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SLAP Tears and the Role of Physio

Written by admin on March 8, 2014 — Leave a Comment

A SLAP tear refers to a Superior Labral Tear from anterior to Posterior. This is an injury to the glenoid labrum within the shoulder joint. Symptoms include a aching within the joint, difficulty sleeping and discomfort whilst lying down as well as a perceived catching sensation.

One of our recent patients injured their shoulder parachuting but like lots of patients, they coped with the symptoms until it was exacerbated by another activity. Our patient sought medical advice due to persistent night pain and difficulty performing overhead activities, in this instance, a tennis serve, due to a pinching sensation. Initially they were given an ultrasound guided steroid injection, which relieved the symptoms temporarily.

Very few people return to full capacity without surgical intervention and treatment is normally an arthroscopic SLAP repair. Our patient underwent this surgery and complained of stiffness and discomfort for 3 months with night pain for 6-9 months. However, all these symptoms post surgery are considered normal.

After the operation, patients are advised to wear a sling for 4 weeks with the shoulder immobilised. Your surgeon will then advise you to have Physiotherapy, starting with a range of movement exercises and progressing on to strengthening exercises; 8-10 weeks post surgery. My patient was back in the tennis court playing gentle tennis by 3 months and “good” tennis in 6 months.

Have you recently been diagnosed with a SLAP tear? Are you looking for a highly specialised physio to help you recover? Our physios are able to see you at work or home and we can often arrange the first appointment within 24 hours. Call us on 0207 884 0374 or emailing info@physiocomestoyou.com.

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Posted in Shoulder Pain

What You Need to Know about Developing Your Child’s Fine Motor Skills

Written by admin on March 7, 2014 — Leave a Comment

Fine Motor Skills are the small movements you make when using your hands, fingers and thumbs to complete tasks that require accuracy and precision.  It is important to help develop the hand and finger muscles that are needed to coordinate these movement patterns from an early age. This will help children to be able to feed themselves, dress themselves and eventually write.

Here are some simple ideas to help develop your child’s fine motor skills. Initially your child may need “hand over hand” guidance to be able to complete the task, but gradually reduce the amount of support they need to encourage them to be independent.

0-4 months

  • Encourage your baby to grasp and release toys e.g. bells.

4-12 months

  • Encourage your child to pass a toy from one hand to the other.
  • Picking up raisins, rice or peas using their finger and thumb.  This is called a “pincer grip”.
  • Encourage your child to turn the pages of a book
  • Sorting different shaped toys and stacking rings

1-2 years      

  • Posting – Cut slots into a shoe box lid of varying sizes and orientation and encourage your child to post buttons of different sizes through the holes.
  • Threading beads onto a shoelace to make a necklace.
  • Drawing with one finger in the sand to help isolate the index finger.
  • Rolling, squeezing and poking play dough.
  • Stacking blocks.
  • Playing with insert puzzles
  • Pulling apart Lego or Duplo blocks to help build up strength.
  • Using tweezers to pick up cotton balls and put in a pot.
  • Scribbling on paper using a crayon

2-3 years

  • Making horizontal and vertical marks on paper and progressing on to circles.
  • Weaving thread in and out of holes.

3-4 years

  • Drawing in between lines on a page e.g. a trail
  • Cutting along lines
  • Practicing doing up buttons, zips and laces

Are you concerned about your child’s fine motor skill development?  Our highly specialised paediatric physios are able to see your child at home and we can often arrange the first appointment within 24 hours.  Call us on 0207 884 0374 or email info@physiocomestoyou.com.

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Posted in Paediatric

Fibromyalgia Syndrome and The Role of Physio

Written by admin on March 6, 2014 — Leave a Comment

Fibromyalgia is also called Fibromyalgia Syndrome, FMS, and some of the symptoms include:

  • Difficulties in sleeping
  • Muscle stiffness
  • Extreme tiredness
  • Increased sensitivity to pain
  • Irritable bowel syndrome (IBS)
  • Problems with concentration (known as “fibro-fog”)
  • Localised points of tenderness known as trigger points
  • Anxiety, depression and mood swings

FMS is a condition that can develop after physical or emotional trauma although some people have reported that their symptoms have appeared gradually. It is a central nervous system disorder and there are links to environmental, genetic and psychological factors.  People with FMS can become hyper sensitive and aren’t able to normalise pain as they would normally do.

“I have FMS, how can Physiotherapy help me?”

Physiotherapists specialise in treating and enabling people to manage a variety of complaints ranging from neurological, respiratory and joint and muscle disorders.  We work with all age ranges and abilities in a range of settings.  Physiotherapy has been proven to work with people with FMS and physios at Physiocomestoyou visit patients at their own home or work place for comfort and convenience.  Although there is no known cure for FMS, physiotherapy can help to reduce pain and provide you with tools to self-manage your condition through:

Patient Education and Awareness

Knowing as much information on FMS will allow you to manage your condition better and learn how to pace your daily activities.

Correct Postural Alignment and Working Postures

This ensures efficient muscle function so that further muscular pain is avoided.

Pain Management and Understanding Pain

Physios can instruct you in how to use a TENS machine to relieve pain and can also use acupuncture.  Working with a physio will enable you to understand how pain affects our bodies; for instance, how and when to use cold and heat in pain management.

Activity Management

How to pace day-to-day activities and balance between activity and rest.

Hands-On Treatment

Massage, trigger point release, myofascial release and some mobilisation of stiff joints have been shown to increase range of movement and reduce pain.

Stress Management

Relaxation and breathing techniques are vital in managing your condition.  

Exercises Therapy

There is lots of research that supports the idea that aerobic activity and strengthening exercises are essential in in the management of FMS.  Hydrotherapy and group activities are also very beneficial.

Cognitive Behavioural Management (CBT)

CBT can help you cope/manage with your diagnosis and the way you handle it.

We will provide information, and where possible, research on the above topics. However if you have a particular question that you would like to be answered, then please contact the magazine and we will be happy to help. Alternatively you can arrange to see one of our physiotherapists within your home or work place by calling us on 0207 884 0374 or emailing info@physiocomestoyou.com.

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Posted in Acute and Chronic Pain

Cervical Problems and The Role of Physio

Written by admin on March 4, 2014 — Leave a Comment

The cervical spine is the technical name for the vertebrae that make up your neck.  You may experience radicular neck pain (pain which radiates along the nerves in your neck) or myelopathy (spinal cord) problems in this area.  Consultants such as Mr Jason Harvey, commonly deal with patients suffering from radiculopathy.  This is set of conditions in which one or more nerves are affected and do not work properly.  You can suffer from general symptoms such as radicular pain, weakness, numbness, or difficulty controlling specific muscles.

The most common cervical spine levels that are affected are C5/6 and C6/7 (the first vertebrae that make up the spine) due to them being the most mobile joints in your neck.  Specific symptoms for these levels are:

  • neck pain
  • shoulder pain
  • rotator cuff weakness (the muscles and tendons in your shoulder)
  • shoulder impingement
  • frozen shoulder (where the shoulder becomes painful and stiff)
  • referred neck pain (from other parts of the body)
  • median nerve compression (which may affect your ability to grip with your hands)
  • double crush injury (neck pain with carpal tunnel syndrome which can cause pain, numbness and a tingling in the hand and fingers).

Consultants will use MRI scans, X-rays, nerve block injections and ultrasounds to assist with diagnosing cervical problems, as well as a stage treatment approach of physiotherapy and analgesia (pain relief), followed by injection therapy.  Surgery will be used once all conservative management has been exhausted.  There are two different surgeries that they will consider: cervical discectomy and fusion or cervical disc replacement.  The latter will require physiotherapy afterwards to regain full range of movement and stability around your neck.

For more information on common conditions that affect the spine, and options for treatment, please visit www.spineinfo.co.uk.

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Posted in Neck pain

Get Rid of Stress Once and for All!

Written by admin on February 25, 2014 — Leave a Comment

We all have the stresses and strains of every day life whether that is work, family life or financial stresses.  But did you know that stress causes physical pain?  Symptoms such as headaches/migraines, back ache, muscle tension/cramps, neck ache or tooth/jaw pain can lead to psycho-social behaviour such as increased consumption of alcohol, drugs or cigarettes, over eating or loss of appetite.

Stress can also affect our emotional and mental well being and result in fatigue, anxiety, depression, low self-esteem, emotional outbursts, fear and panic attacks.  Making time for relaxation is therefore paramount.

Here are a few hints and tips to help you de-stress:

  1. If work is stressing you out, talk to your boss about your workload and see if they can help in any way.
  2. Ensure that you take regular breaks from sitting at your desk and drink lots of water.
  3. If home or finances are causing you stress, speak to someone about it, letting other people know that you’re not coping can really help lighten the load.
  4. Try and make time for you, whether that’s taking a walk at lunchtime, going to the gym or just having some ‘you’ time
  5. Exercise can help enormously with reducing stress and physical pain
  6. Deep breathing exercises:  not breathing in the correct way can cause and aggravate issues around the neck
  7. Ensure that you eat well and regularly. Blood sugar levels can drop if you don’t, which in turn can make you feel anxious and more likely to experience stress

Physiotherapy can help by advising on your workstation environment, relaxation technique and as well use acupuncture and massage to address those tight painful muscles or joints. Your physio can also prescribe a suitable exercise program and instruct you in breathing exercises.

Our physios at Physiocomestoyou can also visit you at your home or workplace saving you the time and stress of travel.  To book an appointment, contact us today on 0207 884 0374 or email info@physiocomestoyou.com.

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Posted in Posture, Uncategorized, Workstation Assessments

Vitamin D: Are You Getting Enough?

Written by admin on February 22, 2014 — Leave a Comment

Vitamin DDid you know that a lack of vitamin D can cause and has been associated with:

  • Bone pain and tenderness due to the softening of bones (osteomalacia) in adults.
  • Bone deformities in children such as rickets
  • Muscle weakness
  • Cancer
  • Increased risk of death from cardiovascular disease
  • Cognitive impairment in adults
  • Severe asthma in children

Research also suggests that vitamin D could assist in the prevention and treatment of a number of conditions including diabetes type 1 and 2, hypertension, glucose intolerance and multiple sclerosis.

Most of our vitamin D is made under our skin in reaction to sunlight.  So in the dark, grey, winter months we may not be getting as much as we need. Other reasons why you may not be getting enough vitamin D include:

  • Lack of sunlight
  • Strict vegetarian diet
  • Dark skin
  • Reduced Kidney dysfunction
  • Diseases such as Crohn’s disease, cystic fibrosis and celiac disease can affect body’s ability to absorb vitamin D from the food we eat
  • Obesity

We can also get vitamin D from our food.  Oily fish like salmon, sardines and mackerel, as well as eggs, cheese, beef and liver are all high in vitamin D.

If you suspect you have Vitamin D insufficiency then contact your GP.  Or if you are worried about aches and pains, why not book an appointment with one of our specialist physios to see you at work or home? Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.

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Posted in Uncategorized

Spinal Cord Stimulation and the Role of Physio

Written by admin on February 21, 2014 — 2 Comments

Are you suffering from back pain and have you undergone multiple spinal injections, spinal surgery and sessions of physiotherapy?  Is pain relief the only thing that gives you mild relief, and are your activities of daily living are still limited?  Dr Towlerman at the Fortius Clinic states that 5-6% of patients will still suffer with back pain 5 years after conservative treatment or surgery.  So what else is out there to help you manage your symptoms?

A Spinal Cord Stimulator is a battery-operated device that stimulates the dorsal horn in the spine. Pain radiates up the spine via the dorsal horn and the Stimulator provides pain relief by the pain gate theory.  This states that the spinal cord contains a neurological “gate” that either blocks or allows pain signals to continue onto the brain.  The “gate” is closed to pain signals when sensory nerves are stimulated and their signals travel to the brain quicker than pain nerves.  The Spinal Cord Stimulator provides a TENS like sensation, but unlike the TENS machine your body will not get used to the sensation.  The similarity with the TENS machine is it can be turned on and off, varied in intensity and used during different activities.  Pain consultants believe that the Spinal Cord Stimulator is most effective for patients with chronic back pain, leg pain, chronic regional pain syndrome, refractory angina and piriformis syndrome.

After the stimulator has been inserted, it is recommended that you should have physiotherapy to re-learn normal movement, strengthen your muscles and learn the correct way to perform tasks.  This has shown to reduce the use of the stimulator over time due to the reduction in pain.

Are you looking to work with a physio after having a Spinal Cord Stimulator implant?  Our specialist physios are able to see you at home and we can often arrange the first appointment within 24 hours.  Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.

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Posted in Back pain

Is Your Child Delayed With Their Advanced Gross Motor Skills?

Written by admin on February 20, 2014 — Leave a Comment

Advanced gross motor skills in children include running, skipping, hopping, jumping and climbing.  Children’s development can appear delayed compared to their peers and this can affect self-esteem and cause avoidance behaviour.  To progress advanced gross motor skills, children need the following:

  • Good strength
  • Motor planning skills
  • Reciprocal planning
  • Balance
  • Proprioception (knowing where their joints are in space)
  • Good cognition

Certain conditions can affect a child’s development with advanced gross motor skills such as:

  • Neuromuscular conditions
  • Neurological conditions
  • Developmental coordination disorder (formally known as dyspraxia)
  • Learning disability
  • Musculoskeletal reasons such as low muscle tone and/or joint hypermobility syndrome

However, as children all develop at different speeds and have different strengths, there could actually be no underlying condition!

How Can a Physiotherapist Help?

A physiotherapist will assess your child and compare their abilities to children of a similar age using the Movement Assessment Battery for Children.  They can also rule out any pathology or reasons as listed above and if after an assessment there are concerns, a physiotherapist can refer your child to the correct health professional.  Once problems have been identified, a specific fun activity programme with agreed goals to progress their advanced gross motor skills could be completed!

Do you have concerns about your child’s advanced gross motor skills?  Our specialist physios are able to see your child at school or home and we can often arrange the first appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.

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Posted in Paediatric

Pain in Your Elbow? You Could Have Tennis Elbow

Written by admin on February 15, 2014 — Leave a Comment

Tennis elbow is a common condition and you may even have had it before or known someone who has.  Sometimes it can clear up in no time or at times it can be persistent taking months to settle. Clinically it’s called lateral epicondylitis as the condition affects the outer boney part of the elbow or lateral epicondyle.

If you think you may have tennis elbow, look out for pain, which is felt on the outer aspect of your elbow. You may also get pain performing activities such as picking up items or turning a key.  Bending or straightening your elbow can also be painful.  It’s typically an overuse activity so you may have been playing lots of tennis, typing, decorating or playing a musical instrument.  Muscles that control out wrist and finger movements originate at the elbow, on a spot called the lateral epicondyle. Small tears can occur in these muscles causing weakness and pain and inflammation can also develop.

In treating tennis elbow, firstly ensure that you have a proper diagnosis either from your GP or your physiotherapist. Some other conditions can masquerade as tennis elbow so having the correct diagnosis means receiving the correct advice and treatment.  Carrying out stretches and eccentric (lengthening the muscle) exercises are shown to be effective in treating this condition.  Within 6-8 weeks of completing your exercises you should notice a difference.  Do rest the elbow from aggravating factors, for example, if your mouse at work aggravates it then change hands.  It’s also a good idea to have a workstation assessment to ensure that you’re sitting correctly at your desk.  There are also braces that can help to alleviate some of the pain around your elbow and taking paracetamol and using ice on the area a few times a day can help to reduce the pain.  However, don’t directly apply ice to the skin, wrap it in a tea towel or plastic bag.

Research has shown that physiotherapy can be effective in reducing pain caused by tennis elbow and your physiotherapist can spot and address caustic factors, treating these by mobilising the elbow joint, relieving tight muscles, as well as massaging, using acupuncture, taping and other modalities.

Are you suffering from tennis elbow?  Our highly specialist physios are able to see you at work or at home and we can usually arrange the first appointment within 24 hours.  Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.

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Posted in Acute and Chronic Pain, Sports Physiotherapy

Rheumatoid Arthritis and the Role of Physio

Written by admin on February 14, 2014 — Leave a Comment

Rheumatoid arthritis or RA is an autoimmune disease. Autoimmune diseases are where our body starts to attack itself and in this case it attacks the cells, which line the joints. RA is typical in that people can experience ‘flare ups’ or times when pain, swelling and dysfunction are worse than usual.  These flare-ups can make you feel tired and unwell and in some cases lungs, heart and eyes can be affected.

RA commonly affects the smaller joints of the body first, for instance, the knuckles of the fingers, toes and wrists. The joints can become very swollen, red, hot and painful.  Women are more affected than men and RA usually occurs around 40 to 70 years of age.  RA differs from osteoarthritis in that it’s an inflammatory condition and the former is more of a ‘wear and tear’ disease. However, over time, osteoarthritis can develop as the joints become worn due to the flare-ups.

RA can be difficult to diagnose, as there’s no single test for it. If you suspect that you have RA, make an appointment with your GP. They will carry out an assessment and if suspected, refer you onto a rheumatologist, who will conduct a variety of blood tests and a comprehensive assessment.

If you suspect you have this condition there is lots of help out there. You will be given support and advice how to best manage this condition. One of our physiotherapists can come to your home or work and carry out a full assessment. They look at how you are generally moving, walking and will test the strength of your muscles and flexibility.

We can advise on:

  • Exercises and stretches
  • How to manage your pain, using cooling packs and TENS machines.
  • Treatment such as acupuncture, massage and taping
  • Advice on supports
  • How to pace yourself so not to aggravate your pain.
  • General exercise advice, such as walking and swimming.

If you suspect you have RA speak to your GP or physiotherapist. Further information on RA can be found via the National Rheuamtoid Arthritis Society website at:  http://www.nras.org.uk

If you are newly diagnosed and want one of our specialist physios to see you at home, contact us today on 0207 884 0374 or email info@physiocomestoyou.com.

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Posted in Acute and Chronic Pain
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