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!

Temporo-mandibular Joint pain / TMJ Pain

 

 

TMJ or temporomandibular pain is a common problem affecting the joint connecting the jaw and head. At Core Body Clinic we have been using physiotherapy to treat temporomandibular pain for many years and with great success. There is hope!  TMJ pain can range from an annoyance to a very debilitating condition and seeing a physiotherapist is the right thing to do and is recommended with the support of scientific evidence.  

MY JAW CLICKS!

The TMJ is composed of many parts: the mandible bone, lower jaw, and the temporal bone or Maxilla. In between the mandible and the socket is a disc. The disc is a very smart structure because it allows the joint open and close with a combination of sideways, up, down, and sliding motions. Surrounding the joint are muscles and ligaments and the TMJ is also supplied by nerves and therefore can be a source of pain.  Because of the location and innervation of the nerves the TMJ refers pain into the jaw, teeth, side of head, face, eye and even the neck.  It can be very unpleasant.  

When we assess a patient with TMJ pain we often find: reduced jaw movement, tenderness around the muscles of the jaw, limited neck and upper spine motion with loss or uneven motion of the upper spinal joints. People often grind their teeth so the muscles are very tired and fatigued with lots of tender trigger points. Its important to diagnose the areas that are causing the pain so that treatment can be effectively targeted. 

 

 

 

 

MY JAW GETS STUCK!

Where do you feel TMJ Pain?

  • Pain in the jaw joints and facial muscles
  • Clicking, grinding (bruxing/bruxism)
  • locking of the jaw
  • Headaches & Dizziness
  • Difficulty opening or closing the mouth comfortably
  • Pain on talking, chewing (especially hard food) & yawning
  • Ear pain, ringing in the ears (tinnitus) & hearing loss

I CANT CHEW PROPERLY!

What Causes it?

  • Trauma direct to the face/head
  • Poor neck, back and head posture
  • Weak neck, shoulder and back muscles
  • Recent illness
  • Wisdom tooth pain or dental pain altering jaw mechanics
  • Injury when chewing or overuse
  • Opening you mouth for too long and too wide
  • Arthritis
  • Stress which causes teeth grinding.
  •  

I have a Headache and grind my teeth. 

 

How is it diagnosed?

  • Signs and symptoms
  • Diagnosis by a Maxillofacial surgeon or Dentist
  • Xray/Scan

 

What can physiotherapy do for Temporomandibular pain?

  • Assessment and correction of posture
  • Work with your dentist who will likely provide a mouth guard
  • Provide manipulative and hands on treatment for pain
  • Improve muscle strength
  • Corrected alignment of spine and jaw
  • Release muscles that are in spasm
  • Teach correct mouth opening and closing
  • Apply preventative treatment 

 

What techniques are used to treat temporomandibular pain?

  • Manipulation of the jaw and spine
  • Trigger point release
  • Acupuncture and electro-acupuncture
  • Ultrasound therapy
  • Relaxation
  • Stretching

 

If you are unsure if physiotherapy for temporomandibular pain is the right choice just drop us a line or email the clinic.  We suggest booking an initial assessment for us to firstly assess your jaw pain and then start sorting it out. 

 

 

 

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.  This condition is common in runners and active people.  It can also be seen in the elderly and those who are over weight. 

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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 Clinic

Achilles Tendon

 

  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.

There are two types of Achilles tendon pain: Mid portion Tendinopathy and Insertional Tendinopathy.

The mid portion one is the most commonly injured part of the tendon.  People often present with pain after they have been running and start to develop pain in the region or they may feel a sudden onset of pain in the tendon.  They typically find the tendon becomes stiff when first walking in the morning and they may have pain when running or after running.  On occasions, there is severe pain and you are not able to run.  

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 as the tendon tries to heal itself. 

 

Symptoms:

  1. Pain in the middle of the tendon 
  2. Pain on running
  3. Pain may get better or worse with activity
  4. Pain in the morning for the first 5 or 100 steps
  5. Pain on descending the stairs.
  6. Pain on hopping

 

What you will not have:

With Achilles diagnosis you will not experience burning pain and Pins and needles

You also will not suffer pain shooting up the leg and into the back

 

Assessment:

At Core Body Clinic we have a dedicated Tendon clinic for assessing the Achilles tendon.  We use a combination of history (what happened), examination and also Ultrasound Scanning.  The scan helps us to understand to what extent the tendon is damaged and this provides you with a prognosis.  We will use a battery of tests to diagnose your problem with checks of your balance, knee alignment during function, foot posture and strength.  

 

 

 

 

 

 

 

We will also check your hamstring strength and length, hip flexor length and also the ranges of movement in your spine.

We will look at calf strength and ankle flexibility and probably give the tendon a poke and prod.  While this helps to show us where the issue is it does not tell us

 

Treatment:

We know that activity is good for tendons. They love it! But in the early stages gentle massage, rest, ultrasound (big placebo but can be therapeutic), taping, R.I.C.E and Anti-inflammatories (NSAIDS) can all help.  But none of these will sort your tendon out.

Once we have confirmed diagnosis we will set about prescribing a bespoke plan of action to get you back to your normal functional level.

Isometric exercises are thought to be helpful by contracting the calf muscle, like a heel raise and holding the position for 30-60 seconds.  

Graduated exercises are the main stay once pain begins to settle. These are carefully constructed and prescribed in consistency with your pain. Over doing the exercises too quickly will land you back to square one. They need to be gradual and increase in load so that getting you back to climbing the stairs or Everest is a smooth pathway of recovery

Massage and Ultrasound can be helpful but we know tendons need LOAD to rebuild themselves so unfortunately while we can’t rub it better, direct therapy can help in the short term.

For more difficult tendon pains we can use Shockwave therapy. 

We may also use taping if you are struggling with pain and orthotics if we feel your footwear is a factor in your Achilles Tendon pain. 

Return to Running

At Core Body Clinic the focus of our Sports Physiotherapists is to work with you to get you back running.  We will NEVER say don’t run unless we truly belive it will do you harm.  If you are a keen runner then we will aim to get you running again at the earliest possible convenience.

We can manage your pain and symptoms with effective strategies like appropriate footwear, taping, load management (how much running and how much exercise you should do) and direct therapies (Massage, ultrasound).

Graduated running is KEY.  Start small.  Walk for 5 minutes, run for 5 minutes, walk, run, walk, run – get the picture? The tendon essentially stores kinetic energy and if in a state of reaction it will become more tender and painful over the time of the run.  Key is to stop before it becomes too sensitised.

Avoid hills to begin with (Hard to do in Reading and Tilehurst!) and have no expectations.  You may need a week or two off.  Aqua jogging is a great alternative early on and changing activity to cycling can be a great way to keep your cardio fitness up.

 

 

Shoulder Pain

Physiotherapists understand the shoulder and more importantly - how to get it better!  The shoulder can hurt for many reasons.  

Common diagnosis include:

  1. Impingement
  2. rotator cuff tear
  3. Bursitis tendonitis
  4. Frozen Shoulder

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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. 

 

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