women who are pregnant often experience bouts of plantar fasciitis, particularly during late pregnancy.

Risk factors

You’re at a greater risk of developing plantar fasciitis if you:

  • are overweight or have obesity. This is due to the increased pressure on your plantar fascia ligaments, especially if you have sudden weight gain.
  • are a long-distance runner.
  • have an active job where you are often on your feet
  • have structural foot issues, such as high arches or flat feet.
  • have tight Achilles tendons, which are the tendons attaching your calf muscles to your heels.
  • often wear shoes with soft soles and poor arch support.

How can we diagnose plantar fasciitis?

Your practitioner will perform a physical exam to check for tenderness in your foot and the exact location of the pain. This is to make sure that the pain isn’t the result of a different foot problem.

During the evaluation, they may ask you to flex your foot while they push on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. They’ll also note if you have mild redness or swelling.

As our feet ultimately support our whole body it is also important to evaluate the strength in the whole lower limb and core muscles as weaknesses higher ‘up the chain’ may contribute to your heel pain.

How is plantar fasciitis treated?

Home treatments like rest, icing and anti-inflammatory drugs are often the first ways to treat plantar fasciitis. If these basic self help measures have no effect then your best option is to come along to be assessed and have a treatment plan put together for you which could include Shockwave Therapy and a prescribed exercise programme.

Shockwave therapy

If pain continues and other methods aren’t working, extracorporeal shock wave therapy can solve the pain issue. In this therapy, sound waves bombard your heel to stimulate healing within the ligament. We have found approx. a 70% success rate with treating plantar fasciitis with ESWT.

Stretching exercises

Specific exercises and stretches can help relieve your heel pain.  Stretching your calves and the plantar fascia itself helps loosen your muscles and reduce heel pain.

It’s important to take time off from certain exercises, like running, to give the plantar fascia time to heal. Swimming and other low-impact activities can let you exercise without worsening your heel pain. When you start running again, be sure to begin slowly.

How long does it take to recover from plantar fasciitis?

For most people, plantar fasciitis improves within a few months of treatments, especially when following the advice and treatment plan from a specialist practitioner.

How can you prevent plantar fasciitis?

Making a few lifestyle changes may help you avoid plantar fasciitis.

Wear supportive shoes with good arch support, and replace your athletic footwear regularly. If you’re a runner, around 400 to 500 miles is the limit for each pair of shoes before you should buy new ones.

Incorporate low-impact exercises into your routine, like swimming or bicycling. Avoid overworking your plantar fascia with very frequent running. Before exercising, be sure to stretch your calves, Achilles tendon, and plantar fascia.

Do your best to stay at a healthy weight. If you’re overweight, try to lose weight to reduce pressure on your plantar fascia.

Achilles Tendinopathy

Achilles tendinopathy is an injury to the band of tissue (tendon) that connects the muscles in your lower leg to your heel bone. You may get pain, stiffness and sometimes swelling around your heel. It’s a common injury, especially if you’re very active or do lots of sports.

About Achilles tendinopathy

Your Achilles tendon is the thickest and strongest tendon in your body. It connects your calf muscle to the bone in your heel, helping you to move your foot when you walk, run, climb or jump.

If you have Achilles tendinopathy, your Achilles tendon becomes damaged and stops working as well as it should. It’s usually damaged through repeated use and injury over time. The damage can make it painful and harder to do your usual activities.

You may sometimes hear Achilles tendinopathy called Achilles tendonitis. This means your tendon is inflamed. But because there isn’t always inflammation when your tendon is injured, this term isn’t strictly accurate.

Achilles tendinopathy symptoms

Achilles tendinopathy can cause several symptoms, including:

  • pain in your heel – this may be an ache or a sharp pain, which feels worse when you’ve been active or put pressure on it
  • stiffness in your tendon – often this is worse first thing in the morning or if you’ve been resting for a while
  • swelling at the back of your ankle
  • tenderness when you touch your tendon
  • a grating noise or creaking feeling (crepitus) when you move your ankle
  • If you feel sudden pain in your heel or calf, this could mean you’ve torn your tendon. This is called an Achilles tendon rupture. You may hear it snap and have trouble bearing any weight on your leg. If this happens, seek urgent medical advice.

Diagnosis of Achilles tendinopathy

Your physiotherapist will ask you about your symptoms and examine your leg, heel and ankle. They may ask you to do a series of movements or exercises to help them see how well you can move your leg. They may squeeze your calf muscle to check the movement of your foot.  They may also ask you about your medical history to check for other related causes or conditions.

Achilles tendinopathy can usually be diagnosed from your symptoms, and you won’t usually need any further investigations.

Causes of Achilles tendinopathy

Achilles tendinopathy is usually caused by overuse – this means repeated stress on your Achilles tendon over time. This can cause changes to the structure of your tendon and sometimes tiny tears, making it weaker.

Any sports or activities that put stress on your Achilles tendon can lead to Achilles tendinopathy. This includes running and anything that involves jumping – for example, dancing, gymnastics, squash and tennis. You may also be more likely to damage your Achilles tendon if you:

  • use badly designed equipment including wearing the wrong footwear
  • have a poor technique or haven’t trained properly for the activity you’re doing
  • suddenly increase how much exercise you do or the intensity of your exercise
  • train on hard or sloping surfaces

Other things that can make you more likely to develop Achilles tendinopathy include:

  • getting older – because your Achilles tendon becomes less flexible and less able to cope with stress
  • having a family history of the condition
  • if you’ve injured your tendon or the muscles around it in the past
  • having certain long-term health conditions such as rheumatoid arthritis, diabetes, high cholesterol or thyroid problems
  • having certain problems affecting your feet or legs
  • being very overweight or obese
  • taking certain medications – for example, antibiotics belonging to the quinolone group; corticosteroids or statins

Achilles tendinopathy treatment

Physiotherapy can help to build up the strength and function in your Achilles tendon.  Depending on the severity and stage of the condition, physiotherapy treatment for patients with an Achilles tendinopathy is vital to hasten the healing process, to ensure an optimal outcome and reduce the likelihood of recurrence. Treatments may often involve:

  • Soft Tissue techniques
  • Shockwave Therapy
  • Stretching programme
  • Joint mobilisations
  • Gait Analysis and Orthotics
  • Taping
  • Hydrotherapy
  • An eccentric loading exercise training programme
  • Progressive rehabilitation programme and return to activity/sports plan
  • Acupuncture
  • Advice/education on optimal tendon loading

Other Conditions

Rheumatoid Arthritis

 

  • Women are three times more likely as men to have RA
  • Over 690,000 people in the UK have RA (that’s almost one in every hundred!)
  • Usually diagnosed in people between the ages of 40 and 60
  • About 1 in 4 people with RA do not realise that with proper treatment they can lead a full and active life.
  • 3 in 5 people have difficulty performing daily activities
  • 70% of people with RA have wrist and hand problems
  • 90% have symptoms in the foot

Data from National Rheumatoid Arthritis Society and the Arthritis National Research Foundation.

What is rheumatoid arthritis?

Rheumatoid arthritis is an inflammatory condition which can affect a number of joints in the body. Usually, the articular surface (lining) and synovium (fluid filled sac covering the joints surface) become inflamed which can then interfere with your normal hobbies or activities of daily living. The inflammation occurs as a result of the body’s immune system attacking various joints although the reason for this is not known. The inflammation may also affect the cartilage and the ligaments within a joint which can be very painful.

 

There are a number of symptoms that may be experienced if you have rheumatoid arthritis and these can vary at different times. Physiotherapy is a very effective way of reducing these symptoms and we have specialist physiotherapists that can provide you with a comprehensive treatment programme that is appropriate to meet your individual needs.

Potential symptoms may include:

  • Pain
  • Swelling of certain joints
  • Stiffness which occurs especially in the mornings
  • Redness over the joints
  • Heat within the joints
  • Unable to carry out your normal activities of daily living
  • Tiredness
  • Anxiety and depression
  • Anaemia (reduced red blood cells)
  • Weight loss
  • Joint instability
  • Deformities
  • Rheumatoid nodules (lumps) over the joints

The most commonly affected joints are:

  • Shoulders
  • Wrists
  • Metacarpophalangeal (MCP) joints (knuckles)
  • Proximal interphalangeal (PIP) joints of the hand (middle joints of fingers)
  • Knees
  • Ankles
  • Proximal interphalangeal (PIP) joints of the foot (middle joints of toes)

Most people with rheumatoid arthritis experience flare ups at different times and it is during those times that symptoms are most severe. Therefore it is important to develop an action plan with your physiotherapist that can help you manage your flare ups most effectively to allow you to remain as active as possible during these times.

How is rheumatoid arthritis diagnosed?

There are a number of tests used to diagnose rheumatoid arthritis and it is often the combined results of these tests that confirm the disease. If you are experiencing any of the symptoms mentioned above, it is important that you go to your GP as soon as possible. Early diagnosis of rheumatoid arthritis will provide a more effective treatment. The tests used include:

  • Blood tests
  • X-rays
  • Ultrasound scanning
  • Number of symptoms

Once rheumatoid arthritis has been confirmed, it is important that you begin physiotherapy as soon as possible to optimise the management of your symptoms. We will provide you with a full assessment and comprehensive treatment programme including a home exercise programme to help you take control of your condition.

How will physiotherapy help with rheumatoid arthritis?

Physiotherapy can help manage and reduce your symptoms in a number of ways. Your physiotherapist will encourage you to take an active role in your treatment programme which will help you to work towards your goals. Physiotherapy can help in the following ways:

  • Pain control
  • Reduce inflammation and joint stiffness
  • Help you to return to your normal activities of daily living or sports
  • Reduce tiredness
  • Increase range of movement at joints
  • Increase muscle strength
  • Relaxation
  • Improve cardiovascular fitness levels

What physiotherapy will be used for rheumatoid arthritis?

There are a variety of physiotherapy options that can be used to treat rheumatoid arthritis. The choice of treatment will depend on a number of reasons including your symptoms and the severity of the condition. Your physiotherapist will work with you to design an individually tailored programme to optimise your treatment and help you remain as active as possible. Potential physiotherapy treatments may include:

  • EMTT
  • Massage
  • Acupuncture
  • Cardiovascular activity (swimming, cycling)
  • Hydrotherapy
  • Range of movement exercises
  • Strengthening exercises
  • Gentle mobilisation techniques

Summary

Rheumatoid arthritis is an inflammatory condition that mainly affects the joints of the shoulder, knee, wrist, hand and foot. The inflammation is caused by an attack of the body’s own immune system on the tissues in these joints. You may experience stiffness, swelling, tiredness and pain as symptoms of rheumatoid arthritis. Physiotherapy is an effective way to reduce these symptoms and helps promote self-management so you can keep doing all the activities of daily living that you usually do.

Call today to book your consultation with either our Lead or Associate Practitioners.

Non-Union Fractures

Most broken bones heal without any problems. After initial treatment, usually new bone tissue forms and connects the broken bone pieces together. However, in some patients some fractures do not heal despite medical treatment. A non-union fracture, also known as a non-healing fracture, occurs when a broken or fractured bone does not heal in the expected period of time.

The expected healing time for each bone can vary – for example, the forearm bones are expected to fully heal in 3-4 months, whereas the thigh bone can take anywhere from 6-12 months. In general, we consider the possibility of a non-union fracture if there is no sign of healing around 6-9 months after the fracture occurs.

What Causes A Non-Union Fracture?

There are a number of different causes as to why a fracture may not heal correctly. Causes for non-union fracture include:

  • Infection at the site of the fracture
  • Inadequate blood supply to the bone
  • Separation of the ends of the bone (during surgery or after surgery)
  • Inadequate surgical stabilisation of the bone

Where Can You Get A Non-Union Fracture?

While non-unions can occur in any bone, the most common bones in which non-union fractures can occur are the tibia, humerus, talus, and fifth metatarsal bone.

What Are The Symptoms Of A Non-Union Fracture?

Most patients will report the following symptoms in a non-union fracture:

  • Swelling
  • Pain
  • Tenderness
  • Instability
  • Limb or joint deformity
  • Difficulty bearing weight

What Are The Types Of Non-Union Fractures?

There are generally 3 types of non-union fractures observed:

  • Hypertrophic: caused by a lack of stability in the fixation used.
  • Atrophic: caused by inadequate immobilisation and inadequate blood supply
  • Eutrophic: caused by a combination of factors.

How Is A Non-Union Fracture Diagnosed?

As part of your hospital visit, you will undergo the following in order to diagnose a non-union fracture:

  • Physical examination
  • Medical history taking
  • X-rays
  • CT scan

An x-ray in particular is useful to help diagnose a non-union fracture. The x-ray will be analysed to look for any signs of union, bone instability, broken metalwork and lucency around the metalwork.

So, how can we help? 

Fractures often heal well, but they can also come with treatable complications such as joint stiffness, muscle weakness, issues with tendons and damage to your nerves.

Effective physiotherapy often involves spending more time treating the injured soft tissues than the fracture itself. The doctors whose primary concern is to manage your fracture can unfortunately overlook these.

An expert musculoskeletal physiotherapy assessment can identify and treat many complications, helping to restore your normal range of movement, strength and function as quickly as possible.

Our expert physiotherapists also have the use of effective evidence based modalities such as shockwave therapy and regenerative therapy which stimulates the body’s own healing mechanism to heal tendon problems.

What should I expect from my rehabilitation?

Your treatment will depend very much on the problems identified during your initial assessment, but may include a mixture of the following:

  • Soft tissue manual therapy, particularly to manage oedema, swelling and trigger points
  • Scar management if you had surgery to fix the fracture
  • Stretching exercises to regain joint range of movement, and optimise muscle length and tone
  • Manual therapy and mobilisations to the joints to assist you in regaining good movement at the joints around the break
  • Structured and progressive strengthening regime
  • Balance and control work and gait (walking) re-education where appropriate
  • Return to sport preparatory work and advice where required.

Our team has access to a well-equipped gym with state of the art equipment. This equipment enables the team to rehabilitate you faster but more importantly effectively, with the aim of reducing any down time.

Booking your assessment & consultation couldn’t be easier:

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