Symptoms of patella tendinopathy

• Pain at the front/bottom of the kneecap
• Thickening of patella tendon
• Pain exacerbated by direct pressure to patella tendon
• Pain exacerbated by quadriceps use
• Pain experienced after exercise
• Calf weakness (sometimes)

It is important to seek treatment in the early stages of the condition otherwise it can become difficult to treat and surgery maybe required.

Patella tendinopathy self help

• Cessation of activities that exacerbate pain.  Fitness can be maintained by undertaking non weight bearing activities; cycling, swimming or hydrotherapy
• Ice therapy

Patella tendinopathy treatment

• Deep tissue friction massage to stimulate circulation and accelerate healing
• Reduction of patella tendon tension via stretching and massage of quadriceps
• Exercise prescription to strengthen other muscle groups of the legs to reduce stress on patella tendon
• Prescription of eccentric quadriceps exercises to accelerate healing
• Osteopathic manipulation of foot joints to improve shock absorbing function of feet to reduce loading on patella tendon

Further patella tendinopathy treatment options

• Ultrasound
• Aprotinin injections to restore enzyme balance within tendon
• Surgery  if conservation treatment is ineffective

• A large Q angle that is associated with wide hips (maltracking therefore more common among females)
• Over-pronating or flat feet
• Genu velum (knock knees)

Patella maltracking is more common amongst individuals who:

• Have a history of patella dislocation
• Participate in lots of high impact exercise
• Have a protruding or small patella
• Are adolescent females (softer patella and large Q angle)
• Have had a recent injury.  The vastus medialis oblique (VMO) muscle on the front-inside of the thigh pulls the knee cap medially (inwards) as the knee straightens. The VMO wastes away quickly with inactivity following injury.

Symptoms of Patella Maltracking

• Swelling possible that is aggravated by activity
• Aching pain at the front and outside of the knee.
• Crepitus – a clicking sound on knee movement
• Pain exacerbated by prolonged periods sitting down
• Pain exacerbated when using stairs especially going down stairs

Patella Maltracking Self Help

• Stretching the muscles on outside aspect of thigh including the ITB (iliotibial band)
• Utilise the R.I.C.E procedure (rest, ice, compression, elevation) to alleviate swelling and inflammation

Patella Maltracking Treatment

• Improvement of knee alignment by
• Reducing Q angle of knee – only possible if this is caused by weakness of the hip abductors and lateral rotators
• Prescription of orthotics to reduce over-pronation of feet
• Equalising forces acting on the patella by reducing ITB tension and strengthening VMO
• Taping knee to improve movement of patella

Plantar Fasciitis Symptoms

• Pain on the underside of the heel that spreads towards to the ball of the foot
• Lumps and nodules around the heel and arch of foot
• Pain usually worse first thing in the morning, easing off after 10-30 minutes
• Pain exacerbated by pulling toes up (extending toes) and lifting foot towards shin (dorsiflexing foot)
• Pain exacerbated when weight-bearing (walking, standing running) and by direct pressure

Plantar Fasciitis Causes

Repetitive strain to the plantar fascia causes it to lose its flexibility and strength and become thickened and inflamed.  Factors that cause repetitive strain include:

• Prolonged standing when at work
• Being over-weight
• Unsupportive footwear
• High impact sporting activity – running, jumping or dancing
• Over pronating feet (feet excessively rolling/flattening when walking/running)
• A forward leaning posture with the bodyweight resting in the balls of feet
• Tightness in the calf muscles
• Stiffness in the foot joints which reduces the shock absorbing properties of the feet

Plantar Fasciitis Self Help

• Rest and reduction of time spent standing, walking and running
• Weight loss (if overweight)
• Rolling a plastic bottle filled with ice under the arch of the foot for 5 mines, 3-4 times per day.  This both stretches the plantar fascia and reduces inflammation
• Calf muscle stretching
• Pulling your foot towards your shin and bending back your toes to stretch the plantar fascia
• Wearing cushioned footwear with good arch support
• Wearing a foot splint when sleeping to stretch and lengthen the plantar fascia
• Taking Glucosamine sulphate supplements may also be of benefit

Plantar Fasciitis Treatment

• Assessment of posture and postural advice
• Improving mechanics of whole leg to reduce forces acting on the foot
• Sports massage to lengthen the plantar fascia and calf muscles
• Deep friction massage of plantar fascia to promote circulation and accelerate healing
• Improve mechanics of the foot
• Prescription of orthotics
• Improving shock absorbing properties of foot by increasing foot joint flexibility

For details of where and when to get an appointment click here.

ITB syndrome symptoms

• Pain located on the outside of knee 2 cm above line of joint
• Pain increased when running, even more so when running downhill
• Pain at maximum with knee flexed (bent) to 20-30 degrees
• Pain increased by pressing into area of pain and bending and straightening the leg

ITB syndrome self help

• Rest and cessation of activities that exacerbate pain i.e. running, downhill running
• Ice therapy to reduce inflammation
• Stretching of iliotibial band
• Self massage using large foam roller

ITB Syndrome treatment

• SPrescription of correct stretching technique
• Prescription of orthotics or an exercises to rectify over pronation of feet

For details of where to we offer appointments click here.

Whiplash symptoms

The symptoms of whiplash usually develop 24-48 hours following injury and include:

• Pain and stiffness (possibly severe) in the neck and shoulders
• Muscle spasm
• Reduced flexibility of neck
• Headache
• Swelling

In a more serious accident the following symptoms may occur.  If experienced immediate medical attention is required.

• Unconsciousness
• Loss of memory
• Arm pain
• Pain located directly on the spine
• Blurred vision
• Dizziness
• Pins and needles, numbness, weakness in the arms or and legs

Whiplash self help

Medical assessment is required before undertaking the following advice.  Once you have received an all clear from medical staff you may:

• Rest with avoidance of any strenuous activity
• Gentle movement and stretching of the neck.  Stretching should not cause pain and should be done as soon as possible following injury
• Anti-inflammatory medication (speak to your doctor or pharmacist about a suitable product)

Whiplash physical therapy

• Stretching of muscles and osteopathic articulation of joints to restore normal flexibility

• Massage to alleviate muscle tension and spasm (important to restore normal circulation to muscles)

• Improvement of posture to lessen strain on neck

Trigger Point Symptoms

• A lump or knot within the muscle
• Increased tension throughout the entire muscle in which the trigger point is located
• Local pain
• Pain that spreads across the back and possibly into the limbs.  This pain can be elicited when trigger point is pressed
• Muscle twitching possible

Trigger Point Self Help

• Stretching of the muscle in which the trigger point is located
• Tennis ball self massage – lie flat on back and place a tennis ball under the trigger point for 30 seconds or more

Trigger Point Treatment

• Deep tissue sports massage to break down knotted muscle fibres and improve circulation to the affected area
• Sustained firm pressure applied to the trigger point with the thumb or elbow (Trigger point Therapy).   This technique is very similar Thai and Shiatsu massage techniques
• Osteopathic spinal and postural analysis to identify the root cause of the repetitive strain causing the formation of the trigger point
• Osteopathic manipulation to release “facilitated”restricted spinal joints that maybe overstimulating the muscle in which the trigger point is found