Injuries :: Shoulder(rotator cuff), Repetitive Strain, tennis Elbow, Frozen Shoulder, Bankart Repair, Calf Injuries, Knee collateral Ligament Injuries

Knee Collateral Ligament Injuries

Collateral ligament sprains of the knee are common. The ligaments run down either side of the knee joint (medial - inside, lateral - outside) and give the knee stability when it is bent. Injury can range from a few torn fibres to complete rupture.

The mechanism of injury is more commonly from a direct blow or fall, though the medial collateral ligament (MCL) can suffer from overuse injury. Initial treatment consists of Rest Ice Compression and Elevation. Gentle range of movement exercises after the first 24-48 hours should be commenced to prevent adhesions in scar tissue.

If symptoms do not settle quickly and swelling persists it would be advisable to see your GP or Physiotherapist for an opinion. These injuries usually respond promptly and well to physiotherapy and sports specific rehabilitation.

Anterior Knee Pain

Often caused by inflammation of the patella tendon or soreness on the under surface of the knee cap, due to poor movement of the knee cap over the joint. Pain is felt at the front of the knee and sometimes either side of the knee cap.

Symptoms are aggravated by squatting, sitting for long periods, stairs and kneeling. Anterior knee pain responds very well to physiotherapy but requires a lot of commitment with home exercises and stretches, along with a very specific set of strengthening and core stability exercises.

Sports massage to help loosen tight thigh muscles is also often helpful, as can biomechanical assessment.

Calf Injuries

Gastrocnemius and Soleus make up the calf muscle. One is stretched with the knee bent and the other with the knee straight so it is important to encompass both when stretching.

A strain of the muscle belly is usually a sudden onset of severe pain, followed with swelling and difficulty pushing off on the affected leg. Chronic strains may be the result of old and poorly healed injuries. The calf strain often occurs as a result of a sudden contraction of calf muscles, for example during a sprint or stepping backwards quickly.

As with all other injuries the immediate administration of a RICED protocol Rest Ice Compression and Elevation is of most benefit. Gentle range of movement exercises after the first 24-48 hours should be commenced to prevent adhesions in scar tissue.

Thumb and finger Injuries

Falling onto the hand or getting the hand stuck in certain positions can cause damage to the ligaments supporting the base of the thumb and fingers. In severe cases they can be completely ruptured and require surgery to repair them.

Partial tears are best treated with a removable splint to provide rest and physiotherapy once healing is well under way to restore range of movement and function.

Like all ligament injuries Rest, Ice, Compression and Elevation will promote best possible recovery. Due to the difficulty in resting hands this can take some time to settle fully.

Tennis Elbow (Lateral Epicondylitis)

Most common in recreational tennis players, the most famous of tennis injuries is typified by pain on the outside (lateral) aspect of the elbow often spreading down the forearm.

The force of the racket repeatedly hitting the ball radiates through the grip and down into the arm, causing trauma to the tissues surrounding the elbow. Incorrect technique, poor grip size selection along with any weakness of or imbalance between, the wrist flexor and extensor muscles will exacerbate this.

Repetitive Strain

The first and most important treatment is rest from the aggravating factor and regular icing (never apply ice directly to the skin - wrap in a damp towel or blanket). Allow at least 2 weeks complete rest and after diagnosis from a professional you should embark on a rehabilitation programme under the supervision of a physiotherapist. The focus of this rehabilitation is to increase strength of the forearm muscles and develop a good extensor/flexor balance.

Shoulder (Rotator Cuff) Tendonitis/Sub-Acromial Bursitis

Rotator Cuff tendonitis is inflammation in the tendons of the rotator cuff muscles and is the most common shoulder disorder.

Shoulder (rotator cuff) tendonitis or bursitis is characterised by pain in shoulder when lifting the arm out to the side of the body (abduction) in front of the body (elevation) or rotating the arm downwards when out to the side (medial rotation).

This causes restriction of movement and if not treated appropriately the pain can become more persistent and particularly severe at night. Eventually, if the condition worsens further problems with the rotator cuff can occur.

Rotator cuff tendonitis and sub-acromial bursitis are initially treated with rest, regular icing and non-steroidal anti-inflammatory drugs (e.g. ibuprofen or diclofenac).

If the problem persists you should make an appointment with a physiotherapist who will check posture and the positioning of the shoulder complex when performing exercises and give specific rehabilitation exercises to perform.

Shin Splints

This is an overuse injury resulting in a number of changes starting with thickening of the overlying fascia, stress reaction in the bone through to stress fracture of the tibia. Pain often occurs in the lower third of the tibia and starts with a dull aching which increases with intensity until relieved with rest, sharp stabbing pains can also be felt during exercise, again settling with rest.

It can progress until walking is painful and the pain is present at night. The condition is often difficult to treat and requires complete rest form running and exercises to maintain strength and improve flexibility of the lower leg muscles. Local treatment and injection can also assist in settling symptoms. Biomechanical assessment and attention to running style also need to be considered.

Achilles Tendonitis

The Achilles tendon is where the calf muscle inserts onto the back of the heel. It is the strongest tendon in the body and can withstand forces up to 1000Kg. There are many different causes of which biomechanics and muscle length are most common. Changes in training and running distances, speeds or time can also cause problems.

Characterised by pain and swelling, often worse first thing in the morning easing off as the day goes on. Physiotherapy is usually necessary and produces excellent results in acute and chronic cases.

Bursitis

Bursitis is inflammation of a bursa (cushion between two muscles). It can commonly occur in the trochanteric bursa at the top of the leg. This can happen due to poor biomechanics, tight muscles, over-use in sporting activities or a leg length discrepancy. Symptoms come on gradually, and present as a diffuse ache or burning pain.

Walking, stairs, sitting with legs crossed and lying on the affected side can reproduce symptoms. Physiotherapy and stretches can help settle symptoms and are important to prevent recurrent episodes.

Deep tissue massage and effective stretching followed by sports specific exercises should ensure a full return to previous levels of activity. Full pain free stretching is a pre-requisite for return to your sport

Back Pain

Back pain may be caused by poor posture, muscle imbalances, excessive weight or by trauma. All of these factors can lead to a general poor 'core stability' - the buzz word in the fitness industry over past years. A lot of stress can then be placed on incorrect musculature and joints through out the back eventually causing pain, discomfort and leading to a degree of disability. Without sufficient strength and flexibility throughout spine, pelvis and hips, problems may worsen.

Rest from aggravating factors and addressing poor posture is the best action to be taken, along with taking non-steroidal anti-inflammatory drugs (e.g. ibuprofen, or diclofenac). It is best to seek medical advice via a GP or a physiotherapist for an accurate diagnosis and provision of an exercises regime to counter the problem.