Reading and Tilehurst's Physiotherapy, Spinal and Sports Specialists

"Treating the cause to help you move pain free and perform better"

Tilehurst Clinic 4 Chapel Hill, RG31 5DG
Reading Clinic Sports Park, University of Reading, RG6 6UR

  

Booking Line: 0118 9310053 

 

 

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Conditions Treated

Physiotherapy provides solutions and treatments for an extensive range of conditions, from neck and back pain to sciatica and plantarfasciitis. Details on some of the common injuries and conditions treated by our physiotherapists at Core Body Clinic can be found below - read on to find out about the symptoms, signs and possible treatments.  This information is not a substitute for assessment and diagnosis by an appropriate clinician.  Get in touch with our Reading clinic today and start the recovery process!

Knee injury - ACL

As physiotherapists we are no strangers to the knee joint and the many different injuries that occur.  Serious knee injuries are associated with team sports/games.  The unpredictable nature of an opponent in a defence or attacking mode of play make for a challenging situation that, while not predisposing a player to injury, certainly places he/she in a risk category. 

The ACL or anterior cruciate ligament is a highly specialised ligament that sits inside the knee and it functions to provide stability during activity and more specifically provides information to the brain concerning knee movements. 

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Shoulder Dislocation

Physiotherapy is key after Shoulder dislocation. The injury describes the dislodging of the humeral head from the glenoid fossa, the two bony anatomical structures that make up the shoulder joint. 

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Headache Pain - Cervico-Genic, Tension, Migraines

Physiotherapy is an effective tool for dealing with Headaches.  Headaches are frequently misunderstood and therefore mismanaged. There have been some 300 different types of headaches described, from well known ‘migraine’ to the more ridiculous ‘chewing gum’ headache.  The Physiotherapists at Core Body Clinic 'know' how to differentiate, diagnose and rehabilitate headache syndromes. 

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Neck Pain

Physiotherapy is brilliant for Neck pain.  The condition affects the upper spine and we often refer to it as cervical spondylosis which is a term relating to degeneration in the spinal joints.  

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Slipped Disc

Physiotherapy is highly effective for the treatment of Discs.  A slipped disc relates to excessive movement in the intervertebral disc (IVD) causing the disc to bulge or herniate. 

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Achilles Tendon Pain

Achilles Tendinopathy 

 

  Running Clinic     Sports Physiotherapy      Treatment

 

Formally known as Achilles Tendonitis the new and preferred term for pain in the Achilles region is ‘Tendinopathy’.  This essentially means Painful Tendon.  Helpful diagnosis!

Now, there are two types of tendon pain: Mid portion Tendinopathy and Insertional Tendinopathy.  Now don’t get too worried about diagnosis as that’s our job to identify and diagnose it appropriately.

The mid portion one is the most common to folk and while there are risk factors it seems absolutely anyone could get this condition.

When a tendon becomes painful it appears to ‘react’ to the load or exercise it has been exposed to.  This loading causes pain.  The tendon essentially becomes intolerant to the exercise and activates nerves to tell your brain. The result is pain! 

Tendons are composed of tenocytes and are therefore structurally different from other tissues in the body.  Initially, there is some inflammation but it appears this is not the main driving force behind the condition.  Because of pain, the calf muscle (in the case of the Achilles) is not able to deliver as much force or contraction. The tendon is loaded to a lesser extent and over time becomes ‘deconditioned’.  The tenocyte matrix is less organised and is again less tolerant to loading. There may be the presence of different cells like proteoglycans which are big sponges and can give the tendon its inflamed appearance.  There is also a suggestion of scar tissue build up but again this is to a lesser extent and perhaps a too simple a model of how the tendon heals itself. 

There does not to be an association between tendon pain in the Achilles and the tendon snapping.  If there is a tendon rupture then this appears to be an acute event without preceding pain.  

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Shoulder Pain

Physiotherapists understand the shoulder and more importantly - how to get it better!  The shoulder can hurt for many reasons.  Common diagnosis include: 'Impingement', 'cuff tear', 'Bursitis' and 'tendonitis'. 

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Lower Back Pain

Physiotherapy should be considered as treatment for back pain in the first few days of onset.  It is a VERY common condition and is characterised by pain emanating from the lower back, pelvis and buttock region.  The Physiotherapists at Core Body Clinic we are experts and well known for treating back pain.

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Plantarfasciitis

Physiotherapy is very effective for Plantarfasciits, a condition characterised by pain on the sole of the foot usually located around the heel or inner arch. We tend to more accurately refer to it as Planter fascia heel pain or Planterfasciopathy. The reason for a change in name is to reflect the current thinking in management strategies. Like Achilles Tendinopathy we tend not to associate planter heel pain with inflammation. Management approaches that have historically focussed on inflammation have not had the greatest of success. The condition, while painful, does not appear to exhibit much in the way of inflammatory markers and thus we must adopt a different treatment pathway or risk prolonging recovery. 

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Medial Tibial Stress Syndrome (MTSS)

 

A.K.A. “Shin splints”

 

                                                              Running Clinic                        Sports Physiotherapy                                 

Common in runners to varying degrees, medial “shin splints” is a generic term given to pain on the inside of the lower leg.  Essentially, on the medial (inside) aspect of the tibia. Medial tibial stress syndrome is perhaps a more appropriate term since is describes exactly what is going on – Stress!  Its a condition associated with over training and is therefore common place for some individuals. 

Historically, it was thought to be the result of periositis or inflammation of the periosteum or membrane that surrounds the bone for muscle and tendon attachment.  However, histological studies failed to identify any signs of such pathology.  We now know that the stress causes breakdown in the balance of bony production and remodelling.  Resorption of bone outpaces the formation of bone in the tibial cortex.  Oddly, the physical exam is enough for diagnosis.  MRI, Xray and CT add little value in how to manage it.

Because of the loss in balance between production and resorption of bone there appears to be a factor of over-training involved. So, train too much and too often with little rest and you might end up with MTSS.

 

Risk Factors:

  1. Female athletes have greater likilhood for development
  2. Possibly greater pronation or loss in its control
  3. There is a relationship between excessive hip rotation
  4. Body Mass Index (BMI)
  5. Previous history of pain in the same region

 

Assessment:

At Core Body Clinic we subjectively assess every patient so you can tell us about the pain, its behaviour and how it started. We will assess training methods to ensure we correct training mistakes and ensure they don’t happen again.  We screen every patient who comes through the door for biomechanical factors.  We look at whole lower chain biomechanics and also assess footwear.  Poorly fitting shoes can cause the lower chain to behave in a very different way and therefore make your nervous system and muscles work a lot harder.  The result is an eventual failure and a loss of purposeful and appropriate functional posture. The tissues are abnormally loaded and pose a risk to MTSS.  We look at running styles as part of our specialised Running Clinic but more importantly we assess muscle length, strength and endurance to give us a clearer picture of how your body functions during sport.

 

Symptoms:

  1. Pain in the lower medial 1/3rd of the tibia
  2. Pain on running with the foot striking the floor or on foot take off
  3. Pain with descending stairs more than ascending
  4. Pain in the morning with the first steps
  5. In severe cases the patient may wake at night

 

Treatment:

After diagnosis the first line is to re-schedule your training regime.  Correct over training methods and work out a plan for appropriate rest and then graduated return to activity.

Correction of foot biomechanics using tape, orthotics or change of shoes is highly effective at reducing pain and preventing future problems.

Massage and dry needling have been shown in our clinic to be effective in reducing pain in the short term.

Graduated strengthening of local and global muscles – from the foot to the head…….we kid you not! What good is a strong ankle if your neck fatigues and you cant balance properly??? – not thought of that? Well, maybe not quite but the theory is a good one.  Essentially we are saying we like our patients to think about every aspect of their training before returning to sport.

 

Prognosis:

A couple of week off of running is usually enough to start a graduated return to running program.  We recommend for moderate cases that a 6 week program be followed. More severe cases need to follow a more graduated regime to ensure the problem does not return. Remember, this is bone stress and not just a muscle pull.  

 

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