At Core Body Clinic, Reading we balance our physiotherapy treatments to include 'Hands on' and manipulative therapies coupled with education, activity pacing and exercise to combine the very best in evidence based practice. We also know that experience counts and the 'when to use and not to use' are important factors that research can not always help us with. Research does not always help us with the 'individual' so we use evidence as a guide and apply our clinical experience to determine the best physiotherapy treatments. Our range of treatments include:
Our injections service in Reading and Tilehurst is very unique because we are one of the few clinics in the UK where we can assess, prescribe and inject during one session. Our injection and diagnostic specialist uses only Ultrasound to guide the injection and only after conducting a thorough examination, history and ultrasound scan. The steroid injection service in Reading and Tilehurst is a fast one stop clinic where you can bypass your GP or ask your GP to refer to our speciliasts where you can receive all your care in one place. All our practices are with the highest standards.
When to use Steroid injections (Corticosteroid) ?
Corticosteroid injections are used when there is chronic inflammation within a joint or around a tendon that is not settling within normal time limits, typically 8-12 weeks. Corticosteroid is a naturally occurring hormone within the body. It is a powerful anti-inflammatory and is very effective at
reducing the pain of inflamed areas.
Many people associate corticosteroids with only short-term relief and there are many negative reports in the media regarding steroids. There are some truths in this, however when used correctly in small doses they often provide fast-acting long-term solutions for many conditions.
In particular corticosteroids are excellent for:
· Wrist Pain
Our injection therapist is a leader in his field and is a specilaist scanner and uses Ultrasound to accurately identify the lesion before the injection is administered. (Please note an extra charge is made for the Scan prior to the injeciton).
We use the latest in injection techniques and only deliver the injection where we know it will make a difference.
ALL of our injections are Ultrasound guided. Research has shown significantly better outcomes when using guided versus unguided injections simply because you can be sure to target the specific injury.
"Getting a scan is your gateway to the correct treatment and could save you time and money!"
Over the past 10 years diagnostic ultrasound technology has improved greatly and is now considered better than MRI for visualising many tendons, ligaments and muscle injuries. The advantage of ultrasound imaging is the real-time fast diagnosis of injuries. Patients can expect to see their injuries on screen during their appointment. This means that treatment can be specifically targeted to individual problems allowing a more effective rehabilitation process. Ultrasound is also very safe as there is no radiation unlike X-ray and CT scans. At Core Body Clinic we use it to diagnose tendon and MSK pain in additon to training and assessing the pelvic floor.
"Get a diagnosis that is correct!"
Who performs our ultrasound scans?
Our diagnostic ultrasound scans are performed by our expert MSK Physiotherapist Jonathan Wride (https://www.curephysio.co.uk/). Jonathan is a dual qualified experienced physiotherapist and Musculoskeletal sonographer having completed extensive post-graduate education to specialise in muscle, joint and tendon injuries. Pelvic Floor scans are conducted by Adrian Wagtsaff, Clinic Director.
The advantage of an expert physiotherapist performing your ultrasound scan is that you can expect a full verbal consultation,physical assessment and ultrasound scan. Having a complete physical assessment and diagnostic scan means an effective treatment plan can be implemented from day one, getting you back from injury as soon as possible. We are happy to liaise with your personal therapist if you are receiving treatment at another clinic.
What to expect?
For the ultrasound scan the injured body part will need to be exposed. Patients are encouraged to dress accordingly for a scan. If you have a lower limb injury then it is requested you bring a pair of shorts with you. For shoulder injuries vest tops are preferable.
The physiotherapist will take a full history of your problem and then perform a physical assessment, which will involve moving the injured region and testing strength of the area. The area will then be scanned with all findings explained at the end of the consultation. This will include a treatment plan or onwards referral for further imaging or specialist review as required.
What is Diagnostic Ultrasound Useful for?
Diagnostic ultrasound is ideal for evaluating the following areas:
Rotator cuff tears
What do we not use ultrasound scans for:
Lumps and Bumps
The abdominal Region
You are advised to see your GP for this. A letter of referral will be supplied if such annomolies are identifed.
Do I need a GP referral?
No. You can book yourself in for an ultrasound scan without a referral from a healthcare professional. However, your GP may refer to our clinic.
Do I need an Ultrasound scan?
If you are unsure if you require an ultrasound scan then contact the clinic for a free phone consultation to discuss you injury. We are more than happy to direct you towards the best pathway for you.
In the video above we can see the bladder working to contract the pelvic muscles. We can accurately check for timing, strength and appropriate contractions. Patients who benefit from this include both male and female patients with conditions treated listed below (note – not limited to).
Pelvic Floor Re-training
If you would like to find out more then please email or call the clinic.
Prevention is better than cure and we firmly believe in making sure all our mum's are fit physically and are not suffering from pelvic girdle pain or dysfunction. That's why we run a mummy check service. You can book this by selecting the Women's Health Physiotherapy option online or by calling the clinic. We want you to be confident when coughing and sneezing after you have had your baby and this is why we are following government guidelines and best evidence based practice by offering this service.
Everyone wants to be there absolute best when pregnant and we want to support you as and when you need us. We see many women with pregnancy back pain, neck pain, joint pain and sciatica. This is quite common and something we can help with.
After your baby, the last thing you think about is YOU! Believe us - we have had children and we know what it does to the body.
After the celebrations have settled and you are merely feeding, walking and enjoying your baby, ask yourself - "am I ok?"
After 6 weeks your body will be getting back to normal. Your stomach muscles will be making their way back to becoming one again, your pelvic muscles will be feeling less stretched and you will start to get more energy (though this is because you are getting used to being a parent and sleepless nights are becoming the norm). Your pelvic muscles should get back to normal. But, after a good stretch and months of a baby pressing down on the bladder there may be some weaknesses that persist. The other thing to consider is that, while the womb contracts and the pelvic anatomy go through some changes with dilation and distension, the passage of the baby may cause stretching. This may not revert back to its normal length. Some women experience trauma and in these cases the tissues in the vagina become stretched leading to alterations that may not improve over time and without specialist assessment. Seeing a women’s health physiotherapist could help you identify a prolapse early on and prevent this from stretching further and weakening over time. It will also help you answer some important questions:
When should I exercise? How hard?
We advise a 6-week check to make sure everything is ok and that you know what you are doing to help your body recover. Think of it like a MUMMY CHECK.
What about if its past 6 weeks and how do you know you are better and back to normal?
Try these simple questions:
How strong do you feel and how long is reasonable before your pelvic floor gets back to normal?
Do you feel confident laughing or coughing?
Are you resuming intercourse with confidence?
Can you get on a trampoline?
Does running feel comfortable?
Do you think your pelvic floor is strong?
Do you think its ok to have a weak pelvic floor?
If you have answered any of the above, then you need to have an assessment by a women’s health physiotherapist.
Checks are simple and straightforward and will save you money and time in the future by preventing a weak pelvic floor from getting weaker.
If you would like to come and see us for a Mummy Check then book in a Women’s Health Assessment for 1 hour and get yourself on the track to recovery.
Core Body Clinic is now working in partnership with Formthotics to deliver this fantastic product.
Formthotics insole orthotic solutions have been in use for the last 30 years and have provided physiotherapists with an immediate solution to foot, ankle and lower limb biomechanical problems. These easy to apply and low-cost insoles can be added during your consultation to remedy an endless number lower limb problems.
At Core Body Clinic we are trained to assess foot and lower limb posture to determine whether the Formthotics solution is right for you. We have used this product oursleves for nearly 15 years after Adrian Wagstaff worked in New Zealand and was introduced to the founder of the Formthotics system, Dr Charlie Baycroft. Dr Baycroft wanted a simple solution for his patients. Adrian was amazed by the low-cost alternative to the costly and often over priced custom built insoles that offer little over these easy to fit orthotic solutions. Adrian who has worn insoles himself for ankle and knee pain for the last 20 years gives his full backing after dicovering this product while in New Zealand. He has not been able to recommend another product over this one in 15 years.
These easy to fit insoles can be molded to your shoes and more importantly to your foot in a matter of minutes using a special heat molding machine that we have at both our clinics in Reading and Tilehurst. This saves time, allows you to rehabilitate pain free instead of waiting The machine softens the insoles cauing them to deepen at the appropriate sites to allow the foot to be manipulated, dropping the joint of the big toe down and supporting the instep of the foot, therby creating an arch support.
Using foot lowerr limb biomechanical knowledge, it is possible to influence the foot and dramatically enhance the efficiancy of the lowerr limb allowing a quick solution to running and lower limb pain.
Formthotics can be fitted to almost any shoe from ski boot to work shoe, from welly boot to running trainer. We use a combination of tests to understand how your leg moves and foot distorts through walking and running. It is essential that we fit the correctly shaped orthotic with the appropriate firmness, width and for the activity type.
Your trainer or sports shoe may have come with an insole. The firmness and quality will depend greatly on the shoe manufacturer. Over the years, products have been released to the market with a lesser quality insole with many company’s opting to leave the decision for the individual as to whether they continue to use the insole already with the shoe or a more custom fitted product.
What can Formthitics be used for?
Achilles Tenonitis / Tendinopathy
Knee pain / Patella pain
Lower Back Pain (where there is a clear biomechanical issue)
Bursitis of the Hip and Knee
Insoles are often used in combination with a treatment regime to help you to continue to train, function or rehabilitate with less pain. It is sometimes necessary to continue to wear the insoles long after your treatment is complete. Some patients may only require the insoles for a short period and the product can be removed after treatment is complete. However, the mechanical and preventative properties of the Formthotic system means you may continue to use the system because of the enhanced mechanical posture of the foot and lower limb. We often recommend you extend these benefits to all walks of your life by fitting formthotics to all of your shoes.
What does the reseach say?
Research has proven Formthotics™ to be effective in reducing pain, treating and preventing injuries and improving patient comfort. In many cases they have been found to be as good, and in some cases better, than custom casted orthotics in the treatment of lower extremity dysfunction.
Larsen et. al 2002 found that customised Formthotics™ drastically decreased incidence of back pain by 20% and lower limb injury such as shin splints by over 10% in military recruits.
Improving foot function and minimising pain
Chia et al. 2009 and Landorf et. al 2006 found Formthotics™ to be very successful in the treatment of plantar fasciitis. Formthotics™ decreased plantar peak forces significantly providing better relief of symptoms than both custom moulded orthotics and competitor pre-fabricated products. Both these studies also found Formthotics™ improve general foot function and minimised pain, improving patient comfort.
Strengthening muscles and tendons
Formthotics™ also encourage “flat feet” to function more like that of a normal arched foot, in turn preventing injury through strengthening otherwise at risk muscles and tendons. This was confirmed by Murley et.al 2010 who compared activity of tibialis posterior and peroneus longus in those with flat feet with Formthotics™ and custom casted devices. He found that tibial posterior activity was significantly increased with use of both types of orthotics, however only Formthotics™ showed improvement of peroneus longus.
The cost of the custom insole formthotic system: £45 (this is in addition to the session your are attending. It is a medical device and may not be covered by your insurer).
Cortisone is the name of a group of medicines that are very strong anti-inflammatories. Corticosteroids are naturally occurring hormones already present within the human body, they are very different to anabolic steroids as used by some bodybuilders. Cortisone can help reduce the pain of a tendon, joint or nerve that is inflamed.
How is cortisone given?
Cortisone can be taken by mouth but an injection is usually more effective as the medication is placed exactly where it is needed, meaning smaller doses can be used. Typically steroids are placed around a chronically inflamed tendon or joint.
What conditions are treated with cortisone?
Most painful tendons can be treated effectively with cortisone injections. Inflammatory joint pain from osteoarthritis can be rapidly reduced with cortisone, as can nerve inflammation such as carpal tunnel syndrome. Some of the common conditions include:
Carpel Tunnel Syndrome
Is cortisone a cure or a temporary fix?
Cortisone can be a cure for any pain that is entirely due to an inflamed structure such as frozen shoulder and tenosynovitis.
Cortisone can also be a temporary fix for any pain that is due to a minor injury but the patient is unable to take the required time for the injury to heal itself. For example with Golfers elbow in elite sports players who are required to continue with their sports activities.
How frequently can cortisone be given?
There are no lifetime limits on cortisone injections however expert medical consensus suggests there should be a 3 month gap between the administration of cortisone. Typically if you do require more than 2 cortisone injections then you may be advised to consider other treatment options.
It is important to understand that cortisone is an excellent way to reduce pain quickly in order to engage in a rehabilitation programme, which will provide the long-term solution to most problems.
Will the injection hurt?
Minor discomfort is common however the vast majority of patients report the injection was far less painful than they thought. The use of ultrasound to guide injections helps significantly reduce pain as the target structure can be accurately located with minimal needle movements.
Are there any complications?
Short term: A small number of people will experience a temporary increase in their pain as the cortisone is working. This is nothing to be concerned about and will pass after 24-48 hours.
Long Term: Too many cortisone injections can cause tendon damage or worsening osteoarthritis. If you are concerned about this then your practitioner will be happy to discuss your specific case with you.
Many patients are concerned that steroid injections will make them gain weight. This is extremely unlikely after a corticosteroid injection as the doses are very small in comparison to oral steroids.
What can I expect from the Injection?
The cortisone is mixed with a local anaesthetic so you will usually experience a mild numbness and pain relief for a few hours. When the local anaesthetic wears off many people experience a dull ache or throbbing sensation. A small percentage of people will get a temporary increase in their pain; know as a ‘steroid flare’. This is nothing to be concerned about and painkillers such as paracetamol can be used to help calm symptoms, this will settle quickly.
It is often best to consider driving arrangements after an injection as the local anaesthetic can cause some localised numbness, therefore driving may be best avoided.
If you are having a joint injected then it is advised to avoid strenuous activity for at least 2 days. If an inflamed tendon is to be injected then 10-14 days of relative rest from sport activities is recommended.
Cortisone will actively work to reduce your inflammation for 21 days. This means that the benefits of cortisone are seen within 3 weeks. The vast majority of people will start to feel benefits within 7 days after the injection.
When used appropriately cortisone is very effective and safe and has been used for decades in medicine. It is used around the world as one of the most trusted methods to treat a majority of joint, tendon and nerve pain.
Electro-acupunctureChronic PainSciaticaNeuro-pathic PainTennis Elbow HIp PainKnee & Hip ArthtritisTendon PainHeadache
Electro-Acupuncture (EA) is the technique of combining normal acupuncture, or dry needling, with the application of an electro stimulus delivered through the needles and into the skin. Conventional acupuncture requires manual stimulation and surface TENS does not penetrate the skin. EA has the potential for profound effects on the nervous system. Electro-acupuncture is a highly effective modality and has been used for decades to treat stubborn conditions. At Core Body Clinic we use it to treat several problems and find it particularly useful in knee arthritis, tennis elbow, sciatica and headaches. Manual needle stimulation works by driving an immune response in the body and increasing the concentration of endorphins thereby suppressing the levels of cortisol, a stress hormone. The aim is to lower the sensitivity of the nervous system and reduce pain. Conditions like sciatica or more chronic and long-term problems where the pain might be neuropathic, EA has been found to be more effective at stimulatind the brain to release neuro chemicals an essentially place a filter to prevent overwhelming the pain centres in the brain.
Electro-acupuncture has the potential to enhance the concentration of endorphins within the body by heightening the stimulus offered by conventional acupuncture. Essentially, making the nervous system aware that every needle is present during the therapy session. With conventional acupuncture, the patient loses the sense that a needle is in situ. With electro stimulation the patient is constantly aware that the needles are providing a stimulus. This enables a continued drive of endorphin release with the aim of providing a longer and much larger treatment effect. Electro-acupuncture has the potential to offer a patient who has previously had a poor response to therapy or conventional acupuncture the chance of pain relief.
Electro-acupuncture has been shown in many studies to provide relief superior to conventional acupuncture. The machine uses different frequencies depending on the type, nature and intensity of the problem. We can be-spoke the dosage specific to the patient and their problem. The technique is different to TENS because the needles are often placed directly into the nerve and blood rich muscle tissue thereby directly influencing the central nervous system.
All needles are sterile, and treatment is only carried out by a certified practitioner. Typically, you will need 6 sessions to build up enough endorphins to see an effect with most patients experiencing a 50% reduction in pain after their first treatment. Treatments can be carried out weekly and then followed up fortnightly and monthly. The exact course of treatment is determined by the nature of the problem and the treatment plan. A one hour session is required for every appointment.
Extracorporeal shockwave therapy uses high-powered sound waves to stimulate the healing of chronically injured tissues. Shockwave therapy has been used in medicine for over 20 years and has a large body of evidence proving its effectiveness at treating many chronic tendinopathies. Shockwave therapy has been adapted from lithotripsy treatment that is still used today as a treatment to break down kidney stones. Shockwave therapy is very different from ultrasound therapy and can mechanically stimulate tissues deep within the body unlike other types of sound wave therapies.
How does shockwave therapy work?
Shockwave therapy works through a variety of biological mechanisms. The powerful sound waves created by the therapy have been shown to cause a cellular level vibration within injured tissues that have a number of beneficial effects:
Increased blood flow to tissues that promotes healing of chronic injuries.
Stimulates the production of fibroblast cells. Fibroblasts are the cells that promote tendon health through collagen production.
Induces a controlled inflammatory reaction within tissues that re-stimulates the healing of injuries that are failing to heal.
Improves the health of bones through direct mechanical stimulation and has been shown to be very effective at healing non-union fractures.
Highly effective at relieving pain in tissues that have been painful for a long period of time, typically over 12 weeks. The shockwaves do this through reducing the chemical substance P and decreasing the sensitivity of tissues permanently.
CLICK ON THE VIDEO BELOW:
When Should You Consider Shockwave Therapy?
If you have been suffering with a tendon problem for over 12 weeks.
If you have tried normal stretching and physiotherapy treatment for 3 months and your pain does not seem to be improving.
If you have been diagnosed with one of the following conditions:
Calcific Rotator cuff tendinitis
What are the success rates of shockwave therapy?
Shockwave therapy has been shown to provide a 70-80% success rate in reducing chronic tendinitis pain within 12 weeks of starting treatment.
What are the contra-indications?
Shockwave Therapy can not be used:
If you are pregnant
Over open growth plates
Over the lungs
Over major blood vessels
Over infected areas
If you have had a recent steroid injection
If you are on anti-coagulant medication
If you have an active cancer
Is shockwave therapy safe?
Yes. Shockwave therapy is extremely safe having been used on millions of patients around the world with virtually no negative side effects. Recent NICE guidelines recommend the use of shockwave therapy and emphasise the safety of the therapy.
A temporary reddening of the area treated
A temporary increase in pain fro 24 hours after treatment
Mild to moderate pain during treatment
Low level bruising if the treated area
What to expect during Shockwave therapy treatment?
Prior to engaging in shockwave therapy your diagnosis will need to be confirmed by a diagnostic ultrasound scan. This is to ensure you are a good candidate for the therapy and to optimise results.
Once diagnosis has been confirmed your therapist will apply the shockwaves to the injured tissue. Typically this will correlate with some tender areas located around your injury. The treatment is non-invasive so no needles are used. There is also no need for local anaesthetic. The treatments itself lasts no longer than 8-10 minutes. During the treatment you should expect to feel some mild to moderate discomfort, this is required in order to achieve maximum benefits. The energy levels applied during treatment can be adapted to suit each individual patient.
What Do I need to do after treatment?
One of the main advantages of shockwave therapy is there are no major restrictions on patients after treatments. It is recommended that heavy impact activity is restricted for 24 hours after treatment but patients will be fine to drive and return to work after treatments.
Many athletes and elite sports teams use shockwave therapy over injections to manage injuries as it allows them to continue training and playing throughout the season.
Do I need to do any other treatments with Shockwave therapy?
Yes. In order to maximally benefit from shockwave therapy it must be combined with a specific stretching or strengthening home exercise programme. The exercises required will be demonstrated and progressed by your therapist during each session.
When will I notice improvements?
Most people will notice an almost instant decrease in pain after treatment. This will be a temporary decrease as the tissue has been desensitised. Over time the pain relief becomes more permanent. Typically most people notice a significant improvement in symptoms 3-6 weeks after their first session. The optimal results of shockwave therapy are realised at 12 weeks after the first treatment.
How many treatments will I need?
Every patient will require a minimum dose of 3 treatments performed at weekly intervals. After the 3rd treatment patients will be reviewed at 6 weeks to assess response to treatment – at that point a decision on further treatment can be made. If an injury has been present for a long-time then a further 3 treatments may be required. Typically patients do not require more than 6 sessions.
What device do CoreBodyClinic use?
At Core Body Clinics we only use the highest-grade medical shockwave therapy equipment. The devices used are the original Swiss made shockwave therapy machines as used in the NICE guideline recommendation trials.
We are also very proud to announce that both focused and radial shockwave therapy are available for use – one of only 6 clinics in the UK to offer this. The advantage of utilising both radial and focused shockwave therapy is that more energy can be used and therefore superior results achieved.
Physiotherapy joint mobilisations are part of the manual and hands-on therapies that we perform at our Reading clinics. Our physiotherapists at core body clinic are experts in delivering these techniques. They can be performed on any joint in the body and are used to treat pain and stiffness affecting the mobility of a spinal or peripheral (ie shoulder or knee) joint. Mobilisations are graded oscillations of pressure directed at a joint and applied in a highly specific manner. They are performed for a duration of 1-3 minutes and tailored according to a patient's pain level and tissue stiffness. The purpose of mobilisation is to enhance movement by reducing stiffness and pain. The physiotherapists at Core Body Clinic are trained to masters level and have undergone 1000's of clinical hours to perfect the skill of joint mobilisation.