MY SPORTS INJURY: BRINGING AWARENESS TO THE IMPORTANCE OF MENTAL HEALTH FOR SPORTS PERFORMANCE & MINDSETAnxiety isan emotion and it is similar to many others, since it has common aspects of these(e.g, anguish, fear, restlessness, tension or worry). It can be classified intotwo levels, healthy anxiety and pathological anxiety. Therefore, anxiety can bea healthy reaction when it effectively helps to cope with a real threat, but itmay not be as healthy in others. In any circumstance of daily life, a certainlevel of anxiety can manifest. It is estimated that more than 20% of the worldpopulation suffers from some symptom related to anxiety without knowing it,sport is no exception. When practicing a sport there are usually situations ofsuccess and failure, that is, both positive and negative situations. A researchstudy published by the British Journal of Sports Medicine stated out that theoccurrence of mental health disordersand issues and symptoms added up to a 34% of depression/ anxiety problems amongst active elite athletes,whereas, an average of 19% was accounted for alcohol misuse in current prosports players. On the other hand, when it comes to former elite athletes the gottenfigures were equivalent to 26% for depression/anxiety and a total amount of 16%for distress, said by Vincent Gouttebarge et la 2019. Accordingto a correlative-predictive study carried out by University of Toronto which highlights thatunsurprisingly 31.7% of the elite athletes in the evaluation presented to havesings of depression of every mentalhealth disorders types, where a figure of 12.9% was representing to severesymptoms, a total number of 18.8% accounted for moderate symptoms and general anxiety symptoms reached up to 5.9%.Furthermore, 8.6% of the screened individuals reported outcomes suggesting ameaningful risk of an eating disorder (Z.A.Poucher et la 2021).      Elite athletes tend to cope with a significantheap of pressure and stress as a consequence of this they have got to deal witha lot of contradictory expectations, particularly at the Olympics, indicatesPoucher. (Z.A.Poucheret la 2021). It is worth to mention that one of the celebrities with mental health disorderswho most recently reported a case of a high-level athlete withdrawing fromcompetition was when the four-time Olympic gold medal-winning gymnast SimoneBiles who claimed to experiencing mentalhealth disorders and anxiety attacks.      Accordingto a recent study with youth soccer players, it was revealed that athletes whoexpressed high levels of anxiety andmental health disorders had 7.08 times more risk of injury than soccerplayers with low levels of anxiety, and those who handled sports pressure worsehad 5.33 times more risk of injury.       From the field of Psychology, the mental health diagnosis uk approach to anxiety attacks takes on an importantrelevance, as it is associated with phenomena, such as stress, tiredness,fatigue, discouragement, or eating disorders, amongst others, which can have animportant impact on physical and emotional health, published in an article of Human Kinetics Journals by Marjorie Bernier et la 2014.     In the first of the aspects reviewed, theeffects of anxiety on sports performance have been extensively studied fordecades. The professionalisation of most sports is increasingly demanding,which affects an exhaustive analysis of any factor that to a greater or lesserextent, and directly or indirectly, may influence the final result of theevent. Several studies have linked a high level of anxiety with a worseperformance of the athlete. Moreover, if the subject experiences negativethoughts patterns and expectations of failure, this may be led to an accomplishedomen in the very near future, points out an article of Verywellmind.      Anxiety raises the frequency of injuriesin athletes from five to seven times, according to the results of a studycarried out by experts from the San Antonio Catholic University of Murcia.     In this sense, an elite athlete can beimpaired by the fact that they may find themselves in a complex of the negativethings without even becoming aware of the positive ones. This, in turn, cantrigger an endlessly vicious cycle resulting in wanting to avoid participatingfrom sporting events or merely giving up, aiming to reduce the failure chancesand underperforming, therefore, this may develop a paucity of motivation,posted in an article issued by Jenkins Soft Tisue Therapy.3 FACTORS THAT CAN BE GENERATED BY MENTAL HEALTH DISORDERS   LACK OF APPETITEIt is widely known that outstanding sporting performance goes hand inhand with nutrition and a balanced diet, for this reason is greatly fundamentalto keep a persistent eating pattern, so is relevant to say that owing to thefact of diminishing food intake can take a huge toll on physical health andcompetition performance. STRUGGLING TO FOCUS  It is not an easy task to focus on yourgoals when you are presenting a storm of countless thoughts thereby is quitetroublesome to concentrate and get in the zone. SOCIAL ANXIETY It manifests itself on occasions as amental block that prevents you from resolving a situation in the mostappropriate way. Also, people and athletes do actually know they are strugglingto carry out certain tasks nonetheless they do not recognise what the main source of thathindrance is.      On the other hand, physical exercise canbe beneficial when is used as a therapy to reduce anxiety both in healthypeople and in individuals with various diseases. The release of differenthormones, alongside psychological factors due to physical activities, can leadpatients to improve in this aspect of their lives.      Anxiety and stress could be classified asa positive emotional state, according to the benefit and perception given tothem, since they can generate an optimal level of alertness in the body,improving cognitive and behavioral activity, with the appropriate handling,level and attention.     A study ofanxiety applied to sport is the so-called pre-competitive anxiety, which usuallyoccurs in the 24 hours prior to a competition. The handling of this will dependon what the athlete is dwelling on and on his experience in sports. However,there are certain factors that can contribute to the increase or decrease ofthis pre-competitive anxiety e.g. changes in the usual situation, importance ofthe event, erroneous information or knowledge of the rival, etc.Anxiety andstress could be classified as a positive emotional state, according to thebenefit and perception given to them, since they can generate an optimal levelof alertness in the body, improving cognitive and behavioural activity, with theappropriate handling, level and attention. The studyof anxiety in high-performance athletes covers a large space in the Sports Psychologyliterature. The importance lies in the impact negative emotional states have onperformance in competition and training. Most of the failures in competitionsare explained by problems due to anxiety management, indicated by Mary D. Walling and Joan L. Duda 2013. WHAT CAUSES ANXIETY IN ELITE SPORTS ATHLETES & SPORTSMENAlthough itis easy to identify typical antecedents of anxiety, it is very difficult to pinpointthe causal nature of these factors, since it is unethical in experimentalconditions to manipulate variables to induce anxiety in those participantsunder study.Therefore,the types of research carried out obey rather a study of a correlational type,that is, relational i.e. the most common personal and situational antecedentsof anxiety.Therefore,the types of research carried out obey rather a study of a correlational type,that is, relational i.e. the most common personal and situational antecedentsof anxiety.THE COMPETITIVE ASPECTS OF ANXIETY The moreimportance you place on your competition, the more likely you are to experienceanxiety. It is veryfrequent that when the date of the competition approaches the athletes begin tospeculate about the situation, our performance and the different possibilitiesthat could come about.Perception of public expectationsAs theathlete obtains achievements and successes in his sports career, theexpectations of others regarding his performance increase. Depending on how theathlete interprets this factor, it can determine his level of anxiety since hecan perceive it as a source of external pressure.PerfectionismResearch onthe desire to achieve perfection and set high standards for one's performanceis controversial. On the other hand, there are those who affirm thatperfectionism is an important step towards the achievement of Olympicexcellence, while others conclude that it is an obstacle to sporting success.Fear of failureAnothercause that can generate diverse reactions; in a smaller percentage, someathletes use it as a motivational tool. However, amongst the most frequentfears, failure appears, due to the predominance of the “win at all costs”discourse, which favours reinforcing vulnerability to performance anxiety.If anathlete believes that their self-esteem is measured by achievement, they mayfeel more nervous at the prospect of defeat, which translates as a source ofthreat to their worth.Low self-confidenceBelievingthat one is capable and has the skills to perform a task or solve a problem isbasically to trust oneself, and that generates tranquility. Self-confidence isa protective factor that goes against interpretations that infringe anxiety. Inthe reverse case, therefore, it is a determinant of anxiety.Learn how to identify the causes of your anxiety to be a better athleteFor anathlete to be able to explore and identify the causes that lead him toexperience greater anxiety when competing, is a preliminary step so that he canbe aware of oneself and train anxiety control in sports situations that morestress and pressure they generate. Althoughthe individual cannot modify the situations that occur in the environment, inthis case, the pressure situation, the athlete can learn to give it anotherinterpretation that is not presented as a threat to his well-being, but ratherthat his perception is positive and represents a challenge.Cognitive anxiety (This is,thoughts and concerns) is usually higher and more stable in the days beforecompeting, being that its somatic part (manifestations throughout the body)remains at a low and stable level, having a maximum expression in the minutesprior to competing.References·       Bernier, M., Thienot, E., Pelosse,E. y Fournier, J. Effects and underlying processes of a mindfulness-basedintervention with young elite figure skaters: two case studies. The SportPsychologist. 2014.  ·       Covassin T, Beidler E, Ostrowski J,Wallace J. Psychosocial aspects of rehabilitation in sports. Clin Sports Med.2015 Apr;34(2):199-212. ·       Vlachopoulos, S., Biddle, S.J. H. yFox, K. Determinants of emotion in children’s physical activity: Atest of goalperspectives and attribution theories. Pediatric Exercise Science, 2016; (9) p.65.  ·       Walling, M.D. y Duda, J.L. Goals andtheir association with beliefs about success in and perceptions of the purposeof physical education.Journal. Teaching Physical Education. 2013; (14)140-156. ·       Gouttebarge V, Castaldelli-Maia JM,Gorczynski P, Hainline B, Hitchcock ME, Kerkhoffs GM, Rice SM, Reardon CL. Occurrenceof mental health symptoms and disorders in current and former elite athletes: asystematic review and meta-analysis. Br J Sports Med. 2019 Jun;53(11):700-706.doi: 10.1136/bjsports-2019-100671. PMID: 31097451; PMCID: PMC6579497.

A SPORTS PHYSIOTHERAPY OVERVIEW OF TREATMENT, PREVENTION & MANAGEMENT OF LABRAL TEARS FACTORING SHOULDER INSTABILITY & NON-SURGICAL PAIN MANAGEMENTThe Shoulder Labrum Tear, as the name suggests, is a painful and limiting condition caused by a tear in the thick piece of tissue attached to the edge of the shoulder. Research studies have been shown that Shoulder Labral Injuries have a prevalence rate of 0.12 per 1000 exposures; in this sense, elite athletes are highly susceptible to sustain these types of shoulder disabilities resulting in instability due to collision over the shoulder, and persistent traumatic events, is worth keeping in mind that overhead and contact sports such as baseball, cricket, rugby, volleyball, American Football, and other overhead arm motions activities similar to throwing are tending to generate the Shoulder Labral Injury , reports (Sandeep Mannava MD et la, 2018).      The Shoulder labrum, as we have just mentioned,  outlines and covers the entire surface of the shoulder joint and also reinforces the socket and ball of said joint (Cooper De et al, 1992).The shoulder joint is made up of the glenoid, which is the shallow depression of the socket, and the head of the upper forearm known as the humeral head, that is the ball which inserts into the socket, explains (Stephen Fealy MD, 2020).  Johns Hopkins says, there are three ways this piece of tissue can be torn, the 1st is completely outside the bone, the 2nd way is where the tendon of the biceps muscle is attached, and the 3rd can bring about both ways within and along the edge of the labrum. Which is why a physical examination and assessment is essential to diagnose alongside MRI Screening to accurately determine the complexity of injury. A research article posted by Hospital for Special Surgery (HSS) indicates the labrum is essential in the fixation of the shoulder because it has many ligament attachment sites which provide support to the joint; the most common are the rotator cuff and several muscles that enclose the shoulder which prevent the shoulder from dislocating.SO, WHAT DOES A TORN SHOULDER LABRUM ACTUALLY FEEL LIKE?        Most commonly symptoms of a torn shoulder are intense sharp shoulder pain, achiness in the joint, instability and a feeling of grating, grinding, locking, and catching while performing shoulder movements.        Patients who usually suffer from this condition usually report deep pain in the shoulder joint accompanied by a popping sensation and instability to hold the arm in specific positions.        According to Rebound, the most common Shoulder Labrum Tear Symptoms are:   Ø  Instability in the shoulder. Ø  Deep pain in the joint. Ø  Popping and Clicking Sensation. Ø  Discomfort or pain when lifting objects or moving the arm. Ø  Reduced ROM. Ø  Weakness in the Shoulder joint, on numerous occasions on one side.        These symptoms vary depending on what type of labrum tear the patient has suffered, they’re described below.   WHAT ARE THE DIFFERENT TYPES OF SHOULDER LABRAL TEARS?        The two most common types of labral injuries are the SLAP tear and Bankart tear.  Both types of tears are usually accompanied by aching pain and difficulty performing normal shoulder movements.   What are SLAP tears?        SLAP acronym means "Superior Labrum Anterior to Posterior”. The part affected in this type of tear is the front area of ​​the upper arm where the biceps tendon connects with the shoulder.          Baseball pitchers and volleyball players who perform high-energy, quick-snap actions across the top of the musculoskeletal area of the shoulder are the most vulnerable to this injury.Patients with SLAP tears may present pain close to the biceps tendon in the front of the shoulder. The anterosuperior labrum usually appears to have a poor blood supply, whereas the inferior labrum has a significant blood flow (Cooper DE et al, 1992).  How incident is the SLAP in the population?Even today the incidence of this condition is a matter of debate; it is known that Snyder has stated on different occasions that the percentage has been growing exponentially hard in the last decades. Proof of this are the studies carried out in 2002 where the incidence in the population was 4 out of every 100,000 people and in 2010 where the incidence increased to 22.3 out of every 100,000 people. Another characteristic of this condition is that the highest incidence usually occurs in young patients between 20 and 29 years of age and between the ranges from 40 to 50 years, lays out (Scott D. Mair et la, 2021).SO, What are Bankart tears?Bankart tears are most common in younger subjects who have had their shoulder dislocated. The joint capsule (fibrous tissues that surround, support, and keep safe the joint) can pull on the lower portion of the labrum and tear it if the ball of the shoulder joint falls out of the socket. As a result of the labrum rupture, the shoulder is more likely to re-dislocate, causing instability.        Anterior instability is caused by a dislocation in which the head of the humerus slips toward the front of the body, and its lifetime reoccurrence is nearly from 1% up to 2%, claims (Matthew Varacallo et al, 2021).        Posterior instability occurs when the ball slips toward the back of the body, it should be noted that this particular one is an odd condition as it represents 10% incidence of all existing shoulder injuries, apprises (Alaina Brelin et al, 2017). The affected individuals with Bankart tears may be concerned that the shoulder will dislocate or slip out of place.ARE ATHLETES THE MOST PRONE TO SHOULDER LABRAL INJURY AND CAN SHOULDER LABRUM TEAR BE PREVENTED?Normally this condition is quite difficult to prevent, unfortunately high performance athletes are predisposed to have it as this condition is sensitive to overhead movements.        However, people who have suffered from a traumatic event such as a fall are also prone to experience it. Older adults are also at risk for this injury as these tissues become more fragile with aging, as well as tissue degeneration caused by recurring overhead manual labourer occupations, points out (David C et la, 2021).        Although SLAP is difficult to prevent there are certain methods that can help prevent it. As we mentioned earlier, athletes are more likely to develop this affection, especially baseball and softball pitchers due to overuse of movement in the shoulder. Monitoring and limiting the pitch count especially in a young pitcher can be a good precaution method against this condition, affirms (John Henry Wilckens, MD). CAN A SHOULDER LABRAL TEAR HEAL WITHOUT SURGERY?Initial treatment for shoulder labrum tear & for SLAP usually does not require surgical intervention; initially Physical Therapy Manchester is used depending on the severity of the tear. "Surgeons should try to be as conservative as possible when treating a torn shoulder labrum," says Dr. Fealy. Surgeons will usually conduct a physical clinical assessment and order MRI or X-ray to determine which the appropriate treatment for the patient is. Sports Physiotherapy Manchester is usually accompanied by anti-inflammatories, and, in specific cases, cortisone injections for Shoulder Labral Injury can also be used. Gradual shoulder extensions performed by a physical therapy Manchester practitioner over a period of one to two months should also be added.  For this reason is essential to seek out and turn up to your Physiotherapist in Manchester in order to fully assess and diagnose your condition with the shoulder labrum tear test, feel free to contact us www.mysportsinjury.co.uk/bookingHOW LONG DOES THE SHOULDER LABRUM TEAR INJURY TAKE TO BE SOLVED UNDER MY SPORTS INJURY CLINIC PHYSIOTHERAPY MANCHESTER MANAGEMENT PROGRAM?      The required recovery time frame to rehab a torn labrum could approximately take from 2 months up to 3 months (8-12 weeks); in this case scenario is paramount that physiotherapy guidance of your Sports Injury is treated and managed correctly by our Manchester clinicians (MorePhysicalTherapy).WHEN DO YOU NEED SURGERY FOR A TORN SHOULDER LABRUM? Surgical treatment should be considered when all non-conservative methods have been tried without efficacy. The type of intervention that will be performed on the patient will depend on the severity of the tear. "If physical therapy fails and the athlete still can’t complete overhead motions, or the shoulder continues to dislocate, surgical treatment might be required to reattach the torn ligaments and labrum to the bone," says Dr. Fealy.   Russel Warren, MD, for Arthroscopic procedures sets out that  one of the most used methods to treat SLAP is arthroscopy, since when carried out through a small incision it is much less invasive than an open operation. Doctors usually recommend more conservative methods for older people who do not perform physical activity on a regular basis; otherwise young athletes are usually managed through arthroscopic surgery to achieve greater efficiency. Find the best Sports physiotherapist in Manchester to treat your Labral Tear Condition.WHAT IS THE RECOVERY TIME FRAME FOR SHOULDER LABRUM TEAR SURGERY?Recovery from surgery depends on different factors such as the specific location of the tear and how good the surgical intervention was. Regularly, the recovery period after undergoing surgery varies from 4 up to 5 weeks when the labrum begins to adhere to the edge of the bone again and it could take twice time period time for it to fully strengthen. In athletes the period is much longer because they will need from 6 months to a year to fully recover.          Patients are usually recommended to wear a sling for four weeks after the operation, regardless of the surgery performed. This helps protect the shoulder while it heals during the post-operative period. In parallel, the recovery process must be accompanied by a Sports Physical Therapist including custom counselling in order to return a full function and live pain-free. The average time of returning to sports and getting back on daily basis activities after arthroscopic SLAP repair surgery ranges from 8 up to 9 months and the success rate accounts for 69.9% of screened individuals who got back their optimal level and proficiency, says (Aarabi Thayaparan et al, 2019).SHOULDER LABRAL TEAR EXERCISES RECOMMENDED BY YOUR SPORTS MASSAGE MANCHESTER CHIROPRACTORS      If arthroscopic surgery is indicated in a SLAP injury, the Physical Manual Therapist must design a program for shoulder rehabilitation including shoulder labral tear exercises, starting with a functional assessment, subsequently; pain treatment, passive / active mobilisations, is important avoid Adhesive Capsulitis of the Shoulder (prolonged immobilization), adjacent trigger point treatments, and Neurodynamic exercises.1.    Toning or strengthening exercise for recovery from shoulder injuries        These are exercises to strengthen or tone the rotator muscles of the shoulder, supraspinatus, infraspinatous, and rotator cuff. In addition, the posterior muscles of the arm as well.         Use a rubber band, dumbbell, perform a short contraction, take a break between contractions of at least 3-4 seconds, it can be done several times a day.2.    Stabilisation exercises for shoulder injuries and rehabilitation        We show you a series of exercises indicated to stabilise the shoulder joint, recommended in cases of shoulder rehabilitation in injuries where stability is affected.        Kneel on and put your hands on the floor like a cat-cow position and start making circles in that position in order to give a little loads to the injured shoulder so the musculoskeletal area actives and stabilise itself.You can also add an unsteady object to the routine like a ball; this exercise can be performed several times a day as well. 3.    Exercises to improve shoulder mobility        We give you various recommended exercises to improve and regain mobility of the shoulder joint complex.        Kneeling, we place our hands and head resting on the floor with our arms extended above our heads. We should feel a stretch in the shoulder or upper or lower back.We stand in a narrow squat rack or under a door frame and place the hand and forearm on each side of the structure. Keeping the arms in that position, we advance the torso until we feel a stretch in the pectoral or shoulder area.We lie on the floor on our back with a mobility roller under the centre of the back longitudinally, or some other structure that raises our back without hindering movement. We place the arms extended to the sides of the body with the palms facing the ceiling. From that position we slide the backs of the hands up to the top of the head and return to the starting point. We should feel a stretch in the chest area and / or in the anterior shoulder area.KEY POINTS TO SUMMARISEThe shoulder is one of the most important regions of our body and at the same time, one of the most affected parts since it suffers a lot of wear and tear on a day-to-day basis. You might think that this deterioration occurs mainly in athletes, but contrary to what people believe, anyone can have shoulder problems due to a fall or a repetitive activity in which the arm has to be raised overhead. These two factors can lead to a tear in the labrum, that is, a partial tear in the cartilaginous ring that surrounds the base of the shoulder joint and provides it with stability.           There are two types of tears. Traumatic tear of the labrum; athletes are very prone to suffering from it. It occurs mainly for these reasons due to a shoulder dislocation and also for an injury as a result of lifting heavy objects or high impact activities. The other one is non-traumatic tear of the labrum; it occurs in people with great laxity, since they have greater mobility in the shoulder joint. It is precisely this joint instability of the shoulder or muscle weakness that causes tears.        Many times this condition is asymptomatic, especially when it is a small tear, so it does not cause pain.        To find out if a labrum tear is suffered, the sports physiotherapy Manchester practitioner will perform the shoulder labrum tear test that assess the labrum and the stability of the shoulder joint, and an MRI may be also prescribed. Depending on the type of tear, it can be treated with physical therapy that will plan a rehabilitation and prevention treatment for certain movements and positions, perform manual therapy to reduce pain and correct movement, do exercises to strengthen the shoulder, balance the muscles, reduce pressure on the labrum and do stretching. Likewise, the sports physiotherapist will help those who have undergone surgery through progressive rehabilitation exercises to prevent the tissues from tearing again.Published by Rafael Peña for www.mysportsinjury.co.ukReferences   Mannava S, Frangiamore SJ, Murphy CP, et al. Prevalence of Shoulder Labral Injury in Collegiate Football Players at the National Football League Scouting Combine. Orthop J Sports Med. 2018;6(7):2325967118783982. Published 2018 Jul 9. doi:10.1177/2325967118783982 Thayaparan A, Yu J, Horner NS, Leroux T, Alolabi B, Khan M. Return to Sport After Arthroscopic Superior Labral Anterior-Posterior Repair: A Systematic Review. Sports Health. 2019 Nov/Dec;11(6):520-527. doi: 10.1177/1941738119873892. Epub 2019 Oct 4. PMID: 31584340; PMCID: PMC6822213. Cooper DE, Arnoczky SP, O'Brien SJ, Warren RF, DiCarlo E, Allen AA. Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am. 1992 Jan;74(1):46-52. PMID: 1734013. Varacallo M, Musto MA, Mair SD. Anterior Shoulder Instability. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538234/ Brelin A, Dickens JF. Posterior Shoulder Instability. Sports Med Arthrosc Rev. 2017 Sep;25(3):136-143. doi: 10.1097/JSA.0000000000000160. PMID: 28777216.

FROZEN SHOULDER: HOW PHYSICAL MANUAL THERAPY CAN HELP TREAT SHOULDER PATHOLOGY: DISCUSSING HOW CONVENTION TREATMENT CAN HELP ALLEVIATE SYMPTOMS A comprehensive guide pain management & reducing stiffness in the Shoulder Joint and increase Shoulder Range of Motion without pain –      What’s Frozen Shoulder? Adhesive Capsulitis more commonly known as Frozen Shoulder injury is considered as a very common upper limb injury due to it can impair swelling, stiffness, dysfunction and irritation of the tissues that surround the joint; these are ones linked to frozen shoulder symptoms. Thus, it can be yielded after a minor trauma and following a shoulder surgery as well, where it is reported 5% up to 10% incidence, SportsMedBiologic stated.      So, How painful is frozen shoulder? This disease of the shoulder tissues can be very painful and disabling. This usually ends in a complete resolution of the condition if it is treated early with primary care conducted by Sports Injury Physiotherapy experts in Manchester.      The term frozen shoulder, which refers to a condition that physiologically implies an increase in the volume of the connective tissue of the shoulder was first introduced by Ernest Codman in 1934 who described it as a distinctly painful condition, where a noticeable lack of movement is experienced in the entire upper arm area and difficulty whilst sleeping on the affected side too.      A research study where 223 patients were observed showed that 20% of the patients claimed to have experienced bilateral pain, that is in both shoulders, in contrast with the fact that 59% only claimed to feel pain in one of the shoulders, most of the patients (91%) complained of mild pain and only 6% reported severe pain, said by Campbell Hand et la (2007).      Furthermore, it was also added the marked decrease in elevation, external rotation, and forward mobility, which are the characteristics of this condition.      An error that is commonly made during physical clinical assessment practices is to classify any condition of pain and stiffness in the shoulder as frozen shoulder; this is a very specific condition and has a resolution that is usually spontaneous, in addition, it has a different management approach in comparison to other shoulder diseases, pointed out by Steven Cutts et la (2005). If you are experiencing such symptoms, It would be suitable to contact www.mysportsinjury.co.uk and book a medical consultation to seek a thorough assessment & examination to diagnose such shoulder injury. Frozen shoulder versus Rotator Cuff, is there any difference?       Rotator Cuff Tear can be often mistaken for Frozen Shoulder as they are the most frequent shoulder pathologies whether in sporting events or day to day activities.      OrthoAtlanta explains that the main difference between these pathologies is when you suffer from Rotator Cuff you present limitation of your range of motion despite this you can help yourself by lifting it manually. On the other hand, when it comes to Frozen Shoulder you cannot lift your arm at certain points as is greatly aching, you will sustain limitation of the range of movement as well.     Frozen Shoulder condition has proven to cause limitation of the ROM which can be represented with the following average ROM parameters, when performing abduction movements 98° is presented, 33° is noticed in external rotation, 117° in flexion movements, and 18° is observed in internal rotation when shoulder is abducted at 90°, issued by Phil Page et la (2010). How effective is the Conservative and Non-Conservative Treatment to Treating Frozen Shoulder?      Is Frozen Shoulder curable? Even with all the current research done it is hard to define if one treatment is better than the other because with both treatment programs the same outcomes can be obtained in a period of two to three years, so, it is worth bearing in mind that there is no a way into how to cure frozen shoulder quickly.     For Frozen Shoulder managed with conservative treatment the suggested time frame to cease the ailment could take up to six to nine months, however, it will depend on the patient and if is complying with the prescribed program, according to Johns Hopkins Medicine.    Additionally, if you will undergo through surgical procedure for Frozen Shoulder is crucial to know that the success rate is about 70% up to 80%, indicated in an article of Raleigh Orthopedic Surgery Center.     Furthermore, the recovery time frame after surgery could last up to 3 months or even more, there is no an exact recovery time, following non-conservative intervention is highly important to see a Sports Physiotherapist or / Sports Therapist to design a rehabilitation program that meets your needs since Orthopedic physicians and Sports Physiotherapy practitioners work jointly in this sort of case, Jonathan Cluett for VeryWellHealth website (2020).       However, the level of disability that can be developed during this time period must be considered to define whether surgical treatment using arthroscopic release and anesthesia can speed up and shorten the recovery process, claimed in a Royal College of Surgeons of England’s article by Sunil Sharma et la (2015).      The main stages in the development of this condition are three, the 1st one is known as the painful or "freezing phase" that normally lasts the first 8 months.      The 2nd phase is the "adhesive phase" that can last up to a year.     Finally, the "resolution phase" which is the 3rd one lasts between one year and 42 months where the patient recovers almost entirely the mobility and function of the shoulder, indicated by Harryman et la (2004).        Although some studies have shown that the typical recovery period is one to three years, other studies point out that a significant percentage of people have had symptoms for up to a decade, so, we could say this condition could be substantially recurring.     It should be noted that surgical treatment does not usually have a schedule to be performed; this is taken into account after having used conservative frozen shoulder treatment and did not work out how it was expected, during conservative treatment it should be clear that the manipulation should be performed by stabilising the shoulder scapula. Manual Physical Therapy can be an essential part of this healing process to speed recovery rates in more younger people. Does Physical Therapy Manchester really help Frozen Shoulder?      Accordingly to research studies, Physical Therapy Manchester does really help thaw Frozen Shoulder, approximately more than 90% of the cases can be wholly treated following a conservative treatment program. The best allies to unfreeze it are your physical therapy practitioner who will help restore movement in order to achieve live pain free and of course time is also vital in the healing process, posted by InMotion.   How common is Frozen Shoulder in the general population and who are more likely to suffer from it?      When the term frozen shoulder was first introduced by Codman, he also set out that one of its characteristics is the difficulty to explain it from a pathological point of view and difficult to treat, curiously after several decades this fact has not yet been significantly changed.      However, according to all the studies carried out around this disease in the general population, it is known that the incidence of frozen shoulder is 3% -5% nowadays, the age range where this condition is most experienced is from 30 up to 40, 50 years old, Hui Bin Yvonne Chan et la (2017) reported.      Interestingly, it is more common in women than in men and it has also been shown that diabetic people tend to suffer from this condition, is relevant to mention that frozen shoulder and diabetes are strictly linked, claimed by Lequesne M et la (1977) whereas patients with systemic diseases such as thyroid diseases and Parkinson’s disease are also prone to sustain frozen shoulder. Why do Diabetic people suffer from this Frozen Shoulder condition?      This is because the exponential increase in blood glucose in diabetic patients tends to cause effects on the production of collagen that adheres to the shoulder, making it sticky due to sugar molecules; consequently the movement is restricted and limited yielding the shoulder to get tense and rigid. This physiological process can be described as glycosylation, according to an article of Diabetes.co.uk (2019).     Diabetic patients have reported to have the highest incidence worldwide reaching about 20% of all frozen shoulder affected subjects, Hai V. Le et la (2017). Athletes vs Frozen Shoulder which Sports are more likely to develop it?      The shoulder has a wide number of tissues, tendons, bones, and interconnected parts that make all its mobility and rotation possible, we use the shoulder throughout the day on a daily basis without even realising it and sometimes we subject our shoulders to physical challenges and a great tension especially when we practice sports, Sports Injury Bulletin affirmed.      For most athletes, frozen shoulder, as well as other conditions that affect the shoulder, have been a major and incessant problem, many factors that can cause the disease, there is evidence confirmed by athletes who claim that the shortening of one of the ligaments of the shoulder may increase.      You may wonder what causes a frozen shoulder, the risk of suffering from this condition may be due to poor posture, a serious sports injury come about by tackles, overuse, stress, collisions, repetitive and poor techniques, thereby some elite athletes also perform specific training to increase the muscle mass of the deltoids, and pectorals, thus shortening said ligament, these are ones of the frozen shoulder causes imparted by Results Physiotherapy.      Some sports such as baseball, softball, football, swimming, and tennis are the most likely to produce not only frozen shoulder but the majority of shoulder injuries that an athlete might suffer throughout their professional career. How long is the recovery time after Conservative and Non-Conservative Frozen Shoulder treatment?      Much has been said about which of the two treatments has the best results and which speeds up the recovery process, it is well known that the first treatment to be carried out when faced with a diagnosis of frozen shoulder is the non-conservative one, where the Physical therapy plays a fundamental role, many patients have recovered full shoulder mobility, and stability with simple physical exercises accompanied by certain anti-inflammatory drugs and sometimes steroid injection for frozen shoulder, published by Mahsa Asheghan et la (2016).      A study published in the Maryland Medical Journal indicated that a total of 32 patients underwent therapeutic manipulation of the shoulder to treat frozen shoulder, these patients were observed for about 58 months to verify the time it would take for each to retrieve mobility and rotation.     The recovery time rate was 13 weeks, where 97% of the participants claimed pain relief and recovery of the nearly utterly mobility, a small percentage needed a second period of therapy to be successful.    Another study done in 2004 in Norway showed that acupuncture is also a method that can speed up the recovery process, calming the intensity and frequency of pain, issued by Dong He et la (2004).    On the other hand, the postoperative recovery time after surgery for frozen shoulder also must be accompanied by physical rehabilitation processes.     Normally the recovery period is between 6 weeks or 3 months, it should be recalled that it is a slow and delicate process which must be carried out gradually with the specific physical therapy Manchester recommended by the sports physiotherapy Manchester specialists and clinicians. How can Physical Therapy for Frozen Shoulder help alleviate symptoms at MY Sports Injury Clinic?     In our facility we provide several conservative treatment approaches which will help you maintain, restore and make the most of the client’s well-being, mobility, and function. Sports physiotherapy will assist you through injury prevention, health and fitness, sports massages, physical rehab, dry needling, acupuncture, and Osteopathy & Body Postural Rehabilitation. How to fix Frozen Shoulder pain based on Physical Therapy and Self-Care via home program?      The objective of these exercises for adhesive capsulitis or frozen shoulder will be to work the mobility of the shoulder in a global way through therapeutic homework, with the least pain allowed. Little by little, you will try to achieve a greater range of motion, which will allow you to advance in pain tolerance.     If shoulder pain conditions our life, causes us stiffness, limitation and other daily problems, it is essential to perform this series of exercises for adhesive capsulitis, where the objectives are: ·      Relieve and reduce the pain that it causes us. ·      Gain range of motion and remove limitations. ·      Strengthen the muscles of the area weakened by capsulitis in the shoulder. Once we have put this routine for frozen shoulder pain into practice and do this routine for frozen shoulder pain on a daily basis, we may be interested in supplementing this information with exercises for shoulder injury such as bursitis, rotator cuff, tendonitis, and so on, which will help us complete the process of fine-tuning the area, relieving and eliminating any shoulder pain. What are the best home exercises suggested by Sports Physiotherapy Manchester Specialists in order to enhance range of motion and ease discomfort in the Shoulder?      Sometimes it is originated by an idiopathic nature and many times of unknown causes leading to the frozen shoulder consequences; it can be one of the most frequent complications after shoulder surgery.      If we have discomfort and shoulder pain, these home exercises for adhesive capsulitis will be carried out at specific times throughout the day and in order to see progress little by little.      When we get up and before going to bed, and you can even practice them in the midday, when it comes to a more phase Advanced Capsulitis in the shoulder.      The repetitions of the exercises for adhesive capsulitis will be carried out for 30 minutes, increasing by 5 minutes each week in the work series until reaching 1 minute each and we can do them anywhere as long as we have a broomstick or elongated object and a comfortable seat, and if there is a possibility, a ball will be also needed.      Exercises for frozen shoulder uk that work capsulitis in the shoulder for shoulder pain will help us to mitigate or alleviate the limitation and stiffness that this pathology often produces.      These exercises for Adhesive Capsulitis should be daily movements that will help us strengthen the muscles and gain range of motion as well, even in most cases eliminating complete stiffness and not the rotation and extension of the shoulder.      These frozen shoulder exercises or shoulder pain exercises are designed and put into practice by our team of Physiotherapists at My Sports Injury Clinic in Manchester City.      The exercises for frozen shoulder are carried out in the early stages of rehabilitation alongside with Physiotherapy approaches adapted and focused on the Capsulitis injury in the shoulder. ·      Exercise 1 Flexion with a broomstick      We begin the exercises for frozen shoulder with the hands at shoulder height, hold a broomstick horizontally in front of the body, and lift with the elbows extended as far as possible.      To keep in mind, avoid compensations by controlling the position of the shoulders, without shrugging. Maintain the movement for 30 seconds, do 10 reps and 3 series. ·      Exercise 2 Extension with a broomstick     Take the broomstick or pole horizontally from behind your body, with your elbows extended, and lift the pole or broomstick back. Maintain the movements repetitively for 30 seconds even if we feel slight shoulder pain. Do 10 reps and 3 series. ·      Exercise 3 Internal rotation with a broomstick for frozen shoulder      Take a broomstick horizontally from behind your body, close to your body, and drag it down your back as if you were scratching your back. To progress, get closer to the grip of the hands. Maintain the movements for 30 seconds, do it 10 times and 3 series. ·      Exercise 4 Codman pendulum Supporting the unaffected side on a table, release the affected shoulder and perform light rocking, taking advantage of the weight of the body. In this way, we try to mobilize the shoulder in small circles, to free the joint space. Hold 30 seconds. Do 3 reps and 1 series.  ·      Exercise 5 Flexion-extension with a rubber or normal ball      Sitting next to a table, roll the ball back and forth to flex the arm. To improve our capsulitis in the shoulder, maintain the back and forth position of the arm for 30-40 seconds. Do 3 reps and 1 series. The prime takeways about this Frozen Shoulder Article      Frozen shoulder is the involvement of the shoulder capsule, which becomes thicker and more fibrous. The pain in the shoulder joint and limitation of range of motion are the biggest problems resulting from adhesive capsulitis. Adhesive capsulitis follows three phases freezing, freezing, and thawing and can take up to 24 months to resolve. Both Conservative and Non-Conservative treatments are effective, when the conservative one fails; a surgical process must be considered. The typical treatment includes the use of ice therapy, anti-inflammatory medications, and physical therapy Manchester. The physical therapist Manchester practitioners will give you an exercise routine to help regain your range of motion and function. Published by Rafael Peña for www.mysportsinjury.co.uk/blog References ·      Chan HBY, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore Med J. 2017;58(12):685-689. doi:10.11622/smedj.2017107. ·      Lesquesne M, Dang N, Benasson M, Mery C. Increased association of diabetes mellitus with capsulitis of the shoulder and shoulder–hand syndrome. Scand J Rheumatol 1977; 6: 53–56. ·      Codman EA. The Shoulder 1934; Boston, USA: Thomas Todd. ·      Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol 1975; 4: 193–196. ·      Dennis L, Brealey SRangan A, et al. Managing idiopathic frozen shoulder: a survey of health professionals' current practice and research priorities. Shoulder & Elbow 2010; 2: 294–300. ·      Linaker, Catherine H, and Karen Walker-Bone. “Shoulder Disorders and Occupation.” Best Practice & Research. Clinical Rheumatology, U.S. National Library of Medicine, June 2015. ·      Asheghan M, Aghda AK, Hashemi E, Hollisaz M. INVESTIGATION OF THE EFFECTIVENESS OF ACUPUNCTURE IN THE TREATMENT OF FROZEN SHOULDER. Mater Sociomed. 2016;28(4):253-257. doi:10.5455/msm.2016.28.253-257. ·      He D, Veiersted KB, Høstmark AT, Medbø JI. Effect of acupuncture treatment on chronic neck and shoulder pain in sedentary female workers: a 6-month and 3-year follow-up study. Pain. 2004;109(3):299–307. ·      Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017;9(2):75-84. doi:10.1177/1758573216676786.

MY Sports Injury : A Physical Therapy Study on  Mid Thoracic Back Pain. How Conservative Treatment is important to manage Thoracic Spine Dysfunction.   -Thoracic Back Pain Exercises to Relieve Symptoms- Mid Thoracic Back Pain can inflict soreness, impairment, dysfunction, and discomfort that occur in the thoracic spine. The thoracic spine is located at the back of the chest; According to Colin Tidy et la (2020) the pain might spread from the base of the neck to the beginning of the lumbar spine zone, mainly the mid thoracic back pain is observed between the scapular bones or more commonly known as shoulder blades. It can result in a significant disability or dysfunction. As reported by Eric Sterne et la (2019) the pain in the spinal region can be generated by numerous sources and is highly important to undergo a comprehensive physical clinical evaluation and accomplish an effective sports injury management care program, it should be noted that the Mid Thoracic Back Pain is way less frequent in comparison to lumbar and cervical pathologies. In this article you shall learn about thoracic back pain etiology, how to prevent mid back, diagnosis, and Physical Therapy treatment required to improve this condition.   How common the Mid Thoracic Back Pain is amongst regular Individuals and Elite Athletes? As said from the abovementioned statement thoracic back pain is less usual than lumbar back pain. A clinical investigation study published by Kristine A Karlson (2004) showed that in the thoracic region in the elite athletes the pain comes about from the chest in most of the cases, so the thoracic back remains pain free. In spite of the fact that the spine is kept safe from sudden movements by virtue of the ribs and the adjacent muscles that surround it, the thoracic back is still liable to suffer from certain types of injuries due to overuse while performing sporting activities, these injuries encompass avulsions, muscle strains, and stress fractures. On the other hand, in the regular population a group of researchers carried out several studies where different groups of 100 people were asked if they sustain or ever suffered this ache, the highest result was in a study where 74 subjects out of 100 answered affirmatively after having experienced thoracic back pain. In conclusion, this condition is common in the general population. Also, there is some evidence of biopsychosocial associations. Is age a determining factor for Mid Thoracic Back Pain? If So, Which subjects are more prone to having Mid Thoracic Back Pain? Some research and studies carried out by Andrew M Briggset la 2009 especially in young patients, where the thoracic back pain turned out to be more common than is usually believed. The mid thoracic back pain (TBP) got an increasing prevalence rate in regard to age since the transition stage between childhood and adulthood was the period where the affected people presented mid thoracic spine pain the most. Generally, these studies reported a higher prevalence for TBP in child and adolescent populations, and particularly for females. Some evidence shows that soreness or dysfunction of the thoracic back pain is not insignificant in adulthood, whereas, the incidence of spinal pain amongst healthy teenagers is described as significant as well, since it has been increasing over the years, which may indicate a growing condition, specifically for future grown-up subjects. However, more worldwide research studies are required in order to prove if this increasing impact is an international matter. This focus attention on how important is to examining prognostic factors and risks for the thoracic mid back pain condition, from childhood through adulthood, published by Anne J Smith et la for BMC Musculoskeletal Disorders. Which sports are the most likely to cause Thoracic Back Pain? Thanks to advances in the prevention of high performance sports-related injuries to the thoracic spine, it is an easy task to find proven equipment with advanced technology that helps the elite athlete to be less prone to suffering from mid thoracic back pain. However, in sports such as hockey, even when the equipment for the head, neck and body provides great protection, this has not been able to reduce the pain in those who practice this sport. As indicated by Current Sports Medicine Journal. In general lines, aggressive sports of total contact such as rugby or American football are the most prone to produce this type of pain and impairment. Notwithstanding, there are several sports that are not as aggressive as those mentioned above, they also tend to produce thoracic back pain, repetitive load sports on the spine like rowing, gymnastics, and golf. Mid Back Pain whilst deadlifting in the gym? Valley Spinal Care (SPC) explains that the deadlift is one of the best and most complete exercises that we can do in the gym. It develops the strength of the whole body and the muscles of the back of the body that are usually neglected or underdeveloped. But, although it is one of the best exercises in the fitness world, it can also cause pain if we do not perform it correctly. For instance, how many times have you felt a sharp pain in your Mid Thoracic Back after doing the deadlift? The deadlift puts a lot of stress on your back and it is normal for your lower back to feel tired after doing the exercise, but your hamstrings, buttocks, lats and erector spinae muscles should also feel tired. If you only notice pain in your Mid Thoracic Back after doing the deadlift, keep reading this and let’s dive into it. How to prevent Mid Thoracic Back Pain while performing Deadlifting exercise routine in the gym? ·Don't lift too much weight Without a doubt, this is the factor that can cause the most pain in the back. Lifting too much weight will prevent you from maintaining the correct posture and technique for the exercise to be safe. ·Keep an adequate breathing technique in order to stabilise your core muscles area When you breathe, you lose internal pressure and control of the diaphragm that supports the spine. Breathing the right way is one of the best ways of the core muscles area to be prepared for carrying out your set of exercises, and it is also an essential part of doing deadlifting suitably. ·Execution speed Mainly, there are two ways to do the deadlift; with stop and without stop. The non-stop deadlift consists of hitting the discs on the ground as you come down from the bar and coming back up without a pause, making a kind of bounce. This form can be helpful in maintaining muscle tension throughout the exercise, but performance may be sped up and correct technique neglected. The deadlift with pause between reps allows you to get back into the proper position and maintain correct technique throughout the exercise. In this way, in addition to making exercise safer, you can help get the most out of it. ·Uneven grip width When holding the bar, be sure to spread your hands evenly apart with the same breadth of your legs. Using an uneven grip can put more strain on one side of the body, making the exercise more difficult, and can also lead to back pain. Concerned about your Back Pain Symptoms? MY SPORTS INJURY | Sports Physiotherapy clinic is easily accessible for the array of business people working in the city center and also offers corporate partners direct Sports therapy treatment into businesses and premises in and around Manchester. Some of the treatments that are available to the patients are Sports Massage, Sports Physiotherapy, Osteopathy & Body Postural Rehabilitation. Designed to treat the direct source of pain, not just the symptoms allowing you to live and pain-free optimal lifestyle. What are the most recommended stretches for Low- Back Pain & Mid-Back Pain by Sports Physiotherapy Manchester Specialists? 10 stretches for Low Back or Mid Back Pain  ·Stretch a Knee to the Chest for mid back pain Lie on your back with both knees bent, hold one thigh behind the knee with one hand and bring the knee toward the chest, hold this position for 20 seconds, relax, and repeat it 5 times on each side. ·Hamstring stretch for low back pain Lie on your back with your legs bent, hold one thigh behind the knee with your hand, slowly straighten your knee until you feel the back of your thigh stretch, hold this position for 20 seconds, relax, and repeat it 5 times on each side. ·Squat against the wall for back pain in general Stand with your back leaning against the wall, move your feet 12 inches in front of the body, maintain your ab muscles contracted as you slowly bend your knees 45 degrees, hold this position for 5 seconds, slowly return to the upright position, and repeat it 10 times. ·Opposite arm and leg exercise This simple exercise reduces tension in the lower back and also strengthens the abdominal muscles. Stand on four supports, with the palms of your hands on the floor and your knees bent raise and stretch your right arm and left leg until they are parallel to the ground, hold the pose for 4 seconds and slowly return to the starting position, repeat the activity with the opposite arm and leg, perform 3 sets of 10 reps on each side.  ·Opposite arm and leg on belly This activity is similar to the previous one, with the difference that this time you will keep your belly on the ground for support, instead of your knees. Lie face down on an exercise mat with your arms extended toward the crown of your head and your palms on the floor, simultaneously raise your right arm and left leg to a comfortable height, hold the position for a couple of seconds and slowly return to the starting position, repeat with the other side and complete 10 reps for each, and perform 3 or 4 sets per session. ·Pelvic elevation The pelvic lift or bridge is an exercise that works the muscles of the lower back and abdominal. Lie on your back on a mat, bend your knees, and put your feet on the floor; keep your hands at the sides of your body and keeping your back straight, lift your buttocks off the floor and lift your pelvis. Hold the pose for 10 seconds, rest, and repeat 10 times.   ·Hip flexion This is a Sports Physiotherapy exercise for Lower Back Pain, although, this exercise is designed to tone the hips, it is proven that it could also have a positive effect to strengthen the lower back, alleviating its discomfort. Put your left foot in front of the other, with your knee bent forward as you straighten your right leg, bend your trunk forward so that your left knee makes contact with the axillary fold and returns to the starting position, perform the same movement with each leg alternately until completing 10 repetitions. ·Oblique exercises The objective of these middle and low back pain exercises is to strengthen the muscles of the lumbar and oblique muscles of the waist. ·Cat-cow stretch This exercise can help make your entire spine, from your hips and lower back to your shoulders and neck, be more flexible. Support yourself with your hands and knees on the ground. The knees should be separated and aligned with the hips, and the hands should be aligned with the shoulders. Your stomach should be firm, as if you were trying to glue your belly button to your spine. Inhale and tilt your pelvis back so that it rises slightly, move your head up as if trying to look up at the ceiling, but don't strain your neck. As you exhale, pull your stomach toward your spine and hunch your back. You should look like an angry cat with a hunched back. Inhale and return to the "cow" position of this pose, perform 10 complete cycles from cat to cow Strech  ·Ball wall squat exercise for your lower back and middle back pain Slowly bend your knees 45 to 90 degrees, hold this position for 5 seconds. Straighten your knees and slowly bend your knees 45 to 90 degrees while raising both arms overhead. What is the mechanism of action of chest back pain? The Centers of Advanced Orthopedics (CAO) has indicated that the most common cause of thoracic back pain/ chest back pain is inflammation of the muscles, ligaments, tendons, or soft tissue of the thoracic spine. This inflammation can be caused by different factors that the general population usually does without realizing it, these are. ·Having suffered sudden sprain or strain (such as in car accidents or sports injuries). ·Having had a fall or a direct blow to the thoracic region can cause pain. Rib fractures that can have an effect on the thoracic nerves as well. ·Sitting for a long time in a desk or computer chair. ·Lasting a long time standing in a stooped position repeatedly. ·Repetitively carrying significant weight with your spine, such as a backpack or suitcase. ·Performing persistent movements where the thoracic part of the spine is involved (such as in sports or at work), also well-known as an overuse injury. Some of the less common causes are those that involve a disease or physiological factor such as Thoracic Herniated Disc, Arthritis, Spinal Infection, and Spinal Toumors. It cannot be assumed that all the pain in the thoracic back is due to the spine itself, in many cases the pain in this area is also produced by problems that affect the lungs, the upper part of the esophagus, the stomach, the pancreas, and up to the gallbladder, issued by Colin Tidy (2020). When you should go to the ER for back pain Sudden spike in pain, discomfort, weakness or numbness. Loss of bladder function. High fever. Severe stomach pain. Unexplainable weight loss. The pain results from a fall or severe blow to your back. Spinal pain rehabilitation is one of the most used and most effective methods in the treatment of both acute and chronic either low back pain or mid back pain and in any type of diagnosis. Sports physiotherapy rehabilitation encompasses a multitude of techniques ranging from kynesiotherapy, which covers everything related to exercises, to electrotherapy with the use of short wave or ultrasound, through hydrotherapy with baths at different temperatures. The role of sports physiotherapy Manchester specialist in the treatment of back pain is to reduce pain and improve the functional capacity of the patient, allowing him to return to work and day to day activities and lead a normal life. Physical therapy Manchester approach also has a preventive task with the aim of improving the patient's ability to manage the back problem and prevent it from appearing again, always attempt to see a sports physiotherapy Manchester expert in order to get your spinal discomfort and dysfunction fixed, request an appointment and finally live pain free. Published by Rafael Peña for www.mysportsinjury.co.uk References ·Karlson KA. Thoracic region pain in athletes. Curr Sports Med Rep. 2004 Feb;3(1):53-7. doi: 10.1249/00149619-200402000-00010. PMID: 14728915. ·Menzer, Heather MD; Gill, G. Keith MD; Paterson, Andrew MD Thoracic Spine Sports-Related Injuries, Current Sports Medicine Reports: January 2015 - Volume 14 - Issue 1 - p 34-40 doi: 10.1249/JSR.0000000000000117 ·Briggs, A.M., Smith, A.J., Straker, L.M. et al. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord 10, 77 (2009). ·Sterne E., Roig R.L., Guirguis M. (2019) Thoracic Back Pain. In: Abd-Elsayed A. (eds) Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-99124-5_136 ·Chua NH, Gultuna I, Riezebos P, et al; Percutaneous thoracic intervertebral disc nucleoplasty: technical notes from 3 patients with painful thoracic disc herniations. Asian Spine J. 2011 Mar5(1):15-9. doi: 10.4184/asj.2011.5.1.15. Epub 2011 Mar 2.

MY SPORTS INJURY REHABILITATION Structural Stability Exercises to Improve Scoliosis Symptoms based on a Pain Management approached Care Scoliosis is termed as a spinal disorder or a deformity in the spine that consists of an abnormal curvature of the vertebrae that compose it, normally people have a natural curvature in their spine when a curvature is considered as scoliosis it must exceed 10 degrees of abnormal angulation to be seen through an anterior-posterior plain radiography. According to a review posted byMedline Plus most of the time when the source of this affection is undefined is called idiopathic scoliosis. It can also be congenital (at birth) or neuromuscular. In some cases, it can develop due to serious injuries caused by sports injuries or accidents, issued by Joseph A Janicki, MD et la (2007). How is the physical examination for Scoliosis in Elite Athletes? The physical examination in the patients who are sustaining scoliosis should begin by taking into account general aspects such as the skin and the neuromuscular system before beginning to evaluate the shape of the back thoroughly, published by Benjamin Alman et la (2007). Height plays a fundamental role when examining the athlete's body as it is essential to control the risk of scoliosis curve progression and even more so when it comes to young patients. The length of the fingers and the extremities should be considered in athletes who have great stature and the relationship between this and the width of the arms helps to diagnose any other anomaly or syndrome that the athlete may be sustaining. In addition, patients who are suffering from scoliosis also suffer from hyperlaxis which is Increased range of movement of joints, and joint laxity the skin may need specialized treatment. Now you may wonder what does hyperlaxis refer to? Well, hyperlaxis in the joints is known as the result when the joints present an increased range of mobility, associated with functional disability, discomfort, and pain of the musculoskeletal system, said by Mariana Haro et la (2014). How to treat Scoliosis conservatively? Much research has been done about conservative treatments to treat scoliosis, what we know as conservative treatments are those that do not need to implement invasive measures such as surgery. The most common and most effective methods contemplate a series of medications for pain management and mostly Manchester physical therapy. A literature review published by R. A Dickson in the Journal of Bone and Joint Surgery explains that amongst the therapeutic programs used to treat Scoliosis symptoms there are some specialized modalities such as electrotherapy where electrical stimulation of the spinal musculature is implemented. Physical agents such as thermotherapy and the ones most frequently used are mechanical modalities consisting of manual physical therapy techniques and therapeutic massages to alleviate and posturally correct curvature, stated by T.Watson(2002). Some of the proven treatments programs which can be found at My Sports Injury Clinic are Myofascial Release, Deep Tissue Massage, Manual Therapy, Sports Physical Therapy, ´Physical Conditioning, Sports-Related Injuries, Acupuncture, Dry needling, Osteopathy, and Body Postural Rehabilitation. Which patients can and cannot receive conservative treatment for scoliosis? As claimed in a research article made by Heather Watters et la (2012) describes that to treat the scoliosis symptoms could be applied two different types of approach can be either conservative management or non-conservative intervention, thus the benchmark to select what kind of treatment is the most adequate will vary depending on the risk progression and how severe is the spinal curvature at the moment of physical clinical assessment with your physio Manchester. In this sense, young individuals that are still in the growth process and present a deviation of the spinal curvature above 45° may require surgery and those subjects that have fulfilled their growth cycle and go through a deviation higher than 50° need to be treated with non-conservative management as well.  To what extent can Scoliosis be managed by avoiding surgical treatment? It is key to note that age plays a major role when deciding on the physical therapy methods for scoliosis i.e. patients who experience a spinal deviation lower than 40° become into consideration as perfect candidates to undergo a physiotherapeutic program with our sports massage Manchester practitioners at My Sports Injury Clinic, explained by Marianna Bialek (2011). Which Scoliosis treatments are most effective, conservative or non-conservative? This will basically vary from the type of scoliosis that is manifested since we could be witnessing three different types of scoliosis, therefore, it could be mild, moderate, or severe, and in this way, our Manchester physical therapists and Chiropractors will determine what the next step to follow is. According to an article issued by Healthline, mild scoliosis is the condition in which conservative treatment is best accepted and has excellent results because the angle of deviation does not exceed 20 °. Whilst moderate scoliosis tends to be handled with Manchester physical therapy and scoliosis exercises, but wearing a back brace in order to correct the posture is also suggested by physio Manchester specialists and physicians, nearly 30% of moderate scoliosis cases require this orthopedic device and a minimum incidence of a 10% of the patients need surgical process involvement, assured by Paul Sponseller in a Johns Hopkins’s article. Meanwhile, when it refers to severe scoliosis the only possible pain management is to operate. What is the Schroth method for Scoliosis? An overview article by Outpatient Rehabilitation Services (CHOC) discusses that the Schroth method is a physiotherapy technique used to treat idiopathic scoliosis and other disorders of the spine. Furthermore, back problems are not limited to adults only; children can also have pain due to these deformations. It is a non-invasive method whose objective is the straightening of the spine, through self-stretching, rotational breathing, and stabilisation by isometric tension. Hence, it is important to acknowledge that Physical Schroth Therapy-based Scoliosis treatment can be really helpful when it comes to treating every case of Scoliosis whether be mild, moderate, or severe, and also there is no restriction of age. An article posted by IvyRehab affirms that it is extremely beneficial since is implemented in back/spine impairments rehabilitation processes and near muscles after going through a surgical procedure. The exercises promote the perception and knowledge of the body by the patient; the postures and movements that he usually performs. It also teaches how to optimise the muscles to achieve a more neutral position that can be consciously integrated into the patient's day-to-day activities. Diaphragmatic Breathing to Help Improve Structural vs Non-Structural Scoliosis A research study by Kaitlyn Alvarez (2019) has demonstrated that deep breathing or diaphragmatic breathing exercise protocols have been embraced as forms of treatment to tackle the curved backbones disorder known as scoliosis. Regarding the difference of the effectiveness of this treatment between structural and non-structural scoliosis is that the diaphragmatic breathing exercises and the so-called pilates where various postures are used such as axial elongation or the organization of the shoulder girdle help alleviate and slightly correct both types of scoliosis. Nevertheless, patients who sustain structural scoliosis tend to show fewer outcomes with these treatments since the course of the abnormal curves of the spine are much more accentuated, and the rib cage in some cases is collapsed causing a respiratory insufficiency. What are the Elite Athletes and Genders most likely to suffering from Scoliosis condition?  An article made by Noralign Functional Rehabilitation says that although scoliosis is normally congenital and develops during an early age, it tends to affect mostly girls, and in adulthood, women are also the ones who most often experience spinal problems. A study carried out at John's Hopkins Hospital and later published in the American Journal of Neuroradiology (AJNR) confirmed that the female gender suffers the most from this condition, however, information was also revealed that most of the cases were usually mild scoliosis. As for athletes, there is no concrete evidence that any specific sport causes you to develop scoliosis; regardless there are several cases in which athletes who perform disciplines with weights have had a slight progression in the curvature of their spine. One of the most popular cases of athletes with scoliosis is that of the Olympic medalists Usain Bolt and Michael Phelps. How long does it take for Physical Therapy-based Scoliosis treatment to be effective? As reported by Brian Dovorany (2020) in ScoliSmart’s review lays out that when scoliosis inflicts mild problems on children it could take from a semester to one year to observe positive progress and improvement in those affected subjects. Furthermore, the outcomes obtained from the recovery process could have a higher degree of efficiency if they are complemented with nutritional support and a muscle retraining program. That being the case Physical Schroth Therapy-based Scoliosis treatment program is equally as important as the any other physical therapy Manchester as if you complete your sports physiotherapy Manchester program successfully you will get excellent results on your spinal disabilities and discomfort, there is not any specific length of treatment because it will depend on the severity of the case. Although, an article of JohnsHopkins explains that the patients start to see the amelioration of symptoms once they already have around 5 to 20 sessions of this type of physical therapy Manchester approach. Which treatments are most effective?   Each treatment is equally effective since not all cases are the same, the recovery time will not be the same for all cases either, remember that what will really determine which treatment will be used to address your injury is the degree of curvature of your spine. Published by Rafael Peña for  www.mysportsinjury.co.uk References ·       Watters H, Volansky K, Wilmarth M (2012) The Schroth Method of Treatment for a Patient Diagnosed with Scoliosis: A Case Report. J Nov Physiother2:113. doi:10.4172/2165-7025.1000113. ·       Paediatrics & Child Health, Volume 12, Issue 9, November 2007, Pages 771–776, https://doi.org/10.1093/pch/12.9.771 ·       Białek M. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria. Scoliosis. 2011;6:25. Published 2011 Nov 28. doi:10.1186/1748-7161-6-25 ·       Rigo M, Reiter C, Weiss HR. Effect of conservative management on the prevalence of surgery in patients with adolescent idiopathic scoliosis. Pediatr Rehabil. 2003;6(3-4):209–214. ·       Coillard C, Circo A, Rivard CH. A new concept for the non-invasive treatment of Adolescent Idiopathic Scoliosis: the Corrective Movement principle integrated in the SpineCor System. Disabil Rehabil Assist Technol. 2008;3(3):112–119. doi: 10.1080/17483100801903913. ·                        Rigo M, Quera-Salva G, Puigdevall N. Effect of the exclusive employment of physiotherapy in patients with idiopathic scoliosis. Proceedings Book of the 11th International Congress of the World Confederation for Physical Therapy. London. 1991. pp. 1319–1321.

HOW TO FIX SPORTS RELATED UPPER EXTREMITY GOLF INJURIES: A SPORTS PHYSIOTHERAPY APPROACH TO TREATMENT, PAIN MANAGEMENT & RECOVERY. Have you ever undergone excruciating ache on the inside of your elbow? You are likely to suffer from what is termed medial epicondylitis which is a tendinopathy of the medial common flexor tendon of the elbow or also well-known as either thrower’s elbow or golfer's elbow, this condition, like tennis elbow, is one of the most common causes of elbow pain. Golfer's elbow is an inflammation of the insertion of the tendinous soft tissues and muscles. The pain of this lesion appears on the inside of the elbow when performing certain movements with palpation performed in a physical clinical assessment. Physiotherapeutic treatment and appropriate self-management is required to alleviate this pain. In this blog post, you will learn about golfer’s elbow signs and causes, golfer’s elbow symptoms that allow it to be detected, golfer’s elbow treatment, and correcting it through sports physical therapy and sports massage therapy treatment. Medial epicondylitis (golfers elbow) represents 10% up to 20% of all tendinopathies of the inner elbow prominence. Golfer's elbow or medial epicondylitis is less frequent than tennis elbow or lateral epicondylitis. Its prevalence is 0.4% worldwide. Affecting mostly people between 45 to 65 years old, being more common in women than in men. 3 out of 4 cases of golfer’s elbow are found in the dominant arm of the affected subject, pointed out byJohn Kiel et la (2021). It is also considered an occupational disease, which has a high prevalence of 3.8% to 8. 2% in some occupations, and although it is known to affect some who play sports (golfers, baseball players, and American football players), it should be noted that 90% to 95% of all patients diagnosed with this injury are not even athletes, stated out by Shiri R et la (2006). The leading treatment includes releasing restrictions, strengthening and stretching underlying tissues, and exercises for the golfer’s elbow which can be guided by our Sports Injury Specialists at My Sports Injury Clinic based in Manchester City. Sports physiotherapy, sports massage and manual therapy are essential services carried out by our experts specialized in treating and managing sports-related injuries that will help alleviate elbow pains. What movement & motion causes the golfer’s elbow? Golfer's elbow symptoms manifest themself with pain in the area of insertion of the tendons on the inside of the elbow, due to strenuous or repetitive movements, direct trauma or over-exertion when doing flexion and pronation twisting movements, and also when performing sports activities like golf, baseball or simply carrying out manual work, i.e. it does not have to be caused just by sports practices.  Nevertheless, you might feel pain in the entire arm as the pain may radiate to the full length of your limb, published by the Institute for Quality and Efficiency in Health Care (IQWiG);  Due to the high mechanical demand to which the golfer's elbow flexors are exposed, this type of injury frequently occurs in them, which is why it is often thought that this is an exclusive condition of this type of sporting activity and that it is the only one related to golf, however, people who have never played golf can suffer from it, as well as it is important to make clear that golfers not only suffer from this tendinopathy but are exposed to many more sports injuries. Golfer's symptoms and signs, how do you know if you suffer from golfer's elbow? If you have got Golfer's elbow you will perceive a notable discomfort, which will present as a stabbing pain inside the elbow, which can sometimes radiate throughout the flexor or anterior side of the forearm, in addition, the discomfort can occur when applying pressure on the internal region of the elbow, what we call the epicondyle. Golfer’s elbow symptoms often appear more intensely when the muscles of the affected tendons (i.e. the wrist flexors or pronators) are activated. For instance, when a fist is formed, the wrist is flexed, or when you want to reach an object at a certain distance. These movements can create pain in the inner side of the elbow referring to the golfer’s elbow. Golfer's elbow tends to affect flexion and pronation of the hand and forearm even more when performing movements against resistance, so affected patients are increasingly restricted in their activities of daily living, even simple tasks such as writing or lifting light objects can become a problem due to the presence of pain. In addition, not only does active movement causes discomfort, but also passive stretching, and if the injury progresses without treatment, pain at rest can also take place. In the case of a golfer's elbow or epicondylitis, the degenerative process that occurs in the tendons (tendinopathy) becomes increasingly aggressive, which can cause neuropathy in the ulnar nerve that is adjacent to the affected area, this leads to the appearance of symptoms such as tingling or paresthesia in the flexor region of the hand and fingers, also called golfer’s hand. Does golfer's elbow merely come about in elite athletes? Although the injury is called golfer's elbow or thrower’s elbow, as we previously mentioned, this does not imply that these athletes are the only ones affected, in fact, the prevalence of this condition is lower in them. Hence, we can enlighten that the foremost reason for this condition to happen is a result of keeping the forearm muscles inactive, and then having sudden exercises or activities that require to overly use the muscles steadily. That being the case, the most frequent activities that prompt the golfer’s elbow are sports like weightlifting, golf, and sporting events that involve throwing movements (e.g. shot put, baseball, cricket, hammer throw, American football, and javelin to name a few).  In the same way, it is relevant to understand that golfer’s elbow can arise by performing manual work tasks like chopping wood, hammering, repairing things, and painting. It is for this reason that we can point out that certain occupations such as plumbing, construction, and carpentry are directly linked as the source of golfer's elbow injury, as well as when cooking, for instance, peeling, and chopping, presented by Kimberly Kaiser et la (2021). Another issue to clarify is that contrary to popular belief, the "swelling" that is usually present at the beginning of this condition does not cause pain. Thus, pain on the inner side of the elbow is due more to tendinopathy and tendon degeneration than to inflammation. The inflammation is just a reaction of your body, in an attempt to repair the tendon when it is overstressed or injured, said by Christopher L. Reece et la (2021). Some situations can promote tendon degeneration of the elbow and therefore lead to medial epicondylitis, such as tobacco use and the presence of type II diabetes. Our Sports Injury Clinic in Manchester is formed by top-notch sports rehabilitators such as sports physiotherapy Manchester clinicians and sports massage Manchester practitioners that implement their knowledge and expertise in the area of primary health care, physical rehabilitation, and sports therapy  Manchester, in order to provide specialized patient care, sports injuries management, and get the patients back to their optimal capability and well-being as the main aim, in this sense, we summarize our services below. ·      Physiotherapy for Sports Injuries regarding sprains, bruises, muscle injuries. ·      Traumatological Physiotherapy regarding fractures, contusions, post-surgical rehab, fissures, sprains, dislocations, tendinitis, lumbago. ·      Rheumatological Physiotherapy regarding arthritis, osteoarthritis, fibromyalgia. ·      Neuromuscular Bandage to reduce pain, inflammation, improve blood circulation, amongst other benefits. ·      General Conditioning includes Manual Therapy and Acupuncture. Golfer's elbow prognosis, how long does a golfer’s elbow take to heal? In accordance with our Physio Manchester specialists in untreated cases, this condition usually takes to heal 6 months up to 2 years or becomes chronic, this means symptoms for a lifetime. Notwithstanding, in most of the treated cases the prognosis is favorable since the golfer's elbow responds very well to sports physiotherapy Manchester conservative treatment, i.e. nonsurgical procedure, pointed out by Amrit V Vinod et la (2015). This gets across that in a few weeks the symptoms shall wear off with conservative management as sports therapy Manchester is significantly an effective management modality to treat elbow joint pain, accordingly discomfort and soreness might disappear utterly in one year. Nonetheless, conservative management usually works for golfer's elbow treatment, if symptoms do not subside within a few months, operative treatment may be required, and also some patients who suffer a relapse after being treated conservatively, ranging from 5% up to 15% but this occurs when the rehabilitation process has been disrupted or was not effectuated as physio Manchester indicated, displayed by Michael C Ciccotti et la (2004). How can a golfer’s elbow be diagnosed? To give an accurate diagnosis, a thorough physical clinical assessment and the patient clinical history are mandatory, the evaluation will be conducted by your doctor or physiotherapist Manchester specialist who will detect if by pressing or flexing the arm, the pain appears or worsens., this physical examination will be composed of tests, imaging studies, and lastly an MRI which is the gold standard to determine and confirm the condition and rule out the presence of other pathologies such as ulnar neuritis. and ulnar collateral ligament instability, indicated by Michael A. Schwartz et la (2004). How to speed up the recovery process for the golfer’s elbow? What’s the cure for elbow pain? The Physical therapy provided in MY Sports Injury Clinic can help relieve elbow pain and increase the recovery process. Using prescribed pain killers alongside golfer’s elbow exercises can reduce stress on the elbow, speed up the recovery process, and minimize the risk of recurrence. Recent innovations in Platelet-Rich plasma injection (PRP) have also shown optimistic results in the process of getting better, explained by Ankit Varshney et la (2017). How to get rid of the golfer’s elbow? The Sports Physiotherapy approach is the cornerstone of care to cure elbow joint pain It is indispensable to attend to the specialist doctor | Sports physiotherapy in Manchester as soon as possible to prevent this injury from progressing and complicating. Pain relievers and anti-inflammatories alone do not improve the problem. Rest, wearing a golfer’s elbow brace, and applying local ice can help relieve symptoms, but it is still not enough. It is necessary to obtain professional help to treat this injury, which is not only limiting, but also very painful. As highlighted above, the treatment to be selected in most cases is conservative, due to its high recovery rate and the few contraindications and side effects. The objectives to be met are mainly to reduce pain and recover functional capacity, for this it is vital to restore flexibility and normalize the strength of the forearm muscles. In addition, it is worth mentioning that non-surgical supportive care reports an 85% up to 90% of effectiveness rate, published in a research study of the Division of Sports Medicine, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital/Rothman Institute, Philadelphia (2004). From our point of view, we maintain that for the definitive solution of medial epicondylitis or golfer’s elbow symptoms it is imperative to assess all the aspects that may cause said injury, not only those of musculoskeletal origin but also visceral and emotional ones. Bearing this in mind, the various techniques and therapeutic tools of sports physiotherapy will be oriented not only to cease the pain and other symptoms but also to the resolution of the present causes. Next, we will present to you the most effective physiotherapeutic techniques and measures for the treatment of this condition: ·      Postural education. ·      Pain education. ·      Immobilization or preion of a golfer’s elbow brace. ·      Neuromuscular bandage. ·      Cryotherapy. ·      Transcutaneous Electrical Nerve Stimulation (TENS). ·      Ultrasound, ·      Eccentric exercises. ·      Myofascial relaxation of the wrist flexor muscles. ·      Ischemic compression for myofascial trigger points. ·      Decontracting massage of the epitrochlear muscles. ·      Golfer’s elbow stretching exercises. ·      Intratissue percutaneous electrolysis (EPI). ·      Dry needling. ·      Shock waves. ·      Neurodynamic exercises ·      Medicinal plants and sports phytotherapy. ·      Stress control and nutritional corrections. The choice of any of the aforementioned techniques will depend on the characteristics of the patient to be treated, the causes, and the objectives that the sports physiotherapist specialist and the patient wish to meet.   Published by Rafael Peña for www.mysportsinjury.co.uk     References ·      InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Golfer's elbow: Overview. 2018 May 30. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507002/ ·      Amin NH, Kumar NS, Schickendantz MS. Medial epicondylitis: evaluation and management. J Am Acad Orthop Surg. 2015 Jun;23(6):348-55. doi: 10.5435/JAAOS-D-14-00145. PMID: 26001427. ·      Ciccotti MC, Schwartz MA, Ciccotti MG. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med. 2004 Oct;23(4):693-705, xi. doi: 10.1016/j.csm.2004.04.011. PMID: 15474230. ·      Reece CL, Susmarski A. Medial Epicondylitis. 2021 Jul 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 32491792. ·      Vinod AV, Ross G. An effective approach to diagnosis and surgical repair of refractory medial epicondylitis. J Shoulder Elbow Surg. 2015 Aug;24(8):1172-7. doi: 10.1016/j.jse.2015.03.017. PMID: 26189803. ·      Varshney A, Maheshwari R, Juyal A, Agrawal A, Hayer P. Autologous Platelet-rich Plasma versus Corticosteroid in the Management of Elbow Epicondylitis: A Randomized Study. Int J Appl Basic Med Res. 2017;7(2):125-128. doi:10.4103/2229-516X.205808. ·      Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006 Dec 01;164(11):1065-74.  

AN OVERVIEW OF PERONEAL NEURALGIA BASED ON SPORTS PHYSICAL THERAPY, TRAUMA AND PAIN MANAGEMENT. The neuralgia of the peroneal muscle is a very rare condition that generally occurs after having suffered trauma or a metabolic syndrome. But it can also be caused by the existence of tumors. This neurological disorder is as a result of an abnormality in the function of this nerve or a lower extremity injury and is subject to experiencing certain neurological deficits and ache throughout the peroneal muscles area.Patients who suffer from this condition tend to experience extremely painful episodes at the slightest stimulation, initially, they will be short and infrequent, however, if the disease progresses untreated, the pain will be more acute and prolonged. An important aspect of neuralgia is that it affects mostly women and is more likely in people who are older than 50 years old.These incidents can become more and more constant and lasting so it is vital to see a medical doctor, sports medicine specialist or sports physiotherapist in manchester when you begin to feel reoccruing pains that are not relieved with analgesics. The sporting events where is more likely to present this kind of injury are baseball, mountain climbing, and gymnastics. There are a wide variety of treatment alternatives for those who suffer from peroneal neuralgia, if this is your case, you are not destined for a painful life, you just have to comply with the appropriate treatment. Often it is found damage nearby the hip that could jeopardize the nerve, a particular injury that involves this nerve is the fracture of the acetabulum which reports a 16% up to 33% prevalence.  Y Hirasawa et la point out that peripheral nerve injuries in sports just reach up to 0.5% of whole sports-related lesions. Firstly we have to understand the anatomical structure of this area, and the distinction between neuralgia and neuropathy as they could be confounded hence it can be a challenge to identify them and diagnose them in clinic. We recommend that you visit a Sports Medical Doctor or / sports injury specialist in order to carry out a physical assessment and examination to determine an accurate clinical diagnosis. Initial appointment bookings can be made by visiting MY Sports Injury Physical Therapy and Rehabilitation Clinic in Manchester City MY Sports Injury Clinic, we offer comprehensive and specialised care; our focuses are movement as a main outcome to recover, to maintain optimal quality of life and re-establish activities of daily living. Our professional practitioners have a depth of knowledge expertise, and experience in providing a high quality standard of care. At MY Sports Injury Clinic | Manchester we also provide an holistic approach using effective, safe treatment techniques and advanced technology, seeking to shorten rehabilitation times and prolong functional movement, overall health and longevity. Some of the specialist treatments services we carry out are Sports physical therapy, Medical Acupuncture, Sports massages, Deep tissue massages, sports injury rehabilitation amongst others. The most frequent pathological conditions / Injuries that our Sports Injury Specialists handle at My Sports Injury Clinic are Musculoskeletal injuries, fractures, sprains, myalgia, dislocations, pre and post-operative, overuse injuries, postural disorders, muscle imbalances and Pain management.   What is the difference between neuralgia and neuropathy? The main reason why it is possible to differentiate these pathologies is that neuralgia is known only as a disorder in the sensitivity of a nerve, generally, it is caused by sports injuries (i.e. direct trauma and sometimes by underlying diseases such as irritation, chronic kidney disease, and diabetes, HIV, herpes, and syphilis infections, as well as pressure on nerves from nearby tumors, ligaments, blood vessels, and bones. For instance a carpal tunnel injury (Wrist & hand) is neuralgia as it is commonly brought about as a consequence of a pronator teres contracture. According to our Sports physio Manchester practitioners state that the neuropathy refers to the lesion of the peripheral nervous system and produces swelling, numbness, pain, and muscle weakness. It can be the result of metabolic problems, infections, sports injuries, traumatic injuries, and exposure to toxins. In addition, one of the most common underlying diseases is diabetes. In most acute cases, the symptoms improve especially if they are treated immediately.   What are the peroneal muscles? The peroneal muscles are muscles that are spotted on the lateral aspect of the leg, between the knee and the ankle. It is responsible for stabilising the ankle and helping to avoid sprains when we twist the ankle. The injuries that most frequently affect these muscles are those products of repetitive and excessive movements that end up generating the establishment of an inflammatory process in the tendons. Therefore, one of the most common injuries that come about in this area is peroneal tendonitis. Other injuries that also affect the tendons are the rupture or tear of the fibers. So the person experiences pain, movement limitation, tissue deficiencies, edema, and, in many cases, bruising. Now, whether the tendon or muscle fibers are affected by contractures or painful points, medical treatment and physiotherapy Manchester sessions are required to help repair the tendons or muscle tissue, which help reduce discomfort, pain management, and also to regain functional movement back into the body. What do the peroneal muscles do? Both fibulae are powerful muscles so they are able to intervene in various movements in the area. So, while the long one is in charge of plantar flexion and the eversion movement of the foot, the other intervenes only in this last movement, which is composed of abduction and rotation.     Where are the peroneal muscles? The peroneal muscles are tissues that belong to the lateral muscles of the leg, which is why they are located on the external outer face of the fibula bone, their function is to evert What are the symptoms of a patient with peroneal Neuralgia?  Broadly patients suffering from this condition tend to express and present the following signs, e.g. hyperalgesia, sensory loss, and pain sensation triggered by stimuli that do not normally cause pain that is regularly located in the lower leg and dorsal foot.As well, there may be the presence of a motor function deficiency, mainly paresis which is muscular weakness caused by nerve damage. How to treat peroneal Neuralgia based on sports physical therapy Neurodynamic exercise rehabilitation can help to mobilise the nervous system this is a group of exercises performed by the Injured Patient. Neurodynamic movements will try to improve the glide and slide mechanism of joints and peripheral nerves including the tissues that surround them, therefore, it is about releasing nerves that may be trapped or adhered causing patients loss of strength, sensitivity or unpleasant tingling, this series of exercises should be specifically dictated and supervised by your sports specialists or sports physiotherapist Manchester once you are diagnosed which such nerve injury. How does the peroneal nerve heal? Consult with your sports physio Manchester what is the best plan for your case, generally, the peroneal nerve heals with physical therapy that consists of strengthening the muscles of your foot and leg, orthotics can also be used, an ankle and foot brace is used to treat foot drop and lastly method to treat the injury of this nerve we find the surgery that is effective as well, the surgical options are to repair the nerve, remove the pressure from the nerve or graft a new nerve in its place. Said by D Garozzo et la (2004). What happens if the peroneal nerve is damaged & How MY Sports Injury can help recovery? When the nerve is injured and this leads to dysfunction, symptoms may include decreased sensation, numbness, or tingling in the upper part of the foot or in the outer portion of the lower or upper leg. As also, the foot drop that is the inability to keep the foot horizontally. At our sports massage Manchester city centre we can provide assistance and guidance with Sports Therapy / Sports physiotherapy sessions that will help to strengthen leg muscles and maintain range of motion in the knee and ankle may improve gait problems related to peroneal nerve injury. Stretching exercises are distinctly essential to avert heel stiffness. How to assess the peroneal nerve? Our sports therapy Manchester physiotherapists will perform a set of maneuver tests of nerve activity that include ultrasound of the nerves, nerve conduction tests i.e. to measure how fast nerve signals pass through the nerves, MRI, and electromyography. Moreover, they also will carry out some motor involvement tests to assess the peroneal nerve, those are known as foot/toe dorsiflexion (DPN) and foot eversion (SPN), issued by Bradley Lezak et la (2021). What innervates the superficial peroneal nerve? The superficial nerve of the fibula supplies the long and short peroneal muscles. This nerve culminates in a sensory branch that innervates the skin of the distal lateral region of the leg, the dorsum of the foot, and the toes, except for the first interdigital space. Published by Rafael Peña www.mysportsinjury.co.uk   References ·       Hirasawa Y, Sakakida K. Sports and peripheral nerve injury. Am J Sports Med. 1983 Nov-Dec;11(6):420-6. doi: 10.1177/036354658301100607. PMID: 6650720. ·       Radić B, Radić P, Duraković D. PERIPHERAL NERVE INJURY IN SPORTS. Acta Clin Croat. 2018;57(3):561-569. doi:10.20471/acc.2018.57.03.20. ·       Lorei MP, Hershman EB. Peripheral nerve injuries in athletes. Treatment and prevention. Sports Med. 1993 Aug;16(2):130-47. doi: 10.2165/00007256-199316020-00005. PMID: 8378668. ·       Garozzo D, Ferraresi S, Buffatti P. Surgical treatment of common peroneal nerve injuries: indications and results. A series of 62 cases. J Neurosurg Sci. 2004 Sep;48(3):105-12; discussion 112. PMID: 15557879. ·       Katirji B. Disorders of peripheral nerves. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 107. ·       Toro DRD, Seslija D, King JC. Fibular (peroneal) neuropathy. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 75.

AN OVERVIEW OF THE CAUSES, TREATMENT & PREVENTION OF ABDOMINAL MUSCLE INJURIES -Sports Physiotherapy can be considered to be an essential service for an effective recovery of coremuscleinjuries specifically Abdominal Strain & sports related hernias- The core muscle injury implies possible damage that can occur to the musculoskeletal area of the mid-section, it is comprised from the chest to the mid-thigh. On the other hand; an ab strain is an injury that damages the internal structure of the abdominal muscles. The abdominal strain is characterised by stretches or tears within the muscle. Although the signs are quite similar to a hernia, we are not talking that they are the same condition. When a muscle is roughly stretched passively (without muscle contraction) or actively (with contraction) muscle tear (sprain) may occur. They are frequent, especially in: The muscles that cross the joints such as those of the hip and in the musculotendinous junction. Muscle injuries are highly common in sports that require a high demand and can reach a total of 10 to 55% of all acute injuries in sporting events, stated by Nicola Maffulli et la (2015). According to statistics, 31% of all lesions in elite football are linked to muscle injuries such as strain, sprain, and tears, and causing the injured player to be absent approximately 25 days from any sports practice including training. What are the Core Muscles and their functions? You may think that it refers only to the area of the body where the abdominal muscles are located but actually, it points out to the abdominal, lumbar, pelvic, gluteal, and deep spinal muscles. MayoClinic explains that the main function of the 'core' is tostabilise the lumbopelvic region that is key in the human body since it is the body stabilisation point for any type of movement, it is the area that gives body control, posture, and balance in sports of high intensity with quick changes in direction.      How can I sustain an abdominal strain? This condition is caused by overexertion of the abdominal muscle, which can happen by doing an activity for which the muscle is not ready, exercising excessively, doing exercise or sports activities improperly, lifting heavy objects, and twisting the body suddenly. What are the activities that can inflict a Pulled Abdominal Muscle to be worse? A post of ClevelandClinic reports that the factors that could increase your chance of developing an abdominal muscle sprain: not stretching properly before exercising, overstressing the muscles, doing sports activities and abdominal strains exercises incorrectly (especially sprinting and jumping), have weak back muscles, participate in vigorous activity, exercising in cold weather, striking the ball. If you have any of these risk factors you must tell your Sport physio in Manchester in order to tackle the abdominal strain most competently. Are abdominal muscle injuries like an abdominal strain predominant in football? Christian Brix et la (2013) lays out that owing to the fact that football is a contact sport, a slew of abdominal injuries can come about, and, these are mainly brought about by blunt trauma. Injuries to the abdominal wall in football are not entirely common however when they do occur they are categorised as severe. For this type of condition, an accurate diagnosis dictated by an MRI is indispensable. Management through a surgical process has shown encouraging outcomes. Core injuries have been reported to have a low incidence figure in professional football in England with 7% of all injuries occurring over numerous seasons. The mechanisms of action most seen for these types of incidents to occur are direct blows to the area, or very sudden movements of the torso that can cause distension. The muscles of the abdominal wall that are most affected are transverse abdominis, internal and external obliques and rectus abdominis, research made by Rob Johnson MD (2014). What is the mechanism of action of the semitendinosus and bicep femoris muscles in a hamstring strain in football players? Joke Schuermans et la (2014) presents that hamstring strain injuries are closely linked to the capability of the semitendinosus muscles and the bicep femoris muscle to provide reaction and support when being taken part in synergistic muscle movement. What are the symptoms that may indicate an Abdominal Muscle Strain?Verywellhealth says that whether you present any of these pulled abdominal muscle symptoms, do not assume it is due to an abdominal muscle sprain. Since these symptoms may be yielded by other conditions, too. Inform your sports massage therapist practitioner in Manchester if you experience any of the following manifestations: ·      Muscle pain immediately after injury. ·      Stiffness and discomfort. ·      Difficulty flexing or feeling pain when stretching the muscle. ·      Pain when touching the area. ·      Muscle spasms. ·      Swelling or bruising (in severe cases). If you’ve torn the muscle, you will feel severe pain. Our work in My Sports Injury Clinic is to provide high quality treatment alongwith education and injury prevention care to each of our patients, whether they are elite athletes, sports players, or regular everyday people. All things considered, we have the best solution when addressing your injury, some of the treatments that we offer in our establishment and home visits are sports physiotherapy, Manchester deep tissue massage, dry needling, body postural rehabilitation, cupping & Chinese medicine acupuncture.    What does a Pulled Abdominal Muscle Injury feel like? If you do suffer from a pulled abdominal muscle the outside of your abdominal wall may have the sensation of feeling very swollen and tender. You may be able to experience these sensations when performing any movement that involves the muscles of the abdomen. How can an Abdominal Strain be diagnosed?                          The sports physio Manchester will ask about your symptoms and medical history. During the thorough physical examination and various abdominal muscles testing, sports therapist will look for: ·      Tenderness over the muscle area. ·      Pain, especially when the muscle contracts ·      The Ability to perform adequate movement testing or movements. How is classified a pulled abdominal muscle injury? The sports therapy Manchester clinicians will classify the degree of the pulled abdominal muscle depending on how severely you have been injured: ·      First degree - muscle fibers are injured; 2-3 weeks to recover. ·      Second degree - a larger number of muscle fibers are injured; 3-6 weeks to recover. ·      Third degree - muscle is torn, may require surgery; about 3 months to recover. How long do core injuries take to heal? If you undergo conservative treatment as sports physiotherapy in Manchester, the recovery time could vary from two weeks to four weeks. Notwithstanding, if we refer to a non-surgical treatment we would be talking about 3 to 8 weeks to fully recover and return to the prior level of proficiency, without ruling out the option that could take more time than estimated due to complications in the rehabilitation process. How long can it take for a Pulled Abdominal Muscle to cure? An article published by MedicalNewsToday informs that a pulled abdominal muscle could take to subside to 15 days up to 31 days if it is a severe case, nevertheless, if we make reference to a mild abdominal strain it could be sorted out in less time. How do you rehab a Strained Stomach Muscle? To treat this pulled abdominal muscle condition, we should have previously attended a physio Manchester specialist to confirm the diagnosis and thus start off the approach methods, what is the pulled abdominal muscle treatment?  After the injury, stop the activity immediately. ·      Rest as needed. ·      Apply a cold compress for 15-20 minutes. Apply ice four times a day for 1-2 days. ·      Take pain relievers, (OTC) such as acetaminophen or ibuprofen. These can also help decrease swelling. ·      Manual therapy Manchester. ·      Gently perform mild stretching exercises when the pain goes away. ·      If you do not improve in 1-2 days, call your Manchester deep tissue massage practitioner up. ·      Ask your sports therapy Manchester physician when you can return to your normal activities. ·      When you feel better, do exercises to slowly regain strength. ·      Use warm compresses when you return to activity. ·      Isometric and concentric muscle exercises. What are the most common injuries of a Strained Stomach Muscle? Some of the most representative muscles of this area are denominated Transverse Abdominis, and the most common injuries of a Strained Stomach Muscleare named Osteitis Pubis,  and Serratus Strain. The primary function of the transverse abdominis is to stabilise the spine and it is also known as a compressor of the entrails of the gut.    In addition, if we focus on the incidence of this condition (Osteitis Pubis) in the general population, we can view that only 0.5% to 6.5% suffer from it, published by Justin A Classie et la. In as much as, the serratus muscle we could say that as it is the only skeletal muscle tissue in the internal area, it has the task of connecting with the scapula in order to keep it in position, likewise by sliding its fibers and contracting it is capable of moving the same bone to which it is attached to be able to perform a rotatory motion. Is it a hernia or pulled muscle? Abdominal Strain vs Hernia The abdomen is a region vulnerable to various pathologies, especially when the person exercises or carries out work carrying heavy objects, these actions can cause injuries to the abdominal wall. For this reason, it is essential to tell the difference, hernias are defects or holes that allow the contents of the abdomen, mainly the intestine and peritoneum, to escape through natural or anatomical orifices, and as time passes this can be noticed and palpated in the form of a bump. Whilst the abdominal tear or pulled abdominal muscle is the injury or rupture in the interior of any muscle of the abdominal wall that occurs after a sudden exercise or movement. How to stave off a pulled stomach muscle to help reduce your chance of getting this condition, take the following steps: ·      Stretch before exercising and cool down afterward. ·      Don't get too exhausted while exercising. ·      Get the right training for sports and exercises. ·      Do exercises to strengthen your abdominal muscles. Work with a personal trainer or a physical Manchester therapist. ·      Learn to lift heavy objects properly, and if you are tired, stop exercising. When you bear abdominal pain, seek out medical attention right away. How can you tell the difference between Muscle Strain and Muscle Soreness? To distinguish the difference it is necessary to know that the main difference lies in the onset of pain, usually, a pain caused by a pulled abdominal muscle will appear almost immediately, and it is intense. However, the pain that is caused by muscle soreness can occur after one or two days, issued by UT Physicians.                   Published by Rafael Peña for www.mysportsinjury.co.uk References ·       Anderson, M.K., Hall, S.J., & Martin, M. (2005). Foundations of Athletic Training: Prevention, Assessment, and Management. (3rd Ed.). Lippincott Williams & Wilkins: Philadelphia, PA. ·       Arnheim, D.D. & Prentice, W.E. (2000). Principles of Athletic Training. (10th Ed.). McGraw Hill: Boston, MA. ·       Ekstrand J, Hägglund M, Waldén M. Epidemiology of muscle injuries in professional football (soccer) Am J Sports Med. 2011;39:1226–32. ·       Garrett WE., Jr Muscle strain injuries: clinical and basic aspects. Med Sci Sports Exerc. 1990;22:436–43. ·       Muscle strain (pulled muscle). (n.d.).https://www.hopkinsmedicine.org/orthopaedic-surgery/specialty-areas/sports-medicine/conditions-we-treat/muscle-strains.html ·       Sprains, strains and tears. (2011). https://www.acsm.org/docs/default-source/files-for-resource-library/sprains-strains-and-tears.pdf?sfvrsn=5b229fcf_2 ·       Schuermans J, Van Tiggelen D, Danneels L, Witvrouw E. Biceps femoris and semitendinosus--teammates or competitors? New insights into hamstring injury mechanisms in male football players: a muscle functional MRI study. Br J Sports Med. 2014 Dec;48(22):1599-606. doi: 10.1136/bjsports-2014-094017. PMID: 25388959; PMCID: PMC4267196. ·       Brix C, Lohrer H, Hoeferlin AABDOMINAL MUSCLE INJURIES IN SOCCER–SURGICAL CASE SERIESBritish Journal of Sports Medicine 2013;47:e3. ·       Johnson, R. Abdominal wall injuries: Rectus abdominis strains, oblique strains, rectus sheath hematoma. Curr Sports Med Rep 5, 99–103 (2006). https://doi.org/10.1007/s11932-006-0038-8.

High Impact and contact actions causes & effects of Sports Injuries. Sports injuries are linked to exercise and can be due to various sources, such as not stretching properly, poor sports practice, an sports incident derived from the actions of a strong impact or contact in physical activity, or lack of regular exercising, amongst other factors. In this post, we will talk about the most frequent sports injuries yielded by high impact and contact actions, the treatment for sports injuries, and how to prevent them, under the evaluation and counseling of MY Sports Injury & physiotherapy | Manchester in our sports injuries clinic known as My Sports Injury Clinic. There are a large number of high-performance athletes and amateur practitioners who bear a sports injury stemmed from severe contact and impacts, either harsh hits with other athletes, objects with which sports activity are performed, or with the surfaces where sports practises are carried out.In high-impact and contact sports where these sports injuries occur more frequently, we find disciplines like football, basketball, boxing, rugby, mixed martial arts, and other extreme sports such as skiing, motorcycling, and motor racing. According to the latest investigation study of Eduardo Tondelli et la (2021), it was possible to demonstrate that the recurrence per game of the sports injury in rugby could be estimated up to 52.4%. Of this statistic, a range of 62.8%, were sports injuries caused by contact, with the lower extremities being the most common injured areas accounted for 58.9%, the most critical injury turned out to be anterior cruciate ligament tear and the one with the highest incidence rate was hamstring strain injury within Rugby & football.       On numerous occasions, a high impact contact could trigger the athlete to lose balance; this would mean that the affected athlete would have to make sudden movements to change direction and twist to trying to compensate for the loss of stability, this generally brings about damage to connective tissue and in the case of suffering a very strong impact, a joint displacement could come about. In addition, Mark Pallis et la (2012) published that acromioclavicular joint separations are quite observed amongst young athletes, men are more likely to sustain it, and where the greatest number of cases of this sports injury was evidenced was in the practise of athletics, adding up to 91%. Another injury of this characteristic is the Anterior Cruciate Ligament (ACL); predominantly has an effect on young individuals, calculating over 200.000 cases of this sports injury in the United States yearly. Moreover, up to 15,000 operations per year of the rupture of the (ACL) have been carried out in England, pointed out by David Beard et la (2017).    This sports injury named ACL has a prevalence of 11.1% in professional football players according to studies made by the Noyes Knee Institute (2018). What are the types of impact and contact sport injuries?The kinds of injuries sustained by impact and contact actions are generally of a violent nature due to collisions with other individuals or elements necessary for sportspractise; as a result of these incidents we as sports physio Manchester also known as sports injuries specialists can spot bruises, cuts, muscle aches, head injuries, dislocations, and even broken bones, explained by a post issued by Sports Medicine Information. Broadly, these high-impact sports injuries get to encompass contusion traumas, fractures, spinal and head injuries, and damage to connective tissue such as ligaments and tendons.  What is the Appropriate Treatment for these sports injuries?As a starting point, treatment for sports injuries will be based on the extent and severity of the injury. Sports injuries that are considered high risks such as bumps, head contusions, and spinal injuries should be treated more urgently. Whereas the other injuries that are not categorised as emergency medical conditions like dislocations, fractures, damage to the connective tissue, strains, sprains, ruptures, and superficial injuries will be treated and heal properly under the supervision of a custom-tailored Sports physiotherapy Manchester treatment. In the most severe cases, a surgical procedure may be needed. Although, both surgical and conservative treatment are be very effective for all types of musculoskeletal conditions.   A Borussia Dortmund player (Youssoufa Moukoko) - performing a Prehab Strength & Conditioning session for Pre-Season At our MY Sports Massage Manchester City Centre, we offer the appropriate Sports physiotherapy treatment for each type of injury. Some of the treatments that our highly experienced certified physio Manchester clinicians include: Manchester deep tissue massage, acupuncture, naturopathic cupping therapy, dry needling, customed exercises routines, osteopathy, physical manual therapy amongst other services in help to self-manageable recovery and prevent future injuries from re-occurrence How many sports-related injuries occur each year?Regarding the most state of the art information, it has been reported that about 8.6 million sports injuries are witnessed per annum, stated by Cary Orthopaedics (2018). It should be noted that strains are by far the most repetitive sports injuries. Which sport causes the most sports injuries each year?Football and Wrestling have been displayed to be the sports that possess the highest incidence of sports-related injury rates within men. Simultaneously, gymnastics and football are the leading sports-related injury disciplines for women, according to the Center of Disease Control and Prevention (CDC) 2015. Sports injuries are of great concern to athletes since an injury of this nature can mean losing the routine in their sports practice until recovery. Next, we will discuss the 3 most frequent ones. What are the 3 most frequent sports injuries? ·      Ankle sprain. This injury is very common in sports practice, but also daily activity. In most cases, it occurs due to an inward movement of the foot that causes tension on the ligaments. The sprain can be mild when there are micro-tears in the ligaments, moderate when there is a partial tear in the ligaments, and severe when the ligaments are torn. The most common symptoms are bruising, and pain. It occurs mainly in impact sports or in which the practise is carried out on unstable surfaces. ·      Muscle strain. It consists of the breaking of the fibers that make up the muscle. It generally affects lower limb muscles such as the gastrocnemius, hamstrings, and quadriceps. A muscle tear or fiber break can be caused by a blow or contusion, or by a sudden contraction of the muscle. Its severity is given mainly by the number of muscle fibers torn in the injury. The main symptom is sudden, sharp, localised pain.    It is one of the most frequent injuries in all types of sport. ·      Fractures. These are the gravest sports injuries. The most common causes of fractures are falls or excessive muscle activity that lasts over time. In most cases, immobilisation, rest, and rehabilitation are required, as well as in the most severe cases, surgery. In both cases, it requires a subsequent progressive recovery. What to do to prevent sports injuries To avoid sports injuries, it is essential to perform a good warm-up of at least ten minutes and stretch at the end. Also join sports practice progressively, as well as perform the prior functional exercise. Sports injuries vary in intensity, so treatment changes depending on the severity. Sports injuries can be chronic when they are produced by repetitive movements and acute if they occur at a certain time due to a specific and violent effort. Published by Rafael Peña for www.mysportsinjury.co.uk       References ·      Eduardo Tondelli, Carlos Boerio, Mauro Andreu & Santiago Antinori (2021) Impact, incidence and prevalence of musculoskeletal injuries in senior amateur male rugby: epidemiological study, The Physician and Sportsmedicine, DOI: 10.1080/00913847.2021.1924045. ·      Kerr ZY, Dompier TP, Snook EM, et al. National collegiate athletic association injury surveillance system: review of methods for 2004–2005 through 2013–2014 data collection. J Athl Train 2014;49:552–60. ·      Kucera KL, Marshall SW, Bell DR, DiStefano MJ, Goerger CP, Oyama S. Validity of soccer injury data from the National Collegiate Athletic Association's Injury Surveillance System. J Athl Train 2011;46:489–99. ·      Marshall SW, Covassin T, Dick R, Nassar LG, Agel J. Deive epidemiology of collegiate women's gymnastics injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train 2007;42:234–40. ·      https://www.stopsportsinjuries.org/STOP/Resources/Statistics/STOP/Resources/Statistics.aspx?hkey=24daffdf-5313-4970-a47d-ed621dfc7b9b. ·      Thorstensson, C.A., et al., Choosing surgery: patients' preferences within a trial of treatments for anterior cruciate ligament injury. A qualitative study. BMC Musculoskelet Disord, 2009. 10: p.100. ·      Pallis M, Cameron KL, Svoboda SJ, Owens BD. Epidemiology of acromioclavicular joint injury in young athletes. Am J Sports Med. 2012 Sep;40(9):2072-7. doi: 10.1177/0363546512450162. Epub 2012 Jun 15. PMID: 22707749.

EFFECTS OF SPORTS HERNIA IN THE ELITE ATHLETES -       Sports therapy & Rehab for sports hernia / groin related pain Sports Hernia has been widely adopted as the medical term implemented to describe and explain some type of chronic pain at the groin level that may have been induced by damage to the soft tissues where tendons, muscles, and ligaments were most likely compromised. It also alludes to the tears in the lower abdomen or in the groin area that may be present when the subject or athlete makes extremely sudden movements of changes of direction. Likewise, there are chances that a sports hernia can worsen and become a conventional hernia, it is not usual for this type of aggravation to happen. Sports hernias are frequently seen in disciplines that require explosive changes of direction such as football, hockey, American football, hurdling, or wrestling. Sports hernias are known to inflict severe pain in the groin at the time of injury, what would be another factor to suspect the suffering of sports hernia, after the incident where the injury arose, the athlete may refer to pain or stiffness with activities such as getting out of bed or getting out of the car. Any activity that increases intra-abdominal pressure such as coughing or sneezing can even cause pain. International Journal of Sports Therapy aka IJSPTexplains that this Athletic Pubalgia soreness is usually experienced with much more intensity than a unilateral or bilateral abductor strain. According to scientific research carried out by the renowned physician Anderson Oliviera et la (2016) treatment time may vary from 31 days to 365 days, also obtaining a fairly high percentage of subjects who went back to their sporting activities as normally did before being injured, reaching an average of 95. 2%. To achieve a successful recovery is strictly to undergo specialised and qualified medical treatment, which will be divided into conservative and surgical treatment, as for non-surgical treatment as the first line of treatment, we find the work performed by sports physio Manchester/ sports therapy Manchester clinicians in My Sports Injury Clinic which is a Manchester City Rehabilitation Centre, where we offer the best of care to our patients and provide a service that meets their needs, some of the treatments we feature are deep tissue massage, manual therapy,  osteopathy, dry needling, manual lymphatic drainage, stretching and so on. What exactly is a sports hernia? Johns Hopkins Medicine sets out that Athletic pubalgia or sports hernia is the term used to describe ailments located in the area of the pubic symphysis. The main feature is the pain in this area, but we can find this same symptom at the level of the adductors, abs, or in the anterior part of the thigh. Sports hernia symptoms generally begin as a discomfort or pain when performing sports activities and as it becomes chronic, it commences to establish itself in the activities of daily life, notably incapacitating those who suffer from it.    This pathology is called "sports hernia" since most of the people who present it are athletes, both high performance and recreational, the most prevalent cases are soccer players, as stated by an epidemiological study with a duration of 9 years, it was evidenced that amongst 43 injured subjects with sports hernia the percentage of soccer players was the highest, reaching up to 58.1% and the runners had 30.2% of incidence, and the average of professional athletes added up to 37.2%. What is the difference between a hernia and a sports hernia? The article of Rock & Armor apprises that traditional hernia refers to defects or holes in the abdominal wall where other tissues can herniate. Sports hernia alludes to tears or injuries to the soft tissues of the groin or lower abdomen that can occur when an athlete makes changing direction all of a sudden. What are sports hernias symptoms? Sports hernia symptoms include chronic groin pain, often in both, accentuated by exercise, coughing, or sneezing. Pain in the pelvis or scrotum or testicles may also be experienced. The pain tends to accentuate over time. Chronic refers to the duration of the problem, not the seriousness of the disorder. A Sports hernia is more common in men. What to avoid with a sports hernia 2 pieces of advice suggested by our physios Manchester to avoid when treating a sports hernia injury, you may be doing something wrong and it is worse than doing nothing to rehab for a sports hernia. 1.    Do not take anti-inflammatories for more than 10 days. The pain you feel in the pubic area may be due to inflammation and your doctor prescribes an anti-inflammatory to combat it. If the anti-inflammatory after 10 days (and we are being very generous with this amount) does not eliminate or calm your pain, it will not do it in 15 days, a month, or a year either. Taking an anti-inflammatory for long periods affects the health of your organs. 2.    Not stop at all. By not stopping at all, we mean that you do not lie down on a sofa or bed to rest the pain, the solution cannot be to give up physical activity. You can and should reduce its intensity, but do not take complete rest. So, exercises for sports hernia will be indicated in future physiotherapy Manchester consultation. How do you diagnose a sports hernia? Have you wondered what the test for sports hernia confirmation is? Your sports therapy practitioner will tell you to do a sit-up if it hurts; it’s likely to suffer a sports hernia. On the other hand, The British Journal of General Practice also known as BJPG enlightens that there are two gold-standard imaging studies to confirm an injury of this type, are the ultrasound and the MRI. Do sports hernias heal on their own? Our physiotherapists Manchester explain that injuries of this nature such as sports hernia cannot heal by themselves since the pain will not disappear permanently simply with ice, and rest. The pain will wear off with the application of the RICE (treatment for sports hernias) as long as the sports action is not resumed on the playing field, and what is sought is the exact opposite, which is to be able to resume sports activity without any pain or discomfort. How to treat a sports hernia if you have ever had an athletic pubalgia/sports hernia, you know very well that it is a pain in the pubic area. This pain occurs in anyone, but it is very common in athletes. Do you want to know what the treatment for sports hernia is? Well, from sports therapy Manchester, the main objective in the face of this problem will be to reduce pain in a way that allows us little by little to return to sports activity. The physiotherapy Manchester treatment that is proposed to be the treatment for sports hernia is: ·      Isometric and eccentric exercises of the adductor and abductor muscles, as well as the abdominals ·      Stretching and sports massage Manchester techniques of the adductors, hamstrings, and psoas. ·      Manipulation of the symphysis pubis. ·      It is recommended that in an acute phase of the patient keep sports rest that demands great effort. Our sports therapy Manchester treatments at My Sports Massage Manchester City Centre include a comprehensive assessment of your injury and a follow-up of it to achieve a complete recovery. How to heal a sports hernia without surgery Intermountain Healthcare affirms that generally conservative treatments in these types of conditions have a 90% chance of being successful in their resolution. Some of the steps to follow would be: ·      Rest; your sports therapy treating specialist may advise you to stop any practice for the first seven days after the injury has occurred. ·      Ice; the implementation of ice will make it easier to decrease swelling. ·      Medicine; pain relievers, and anti-inflammatory pills. ·      Injections. ·      Physical therapy Manchester. How long are you out with a sports hernia? The time you will be away from sports activity depends solely and exclusively on the severity of your injury. Orthoinfo informed thatin a high percentage of cases, normally a non-surgical treatment would last up to a maximum of 6 weeks. In the event that the pain returns after conservative treatment, the possibility of undergoing surgical treatment should be evaluated. How long is recovery from sports hernia surgery? Full recovery after being involved in the surgical process could take up to 12 weeks, only if the recovery plan is carried out alongside sports therapy after the operation we will obtain the best outcomes, it is necessary to adhere to this recommendation. Published by Rafael Peña References ·       Wilkerson, R. Sports hernia (athletic pubalgia) https://orthoinfo.aaos.org/en/diseases–conditions/sports-hernia-athletic-pubalgia/. Updated June 2017. Accessed February 2019. ·       Reis F.A., Rosenfeld A., Ikawa M.H., Silva F.D., Costa J.D., Natour J. A importância dos exames de imagem no diagnóstico da pubalgia no atleta. Rev Bras Reumatol. 2008;48(4):239–242. ·       Schilders E Dimitrakopouiou A Cooke M et al. Effectiveness of a selective partial release for chronic adductor‐related groin pain in professional athletes. Am J Sport Med. 2013;43:603‐607. ·       Minnich JM Hanks JB Muschaweck U et al. Sports Hernia: Diagnosis and treatment highlighting a minimal repair surgical technique. Am J Sport Med. 2013;39:1341‐1349. ·       Taylor D.C., Meyers W.C., Moylan J.A., Lohnes J., Bassett F.H., Garrett W.E., Jr. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia. Am J Sports Med. 1991;19(3):239–242. ·       Joesting DR Diagnosis and treatment of sportsman's hernia. Curr Sports Med Rep. 2002;1(2):121‐124. ·       Rabe SB Oliver GD Athletic pubalgia: Recognition, treatment, and prevention. Athl Train Sports Health Care. 2010;2:25‐30.

KNEE JOINT INJURY|MENISCUS STRAIN & TEAR IN ELITE ATHLETES -       Sports physical therapy rehabilitation – When we refer to any knee joint injury such as Meniscus Strain and Meniscus Tear it is proven that a high amount of them are linked to sports practise especially in sports like football, volleyball, skiing amongst others and most of them are due to unsuitable technical skills or since the physical activities are executed in improper environments. They can also be produced right after a contact such as tackles and blows unexpectedly. This means that contact sports and trauma scenarios are highly prone to trigger Meniscus injuries and other joint knee injuries.  The blog post of MYchoice explains that when there are sudden movements of pivoting or twisting, and when the joint is being compressed these actions put in danger the knee and can lead to a pulled or torn meniscus. If you suspect that you or any of your acquaintances are suffering from a meniscus tear, knee pain, and other types of lower limb injury your duty is to visit a professional health provider like our sports therapy Manchester practitioners where a thorough check-up will be run, also having sports physiotherapy assessments in My Sports Injury Manchester City Centre is the initial stage to the treatment of our patient, in which we try to obtain all the essential and relevant data of the ways the injury occurred, through medical history and in-depth physical examination. According to a study by Martin Majewski et la published in Research Gate, the knee is a biomechanical zone that is described as an area of utmost care due to its anatomical complexity. It has been reported the incidence of knee injuries accounted for 19.530 sporting event injuries out of 17.397 subjects during a 10 years’ time frame follow-up where 38, 8% of these injuries were related to lesions in the knee joint. Male athletes scored a higher rate than female athletes with 68, 1% over 31,6%. The average age where this type of knee joint injury was observed more frequently was between 20 and 29 yo nearly 50% of the patients had the appointed age. | First of all, we must know what the meniscus is for. What is the meniscus for?  Under our MY sports Injury therapy Manchester specialists clinics a meniscus tear is a pretty common knee injury. The meniscus is a rubbery, C-shaped disc that cushions the impact of steps on the knee. Each knee has two menisci: one on the outer edge of the knee and one on the inner edge. What sports have the most meniscus tears cases? The meniscal tear is well-known for producing instability in the knee which can intervene and impair the regular performance of the elite athletes making them be out of any sporting event until returning to their preceding proficiency. Statistically, the most affected sports by this condition are Football reaching up (35%), Skiing accounts for (26%), and other sports such as Wrestling, Basketball, Tennis, and Baseball. No evidence was found for the average prevalence of TM in these sports. How do Meniscus Tears happen? There is a main way where knee ligament injuries occur in this case the meniscus tear is produced when the foot is firmly resting on the floor and the knee is abruptly twisted either by its movement itself or by an external force. Cedars-Sinai stated that this condition can also be developing itself gradually over the years due to loss of elasticity in the menisci i.e. in elderly adults, degenerative knee changes can induce to meniscal tear with just a minor or no trauma. Regardless of the knee symptoms, meniscus injuries are habitual amongst elderly people and middle-aged subjects, these injuries are frequently associated with knee osteoarthritis. The stats of people who have presented torn meniscus without a previous traumatic event can reach up to 31 % according to the research study made by Wolf Petersen et la 2015. However, you have to be very clear that an injury of this type can be suffered at any age, although young athletes are quite prone to sustain them. What does a torn Meniscus feel like? A torn meniscus has the following characteristics and it feels as if your injured knee is losing range of motion due to a blockage that does not allow you to extend your leg to its full capacity. In addition, MayoClinic points out that you can also get to present stiffness, inflammation, and soreness. Another sensation that can be related to a meniscal tear is that the injured leg begins to give way. How Meniscus Tear is treated? My Sports Injury Clinic is a sports physiotherapy Manchester rehabilitation Centre where the physical therapists and sports therapy clinicians will guide you through the best possible treatment options for your torn meniscus. How your doctor/ physio Manchester treats your meniscus tear depends on several factors, including the type of tear, its location, and its severity. Your age and activity level may also influence treatment options. Treatment could include: ·       Rest, ice, wrap the knee with an elastic bandage and keep the leg elevated on pillows. ·       Pain killers to cease the pain. ·       Physiotherapy/ Sports therapy Manchester. ·       Exercises scheme. ·       Corticosteroid injections. ·       Surgery to repair the meniscus. ·       Surgery to remove part of the meniscus. Meniscus Tear how long to heal? The recovery time will vary as it depends on the grade of the lesion, age, lifestyle, and if it is treated conservatively or through surgery. Therefore, whether you will be put through a conservative approach like sports physiotherapy Manchester it could take from 42 to 56 days to heal properly not needing a surgical procedure. Most of the cases give exceptional results implementing physical therapy management as the first line of treatment i.e. it is extremely effective. On the other hand, a research study by the University of Michigansays the recovery process after surgery could take longer and could even take 3 to 6 months to be completely recovered. How Meniscus Tear is diagnosed? The Doctors of Physical Therapy’s article indicates that some hands-on tests that may be required to determine and diagnose the tear even though a single clinical maneuver run by physio Manchester cannot make the diagnosis but a set of them may foretell a torn meniscus. Some of the techniques carried out by sports physiotherapists Manchester to pinpoint this condition are Positive McMurray’s test, Pain with flexion and extension overpressure, and history of the joint locking. The odds that you must need an imaging study to bear out the Meniscus tear are high; it is likely to make use of an MRI study which is the most precise means to confirm it. It has been revealed that 36% of individuals have a tear without actually presenting any symptom of pain in the knee area.  How often do Meniscus Tears need surgery? Meniscus tear surgery may be needed when you are suffering from grade 3 and grade 4 and after being treated unsuccessfully with non-surgical management, how do I know if the conservative treatment is not working? Well, if the manifestation of the symptoms continues after 8 weeks of having started off the physical therapy, your physicians would recommend undergoing surgery to repair the tear. These procedures are called meniscus repair, meniscectomy, and meniscus replacement. Those surgical processes are notably efficient notwithstanding the fact that they could result in osteoarthritis in the long term.    How often does a Torn Meniscus require Physical Therapy after the surgical process? Every time that any patient has been undergone a non-conservative treatment the process of getting better has to be accompanied by sports therapist / Physical Therapist in Manchester. This measure is highly essential since it would provide the knee the strength and mobility necessary to regain the lost quality of life, so and early sports therapy rehabilitation is imperative after surgery to progress as good as possible and return to the sports practise, informed by Matthias Koch et la (2020).   Can a Meniscus tear heal on its own? Sometimes, some individuals may reckon that their torn meniscus injury will heal on its own, unfortunately, not all injuries of this nature can heal on their own, and so a treatment plan is strictly indispensable. PennMedicine reports that if your tear is situated on the meniscus’ external one-third,  there are chances that it may heal by itself due to that zone possesses rich blood cells and blood supply which can help to regenerate the damaged tissue.   What happens if a meniscus tear is left untreated? Bad things can happen; complications can take place if you do not treat a torn meniscus, a portion of your meniscus might lose and slide into the joint space, and the worst scenario is that you probably will need a replacement surgery to restore knee functionality. An unsolved tear may also drive arthritis.   Can you strain your meniscus? Indeed you can strain the meniscus since it has the same mechanism of action to get injured as the tear, only that in the case of strain it is less severe and the recovery could be faster.   How long does a meniscus strain take to heal? MercyHealth highlights that usually a mild meniscus strain can be healed within a period from 14 days to 21 days and one of the prime symptoms is discomfort and pain in the outer knee.   Why does the Meniscus tear heal poorly? Eventually, when this occurs it is because the blood supply to the meniscus is very limited, we must remember that blood is the main source through nutrients that reaches the structures of our body and this is what allows us to heal and recover from injuries, cited from OrthoVirginia. Hence, we can say that this is due to the absence of a good blood supply in the affected area.   What exercises can’t I perform with a torn meniscus? The exercises that our sports therapy Manchester practitioners advise that should not be performed are those related to twisting, pivoting, and deep squats, we must avoid them at all costs, since they will add extra pressure to the already unstable injured knee. Otherwise, if doing other types of physical activity makes your knee unsteady or causes any kind of pain or discomfort, stop immediately and do not do it again.   Is it ok to massage a torn meniscus? Definitely yes including a cluster of maneuvers over the surface tissue applying adequate pressure to hit the deep structures. It is implemented to boost the blood flow and also to reduce swelling, minimise muscle spasms, and encourage normal tissue repair.   How do you rehab a torn meniscus without surgery? When your doctor gives the green light to begin sports therapy Manchester treatment, it is advisable to perform the following exercises to improve stability and strengthen your knee. ·      Quadriceps setting. ·      Mini-squats. ·      Straight leg raise. ·      Hamstring heel digs. ·      Leg extensions. ·      Standing heel raises. ·      Clams. ·      Hamstring curls. Written by Rafael Peña for www.mysportsinjury.co.uk   References ·       Koch M, Memmel C, Zeman F, et al. Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?. Rehabil Res Pract. 2020;2020:3989535. Published 2020 Mar 29. doi:10.1155/2020/3989535 ·       Kelln B. M., Ingersoll C. D., Saliba S., Miller M. D., Hertel J. Effect of early active range of motion rehabilitation on outcome measures after partial meniscectomy. Knee Surgery, Sports Traumatology, Arthroscopy. 2009;17(6):607–616. doi: 10.1007/s00167-009-0723-2. ·       Badlani J. T., Borrero C., Golla S., Harner C. D., Irrgang J. J. The effects of meniscus injury on the development of knee osteoarthritis: data from the osteoarthritis initiative. The American Journal of Sports Medicine. 2013;41(6):1238–1244. doi: 10.1177/0363546513490276. ·       Mordecai S. C., al-Hadithy N., Ware H. E., Gupte C. M. Treatment of meniscal tears: an evidence based approach. World Journal of Orthopedics. 2014;5(3):233–241. doi: 10.5312/wjo.v5.i3.233. ·       Majewski, Martin & Susanne, Habelt & Klaus, Steinbrück. (2006). Epidemiology of athletic knee injuries: A 10-year study. The Knee. 13. 184-8. 10.1016/j.knee.2006.01.005. ·       Cardone DA, et al. Meniscal injury of the knee. https://www.uptodate.com/contents/search. Accessed Oct. 8, 2019. ·       Cardone DA, et al. Meniscal injury of the knee. https://www.uptodate.com/contents/search. Accessed Oct. 8, 2019. ·       AskMayoExpert. Meniscal tear. Mayo Foundation for Medical Education and Research; 2019.

Active Mobility Exercises for Your Wrist & How to Strengthen it Wherever you are!     When it comes to working out, most people usually think of exercising their legs, arms or other major body parts. However, having flexible, mobile wrists is something that shouldn't be overlooked. Without it, you can’t perform certain workouts properly, and you risk further injury that can prevent you from exercising altogether. Plus, it’s not just exercise (or lack thereof) that leads to immobile wrists. Daily activities such as typing, writing, and even constantly using mobile phones can all contribute to tight wrists.   Strengthening exercises and wrist massage therapy are especially important for those working from home. This should also be paired with ergonomic work setups; after all, these exercises will not be effective if you continue to work with your wrist in bad positions. The Health and Safety Executive describes ergonomics as the design of rooms and equipment, which can affect one’s performance and promote better health and productivity. Tools like ergonomic keyboards, chairs, and wristpads achieve this by incorporating a design that is best suited to the worker’s health.   To ensure your wrists stay strong and mobile no matter what you're doing, here are some exercises you can do to keep them in the best possible shape:   Kettlebells     VIDEO: [Embed: https://www.youtube.com/watch?v=uT1LV1eLcdM#t=33] (Video Credit: Kettlebell Fitness Athletics)   Many kettlebell exercises are dynamic and more appropriate for fast lifts and strength training. But these weights are so versatile that they can be used for mobility too. A great example is a double kettlebell rack walk. Take a kettlebell in each hand and lift them to the underside of your chin so that your palms and your wrists are facing each other. Walk forward while holding the kettlebells in the same position. Keep going for your desired number of reps.   When starting with workouts like these, it can be easy to push yourself harder than intended. If kettlebell exercises leave you unable to move for a few days, then working with a sports massage therapist is best to relieve any soreness and tension. Make it a habit to visit these professionals now and again to ensure your muscles stay flexible and maintain their full range of motion.   Theraband     Therabands are great since they can be used pretty much anywhere, thanks to their compactness. It’s also the only workout that’s the least likely to cause wrist strains.   If you have problems with functional mobility, then the Theraband is an excellent option to improve the affected area. These thick elastic bands come in varying levels of resistance, so make sure to choose one that’s challenging enough, but doesn’t cause an uncomfortable strain.   CrossFit     VIDEO: https://www.youtube.com/watch?v=2IDqSq138_g&feature=youtu.be (Video Credit: Airrosti Rehab Centers]   If you haven't heard of this trendy exercise, CrossFit is a program developed to offer a full-body workout that combines elements of cardio, weight lifting, gymnastics, core training, and much more. Since it is based on the fundamentals of functional fitness, CrossFit focuses on using movements that you use often such as picking things up from the floor, climbing stairs, and carrying heavy bags. As such, the strength and mobility it can build for your wrists and other joints can be applied to your day-to-day activities too.   However, it's also best to exercise caution when joining high-intensity sports like CrossFit, as there is always a risk of injury involved. Consulting a sports physiotherapy professional can prevent sports-related injuries and maximise your performance.   Wrist Walks     As one of the few exercises you can perform without equipment, wrist walks are something that should only be attempted if you’re strong enough to carry your own weight (similar to push-ups). It’s done by placing your palms flat against the wall, fingers pointing up, and “walking” down with your hands until you reach a point where your hands cannot walk any further. Reverse the directions of your hands so that your fingers point towards the floor and walk back up. Repeat for as many reps as you desire.   Nothing is more frustrating than missing exercises due to poor wrists, but skipping wrist exercises will only cause you more pain in the long run. Along with exercise, our feature on the Magnitude of a Good Posture highlights how proper posture can promote mobility and strength, and your wrists are no exception. Whether you’re experiencing pain during push-ups or from typing at your desk all day, it pays to address the pain through different means, whether that’s through ergonomics or with the help of My Sports injury clinic Manchester.   Written by Mary Kramer for mysportsinjury.co.uk

All the sports activities to exercise your body and high-performance sports, including walking, have the risk of suffering a strain or a tear.Comprehensive Orthopedics, S.C. explains that the regions of the body that are more exposed to suffer any of these conditions are those that are more involved in the specific activity that is carried out e.g. in disciplines such as football, boxing, jumping sports, basketball, and volleyball have in commonality the an increased risk of suffering either a strain or a tear in the lower limbs. The same things happen with sports that perform quick starts in track and field sports such as long jump, running races, and hurdling.   Every time an individual comes to MY Sports Injury Rehabilitation Centre of Manchester City  The first step to follow is to carry out a Comprehensive Physical assessment and Musculoskeletal joint / muscle examination carried out  by our sports physios Manchester and thus be able to determine what is the source and root cause of the sports injury. From then on they will develop a customised work plan where the sports injury will be addressed and treated effectively and so the patient can resume their prior lifestyle. The benefits of sports therapy Manchester in these types of injuries are highly guaranteed, the application of a sports physiotherapy approach is characterised by being one of the most effective conservative treatments in any kind of sports injury, some pathologies, and pain are due to improper biomechanics and functional movements. It’s important to seek out sports physiotherapy specialists therapy counseling before and after the sporting event. According to stats of the Journal of Athletic Training the prevalence of a knee strain in young athletes is exponentially high but the rates can vary significantly by gender, sports, and age. The sports where the highest occurrence takes place are basketball and football for men and also women. The average age most likely to suffer a strain is between 15 and 19 years, this statistic represents both genders. According to the Journal of Sport and Health Science terms of a hamstring strain accounted for 12 percent of all injuries that occurred in the football season and had a recovery time of 17 days. Now, you may be wondering, how can I tell a strain from a tear? What’s the difference between a strain and a tear? Simple, the difference is that strain occurs when either a tendon or a muscle is stretched to a higher range than it can be subjected to. Cape Cod Healthcare presents that a strain may be the consequence of a single event or persistent movements that can take a toll on the tendon or the muscle. On the other hand, it can be said that the tear is more severe than a sprain and a strain, a ligament can be torn and the same happens with a tendon and a muscle in this kind of sports injury scenario. Scre    Now that you have no doubt what is the difference between a strain and a tear, we can continue explaining what each injury consists of, their causes, and the sports medicine approach that should be performed for both knee injury MCL and distal hamstring strain. What is a Medial Collateral Ligament? The medial collateral ligament is one of the ligaments of the knee joint. A ligament is a tough, flexible strip of tissue that holds cartilage and bone together. Cedars Sinai indicates that one of the most essential functions of this ligament is that it lets the knee be stable and also to be able to rotate, as well as preventing the knee from being too extended inwards. What causes Medial Collateral Ligament pain? This injury can be produced by either a strain or a tear. The knee has a band of connective tissue inside it and that‘s called the Medical Collateral Ligament. The Michigan Medicine / University of Michigan sets down that you can harm your MCL through movements that implicate rapid changes of direction, twisting, and bending. For example in football, a medial collateral ligament injury can occur when the knee is struck and the blow causes it to change its natural direction of motion. Also, this type of lesion can come about in sports with a lot of weaving and jumping movements like skiing. What does Medial Collateral Ligament pain feel like? In obedience to sports physios Manchester the MCL’s the symptoms are quite similar to any other type of knee injuries however they are graded into 3 types depending on the severity, nature and symptoms of damage sustained. For this reason, you must go to MY sports Injury rehabilitation clinic so that you can be evaluated by a professional who specifies what the problem is. Although the main characteristics published by Healthline are inflammation in the knee joint, a similar sensation where you experience that your knee is about to give way when you are lifting weight, a lot of sensitivity and pain in the inner knee, and a clicking sound at the exact moment when you get injured. How do you know if you have a Medial Collateral Ligament injury? When your sports physio Manchester is evaluating you rigorously, the following technique will be carried out to determine if you are indeed suffering from MCL. How to diagnose Medial Collateral Ligament Injury? your injured knee will be bent gently by your physio Manchester, then a little pressure will be applied to the outside of the knee, at that moment they will notice if the inside of the knee is loose, which would be enough to diagnose it.Although to be more precise in the diagnosis, an MRI is extremely recommended, which is the gold standard procedure in this type of sports injury, this imaging study may help out ruling out any others type of problems in the knee, announced by Kyle Andrewset la (2017). How to heal Medial Collateral Ligament? Right after the injury, treatment may include: ·      Over-the-counter pain relievers. ·      Follow these instructions: rest, ice, compression (with an elastic bandage), and elevation (put the knee up). ·      Wearing a knee brace, health professionals such as our sports physios Manchester will advise on the best type of knee brace to protect the medial collateral ligament and knee joint during the healing process. Other treatments may include: ·      Make use of crutches during recovery. ·      Physical therapy/ Sports therapy Manchester to strengthen muscles and improve flexibility. ·      Surgery (in the most severe cases is needed). How to strengthen Medial Collateral Ligament? The physiotherapist Manchester in this stage of strengthening the ligament will introduce the sports physical therapy approach with a series of exercises, those are the following: ·      Electrostimulation may be helpful in reducing reflex muscle inhibition. ·      Half squat with monopod support, the opposite leg resting on the yoga ball and we stretch it back by flexing the leg resting on the ground. We repeat the process 10 times and change legs. ·      The exercise bike is also helpful in restoring movement. Initially, the bicycle saddle is placed as high as possible and then gradually lowered to increase the degree of flex. ·      Exercises such as towel extension and hanging legs prone are used to achieve equal extension or hyperextension of the contralateral leg. ·      For knee flexion, the patient sits at the end of a table to allow the force of gravity to assist flexion. The contralateral (unaffected leg) aids flexion by gently pushing the affected leg. ·      Step up or bench rises: we start with one foot resting on a bench of variable height so that the leg that runs perpendicular to the support bench and the weight of the body falls on this foot. The body is upright and relaxed and the other foot is with the tips of the toes resting on the floor near the bench. How long for Medial Collateral Ligament to heal?  The overview of Medial collateral ligamentinjuries has affirmed that the primary method of treating grade 1 and 2 MCL injury is the conservative treatment which takes in a strength training program and a range of motion exercises routine. If you are dealing with MCL grade 1 it might take only a few days to heal (less than a week). But, if you’re sustaining MCL grade 2 it could take up to 28 days to heal adequately. However, if you have been diagnosed with MCL grade 3 you might require a surgical process and sports therapy rehabilitation, this grade might be last up to 2 months to get a full recovery.  Also, it is important to note that physical therapy has been highlighted as a highly effective treatment for cases of grade 1 and 2 lesions in the medial collateral ligament. Medial Collateral Ligament Injury takeaways: ·      The MCL is the ligament that gives the knee joint more stability. Also, they emphasize that this ligament injury is the most common among knee injuries in elite athletes; they also noted that an average of 7.9% of all knee injuries causes a ligament tear can be witnessed. ·      There are three types of MCL, and it’s defined by grades, it could be 1, 2, or 3. Grade 1 is the least serious, your ligament is not torn at this point, and it was just stretched out. Grade 2, this probably indicates that your ligament has been prejudiced up to being partly torn. This eventually may produce an instability sensation in the joint of the knee. Grade 3 is the worst of all of them, coming about when the ligament is entirely torn. In this case, non-conservative management is strictly required. ·      You must attend a physio specialist consult so they can examine you and determine what grade is the one you present and thus be able to begin to tackle your sports injury. Important points to know about hamstring strain injury The average age with more odds to get a hamstring strain is comprised between 16 and 25 yo.  The sports where you might be more susceptible to suffering HS are football, and track and field sports which are the sports where the hamstring is exposed to carry the most burdens. The UEFA made a study where was found that an annual rate of players who sustained a hamstring strain has risen to 2, 3% per year amongst every European League within a 13 years follow-up, this was published by Statpearls / Hamstring Injury.   How do you treat a strained hamstring? WebMD states that the not-so-serious cases like mild to moderate make well by themselves, it is only necessary to give them some time. If you would like to speed up the recovery time a bit, follow these pieces of advice: ·      Rest the injured leg, endeavor to avoid adding weight to your harmed leg as much as possible. In scenarios where the pain is intensive, crutches may be needed until the pain disappears. Enquire your sports therapy physio Manchester if you require them. ·      Apply ice over the leg, it is well known that ice may help to ease the pain and reduce the inflammation.Do this every three to four hours for 20 to 30 minutes for two to three days until the pain disappears. ·      Compress your leg; wear an elastic bandage to cover the leg and contain the inflammation. ·      Raise the leg; be capable of keeping your leg as high as possible when lying down and sitting down.It is advisable to use a pillow. ·      Take anti-inflammatory pills, like NSAIDs. ·      You must strengthen the hamstring by doing a strengthening and stretching exercise routine, this needs to be supervised by a sports therapy specialist. Give strength to the hamstring is an essential manner to prevent and steer clear of a hamstring strain. In critical cases where the muscle has absolutely torn a surgery will be performed, the muscles will be repaired and reattached to each other. How long does a Hamstring Strain take to heal? Mainly, the hamstring strains where the muscle has not been involved in any rupture it would take from 28 days to 56 days to heal. In as much as the hamstring has been torn it must be mandatory to perform a surgery, it would take up to 3 months till you recover your prior level of range of motion, and capacity. You should start off to notice some improvement and relief by turning up a physical therapy constantly, issued by the journal Healthline/ Hamstring / Recovery time. Should you massage a hamstring strain? Sports massage Manchester can be perfectly drawn on as a conservative treatment for hamstring injury since it helps to relax the tight muscles, therefore, assists in the muscles stretching, also it can help to boost blood flow through the injured area to finally heal the hamstring injury properly. Sports massage for a hamstring strain is aimed at reducing muscle tightness and speed up the recovery process. As the recovery progresses, the physiotherapist Manchester will implement a deeper work like transverse friction massage. To sum up, sports massage therapy has countless benefits when treating this type of sports injury, make known by Mel Wright Deep Tissue and Sports Massage Therapy.                                                            published by Rafael Peña for www.mysportsinjury.co.uk REFERENCES ·       Andrews K, Lu A, Mckean L, Ebraheim N. Review: Medial collateral ligament injuries. J Orthop. 2017 Aug 15;14(4):550-554. doi: 10.1016/j.jor.2017.07.017. PMID: 28878515; PMCID: PMC5581380. ·       Poudel B, Pandey S. Hamstring Injury. [Updated 2020 Sep 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. ·       Phisitkul P, James SL, Wolf BR, Amendola A. MCL injuries of the knee: current concepts review. Iowa Orthop J. 2006;26:77-90. ·       Fetto JF, Marshall JL. Medial collateral ligament injuries of the knee: a rationale for treatment. Clin Orthop. 1978;132:206–218. ·       Paulos LE, et al. The biomechanics of lateral knee bracing. Part I: Response of the valgus restraints to loading. Am J Sports Med. 1987;15(5):419–429. ·       Pforringer W, Beck N, Smasal V. Conservative therapy of ruptures of the medial collateral ligament of the knee. Results of a comparative follow-up study. Sportverletz Sportschaden. 1993;7(1):3–7. ·       Naqvi U, Sherman Al. Medial Collateral Ligament Knee Injuries. [Updated 2021 Mar 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. ·       Chang JS, Kayani B, Plastow R, Singh S, Magan A, Haddad FS. Management of hamstring injuries: current concepts review. Bone Joint J. 2020 Oct;102-B(10):1281-1288. doi: 10.1302/0301-620X.102B10.BJJ-2020-1210.R1. PMID: 32993323. ·       Ernlund L, Vieira LA. Hamstring injuries: update article. Rev Bras Ortop. 2017;52(4):373-382. Published 2017 Aug 1. doi:10.1016/j.rboe.2017.05.005.

HOW TO TREAT SNAPPING HIP SYNDROME SYMPTOMS WITH SPORTS PHYSICAL THERAPIES This snapping hip syndrome is an uncommon hip disorder; it is also called coxa saltans and dancer’s hip amongst physicians and sports therapy practitioners. Healthline specifies that the snapping hip syndrome may impact any person of all ages or genders but women are actually more prone to be harmed by SHS. Predominantly, this disorder is innocuous nevertheless it can inflict joint damage as its main risk. In more severe cases it may bring out a lot of pain which can decrease sports performance in athletes and execution in dancers. ChoosePT informs that the statistics of patients with SHS worldwide can reach around 5% up to 10% being the elite athletes such as runners, weight lifters, and footballers along with dancers the patients with higher prevalence. So How can physical therapy help me to treat Snapping Hip Syndrome? Sports physiotherapy is widely known as the means to achieve a full recovery from a sports injury, treat certain pathologies, and most importantly, prevent them. If you consider that you are suffering from this condition, you should go to the nearest sports physiotherapy clinic, remember that something that is not treated in time can go from mild to severe and harm you, even more, affecting your lifestyle’s quality considerably. At our MY Sports Injury Manchester Rehabilitation Centre we have highly trained staff such as our sports therapy Manchester practitioners, Acupuncturists, and deep-tissue therapists who will assess you and pinpoint which is the most appropriate treatment for your condition and in this case if you are going to require snapping hip syndrome exercises, always ensuring the physical and mental well-being of our patients. How does Snapping Hip Syndrome sound like? Individuals who have been impaired by snapping hip syndrome usually can perceive a particular snapping sensation or sound coming from the front/ groin area, side, or back of their hips when walking, dancing, running, standing up, and weightlifting. It is like one or both hips are snapping or popping. This audible click is produced in the joint around the hip. What is snapping hip syndrome? Anatomical point of view  This snapping hip syndrome can occur in different areas of the hip where tendons and muscles slide over the hip bones. The most common site where it occurs is where the iliotibial band passes over the greater trochanter, which is a protrusion of the proximal femur. Why does Snapping Hip Syndrome occur?  A publication of US National Library of Medicine National Institutes of Health - Understanding and Treating the Snapping Hip, a reliable journal, says when the hip flexes, the IT band moves or "jumps" over the trochanter. This movement of the iliotibial band over the greater trochanter produces the clicking sound and the “giving way” sensation typical of the pathology. This pathology can eventually irritate the trochanteric bursa, causing bursitis, which is the inflammation of the bursa. Other tendons that can cause a dancer’s hip are the rectus femoris tendon, the hamstring muscles, or the iliopsoas tendon. A labrum injury can also cause symptoms of a snapping hip. In the medical reference article, Snapping Hip Syndrome, it is mentioned that there are manifold causes of dancer’s hip and its classification is established by body structure that is the source of clicking sensation and soreness in acute cases. Two prime denominations of SHS have been classified: ·       Extra-articular SHS (either internal or external). A literature review Extra-Articular Snapping Hip reports a figure of 90% elite ballet dancers with SHS and 80% of these cases are bilateral. The incidence in women with SHS is quite remarkable from the teenage years. Being higher in comparison to adolescent men, where 12 young female individuals were diagnosed and just three boys were detected with SHS. ·       Intra-articular SHS. What causes Snapping Hip Syndrome? WebMD explains that the SHS is the result of repetitive tension in the muscles and tendons that surround the hip. ·       People who participate in sports and activities that require repetition of hip flexion are more likely to experience snapping hip. Dancers are especially vulnerable. ·       Young athletes are also more likely to have SHS due to the additional stress on the muscles due to accelerated bone growth. ·       Acetabulum labrum injury. How can Snapping Hip Syndrome be diagnosed? The diagnosis of Snapping Hip will be fundamentally clinical, trying to reproduce the click with various tests or specific manual techniques, examining whether the click comes from the hip joint itself or from the tissues that surround it, such as muscles or tendons. What is the treatment for Snapping Hip Syndrome? Sierra R. Musick et la (2020) most of the patients respond to conservative treatment, which consists of: ·       Rest; a period of rest and modification of activities helps control symptoms. ·       Physical therapy; exercises to stretch and strengthen the muscles around the hip, especially the iliotibial band. It may require the help of a physical therapist/ sports massage Manchester therapist. Physiotherapy and osteopathy treatment involves a global assessment of the subject. We will assess the mobility of the hip, both by excess and by default, of the musculature and all the structures that surround it. It can be very useful to achieve a good release of the adhesions of the tensor fascia lata / iliotibial tract concerning the vastus lateralis, up to the knee. ·       Corticosteroid injection. It should be noted that conservative treatment with physical therapy in cases of SHS with mild to moderate pain is highly effective. Is it necessary surgical treatment for Snapping Hip? If sports physiotherapy management does not cure your Snapping Hip completely,your healthcare provider may recommend surgery which is known to be efficient in grave scenarios for this type of disorder. The type of surgery will depend on the cause of your SHS.The operation can be performed either with arthroscopy or open. The primary aim of the surgery is to eradicate the strain of the tendon to remove the snapping. Yi-Meng Yen, MD, PhD et la (2016). At MY Sports Injury Rehabilitation Centre of Manchester City we will carry out a team and coordinated work between all the professionals of My Sports Injury Clinic (Sports physiotherapists, Personal trainers, Sports Therapist practitioners, Osteopaths amongst TCM Acupuncturists), and thus be able to achieve a complete functional and sports re-education What are Snapping Hip Syndrome Exercises? Sports Physiotherapy Manchester ·      Stretch for quadratus lumbar fibers. This has its variants to stretch the muscle fibers according to their orientation.Quadratus lumbar fibers stretching| Sports Physiotherapy Exercises | MY SPOTS INJURY CLINIC ·      Pyramidal stretch. With these stretches, you work on the pyramidal and all the buttocks (major, middle, and minor), including the tensor fascia lata. However, the stretches below are best suited for the pyramidal muscle. Pyramidal stretch | Sports Physiotherapy Exercises | MY SPORTS INJURY CLINIC ·      Tensor fascia lata muscle stretch. Standing next to a wall, with the injured side closer to the wall, lean on the hand on the same side, cross the good leg over the other leg keeping the affected foot flat on the floor and tilt the pelvis (hips) towards the Wall. Tensor fascia lata muscle stretch | Sports Physiotherapy Exercises | MYO   ·      Long adductor muscle stretch.                               Lying on your back, with your legs raised against a wall, we slowly spread our legs until we feel the adductor muscles begin to stretch. Long adductor muscle stretch | Sports Physiotherapy Exercises | MYO   ·      Iliopsoas muscle stretch.  The muscle is stretched on the side of the leg that is behind. Iliopsoas muscle stretch | Sports Physiotherapy Exercises | MYO ·      Sartorius muscle stretch. The lower leg muscle is stretched. In this way, the leg that is above and that hooks the knee below must pull downwards (in the direction of internal hip rotation, with the knee previously flexed at least 90º). Sartorius muscle stretch | Sports Physiotherapy Exercises | MYO Key points about Snapping Hip Syndrome, conclusions: ·      The snapping hip is the clicking sound produced in the joint or around the hip associated with added bursitis or the presence of muscle spasms. ·      A dancer’s hip can occur due to various factors: lower limb dysmetria, activities that require extreme and repetitive ranges of movements of joint range, the strain produced in the psoas muscle, and /or presence of bone alterations. ·      It is more common amidst women between 15-40 years, although there are also cases in men. ·      Only 30% of people with it present pain. ·      Symptoms: audible pop in the hip when performing movements of said joint, superficial lateral or deep anterior pain in the groin area, palpation of the femoral trochanter is painful, there is no pain unless exercise is performed. ·      Treatment: rest, cold, analgesics, and exercise program (warm-up, stretching, and eccentric exercises, especially in athletes). Written by Rafael Peña for mysportsinjury.co.uk       REFERENCES ·       Nolton EC,Ambegaonkar JP, Recognizing and Managing Snapping Hip Syndrome in Dancers. Medical problems of performing artists. 2018 Dec;     [PubMed PMID: 30508831]. ·       Yen YM, Lewis CL, Kim YJ. Understanding and Treating the Snapping Hip. Sports Med Arthrosc Rev. 2015;23(4):194-199. doi:10.1097/JSA.0000000000000095. ·       Nunziata A, Blumenfeld I. Snapping hip; note on a variety. Prensa Med Argent. 1951 Aug 10;38(32):1997–2001. ·       Lewis CL. Extra-articular Snapping Hip: A Literature Review. Sports Health. 2010 May;2(3):186-90. doi: 10.1177/1941738109357298. PMID: 23015936; PMCID: PMC3445103. ·       Musick SR, Varacallo M. Snapping Hip Syndrome. [Updated 2020 Aug 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. ·       Nolton EC, Ambegaonkar JP. Recognizing and Managing Snapping Hip Syndrome in Dancers. Med Probl Perform Art. 2018 Dec;33(4):286-291. ·       Potalivo G, Bugiantella W. Snapping hip syndrome: systematic review of surgical treatment. Hip Int. 2017 Mar 31;27(2):111-121.

Back pain is more common than you think. In fact, statistics from the American Chiropractic Association show that back pain is a leading cause of disability worldwide, and most of these cases are due to bad posture rather than natural causes like fractures. Other effects of bad posture include more musculoskeletal-type injuries and pain in the neck and shoulders. On top of this, circulation, digestion, and even lung function may also be impaired.   Fortunately, avoiding and combating these effects is simple: improve your posture. Wondering how to get started? Here are some tips.   Ensure your workspace is ergonomic   Not having the proper chair and table, especially if you’re at your desk all day, means you’re more prone to posture problems. HR News reports that one-third of UK office workers suffer from backache due to their work environment, while another 13% complained of neck pain. Luckily, Pain Free Working explains that ergonomic chairs can help improve postural disorders and misalignment of the spine. These chairs have adjustable components, such as seat height, backrest, and armrest to help you maintain proper posture for long periods of time. However, remaining seated for hours at a time can still take a toll on your body. To address this, The Independent suggests standing desks that can prevent you from being inactive for too long.   Avoid slouching   Even when you’re not at your work desk using an ergonomic chair, it's important to try not to slouch. It may feel tiring to keep your back straight all the time — but that’s only because your body isn't used to it yet. Slouching adds stress to your spine, and also strains other bones, muscles, and joints that are directly connected to the spine. Aside from that, slouching also squishes your internal organs, leading to digestive and even respiratory problems. In the article The Magnitude of a Good Posture: The New Rules of Posture, it is said that good posture aligns body parts to keep the spine in line. This correct alignment of body parts reduces wear and tear on joint surfaces, which can otherwise lead to arthritis and joint pain.   Start a regular yoga or pilates routine   Yoga gently stretches your muscles, helping you become more flexible. It’s also good for building muscle strength and relieving back pain. A workout similar to yoga is pilates, which is also low-intensity, low-impact, and helps you build muscle strength. Professor Greg Whyte, an authority on sports science, differentiates the two — saying yoga is generally more about flexibility, while pilates is more about strength. Another difference is that yoga is connected to spiritual pursuits, while pilates has origins in physical healing and rehabilitation. Regardless of what you choose, you’d be glad to know you can do both yoga and pilates for stress relief and good exercise.   Mind how you sleep   It’s hard to remember how to sleep when you’re already in bed, but it’s still worth keeping in mind that the way you sleep can greatly affect your posture when you wake up. Consider sleeping in a loose fetal position, since it’s great for back pain. Sleeping in a tight fetal position, however, can limit your breathing and leave you sore when you wake up. Meanwhile, sleeping on the side with a pillow between your legs also helps avoid back pain and aligns your hips. All in all, laying on your back has the most benefits — helping to protect your spine and relieving hip and knee pain.   Correcting your posture may feel uncomfortable at the start, especially if you’re not used to it, but it’s worth it in order to improve your overall health.   Written by Mary Kramer for mysportsinjury.co.uk

HOW TO FIX ROUNDED SHOULDERS | & SPORTS PHYSIOTHERAPY MANAGEMENT TO SOLVE POSTURAL ALTERATIONS. What is a rounded shoulder? The rounded shoulders posture is one of the most common dysfunctions in this modern day technology driven life , this posture can be the consequence of an increase in the curves of the dorsal spine and protraction of the muscles of the deltoid muscles in the shoulders. To correct this rounded shoulder posture, which in the long term can cause injuries at different levels (shoulders, cervical, and back); there are specific methods according to sports physiotherapy protocols, the stretching of these retracted muscles and different rounded shoulder exercises to gain mobility in our spine. MY Sports Injury Clinic’s outlines the guidelines to correct rounded shoulders and prevent the hunched over back which is important to return to a healthy posture during your everyday lifestyle. “The incidence of rounded shoulder posture (RSP) and forward head posture (FHP) within a group of healthy individuals comprises an average age of 20 to 50 years. It was found that 66% of them suffered from forward head posture (FHP), on the other hand, 77% of them experienced right rounded shoulder and a figure up to 66% experienced left rounded shoulder” Stats stated out by Dalia Mohammed Mosaad et la (2020). In addition to the rounded shoulders, there is also the upper crossed syndrome. Do you know what the upper crossed syndrome consists of? The upper crossed syndrome refers to the imbalance that occurs in the muscle groups of the upper part of the trunk. It is a postural alteration in which a group of muscles is shortened and hypertonic while their antagonists are weakened. This results in a posture in which the shoulders are elevated and anterior and the head in a forward position. “It has been indicated that an average rate of 28% amid laundry workers have experienced upper crossed syndrome this is due to abnormal posture for long periods, the trigger symptom was neck painfor this and many other reasons it is imperative to have a postural awareness”. Junaid Chandsaheb Mujawar and Javid Hussain Sagar (2019).  This posture already described due to upper crossed syndrome influences the adjacent joints, being the craniocervical joint the most predisposed to injury due to the forward position of the head, which can cause neck pain, dizziness. “The recurrence of upper crossed syndrome amongst university medical students accounted for 37.1%” Iqra Mubeen et la (2016). The next joint is glenohumeral, which, due to the position of the shoulders already described, causes injuries to the rotator cuff of the shoulder and bursitis. This postural alteration also affects the dorsal spine producing blocked areas of movement, so the last cervical vertebrae have an excess of movement to compensate, having a high risk of generating herniated discs at that level. “A study related to the prevalence of upper crossed syndrome amongst IT professionals has stated that 38,3% of the upper crossed syndrome subjects displayed having a positive pectoralis major contracture test and 41,7% of them featured a positive trapezius weakness test”. Jyothi Seshan et la (2020). Whatever your case, whether it is rounded shoulders or superior crossed syndrome, it is essential that you put your case in the hands of the experts, since only they will be able to diagnose and provide you with the best treatment to correct any problem and treat it effectively. It can be a physical therapist/ sports physio Manchester. The specialised cares necessary to address and treat this type of alterations are provided in our sports rehabilitation centre located in the city of Manchester where you will be cared for by our health professionals/physiotherapy specialists where you can receive physiotherapeutic treatments such as; acupuncture, deep tissue massage, sports massage, manual therapy, and any other that is necessary to restore your quality of life. “Investigation results have shown that a combined treatment incorporating manual therapy and stabilising exercises reported better results than stabilising exercises alone. Sports physiotherapy management is highly recommended and beneficial in rounded shoulders syndrome, upper crossed syndrome, and the management of chronic neck pain. It enhances any postural alteration and the upper limb function.” Malihe Hadadnezhad et la (2019). Resuming the postural alteration known as rounded shoulders you might wonder what inflicts it. Does the rounded shoulders syndrome affect my body posture only? There are different rounded shoulders causes one of them is emotional nature that can cause us to tend to a certain posture. This postural alteration is one of the main causes of back pain, as it is closely linked to body posture and the discomfort it can cause if it is not correct. “Research outcomes indicated that there is a close interaction amongst forward head position, rounded shoulder syndrome, neck pain, and impairment. Besides, proper posture habits and posture training exercises which must be indicated by sports physiotherapy practitioners are recommended to prevent postural deformities, postural pain syndrome, and dysfunction.” Issued by Eun-Kyung Kim et la (2016). Otherwise, sometimes it also influences the psychological health of the patient, reducing their self-esteem and motivating the onset of depression. “Broadly, research outcomes showed that sports physiotherapy treatments and manual therapy incorporating joint movements’ maneuvers are more feasible and effective than just soft tissue techniques because bring out positive results in diminishing the patients’ anxiety and depression levels.” Gemma Espí et la (2016). Under this premise, what aspects are behind the rounded shoulders syndrome? What causes rounded shoulders? According to experts in this area such as sports physiotherapists, rounded shoulders syndrome is a direct consequence of a sedentary lifestyle and the excessive and continued use of electronic devices that force or push you to adopt an inappropriate posture. Walking while looking at the mobile phone or working every day in front of a computer are two of the actions that cause this problem. What should you do to solve this problem? How to correct rounded shoulders through physiotherapy exercises, self-massage, and stretching. First of all, you have to try to maintain an upright posture both at rest and in movement, that is, place your shoulders perpendicular to the waist. “Rounded Shoulders physiotherapy exercises have proven to be beneficial to lengthen and strengthen the pectoralis minor, and also rounded shoulders sports physiotherapy exercises routine makes possible the activation of the lower and middle trapezius and serratus anterior which it’s vital to improve the body posture and fix the postural alteration induced by rounded shoulders condition”. Kiana Fathollahnejad et la (2019). On the other hand, although the ideal is to go to  physiotherapy counseling to advise you on the most appropriate treatment and to help you carry it out, some very simple rounded shoulders exercises can support this procedure. Which are? ·      The first is to bring your shoulders back and then try to get your shoulder blades as close as possible. Once this posture is achieved, you must hold it for about a minute, and repeat it several times. ·      You can also lie down on a mat and, on your back, bring one of your knees close to your chest. Stay like this for a few seconds and switch legs. ·      Keep lying on the floor, but this time you should stretch your arms over your head. Then lift one arm and the opposite leg at the same time and alternate. With 3 or 4 sets of ten repetitions, it will be enough. ·      Another very interesting exercise is to place a tennis ball between your lats and try to hold it while leaning your back against the back of a chair. You must remain in this position for half a minute and repeat it six or seven times. How to correct upper crossed syndrome through sports physiotherapy management. ·      Dorsal extension. It is a physiotherapy exercise to make the dorsal area more flexible in extension. With a point of support in the chosen area of the dorsal area, perform flexion-extension movements slowly and smoothly. Hold until you notice relaxation of the tissues. ·      Dorsal extension and opening of the anterior chain. Gently work the extension with a semi-inflated ball or foam rolling, place your hands on the cervicals. Once the area is relaxed, rest your head back and bring your arms progressively back. Maintain the position and stretch of the anterior chain. ·      Posterior musculature toning. With the back straight and the cervicals maintaining a corrected position towards the double chin, perform these two exercises with an elastic band. ·      Protraction-retraction The elbows are kept extended and the movement that we must carry out is as if the scapulae were together towards the midline (hold the contraction for a few seconds (8-10) and relax. ·      Low row. This time we flex the elbows and do a shoulder extension. Hold back position (8-10 sec). The elbow goes beyond the position of the body backward. Perform 10-15 repetitions 2-3 sets.           REFERENCES ·       Iqra Mubeen et al, Prevalence of upper cross syndrome among the medical students ofuniversity of Lahore. International Journal of physiotherapy, June, 2016; 3(3): 381-384. · ·       Vijay mohan et al, Prevalence of complaints of arm, neck, and shoulders among computer professionals in Bangalore: A cross- sectional study. Journal of family medicine and primary care, October 1, 2019. ·       Muscolino, J. Upper crossed syndrome. Journal of the Australian Traditional-Medicine Society.2015; 21(2),80-85. ·       Mujawar JC, Sagar JH. Prevalence of Upper Cross Syndrome in Laundry Workers. Indian J Occup Environ Med. 2019;23(1):54-56. doi:10.4103/ijoem.IJOEM_169_18. ·       Kim EK, Kim JS. Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture. J Phys Ther Sci. 2016;28(10):2929-2932. doi:10.1589/jpts.28.2929. ·       Espí, Gemma & López-Bueno, Laura & herrero, maria teofila & Martinez-Arnau, Francisco & Monzani, Lucas. (2016). Efficacy of manual therapy on anxiety and depression in patients with tension-type headache. A randomized controlled clinical trial. International Journal of Osteopathic Medicine. 22. 11-20. 10.1016/j.ijosm.2016.05.003. ·       Fathollahnejad K, Letafatkar A, Hadadnezhad M. The effect of manual therapy and stabilizing exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study. BMC Musculoskelet Disord. 2019;20(1):86. Published 2019 Feb 18. doi:10.1186/s12891-019-2438-y. ·       Gupta BD, Aggarwal S, Gupta B, Gupta M, Gupta N. Effect of deep cervical flexor training vs. conventional isometric training on forward head posture, pain, neck disability index in dentists suffering from chronic neck pain. J Clin Diagn Res. 2013;7:2261–2264. ·       Fredin K, Loras H. Manual therapy, exercise therapy or combined treatment in the management of adult neck pain-a systematic review and meta-analysis. Musculoskelet Sci Pract. 2017;31:62–71. doi: 10.1016/j.msksp.2017.07.005.

WHAT IS THE CORRECT SLEEPING POSTURE? – EVERYTHING YOU NEED TO KNOW FOR HEALTHY SLEEP HYGIENE & PAIN PREVENTION. Did you know that sleeping well is as important to our health as having a good diet and exercising regularly? That is why in this My Sports Injury Clinic’s article regarding correct sleeping posture and healthy sleep hygiene you will know the reasons why it is essential to have a sleeping good posture and how to correct sleeping posture. Thus, avoid a bad rest that has negative consequences on our body and mind, favoring the development of diseases, disorders, and injuries of all kinds. Not having a sleeping good posture can make the back pain, shoulder suffer, as well as neck area. Avoid circulatory problems and discomfort caused by poor posture, by the hardness of the mattress; these are elements that cannot be left lightly. “Taking into account the effects of poor sleep quality, such as daytime sleepiness, extreme tiredness, and depression. All this can be caused by poor posture when sleeping, the existence of sleep disorders is likely to make complex the treatment for low back pain, and also the disorders when sleeping can lead to poor results in your sports performance and overall in the quality of lifestyle. It was accounted that 58,9% of the patients who sought assistance to their low back pain, stated that their LBP was disturbing their sleep quality.” Promulgated by Saad M. Alsaadi et la (2011). “An analysis of different parts of the body showed that sleep problems can cause the onset of neck pain, particularly it was shown that the female gender is more likely to suffer this.” Stated out by Alessandro Andreucci et la (2017). “Different types of sleeping postures, can you identify what are the correct ones?”“A fact: people who sleep less than five hours continuously have a 12% higher risk of mortality.” Can Sports physiotherapy treatments help to solve my sleep disturbance? – Are they beneficial? “Physical therapy and physical exercise prove to be feasible as an alternative or supplement to existing treatments for sleep disturbance i.e. middle-aged and elderly people who are constantly active practising or carrying out a sports program have moderate positive results in their quality of life, this means that physiotherapy is beneficial for sleeping problems.” Pei-Yu Yang et la (2012). It is proven that both muscle discomfort and insomnia problems can be improved by using the appropriate rest equipment. We already know that to have a restful sleep we must have a good sleeping posture, which is key to the performance of any individual in their day-to-day life, but especially for elite athletes. “Sleep is an important part of welfare and good physical condition and has a major impact on cognitive performance, physical development, emotional regulation, and quality of life. Evidence showed that extending athletes’ sleep time and enhancing sleep quality are linked to upgraded performance and higher likelihoods to succeed in the competition. Moreover, better sleep thanks to good sleeping posture can diminish the risk of athletes’ illness and injuries” Issued by Andrew M Watson (2017). Keep in mind the top 5 tips for healthy sleep hygiene. §  “Sleep only when you are sleepy. If you are not sleepy, get up and do other things until you are sleepy. §  Regular bedtime habits can assist to relax and prepare for sleep, for example, a warm bath and reading. §  Get up at the same time each morning including days off and weekends. §  Try to keep a full night’s sleep every single night, and avoid daytime naps as much as possible. §  Stay away from high-intensity exercise before going to bed.” According to Kenneth C. Vitale et la (2019). What are the disorders that are generated by sleeping without having a correct sleeping posture? The following are the musculoskeletal disorders that are caused by poor sleeping posture and the reasons why each of them occurs: §  Pain in the joint capsule of the elbow due to sustained elbow hyperextension. §  Disorders of the spine due to torsion of the body. §  Pain in the knees from pressure maintained one on the other. §  Hip disorders (snapping hip, trochanteritis, amongst others) due to closure of the angle of the femur. “A multidisciplinary team such as physical therapists in mild cases who implement a non-surgical treatment such as physical therapy, steroid injections, and stretching and orthopedic physicians are required in severe cases to assess and treat this kind of condition. Around 5-6% of counted citizens are impacted by snapping hip syndrome.”  Matthew Varacallo and Sierra R. Musick (2020).    §  Paresthesia in the arms due to decreased circulation. Have you ever wondered, what is the most efficient way for your sleep to be tremendously restful and for your body to have a good sleep posture and healthy sleep hygiene that does not overload any system or cause disorders and discomfort when getting up? What is the correct sleep position? You can sleep on your back or lying on your side since they are the positions that generate the least disorders. Never face down because the feet generate a flexion that generates disorders in the posterior myofascial chain and the head is always turned to breathe in the same direction and the arms are raised to be more comfortable, this causes poor adaptations in the cervical spine and paresthesias in the hands due to decreased blood flow. “The outcomes of the study displayed that the amount of younger patients who sustained nighttime paresthesias was higher in comparison to the carpal tunnel syndrome patients, this occurred due to their sleeping posture making them prone to experience subclinical compressive neuropathy. Paresthesias patients on an early onset can be perfectly treated with a conservative approach such as night splints, physical therapy, tips for healthy sleep hygiene, and a correct sleeping posture.”A study published by Carrie L. Roth Bettlach et la (2019). Next to damage to the musculoskeletal system, surgery, or an injury, meet a cozy posture when sleeping may be grueling. Our team of physios Manchester at My Sports Injury Clinic will provide you some recommendations on how to improve sleeping posture and encourage easing sleeping posture back pain. For those patients suffering from knee, shoulder, neck, or back pain due to bad sleeping posture, our staff of sports physiotherapy specialists will recommend you the following indications for comfortable sleep. On many occasions, patients schedule an appointment and attend to My Sports Injury Rehabilitation Centre or contact our physical therapy physicians for home inquiries. These patients generally are going through orthopedic/ sports rehabilitation or other types of sports therapy services. When they arrive at Manchester City Rehabilitation Centre, they discuss having issues finding a correct sleep position favorable to healing. Sometimes, their most-liked sleeping posture starts to produce extra discomfort and pain, upsetting any opportunity of having a placid snooze. Whether you endure a sports injury or feel sore every day, here are the best sleeping positions for coping with discomfort: What are the best sleeping postures for coping with discomfort and soreness? ·      Sleeping posture for back pain: If back pain due to poor posture when sleeping prevents you from falling asleep, there are sundry sleeping postures that can assist, according to our physical therapy Manchester experts: Sleep on your side: Let one side of your body lays on the bed taking into account the shoulder to be in contact with the mattress and place a pillow between your knees. Sleep on your back: You’ve got to put a pillow under your knees; this sleeping posture may be the best alternative for pain in the back. To increase support, you could also situate a small rolled towel beneath your back. ·      Sleeping posture for neck  pain: Sleep on your back: Sleeping in this position will keep your cervical vertebrae straight. Good posture always helps your rest and your health.Avoid using a rigid and hard pillow at all costs; this will cause stiffness and pain in the morning. Sleep on your side: If the position is more comfortable to support your neck in better conditions, and make sure to use a pillow that is lower beneath your head and higher beneath your neck, this will keep your cervical spine aligned.  ·      Sleeping posture for shoulder pain: If it is the source of shoulder pain, attempt to lie on the side that is without pain and bend your legs a bit. The best thing is that you sleep on your back. If you want to sleep on the side of the shoulder that does not hurt, another option is to place a pillow from your chest to your face, so that you hug the rest of the pillow with your arm. ·      Sleeping posture for knee pain: At night, when the joints swell up due to the absence of exercise, the knee joint pain usually aggravates. The pillow provides comfortable support and helps relieve pressure from the knees. Back sleepers can place the pillow under their knees, while side sleepers can put the pillow between their knees. ·      Proper body alignment for good sleep: It makes no odds which sleeping position you choose, correct body alignment is key. To achieve this, concentrate on adjusting the alignment of your hips, shoulders, and ears, and fill out the gaps with pillows. Recall moving the whole body at the same time when turning around in bed. Are you undergoing shoulder, neck, or back pain when sleeping? Drop us a message for our physical therapy Manchester practitioners to give you the guidance to live life pain–free. What are the sleeping postures to avoid? – Sleeping face down, the less recommended posture. In our modern era, medical professionals / physical therapists agree that this position is the least suitable. This is because, when sleeping on the stomach, we are forcing our body to maintain a forced posture for several hours. In this position, not only is excessive pressure exerted on the entire body; the cervical area (muscles, tendons, nerves, and bones) is subjected to great stress due to excessive rotation of the spine that can lead to back and cervical problems (tendonitis, low back pain, neck pain). On the other hand, a bad position at night can lead to health problems, especially if they are maintained over time. In milder cases, abnormal neck or back posture can cause us to wake up with neck or lower back pain. "In the case of the cervical spine, it is important that the pillow seeks a relationship (alignment) of the position of the head and neck similar to what we would have while standing." Said Juan Pareja (2020). In his opinion, neither should one sleep with the arms stretched out to the sides of the body, or bent over the body: "They should be prevented from protruding from the edge of the bed to avoid compression on the nerves of the upper extremities." Pareja added, "A typical compressive paralysis is that of the radial nerve due to the sustained support of the arm on the edge of the bed." References ·      Watson AM. Sleep and Athletic Performance. Curr Sports Med Rep. 2017 Nov/Dec;16(6):413-418. doi: 10.1249/JSR.0000000000000418. PMID: 29135639. ·      Vitale KC, Owens R, Hopkins SR, Malhotra A. Sleep Hygiene for Optimizing Recovery in Athletes: Review and Recommendations. Int J Sports Med. 2019;40(8):535-543. doi:10.1055/a-0905-3103. ·      UCSD Center for Pulmonary and Sleep Medicine. Sleep Hygiene Patient Information Handout [Brochure]. San Diego, CA: University of California San Diego; 2017. ·      Van Ryswyk E, Weeks R, Bandick L, O’Keefe M, Vakulin A, Catcheside P, Barger L, Potter A, Poulos N, Wallace J, Antic NA. A novel sleep optimisation programme to improve athletes’ well-being and performance. Eur J Sport Sci 2017; 17: 144–151. ·      Gaspar MP, Kane PM, Jacoby SM, et al. Evaluation and management of sleep disorders in the hand surgery patient. J Hand Surg Am. 2016;41(10):1019-1026. ·      McCabe SJ, Gupta A, Tate DE, et al. Preferred sleep position on the side is associated with carpal tunnel syndrome. Hand (N Y). 2011;6(2):132-137. ·      Roth Bettlach CL, Hasak JM, Krauss EM, et al. Preferences in Sleep Position Correlate With Nighttime Paresthesias in Healthy People Without Carpal Tunnel Syndrome. Hand (N Y). 2019;14(2):163-171. doi:10.1177/1558944717735942. ·      Alsaadi SM, McAuley JH, Hush JM, Maher CG. Prevalence of sleep disturbance in patients with low back pain. Eur Spine J. 2011;20(5):737-743. doi:10.1007/s00586-010-1661-x. ·      Alessandro Andreucci, MSc, Paul Campbell, PhD, Kate M Dunn, PhD, Are Sleep Problems a Risk Factor for the Onset of Musculoskeletal Pain in Children and Adolescents? A Systematic Review, Sleep. ·      Yang PY, Ho KH, Chen HC, Chien MY. Exercise training improves sleep quality in middle-aged and older adults with sleep problems: a systematic review. J Physiother. 2012;58(3):157-63. doi: 10.1016/S1836-9553(12)70106-6. PMID: 22884182. ·      Musick SR, Varacallo M. Snapping Hip Syndrome. [Updated 2020 Aug 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448200/

PAIN AND NUMBNESS CAUSED BY NEUROPATHY IN THE UPPER EXTREMITIES - EVERYTHING YOU NEED TO KNOW ABOUT THE PRONATOR TERES SYNDROME / CARPAl TUNNEL. The Pronator Teres Syndrome (PTS) is a reasonably rare injury it is important to be assessed and diagnosed by a specialised team of sports physiotherapists with high expertise at our Sports Rehabilitation Centre - My Sports Injury Clinic located in the city of Manchester, in which it is provided to each of our patients, whether elite athletes or businessmen, a comprehensive assessment and an accurate diagnosis to continue with the necessary treatment and rehabilitation programs implemented by our sports physios in Manchester to address and treat in the most appropriate way these types of injuries called nerve compression, also known as neuropathies in the upper limbs. In this case, we will elaborate on the pronator teres syndrome insight that is often confused with carpal tunnel syndrome. My Sports Injury Clinic Blog discusses the biomechanics, symptoms, anatomy, and different treatments of this condition carried out by the sports therapist practitioners. Also, it presents follow-up guidelines and shares some ideas on how sports physical therapists can deal with this rare injury. Before explaining the injury and its entire approach, we must know what the anatomical structure known as the pronator teres consists of and its main functions. What does the pronator teres consist of? The pronator teres is a prominent muscle that belongs to the epitrochlear muscles and that crosses from the inner part of the elbow to the outer edge of the radius bone. Hence, it is due to the position it has that it can perform a rotational movement that involves the two bones of the forearm.     Muscles are found in many parts of the body, which is why they have different sizes and arrangements of their fibers. For example, in the forearm, the pronator teres and the pronator quadratus, the palmaris longus, the flexor carpi radialis longus, and the ulnar anterior are located on the anterior face. What does the pronator teres do? – What movement does the pronator teres muscle perform? Thanks to the arrangement of its muscle fibers, it is a tissue capable of rotating the bones of the arm, which ends up bringing the thumb in a medial direction. This is known as pronation, supination being its opposite movement. Besides, some authors point out that he also flexes the elbow. What injuries affect the pronator teres? “Many injuries of muscular origin can affect the muscle ( tears, contusions, strains, etc.), but specifically there is one known as the pronator teres syndrome, which affects the median nerve with greater predominance as it passes through this place. Causing characteristic symptoms such as pain, loss of strength, and difficulty in moving the area.” Marine Dididze et la (2021). What causes pronator teres syndrome? Pronator Teres Syndrome broadly originates from reiterative motion, which causes a lot of tension in the muscles of the forearm. If your daily activities incorporate any activity that demands continuous rotation of the forearm muscles such as cleaning fish, repeated use of screwdrivers, and hammering those repetitive movements can lead to overuse of the muscle known as Pronator Teres. “The causes of pronator teres syndrome may be related to trauma to the upper limb, with the formation of a hematoma or bone deformity, as well as congenital anomalies and due to hypertrophy of the pronator teres muscle and fascia. The presence of a mass, such as a lipoma, can also cause extrinsic pressure on the nerve. More cases in the literature have described the presence of a fibrous band between both heads of the pronator teres muscle, as the main compression site, and this leads to variable symptoms with limitation of function.” As stated by Jon A Jacobson et la (2010).                         Graphic representation of forearm pain due to pronator teres syndrome | MYO shows you how to relieve it. In which sports are you more likely to suffer from pronator teres syndrome? Forearm aches due to pronator teres syndrome. This is an uncommon situation for elite athletes, whose exercise requires a firm grasp in the posture of forearm pronation, such as bodybuilders, tennis practitioners, baseball batters, cricket, and rowers. The symptoms can simulate be more like carpal tunnel syndrome which is more common.  A firm grip in pronation position by rowers. Common symptoms and signs experienced by pronator teres syndrome athletes include: ·       Aching discomfort (39%). ·       Weakness (49%). ·       Numbness (58%). ·       Paresthesia (25%). At My Sports Injury Clinic Rehabilitation Centre, we have undergone rigorous training to treat this condition. We are an interdisciplinary sports physiotherapy clinic in Manchester City, providing sports massages / deep tissue massage therapy, myofascial release, chiropractic, rehabilitation exercises, manual therapy, personal training, physical therapy, and acupuncture. Using these different types of services we can help the patients and the customers achieve the best results and best conditions to live pain and limitations free. How can you treat pronator teres pain? - What is the conservative treatment for pronator teres syndrome? “Some authors suggest a period of immobilization, although a regimen that includes movement and rest of the flexor muscles of the forearm, stretching exercises, mild activity, modification of the activity that produces pain for a minimum of six months has been more recommended, accompanied treatment with anti-inflammatory drugs.” Mackinnon and Novak (2011) “Other authors comment that in a patient with arm pain with occasional paresthesia, supportive measures are recommended, such as analgesics, periods of ice / heat, rest splint, and activity modification. And they also cite that, without the necessary evidence to support the efficacy of surgical decompression of the median nerve in patients with scattered symptoms in pronator syndrome. They are in favor of conservative treatment.” Norris et la (1976). “Conservative treatment is effective in 50% to 70% of patients. Corticosteroids have also been shown to be effective. Morris and Peters found that corticosteroid therapy in the pronator teres, combined with activity modification, resulted in a subjective improvement of symptoms in five of the seven patients studied.” “The implementation of electrical stimulation and ultrasound has been displayed to be beneficial in the treatment process of other neuropathies, and their implementation may be favorable in the pronator teres syndrome’s treatment. A study showed that 50% of pronator syndrome patients informed relief of symptoms within four months of starting care.” LaTayo et la (2004). Is surgical treatment effective? “When an occupying injury is present and conservative management fails, surgery may be indicated. The success rate with surgery in the treatment of pronator syndrome is close to 90% in the literature, although there is no consensus on how long a conservative treatment should be followed before surgical intervention.” How is pronator teres syndrome diagnosed? – How do you test for pronator teres syndrome? The convalescent individual stands with an elbow flexed at 90 degrees. Then, the sports clinician/ physiotherapy practitioner is going to place one hand on the patient's elbow to stabilise it, and the other one will hold the hand in the handshake position of the individual in pain. When the practitioner tries to turn into a supination position on the patient's forearm, the patient will maintain this position, causing the patient to contract the muscles of the forearm. While maintaining resistance to internal rotation, the clinician will stretch the patient's elbow.If the discomfort or the pain of the patient reappears there is the possibility of the existence of compression of the median nerve by the pronator teres i.e. pronation activity exacerbates symptoms. How is Pronator Teres syndrome treated? – How to strengthen the pronator teres. Possibly the most significant aspect of the treatment process is to avoid reiterative strong grasps. Determined massage techniques can help to ease the tenseness of your injured forearm in this way reducing your median nerve compression. These techniques can lengthen the pronator teres muscle and they are known as “releasing” the pronator teres, these types of sports massages must be carried out by sports physiotherapy clinicians. Even though upper limb exercises can relieve symptoms once they have been started, regular stretching exercises can also help control and possibly prevent PTS.   ·       Pronator teres stretching. When bending your elbows, hold a heavy object (5-10kg) with your hand. Place heavy objects so that most of the heavy objects face the thumb side. Keep stretching for 30 seconds each time and repeat five times. “EXERCISES ROUTINE TO STRENGTHENING THE PRONATORTERES”.                          ·       Strength exercises routine to focus on supinator teres. For the disequilibrium between the supinator and the pronator teres, direct supination intensity work is required: 1.     Grab a weighted stick or a hammer with just one hand. 2.     Maintain the elbow straight, so that one end of the counterweight turns the arm into an internal rotation position (this makes the supinator eccentric). 3.     Put back the stick or the hammer to the vertical position. 4.     Execute three series of fifteen repetitions.      REFERENCES 1.     Jacobson JA, Fessell DP, Lobo Lda G, Yang LJ. Entrapment neuropathies I: upper limb (carpal tunnel excluded). Semin Musculoskelet Radiol. 2010 Nov;14(5):473-86. doi: 10.1055/s-0030-1268068. Epub 2010 Nov 11. PMID: 21072726. 2.     Lee MJ, LaStayo PC. Pronator Syndrome and Other Nerve Compressions That Mimic Carpal Tunnel Syndrome. J Orthop Sport Phys Ther 2004;34:601-609. 3.     Gessini L, Jandolo B, Pietrangeli A. Entrapment neuropathies of the median nerve at and above the elbow. Surg Neurol. 1983;19:112-116. 4.     Hartz, C R, R L Linscheid, R R Gramse, and J R Daube. “The pronator teres syndrome: compressive neuropathy of the median nerve.” The Journal of Bone and Joint Surgery. American Volume 63, no. 6 (July 1981): 885-90. 5.     Morris, H H, and B H Peters. “Pronator syndrome: clinical and electrophysiological features in seven cases.” Journal of Neurology, Neurosurgery, and Psychiatry 39, no. 5 (May 1976): 461-4. 6.     Eversmann WW. Proximal median nerve compression. Hand Clin. 1992;8:307-315. 7.     Nebot-Cegarra J, Perez-Berruezo J, Reina de la Torre F. Variations of the pronator teres muscle: predispositional role to median nerve entrapment. Arch Anat Histol Embryol. 1991;74:35-45.  8.     Tulwa N, Limb D, Brown RF. Median nerve compres- sion within the humeral head of pronator teres. J Hand Surg [Br]. 1994;19:709-710.  9.     Howard FM. Compression neuropathies in the anterior forearm. Hand Clin. 1986;2:737-745. 10.  Institute for Integrative Healthcare Studies; Techniques for Releasing the Pronator Teres; N. Cutler, L.Ac.; October 2009  

SHOULDER LIMITATIONS: DYSKINESIA, GIRD AND SCAPULOHUMERAL RHYTHM AND ITS INFLUENCE FOR SPORTS PERFORMANCE Upper back pain and scapular pain could be produced by overuse, muscle strain, uncoordinated movements of the involved joints or injury to the muscles, ligaments, and discs that support the spine. Bad posture is one of the upper back pain causes as well. Compression on the spinal nerves from certain problems, such as a herniated disc, these causes of upper back pain on the right side, upper back pain on the left side, and scapular pain can lead to further abnormalities such as shoulder limitations and limitations to scapular movement like dyskinesia, glenohumeral internal rotation deficit. The coordinated movement between the glenohumeral joint and the thoracic scapula is known as the scapular humeral rhythm. When flexo-abduction of the shoulder is performed at 180 °, this movement immediately intervenes in the displacement of the scapula because this singular bone piece is an important part in stabilising the upper limb and the upper back sides; of the 180 ° mentioned above, 120 ° have occurred in the glenohumeral joint while 60 ° have occurred in the scapulo-thoracic joint, which is known as the Scapulo-Humeral Rhythm. “The impact of sporting-related practices on the scapular resting position and the scapulohumeral rhythm and its quantitative relation 75 subjects were included in this research that they were fifteen volleyball practitioners, fifteen table tennis practitioners, fifteen handball athletes, and fifteen non-sports individuals. It was found that the static position of the scapular bone between the main and non-main shoulders of each group did not have asymmetry in upward/downward rotation, but the main shoulder of the handball player had a larger downward ratio than the main shoulder of the non-athlete in the resting position.Besides, in the five groups, the shoulder-brachial rhythm ratios of different abduction angles are significantly different, because the scapular kinematic behavior ratio of table tennis players and non-athletes is larger than handball players. To summing up, even though, some healthy athletes from different sports and non-athletes may not have asymmetry in the up/down rotation, exercise-related activities may affect the scapulohumeral rhythm” By Seyed Hossein Hosseinimehr (2020). The interrelatedness of these structures is essential for ideal mobility of the shoulders when the regular location of scapular bone relative to the humerus changes. It may lead to scapulohumeral rhythm dysfunction. Changes in the regular position are also called scapular dyskinesia. “In this sense, the proposed ratio for this scapular humeral rhythm, according to Inman et la (1994), is 2: 1, that is, for every 3 degrees that occur in shoulder elevation, the second occurs at the expense of the joint glenohumeral and 1st by the action of scapular rotation.” The lifting movement of the arm is carried out in a continuous, coordinated manner, during which for every 15º of movement, 10º lie in the glenohumeral and 5º in the scapular rotation, maintaining a ratio of 2: 1. In which sports situations is it necessary to have an optimal stabilisation and functioning of the shoulders? Different positions of the shoulder in contact sports situations where joint stability is required. These sports are football, rugby, basketball, amongst others. Different sports gestures where the great amplitude of shoulder movement is required for a more effective resolution. These sports are javelin throw, volleyball. Different sports gestures where mobility and stability are required. What is dyskinesia /scapular dyskinesia according to My Sports Injury Clinic Clinicians? First of all, we must know that our physical therapists of MY SPORTS INJURY IN MANCHESTER CITY CLINIC CENTRE will explain to you that dyskinesia is abnormal involuntary movements that mainly affect the limbs, trunk, or jaw and that occur as a manifestation of an underlying pathological process. According to the experts of MY SPORTS INJURY CLINIC, scapular dyskinesia is described as observable alterations in the position and movement of the scapula concerning the rib cage, which can generate alterations in the kinematics of the scapulohumeral, that is, this scapular dyskinesia most likely generates consequences in the gleno-humeral joint due to their intimate relationship in the movement. Why does dyskinesia occur? “Compared with non-overhead athletes, the prevalence of scapular dyskinesia in overhead athletes is higher, about 61% within sports like baseball, volleyball, basketball, American football, and cricket”. Under Yamaguchi and Cols (2000) “There are several factors that can cause this alteration/ shoulder-scapula limitations. The most frequently encountered are Postural alterations that promote this pathology, such as in a resting position with excessive thoracic kyphosis and an increase in cervical lordosis, which can result in excessive scapular protraction and acromial depression, which increases the potential to produce impingement”. Other factors associated with scapular dyskinesia stem from muscle dysfunction, specifically an alteration in muscle coordination. “For scapular stabilisation, co-contraction of the upper and lower trapezius and rhomboids with serratus anterior is required. For scapular elevation, co-contraction of the serratus anterior and lower trapezius with upper trapezius and rhomboids is required. If these muscular couplings do not occur, the production of scapular dyskinesis is possible. In the serratus anterior muscle, a decrease in its activity has been demonstrated in patients with subacromial impingement during loads and their phases” Ludewig and Cook (2000). What are the different types of Dyskinesis that you could suffer from? ·      Inferior dysfunction. ·      Medial dysfunction. ·      Superior dysfunction. Another limitation of shoulder/scapular movement discussed in this article is GIRD (Glenohumeral Internal Rotation Deficit) which will be described below. Visit My Sports Injury Clinic Rehabilitation Centre for An Appointment In MY SPORTS INJURY CLINIC located in Manchester City, we offer a huge variety of high ends rehabilitation programs focused on the well-being of the patient, and life without limitations. How can be defined GIRD? GIRD can be defined as the loss of degrees of glenohumeral internal rotation. This limitation tends to occur more frequently in pitchers of cricket and baseball, especially in the throwing shoulder compared to the non-throwing shoulder. Loss of glenohumeral internal rotation on the skillful side compared to the other limb. This is a characteristic alteration of overhead sports. “The main content of non-surgical treatment of GIRD patients is still posterior capsule stretching. A comprehensive treatment plan should also focus on the entire dynamic chain, including the lower limbs, core, and shoulder bones. For symptomatic throwers who cannot undergo extensive non-surgical treatment, shoulder arthroscopy can be performed. It is important to realise that not all patients with GIRD can be diagnosed with internal impingement.”  Michael B Rose and Thomas Noonan (2018). To conclude this article we share some conclusions: ·      A retraction of the posterior capsule could be a risk factor for developing rotator cuff friction syndromes. ·       Dysfunction of the scapulohumeral rhythm, either due to poor location, or an altered scapular movement, can result in a dysfunction in the scapulohumeral joint and the consequent increase in the risk of injury   What has been developed so far can serve as a starting point in the analysis of possible treatment approaches for impingement injuries or subacromial friction syndrome. This represents the irritation and wear generated by friction in the structures below the acromion and related to them.                               References ·      Kibler WB, Kuhn JE, Wilk K, et al. The disabled throwing shoulder: spectrum of pathology – 10-year update. Arthroscopy. 2013;29(1):141–161. e126. ·      Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology – part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19(4):404–420. ·      Kibler WB, Sciascia A, Thomas SJ. Glenohumeral internal rotation deficit: pathogenesis and response to acute throwing. Sports Med Arthrosc Rev. 2012;20(1):34–38. ·      Ken Yamaguchiand col. Glenohumeral motion in patients with rotator cuff tears: A comparison of asymptomatic and symptomatic shoulders. Journal of Shoulder and Elbow Surgery Volume 9, Issue 1, January–February 2000. ·      Paula M Ludewig and Thomas M Cook. Alterations in Shoulder Kinematics and Associated Muscle Activity in People With Symptoms of Shoulder Impingement. Physical Therapy March 2000. ·      Struyf, F., Scapular positioning and movement in unimpaired shoulders, shoulder impingement syndrome, and glenohumeral instability, Scandinavian Journal of Medicine and Science in sports, jrg20, nr3, 2011, p352. ·      Rundquist P, Anderson DD, Guanche CA, et al. Shoulder kinematics in subjects with frozen shoulder. Arch Phys Med Rehabil 2003; 84:1473–1479. ·      Codman EA: The Shoulder,Boston: G.Miller & Company,1934. ·      Hosseinimehr, Seyed Hossein & Anbarian, Mehrdad. (2020). The effects of activities related to sports on scapular resting position and scapulohumeral rhythm ratio. Sport Sciences for Health. 16. 10.1007/s11332-020-00647-1.

Sports Physiotherapy scope to treat and prevent baseball injuries.   On some occasions, there are game situations where the professional baseball players suffer a muscle injury or slight pain, due to impacts/ trauma with other players, wild pitches (when the batter is hit by a ball thrown by the pitcher) or collisions with fences, etc. Sports physiotherapists / physical therapists / sports massage specialists, who work with the teams, must always be very attentive to any situation. They are the specialists in their area and responsible for the physical health of the players, but the most important thing is that they must always keep the manager and pitching coach posted of the physical condition of the players and pitchers. Cricket is also known as a sport that has similar strains injuries to baseball due to its very similar body movement patterns across game situations i.e. hamstring strains can be the result of many different actions like running between wickets, fast bowling. In general, hamstring strains are yielded by rapid direction changes and “out of the blue” movements. Cricket players are predisposed to sustain strains owing to the fact that they are standing still for a long time before sprinting, and in other positions the strains are caused as a result of overuse. “According to stats acute-on-chronic rated 16% to 22.8%, on the other hand, chronic injuries accounted 8% to 22%, but acute ones are the most common reaching 64% up to 76%. The most frequent injury in modern cricket is hamstring strain, and the most serious is the stress fracture of the lumbar spine in young fast bowlers.” Dinshaw N Pardiwala et la (2018).   During the baseball season there are a certain number of injuries, which, treated properly and on time, are quickly eliminated. There is an invariable rule that must be followed when these appear. If the injury is of a minor nature and the sports physiotherapist, coach or manager is qualified to treat it, they must do so and, if not, the injured elite baseball player / big leaguer must be onward referral to a specialist physician. My sports injury clinic is a rehab Centre located in Manchester city which offers high-end sports massages treatment options and allows every individual live pain / limitations free. In this article you are about to find every baseball related injury and how physical therapy / manual therapy / sports massages help to deal with them and avoid them.   What are the baseball positions that most predispose to a high incidence rate of suffering an injury? - How often do baseball related injuries occur?   “Qualifying criteria of the study, to be a pro baseball player in the Major Leagues (MLB), the American sport journal of sports medicine reported that it was observed that the players’ average put on the DL (it means disabled list) was high reaching a figure of 438.9 per each year/ season. The results of the study showed that of every 1000 (AE) athlete exposures, 3,61 of them got injured and were included on the list. There was not any variance between (NL) national league and the (AL) American league regarding injury rate. Statistically, the overhead throwing positions as Pitchers were more prone to suffer injuries obtaining a concurrence rate of 34% comparing field players. Also, it was found that upper body injuries represented a figure of 51.4% while lower limb injuries reported 30.06%. Spine and core muscle tissue injuries estimated for 11.7%, and other injuries and diseases represented 6.3% of the total number of the incoming injured players on the list. Overall, 55.6 days was the average of the players within that list.” Issued by Matthew Posner et la (2011).     The different types of injuries and the correct way to treat them will be described below, what are those kinds of injuries?   ·      Muscle aches; improve your physical condition, start the work from low to high and increase it as your body feels able to do it with more intensity. Rest, heat treatments and sports massages are advised, as the case may be. The player must take the heat treatment and sports massages methodically, but never without stopping training, although decreasing the intensity of the work, while the muscular pains last. “The repeated throwing and hitting moving patterns in baseball put mechanical stress on the lumbar spine, which may yield into (LBP) low back pain. A current finding displayed that more of 70 percent of abdominal muscle core strains take place on the opposite side of the dominant pitching side. Numerous stabilisation schemes and core stretching programs turned out to be effective to treat LBP reaching up to 80% of success i.e. it’s essential to know that these kinds of rehabilitation treatments must be performed by qualified sports massage practitioners / physical therapy clinicians / competent and responsible physiotherapists.” Stated by Joseph G. Wasser et la (2017).   ·      Throwing arm pain; rest is the best medicine, accompanied by heat treatments in any form: diathermy, hot packs, sports massages, etc. Maintaining the treatment until the pain disappears completely. Rest should only be for the throwing arm, because any attempt to work on the arm will aggravate the injury. Bursitis, rotor and shoulder muscle injuries, in addition to elbow pain (Tommy John injury), should be treated by a specialist doctor, since they are serious injuries, cause a lot of pain, they demand special care and at the end surgical procedures is the best management option.   “Baseball pitchers’ arm injuries are common atevery tier of the sportdue to the inclusion of professional pitchers on the handicapped list, an estimated annual loss record of $500 million. Moreover, throwing arm injuries in baseball reported to be almost 50% of all kinds of disabilities in the big show, 25% of the whole throwing injuries were arranged as grave in college athletes”  Cristine E. Agresta et  la (2019).   “According to reports, four professional pitchers suffer from resistant shoulder or bursa bursitis and require surgical removal of the thickened bursae. The average duration of symptoms before the surgery approach was 18.8 months. Conservative treatments include shoulder exercises, rest, deep tissue massages, manual therapy, NSAIDs, sports physiotherapy and cortisone jab. These were not enough to relieve pain and solve the bursitis problems so non-conservative process had to be involved.  Resistant scapular bursitis should be surgically removed.”  By D J Sisto, F W Jobe.   “The recovery time for mild bursitis is nearly 14 - 21 days if it is treated with sports physiotherapy/ physical manual therapy and the recovery time for the surgical operation of this injury is approximately 48 - 54 days” Published by the official website of MLB.   ·      Charley horse; it is the tearing of the fibers of the muscular tissues, breaking of blood vessels, due to a violent contraction of one or more muscles. As soon as this injury is reported, the first thing to do is to make sure if it is truly a charley horse and if so, immediately proceed to an application of ice for thirty minutes to constrict the blood vessels and eliminate the possibility of an internal spillage of blood. Rubbing the ice on the damaged part eliminates the pain. After ice, any form of heat can be used. Gentle, slow, rhythmic massages / sports massages / sports physiotherapy lasting 15 to 20 minutes, together with rest, is what will help the player to recover completely. “Exercise related muscle cramps also known as charley horse is described as spasmodic, painful, and non-voluntary shrinkage of musculoskeletal tissue that happens immediately after the exercise / routine or during sporting competition. Stats displayed that there is a high evidence of incidence amongst elite athletes that play endurance sports.  Charley horse most efficient primary treatment methods are passive stretching indicated by sports physiotherapy and rest. The key to preventing Charley horse is to diminish premature muscle fatigue’s risk.” Pointed out by Malcolm Collins et la (2008).   ·      Other injuries, baseball players can sustain and present symptoms of diseases of a respiratory, lumbar, neurological, visual, allergic nature and infectious processes of the skin or feet, as well as with bone-type ailments. Neurological problems, body misalignment and muscle pain may be treated by sports physiotherapists perfectly. Conversely, in severe cases must be referred by the sports clinicians and authorised personnel, to a specialist doctor. “Superior labrum anteroposterior lesions, proximal humeral epiphysiolysis, rotator cuff dysfunction and glenohumeral instability are some common injuries stemmed by the practice of baseball in young athletes due to skeletal immaturity, inadequate of throwing arm movements, fatigue and overuse.”  Brian J Krabak and Jason L Zaremski (2012).     Can truly physical therapy / sports massages / manual therapy assessment and treatment procedures provide relief in baseball related injuries / disabilities recovery?   “Baseball players who exhibit insufficient shoulder range of motion (ROM) have an increased risk of arm injuries. As a matter of fact, there is a paucity of evidence what the best treatment choice for this injury is in order to allow the shoulder’s range of motion be wholly competence, so, here it’s the thing.   What’s the relevancy of stretching and manual therapy / sports physiotherapy in baseball?    Compared with stretching alone, the manual therapy alongside self-stretching function meaningfully minimise the risk factors of ROM for baseball players with limited arm motion. Other manual therapy’s benefits are that sports manual therapy can support to play down ROM deficiency in clinical scenarios where stretching has not been effective at all.” Ellen Shanley et la (2017).     “Repeated overhead throws place huge demands on the shoulder joints of overhead throwing athletes. Therapist practitioners, sports clinicians, sports physiotherapists, manual therapy practitioners and medical staff are responsible for steadiness and mobility stabilisation to maximise and achieve the required physical performance.” Cited from the study of Omidreza Jalali et la (2018).         REFERENCES ·       Posner M, Cameron KL, Wolf JM, Belmont PJ Jr, Owens BD. Epidemiology of Major League Baseball injuries. Am J Sports Med. 2011 Aug;39(8):1676-80. doi: 10.1177/0363546511411700. Epub 2011 Jun 27. PMID: 21709023. ·       Wasser JG, Zaremski JL, Herman DC, Vincent HK. Assessment and rehabilitation of chronic low back pain in baseball: part II. Res Sports Med. 2017;25(2):231-243. doi:10.1080/15438627.2017.1282362. ·       Wasser, Joseph G et al. “Assessment and rehabilitation of chronic low back pain in baseball: part II.” Research in sports medicine (Print) vol. 25,2 (2017): 231-243. doi:10.1080/15438627.2017.1282362. ·       Agresta CE, Krieg K, Freehill MT. Risk Factors for Baseball-Related Arm Injuries: A Systematic Review. Orthop J Sports Med. 2019;7(2):2325967119825557. Published 2019 Feb 25. doi:10.1177/2325967119825557 ·       Sisto DJ, Jobe FW. The operative treatment of scapulothoracic bursitis in professional pitchers. Am J Sports Med. 1986 May-Jun;14(3):192-4. doi: 10.1177/036354658601400302. PMID: 3752357. ·       Schwellnus MP, Drew N, Collins M. Muscle cramping in athletes--risk factors, clinical assessment, and management. Clin Sports Med. 2008 Jan;27(1):183-94, ix-x. doi: 10.1016/j.csm.2007.09.006. PMID: 18206574. ·       Bailey LB, Thigpen CA, Hawkins RJ, Beattie PF, Shanley E. Effectiveness of Manual Therapy and Stretching for Baseball Players With Shoulder Range of Motion Deficits. Sports Health. 2017 May/Jun;9(3):230-237. doi: 10.1177/1941738117702835. Epub 2017 Apr 12. PMID: 28402756; PMCID: PMC5435155. ·       Zaremski JL, Krabak BJ. Shoulder injuries in the skeletally immature baseball pitcher and recommendations for the prevention of injury. PM R. 2012 Jul;4(7):509-16. doi: 10.1016/j.pmrj.2012.04.005. PMID: 22814728. ·       Stone, Michael & Jalali, Omidreza & Alluri, Ram & Diaz, Paul & Omid, Reza & Gamradt, Seth & Tibone, James & Weber, Alexander. (2018). NONOPERATIVE TREATMENT FOR INJURIES TO THE IN-SEASON THROWING SHOULDER: A CURRENT CONCEPTS REVIEW WITH CLINICAL COMMENTARY. International Journal of Sports Physical Therapy. 13. 306-320. 10.26603/ijspt20180306.  

HOW TO PERFORM A REMARKABLE GOLF: KEYS TO A TOP ELITE PERFORMANCEEven though golf is considered as a non-high-impact sport, it can cause a variety of injuries. A wide array of golf related injuries are yielded by overuse/ monotonous movements/  poor golf swing techniques / mechanics. Most common golfing injuries are experienced in the lumbar back area, in others common injured zones by bad practices of golf basics are included shoulder, elbow, hand and wrist. It is extremely important to take into account and know how to perform a quality golf swing, so in this way not give away any type of advantages at the time of competition, whether elite competition or beginner/ amateur practice. In this MY SPORTS INJURY CLINIC blog post you will allow yourself to dig out everything you need to know about. MY SPORTS INJURY CLINIC GOLF INJURIES AND RGIHT WAY TO MAKE A GLOF SWING - FEMALE GOLF COMPETITION LOWER BACK PAIN - HOW MY SPORT INJURY IN MANCHESTER CITY CAN HELP TO ANY GOLF INJURY RECOVERY  “When there are injuries produced by golf practice hardly ever they are given the same acknowledgment as contact sports, combat sport. Nevertheless, golfing injuries are befallen more frequently than you thought. A scientific research was carried out where the aim was to review the profile of the golf female players’ discomforts. A statistic of five hundred twenty two (522) female golf practitioners were included in the study where (35,2%) of them presented having experienced an injury due to practice golf within a period of time of twelve months before the Women's Pennant Competition in Victoria, Australia. It was indicated lower back as the most frequent injured zone and strains were pointed out as the most common source of injuries representing a figure of 67, 9%. Around of 184 injuries informed 154 of them were treated by a health care professional provider. Likewise, it turned out that sports physicians / physiotherapists / physical sports clinicians were the most consulted and sought after to handle these kinds of injuries.Statistically 69, 7 % of the golfers could not be performing in their competitions properly due to the injuries causing competition games and practices to be missed, reaching up to an amount of 78, 9% of affected performance”. As per A J Fradkin et la (2005). [RH2]  Muscle Strains & Back Pain - What are the treatment options? Physical therapy in Manchester City - Book an appointment at MY SPORT INJURYBack Strains Injuries - How can sports therapy be beneficial to fix strains? MY sports injury clinic based on Manchester City Centre“Pitcher’s elbow, golfer’s elbow or medial epicondylitis is a regular tendinopathy which is yielded by overload/ repetitive movements of the elbow area, also known as repetitive strain injury (RSI). It could be produced by playing American football, baseball, golf and tennis and many other sports where a racquet is required. The medial epicondylitis is way less frequent than the lateral one. Thus, it comprises a number of 10% to 20% of the whole epicondylitis injuries. In accordance of the research the occurrence is 0, 4% amongst of global population i.e. is not a common injury, Physical therapy is mainstay management approach which seeks to relieve patients’ pain and avoids surgical intervention. Considering the non-conservative treatment in serious golfer elbow injuries, both treatments conservative and surgical have proven effectiveness. ” Kimberly Kaiser and John Kiel (2020). You already know that the movement we make to hit the ball when making the stroke is called swing. If you are starting to play golf as a past time, you have wondered more than once how to make a good swing. Although practice on the ground is essential, we are going to explain some keys to you regarding the swing. My sports injury clinic located in Manchester city recommends you to follow the guidelines below.   Before we get down to work we must not forget that what you want to achieve with the swing is to maximise the speed of the clubhead at the moment of hitting the ball to reach the maximum distance and making use of a good alignment of the body is also key as if you don’t control your body you will be spraying ball to any course except for the targeting one wanted for the golfer. Stages of golf swing / Thoracic vector in golf coordination / Essentials for the ball contact in golf by MY SPORT INJURY CLINIC “In this review it was highlighted that there were three frameworks and they were used to calculate the horizontal plane alignment of the upper body; cardan angles, chest vector and the last one is inter acromion vector. Then, it used the intra-class correlation and 95% agreement to limit the agreement between the evaluation methods. Outcomes found displayed that thorax/ chest vector can be employed to give precise estimation of thoracic alignment in every phase of the swing.” Published by C E Milner, T Vernon and J S Wheat (2007). Learn how to get a good upper body alignment posture while practicing golf - MY SPORT INJURY CLINIC RECOMMENDS THESE STEPS. An outstanding swing will depend a lot on our position (stance / good alignment) and on how we hold the club (grip), which must be done by keeping the shaft as close as possible to the base of the fingers. What is the correct position during the swing performance? The first thing you have to know to make a swing is that to have a good position we must open our legs to the width of the hips. Just like the photo below. Proper stance in golf swing / Correct posture during ball contact in golf sporting events / My sport injury advices. If we do not adopt the necessary techniques to make a swing when we practice golf, it is very likely that we will get an injury. “The prevalence showed in the study was that golf players linked with lesions in the lower back area varies from 15 % (fifteen percent) up to 34% (thirty four percent) in non-professional golf players, on the other hand, a figure of 22% (twenty percent) up to 24% (twenty four percent) in professional/ elite golf practitioners. Overall, the incidence within male golfers group is 25% and it can reach up to 35%” meanwhile within female golfers group is 22% and it can encompass up to 27%.” Cited from the research made by  Andrew J. McHardy et la (2007). We bend slightly from the hips forward and bend our knees. The arms must have width so that they remain straight during the blow. The ball must be in the centre, but slightly displaced to the left, although it will depend on the chosen club. As we mentioned the knee is essential to perform a good stance, but, Can I injure my knee while playing golf? “The incidence of sustaining knee injuries in professional golf athletes and amateur golf ones is ranging from 3% to 18%, and the assessment measure on skill level or gender is not evident. Although, older golfers presented higher risk of having knee injuries” Research issued by Matthew L. Baker et la (2017) How to start off a good swing. You must be aware that the first part of the swing begins by separating the head of the club from the ball. You have to do it gently and with your arms outstretched. The movement must end with the stick over the shoulder and parallel to the ground. “In short, the injuries of professional golfers are usually linked to their swings, According to reports, various acute and chronic injuries include, median neuropathy, ulnar nerve neuropathy, wrist fractures, eye injuries, skin rashes and tendinitis.  Repetitive swings cause the most damage to men and women; areas such as the lower back, left hand and left wrist get injured commonly, collecting an average of two injuries for every professional golfer. ” Study named as the price golf players have to pay by Terence J Gioe and John R McCarroll (1982). Wrist Pain - Wrist injury - Wrist injury fitter golfers - Tendinitis in professional golfers - What do i need to do to treat it? Sports therapy / Physical therapy recovery   Golf Wrist Injuries and Hand Physiotherapy in Manchester city sports therapy centre. Can physical therapy / spinal manipulation improve my swing performance? “Comparing muscle stretching alone to chiropractic therapy related to muscle stretching looks like it is tied in to the improvement of golfers' full swing performance i.e. spinal manipulation / physical therapy will give better results than a solo stretching workout” Soraya M.V. Costa and others (2009).[RH3]  What is the right way to hit the golf ball? Once this movement is finished, we move on to the change of direction of the swing which we are going to hit the ball. The lowering of the stick begins with a hip movement which we reverse the turn of our body while lowering the head of the stick. This movement must be done with controlled force. When we hit the ball, far from finishing the swing, we must continue with the movement. How to finish your golf swing smoothly. Given the movement we have made previously and the force which we have hit the ball, it will be difficult for us to stop. So we continue to slow down little by little. The golf club will continue to draw an arc around our body. When this movement ends, the club should be above our head. To make a good swing it is necessary to practice and have an expert player who teaches you that is vital to achieve it. Most common golf injuries / Knee injury / Lower back pain in golf players / What the experts of My Sport Injury Clinic in Manchester City think References ·       Fradkin AJ, Cameron PA, Gabbe BJ. Golf injuries--common and potentially avoidable. J Sci Med Sport. 2005 Jun;8(2):163-70. doi: 10.1016/s1440-2440(05)80007-6. PMID: 16075776.   ·       Wheat JS, Vernon T, Milner CE. The measurement of upper body alignment during the golf drive. J Sports Sci. 2007 May;25(7):749-55. doi: 10.1080/02640410601113213. PMID: 17454543.   ·       McHardy A., Pollard H., Luo K. Golf injuries: a review of the literature. Sports Med. 2006;36:171–187.     ·       McHardy A., Pollard H. Lower back pain in golfers: a review. J Chiropr Med. 2005;4:135–143.   ·       Gosheger G., Liem D., Ludwig K., Greshake O., Winkelmann W. Injuries and overuse syndromes in golf. Am J Sports Med. 2003;31:438–443.     ·       McCarroll J.R., Gioe T.J. Professional golfers and the price they pay. Phys Sportsmed. 1982;10:64–70.   ·       McCarroll J.R., Retting A.C., Shelbourne K.D. Injuries in the amateur golfer. Phys Sportsmed. 1990;18:122–126.     ·       Cabri J, Sousa JP, Kots M, et al. Golf-related injuries: a systematic review. Eur J Sport Sci. 2009;9:353–366. doi: 10.1080/17461390903009141.   ·       Gatt CJJ, Pavol MJ, Parker RD, et al. Three-dimensional knee joint kinetics during a golf swing: influences of skill level and footwear. Am J Sports Med. 1998;26:285–294. doi: 10.1177/03635465980260022101.     ·       Marshall RN, McNair PJ. Biomechanical risk factors and mechanisms of knee injury in golfers. Sport Biomech. 2013;12:221–230. doi: 10.1080/14763141.2013.767371.   ·       McCarroll JR, Gioe TJ. Professional Golfers and the Price They Pay. Phys Sportsmed. 1982 Jul;10(7):64-70. doi: 10.1080/00913847.1982.11947272. PMID: 29267100.   ·       Seaman D. Golf and chiropractic: a natural combination. Dyn Chiropr. 1999;17(17) .

THE MAGNITUDE OF A GOOD POSTURE: THE NEW RULES OF POSTURE WORK FROM HOME Keeping a healthy posture during daily occupations not just helps to put a stop to waist, back and neck pain but helps out to avoid these issues from getting worse over time as well. “Studies have confirmed that optimisation in posture cognisance are lengthwise tied in to the fact of easing patients pain/ ache particularly patients with pain located over shoulder and spinal region” Cited from Postural consciousness and the connections to soreness of Holger Cramer et la (2018). WHAT A GOOD POSTURE IMPLIES? Although we often think that posture has to do only with the position of the back in relation to the support of the head, actually posture is the position in which we support our body while standing, sitting or lying down. Good posture is the correct alignment of the body parts supported by correct breathing and muscle contraction that helps to keep the spine in line. “State of the art rehab-science has pronounced according to the investigations that it’s noticed that breathing workout possesses a transcendent sway in the steadiness and the competence of move of the spine on patients with lumbar unsteadiness who have changed their breathing methods and in general body posture. In the face of the impact of breathing on mental and physical healthiness it is necessary to conduct continuous clinical research about breathing in patients with abundant persistent musculoskeletal conditions” Byoung Kwon Lee et la (2018). Usually we do not worry about having a normal posture; this is the direct work of certain muscles that act without us having to think about it directly. Various muscle groups; mainly the postural muscles, they are critically important to maintain good posture. While ligaments help to hold the skeleton together, these postural muscles, by working properly, prevent the forces of gravity from pulling us forward. Postural muscles keep up our balance during movement and posture as well. “In the medical observation, convalescent individuals who experience long-standing back pain in general perform extra movements to make up to and hold up posture and equilibrium of the spine under outer loads. The countervailing gestures not just impair the waist area but the neck, shoulder and sternum zones as well. At the same time, the increase in contractility and muscle strength can reduce abdominal pain, and stabiliSe the function in daily life by improving trunk muscle strength and core muscles. The repercussion of the outcomes prove that the throughput of forced breathing practices for patients sustaining low back pain with the need of up and running enhancement and spinal steadiness i.e. they showed that this physical therapy can effectively improve trunk stability and occupation of daily living in chronic LBP patients the stabilisation therapy schedule was executed for about a month and a half for a period of 45 minutes twice a week. ” Chul Ki et la (2016). HOW CAN A PROPER POSTURE BE WORTHWHILE? It initially helps us stand, walk, sit, and lie down in positions that put the least effort by supporting the muscles and ligaments during movement and weight-bearing activities. Proper posture gives us a hand in order to keep our joints and bones in the spot on alignment thereby our muscles perform correctly, reducing atypical wear and tear on joint surfaces that could ensue into degenerative arthritis and joint pain. WHAT ARE THE IMPLICATIONS OF WRONG POSTURE? Poor posture can lead to excessive tension in our postural muscles and can even cause them to relax, when they are held in certain positions for long periods of time the immediate result can be to develop intense back pain, the more the postural muscles weaken, the body will be more prone to get injured and back pain. The most common factors that contribute to poor posture are weakness of postural muscles, overweight, stress, anxiety, gestation process, high-heeled footwear and irregularly tight muscles, as well as mistaken work posture. CAN I CORRECT MY OWN POSTURE ? Certainly yes, however, long-lasting postural problems will usually take longer to rectify as the joints have often adapted to your poor posture for a long time. The first step is to become aware of your own posture and to know which posture is correct. Once you have learned that you have poor posture, it is necessary to re-educate the brain to make it aware and be willing to involve a lot of practice in order to make a significant change. For these and many more reasons it is imperative to seek professional assistance like the one we feature at MY SPORT INJURY & physiotherapy clinic in Manchester which offers high–ends Manual therapy techniques and the guidance you need that will allow you to set you free pains and impairment you’ve been suffering from. It is highly recommended to take a yoga class, any type is good because all yoga classes aim to motivate the body's own function supported by breathing, each time this discipline is practiced, and this will be a reminder of the work that your body is able to return to a healthy posture. HOW CAN YOGA HELP TO IMPROVE BREATHING? – IS PRANAYAMA BENEFICIAL? Pranayama, or techniques for learning to breathe properly, has innumerable benefits: ·      It increases lung capacity, so the lungs can get the air they need in fewer breaths, unlike people who cannot take deep breaths, and have complications derived from it. ·      You have more stamina to perform physical efforts. Observe people who breathe badly. They get tired quickly with little effort, such as walking up stairs. “After the implementations of pranayama yoga physical therapy sessions, solely reached a figure 33% of the evaluated individuals belonging to the experimental group met a high evidence of anxiety before evaluation, and this proportion was almost twice that of the checkpoint group obtaining 66.7%. Pranayama has an air of being a positive method on test performance and test anxiety, for both elite athletes and regular students.”Azadeh Nemati (2013).   ·      Generates tranquility and peace of mind. A slow and sufficient breathing is the natural state of the body, without tension, which also causes fatigue and mental fatigue. ·      Revitalizes the body. After exercising, you regain a normal heart and breathing rate. For what is this? Because you need less air than you've been using. Therefore, if your lung capacity increases, you feel better and more willing to move, go out for a walk, do physical exercise, etc. ·      Slow, deep breathing reduces the strain on the heart, which becomes more efficient and strong, works better, and lasts longer. ·      In a moment of stress or anxiety, it manages to reduce it considerably and even eliminate it. Another option is to consult a chiropractic practitioner / physical therapist / chiro clinician; they have spinal alignment techniques that can help you obtain the correct posture, including the recommendation of exercises to strengthen the main postural muscles. A chiropractic doctor can help you choose appropriate postures during your activities, helping to reduce any risk of injury. “Given the moderate evidence from studies, it is indicated that chiropractic management for lower back pain is as effective as physical therapy. There was little evidence in which chiropractic treatment was compared with medical care and physiotherapies in which it is indicated that these approaches and management have the same conclusion, there was not an outstanding difference in terms of the results obtained after the treatment of different injuries sports” Marc-André Blanchette et la (2016). Only few people have a real understanding of the importance and necessity of good posture. Thinking of involving time and effort in something that we consider we have earned and free as posture can be a mistake, because sooner or later the inevitable consequence of back pain will appear and the more damaged our body is, the more difficult it will be to restore it. If you already have a chronic back pain problem, seek professional assistance; attend to your nearest Health-Care Centre is the first step to take to allow you to get rid of your impairments / afflictions.           REFERENCES ·       Stanos S, Mogilevsky M, Rader L, McLean J, Baum A. Physical medicine approaches to pain medicine. In: Smith HS, editor. Current therapy in pain. Philadelphia: Elsevier; 2009.   ·       Kauffman TL. Bolton MA: Posture. In: Kauffman TL, Scott RW, Barr JO, Moran ML, editors. A comprehensive guide to geriatric rehabilitation. 3. Edinburgh: Churchill Livingstone; 2014.   ·       Massion J. Postural control system. Curr Opin Neurobiol. 1994;4(6):877–887. doi: 10.1016/0959-4388(94)90137-6.   ·       Laskowski ER. Proprioception. Scient Princ Sports Rehab. 2000;11:323–340.   ·       Bradley H, Esformes J. Breathing pattern disorders and functional movement. Int J Sports Phys Ther. 2014; 9(1):28-39.   ·       Chaitow L, Bradley D, Gilbert C. Multidisciplinary approaches to breathing pattern disorders. New York. Churchill  Livingstone. 2002.   ·       Comerford MJ, Mottram SL. Movement and stability dysfunction--contemporary developments. Man Ther.  2001;6(1):15-26.   ·       Stevens VK, Bouche KG, Mahieu NN, et al. : Trunk muscle activity in healthy subjects during bridging stabilization exercises. BMC Musculoskelet Disord, 2006, 7: 75.   ·       Akuthota V, Nadler SF: Core strengthening. Arch Phys Med Rehabil, 2004, 85: S86–S92.   ·       Hodges PW, Moseley GL: Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol, 2003, 13: 361–370.   ·       Selami A, Yavuz F, Yesilyurt S. Sosyal Bilimler Dergisi. 2009:146–60.   ·       Spielberger CD. Manual for the state- trait anxiety inventory. Palo Alto, CA: Consulting Psychologist Press; 1983. ·        Huberty TJ. Test and test performance. Principal performance. 2009.

DRY NEEDLING VERSUS ACUPUNCTURE While in acupuncture the needles are applied at certain points that are located in meridians, which do not have to be close to the injured area, in dry needling the needle is applied directly to the trigger point. Both are invasive methods used to treat pain disorders and can be used for myofascial trigger points. The two methods use similar needles that pierce the patient's skin and both dry needling and acupuncture therapies have proven to be very useful in clinical practice. “Some studies showed some low – quality to medium-quality evidences that dry needling therapy sessions carrying out by a professional physical therapy practitioner is way more efficient than sham dry needling, no treatments, and other treatment alternatives for relieving aches and getting a better pressure of pain threshold in convalescent patients exhibiting musculoskeletal soreness within a follow-up of eighty four days.” Eric Gattie et la (2017)“In case of suffering pain located in the lower back there are researches that displayed that acupuncture solo treatment tenders better outcomes i.e. specifically giving a short- term ache relief comparing to no treatment choices and acupuncture plus other management approaches" Stated by Lizhou Liu et la (2015)IS DRY NEEDLING AS A PHYSICAL THERAPY TREATMENT OPTION? Dry needling is an innovative physiotherapeutic technique that uses acupuncture needles to treat certain ailments, especially myofascial pain syndrome, but its similarity to acupuncture ends here, these two techniques should not be confused. It is defined as a semi-invasive technique because the needles penetrate the skin in search of the trigger point which is the cause of myofascial pain in order to press it, deactivate it and end the pain. To find it, the stimulation, comprehension, contraction, stretching, of the muscle is vital, since if pain occurs this suggests that there is a trigger point.Lin liu et la (2015) pointed out that “In the short and medium term, dry acupuncture physical therapy method is recommended and suggested to reduce MTrP (Myofascial trigger point) pain found out in neck and shoulders areas, but in the medium term, wet acupuncture is observed to be more effective than dry acupuncture in reducing MTrP pain in the neck and shoulders.” To understand exactly what dry needling is for, we must delve into myofascial pain syndrome and, for this, we must define its causes; trigger points. Trigger points are areas of the muscle that are weak and with great sensitivity to palpation. They occur when the sarcomeres (areas of the muscle fibers where the muscle contracts) are permanently contracted by the continuous release of acetylcholine, which prevents the relaxation of the fibers and decreases blood flow.“Acupuncture and how beneficial it is, for a one-month period of intense competition for four international women's volleyball players. Perform dry acupuncture of the shoulder and brachial muscles. Evaluate the range of motion, intensity, and pain before and after treatment, and perform functional evaluation of pain immediately after competition and overhead activities. All scores improved after treatment and athletes were able to continue their daily activities. Previous studies have shown that myofascial trigger points may cause significant functional weakness and reduced range of motion, accompanied by pain. Trigger point dry acupuncture has successfully treated athletes with myofascial pain and impingement symptoms, but it only improved subjectively, not during the competition phase. It can help maintain the balance and strength of the rotator cuff, decreasing further pain and injury.” Nichola J Osborne and Ian T Gatt (2015).Trigger points can be caused by many different causes, practicing combat/contact sports, repetitive movements, tackles, cold currents that directly affect the muscle, keeping the muscle in a shortened position for a long time, blows, injections, etc. There are many types of trigger points: Active: Always painful, they respond to pressure with local spasms. Latent: It only hurts when palpating. Core: Located near the center of the muscle fiber. Key: It is responsible for the activation of one or more trigger points. Satellite: Activated by the key trigger point. Primary: It is activated by a repetitive movement, acute or chronic overload; it does not mediate another muscle in the activation.WHAT ARE THE INDICATORS FOR DRY NEEDLING?The indications to perform the Dry Needle are multiple and varied, always remember to attend to health care premises where you’ll find the professional practitioners like physical therapists, sports massage clinicians and others to carry on your Dry needling treatment  under maneuvers backed up and warranted by science, the most frequent are: Patients with any shoulder pathology. For example: 1.    Frozen shoulder. 2.    Hemiparesis. 3.    Subacromial syndrome (inflammation of the shoulder muscles, it means of the rotator cuff). ·     When there are muscle problems.· Low back pain such as sciatica. ·Radiculopathies and neck pain. ·Pain due to whiplash.·When there is hip pain. ·When there is knee pain. ·Plantar fasciitis (inflammation of the fascia of the foot, the pain is located in the sole of the foot).“A steroid jab can relieve plantar pain swiftly, but dry needling can feature more above standard outcomes in patients presenting plantar fasciitis in the long term.” Contrast between dry needling treatment and steroid injection by Shirvan Rastegar et la (2018). ·Tendinopathies, such as Tennis Elbow or Golfer's Elbow, that is to say any type of tendinitis. “In fact, a recent study found that 80% of patients with elbow extensor (tennis elbow) tendinitis had excellent results after using dry needling. Similarly, 72% of patients with patellar (knee) tendinitis had great to excellent results after using dry needling” ·It is also indicated in some headaches and migraines. ·Fibromyalgia. ·Joint pain in general.WHAT IS A PHYSICAL THERAPY ACUPUNCTURE SESSION TREATMENT? Acupuncture is made up of thrusting very thin needles into the skin at cautious and strategic zones over the human body. Acupuncture, a key component of traditional Chinese medicine, is frequently used to treat pain from practicing sports. Its use is increasingly common to improve general well-being, for example, to manage stress. “According to the outcomes of every case report, it was confirmed that acupuncture was used to treat distinct types of sports injuries that elite athletes experience. Acupuncture can help relieve short-term pain and recover from dysfunction and is used as a very useful non-surgical and non-invasive treatment for sports injuries such as acetabular hit, lateral meniscus rupture, sports hernia and ganglion cysts. In addition, acupuncture has been suggested as a treatment method worth trying for conditions such as muscle aches and delayed-onset muscle soreness.” Ji-Won Lee et la (2020).WHAT ARE THE INDICATIONS FOR ACUPUNCTURE? The indications to perform an acupuncture treatment are not only for sports injuries, it can also be performed for different conditions, pathologies, ailments, muscle aches and others, such as: “The entire number of athletes taken into account within the evaluation is 211, of which 119 (56.4%) are men. The age of the athletes is 8 to 77 years the average is 24.8 yo. Among 211 sports injuries within sports like basketball, football, golf, running, ice hockey, track and field, swimming, etc. Musculoskeletal system and connective tissue diseases scored for the highest proportion of the main symptoms reported in each case report/series 46.4%. The most injured parts were knees (medial collateral ligament injury (19 cases), knee jumping (8 cases), meniscus injury (1 case)), followed by elbows, tendinopathies, and shoulders (rotator cuff injury - 2 cases). In addition, studies on various musculoskeletal diseases are reported, including tendon syndrome with chronic pain in multiple body parts (22 cases).” Ji-Won Lee et la (2020). ·      Respiratory and pulmonary disorders. ·      Respiratory diseases. ·      Digestive and intestinal disorders ·      Eye, ear, mouth and throat diseases. ·      Gynecological disorders, menstrual pain. ·      Joint diseases and pain. ·      Neurological disorders.·      Sudden acute disorders. ·      Skin diseases. ·      Urinary and reproductive disorders. ·      Treatment to stop smoking. ·      Weight loss treatment. ·      Treatment for stress, respiratory and lung disorders.“Based on the data collected from ten fortuitous trials showed that there is evidence where, needle treatment is an efficacious method to treat pain and physical dysfunction linked to knee osteoarthritis. There is insufficient evidence to show whether acupuncture affects other factors related to knee arthritis” Terry Kit Selfe et la (2008).“There was an investigation where it was vouched that acupuncture keeps to initiate the production of BDNF (Brain derived neurotrophic factor), and the enhancement of TrkB (tropomyosin receptor kinase B) expression activates downstream signal transduction pathways to restore neurological deficits, thereby providing more molecular mechanisms for understanding traditional acupuncture therapy.” Xiaohong Li et la (2017).REFERENCE   ·       Kochanek P. M., Clark R. S. B. Traumatic brain injury research highlights in 2015. The Lancet Neurology. 2016;15(1):13–15. doi: 10.1016/S1474-4422(15)00339-7.   ·       Kline A. E., Leary J. B., Radabaugh H. L., Cheng J. P., Bondi C. O. Combination therapies for neurobehavioral and cognitive recovery after experimental traumatic brain injury: is more better? Progress in Neurobiology. 2016;142:45–67. doi: 10.1016/j.pneurobio.2016.05.002.     ·       Zhao Z., Zhang W., Xing J., Yan X. Modern research progress regarding effect mechanism of acupuncture on post-traumatic stress disorder. Zhongguo Zhen Jiu. 2015;35(10):1085–1088.   ·       Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. American Journal of Public Health. 1994;84(3):351–358.      ·       Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis and Rheumatism. 1998;41(5):778–799.   ·       Warburton D.E.R., Bredin S.S.D. Health benefits of physical activity: A systematic review of current systematic reviews. Curr. Opin. Cardiol. 2017;32:541–556. doi: 10.1097/HCO.0000000000000437.     ·       Pedersen B.K., Saltin B. Exercise as medicine—Evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand. J. Med. Sci. Sports. 2015;25:1–72. doi: 10.1111/sms.12581. ·       Petridou A., Siopi A., Mougios V. Exercise in the management of obesity. Metabolism. 2019;92:163–169. doi: 10.1016/j.metabol.2018.10.009.   ·       Parkkari J., Kujala U.M., Kannus P. Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work. Sports Med. 2001;31:985–995. doi: 10.2165/00007256-200131140-00003.

MMA or Mixed Martial Arts is the fusion of different styles of traditional martial arts. The best aspects of disciplines such as kickboxing, boxing, wrestling, muay thai, Brazilian jiu jitsu, karate and judo, mixed all in one to form an effective and complete fighting style, where two mixed martial arts professional athletes face each other in a cage under right rules that protect them from severe damage, but at the same time allow so much action that they have made MMA the fastest growing unarmed combat sport worldwide. Radio Salil et la (2013) pointed out that “90% of injuries are yield by training itself, which is one of the prime conclusions of the study carried out on sports injuries, their prevention and recovery. According to this study, the most affected zones by lesions are the knee, thigh and ankle.”IS THERE ANY DIFFERENCE BETWEEN UFC and MMA? UFC is the abbreviation of Ultimate Fighting Championship, the main organization of MMA in the world, created in the United States. The popularity of this organization is what has made people relate directly to the sport. “A study of 9 weight divisions of UFC was made, in which it there were 291 injuries over 285 fights i.e. the injury average of athletic exposure was 51 per 100 fighters/ athletes. Males fighters (fifty-four injuries per one- hundred athletic exposures) had a higher average of suffering an injury than female ones” Stated out by Joseph A. Abboud et al (2018).WHY IS PHYSICAL THERAPY SO VITAL DURING PRE AND POST TRAINING / COMPETITION? The risks of not following preventive protocols can lead to problems such as muscle inflammation or rupture, delayed muscle damage, or fibrillar micro tears. For this reason, the work performed by the sports physiotherapist / physical therapy specialist in Manchester city in the pre and post training phase allows the prevention of muscle injuries and optimal muscle recovery. As part of these prevention assignments, MY Sports Injury | Manchester injury specialists recommend applying a topical anti-inflammatory before and after sports activity, because thanks to its heat effect, it helps to prepare the muscles and joints. WHAT ARE THE MOST COMMON INJURIES IN MARTIAL ARTS? Martial arts can lead to a wide variety of injuries. The type of injury often depends on the particular martial art form of being performed. Many forms of martial arts are non-contact and are characterised by overuse injuries. Contact martial arts vary widely in their techniques, standards, and protective equipment and these factors affect the type and rates of injury. “A figure of 55 martial arts practitioners with an age average (18-39 years) was included in the research that showed 207 injuries, in which high belt ranks had significantly fewer injuries compared to low belt ranks and Amateur fighters showed fewer severe injuries than Professional fighters. Most frequent parts of the body impaired were face, neck and head obtaining 38, 2% of prevalence, in second place was found the lower limbs 30, 4 % of recurrence, upper limbs 22, 7% of incidence, trunk region 8, 2 per cent and groin area presented 0, 5 per cent.  Injuries in specific areas such as toe, nose and shoulder displayed to be the most common with 6, 3% all of them. Contusions with 29, 4% continued by strains with 16, 2% of prevalence, next, sprains with 14, 9% of frequency and finally abrasions 10, 1%, they were the most frequent injuries found in the study” Lt. Charles E. Rainey (2009).THE MOST FREQUENT INJURIES IN CONTACT MARTIAL ARTS. Concussion; common symptoms of concussion include headache, dizziness, nausea, balance problems, concentration difficulties, and memory problems. Martial arts that use kicks and blows to the head are more prone to causing concussions.   Face / eyes / ear / nose; kicking or punching can result in minor injuries such as cuts, bruises and lacerations. These types of injuries can be minimized by selecting the martial arts style, coupled with proper training and the correct use of protective equipment.   Neck; minor neck injuries, such as bruises and abrasions, are the most common. However, some forms of martial arts, such as jiu-jitsu, judo, and mixed martial arts, do allow the choking techniques that can result in loss of consciousness. It is important to understand the risks of different forms of martial arts and always train under proper supervision.   Extremities; limb injuries include cuts, bruises, sprains, and strains. Joint fractures and dislocations are less common, but can occur, particularly in styles that use joint locking techniques.“The injuries mainly occurred in MMA are muscle contusions. In Judo, Karate, Taekwondo, Aikido, Fight, muscle contusion is the main sports injury. After monitoring more than 5000 competitors, 65% of them have suffered a muscle contusion. Being this the cause that is repeated the most times regardless of the category or gender of the competitors.”“Throughout the course of 2008 and 2012 Olympic Games within judo/ martial arts matches, it was observed that the average number of sports injuries due to the practice of martial arts was about 11% i.e. musculoskeletal contusions, tears, cramps and sprains represented the most frequent injuries usually affecting shoulders, fingers and the knee” Gerhard Ruedl et al (2013).“Throughout the course of 2008 and 2012 Olympic Games within judo/ martial arts matches, it was observed that the average number of sports injuries due to the practice of martial arts was about 11% i.e. musculoskeletal contusions, tears, cramps and sprains represented the most frequent injuries usually affecting shoulders, fingers and the knee” Gerhard Ruedl et al (2013).Muscle injuries can be classified according to many factors: mechanism of production, time of evolution, location of the injury. LET’S CLASSIFY THEM ACCORDING TO THE PRODUCTION MECHANISM: Extrinsic (factors outside our body): muscle contusion. Intrinsic (factors related to our own movement): muscle tear, elongation, strain, muscle cramps. To know the extent of a muscle injury it is necessary to use diagnostic tests such as ultrasound or magnetic resonance imaging. Only through this type of test we can get to know how the tissue is. The recovery time will depend on the amount of muscle tissue that is affected, the place of production, age of the subject and the assistance of your health care provider in this case musculoskeletal clinicians / physical therapy practitioners. “Magnetic resonance imaging has been widely used to accurately assess and diagnose musculoskeletal injuries. MRI has been well received and accepted as a diagnostic method by trauma physicians and specialist physiotherapists due to its accuracy, emphasizing its use in conditions caused by accidents and sports-related injuries” Conveyed by A L Deutsch, J H Mink (1989). A term widely used in rehabilitation and one of the most frequent injuries in sports, we refer directly to the musculoskeletal system, since this is where these common injuries occur. Within sports we are subjected to a lot of impact, jumps, changes of direction, over efforts, which together can cause the muscle to begin to damage, generating adhesions at the muscular level. But when the intensity exceeds the limits of resistance at the muscular level, inflammation or muscle contusion occurs, generating a lot of inability to execute certain types of movements and in turn a lot of pain when pressing the damaged muscle, thus confirming a muscle contusion. HOW CAN PHYSIOTHERAPEUTIC MANAGEMENT ASSIST TO TREAT MUSCLE CONTUSION? The treatment is conservative since the athlete is asked to continue executing movement during the treatment as well as therapeutic isometric work; physical agents are applied to the injured area. Within this type of pathologies, the use of invasive techniques such as dry needling is recommended. Some of strategies and treatment choices during a physiotherapeutic / soft tissue therapy session to return to the prior level of proficiency are: Ice. Anti-inflammatory drugs. Interferential electrotherapy.  Laser therapy. Isometric exercise. Proprioceptive exercise. Dry Needling Acupuncture.“A huge variety of non-surgical strategies to treat acute and severe injuries and musculoskeletal disorders are utilised i.e. the main focus is to minimize and avoid future damage to the injured area, decrease edema and haemorrhage, ease spasm and pain, and encourage healing. Moreover, muscle injuries due to its nature demand a functional approach from acute stage until the aim of returning to sport, conservative management is highly effective for these muscle contusion injuries  and one of its immediately treatment options is RICE which means rest, ice, compression and elevation” Research made by  L. Baoge et al (2012). Rest after activity is an extremely important component of any treatment program once an anatomical structure is injured, the healing process begins immediately. If the injured structure is not allowed to rest and it receives external pressure and stress, the healing process has no chance to start. Rest does not mean that the athlete does nothing, the term rest concerns the part of the body injured during this period, the athlete must continue to work on their cardiovascular capacity and perform strengthening and flexibility exercises in other parts of the body that have not been affected.  REFERENCES ·       Woodward TW. A review of the effects of martial arts practice on health. Wisconsin Medical Journal. 2009;108(1):40–3.   ·       Bahr R, Holme I. Risk factors for sports injuries – a methodological approach. British Journal of Sports Medicine. 2003;37:384–392.   ·       Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402–7.   ·       Surgeon General's report on physical activity and health. From the Centers of Disease Control and Prevention. JAMA. 1996;276:22.   ·       Border WA, Noble NA. Transforming growth factor β in tissue fibrosis. The New England Journal of Medicine. 1994;331(19):1286–1292.   ·       Järvinen TAH, Järvinen TLN, Kääriäinen M, Kalimo H, Järvinen M. Muscle injuries: biology and treatment. American Journal of Sports Medicine. 2005;33(5):745–764.   ·       Arrington ED, Miller MD. Skeletal muscle injuries. Orthopedic Clinics of North America. 1995;26(3):411–422.   ·       Buse GJ. No holds barred sport fighting: A 10 year review of mixed martial arts competition. British Journal of Sports Medicine. 2006;40:169–172.     ·       Poliakoff MB. Combat sports in the ancient world: Competition, violence, and culture. New Haven, CT: Yale University, 1995:54–7.

There are an extensive number of elite athletes, amateur sports players and general population who have or suspect to have a herniated disc. In this article it will cover all the important matters about spine pain disc compression in various sports environments, and how Manual physical therapy approach can benefit.WHAT IS THE TRIGGER TO A HERNIATED DISC? A herniated disc is a disease in which part of the intervertebral disc goes over towards the root of the nerve and squeezes it. Usually due to wear, this can occur throughout on the spine, and can irritate any nearby nerve. Depending on the location of the herniated disc, it can cause weakness in a leg or arm, neurological deficit, numbness, pain, disability and intense discomfort. Gibson JA et la (2007) stated that “Lumbar disc prolapse (herniated disc / herniated disc) accounts for less than 5% of lower back problems, but is the most common cause of nerve root inflammation pain (sciatica).A comparative point of view between a normal disc anatomy structure and a herniated disc. In most cases, this pain resolves with conservative treatment without surgery. However, approximately 10% of them will require surgical intervention for their treatment. “The highest incidence rate of grown-up patients with herniated disc is up to thirty – fifty years, and a derivation of the herniated disc is lumbar herniation which is the most common reason for radiculopathies reaching a figure of up to 90%” Stated by Mohammad Reza Pourahmadi et la (2016).HOW OFTEN DO ATHLETES GET A HERNIATED DISC CONDITION? In the literature, football injuries predominantly affect the ankle, knee, thigh and calf muscles. The most common types of injuries are strains, sprains, and contusions. Although the prevalence of disc herniated condition in footballers is not that high comparing other injuries / performance deficits / pain and ailment sources amongst high impact sports. The published statistics of low back pain in athletes range from 1% to 30% and are influenced by the type of sport, gender, intensity and frequency of training, and technique. Back problems / injuries can also occur predominantly in the lumbar spine, which decrease or limit the quality of life of the athlete. “Professional Football Players of National Football league USA (NFL), specifically defensive and offensive ones are highly prone to suffer herniated disc located in the lumbar area” Kunal Shah (2018). “A herniated disc confirmed via MRI study displayed that the occurrence of this condition amongst pro beach volleyball players is 76 percent” Research made and released by Fabrice A. Kulling et la (2014)If the herniation is voluminous and compresses all the nerves it encounters, it can cause what is called a cauda equina or cauda equina syndrome, which is a surgical emergency. Assessment & diagnosis from a professional certified clinician / sports physiotherapist with high expertise and experience is compulsory in order to assess the herniated disc and obtain the follow-up steps to treat it in an early onset, the sooner the better!WHAT ARE THE SYMPTOMS PRODUCED BY HERNIATED DISCS, DEPENDING ON ITS ANATOMICAL LOCATION?   Depending on the level at which the hernia is, it determines where herniated discs will be causing affectations. There are some hernias that have contact with the sciatic nerve causing pain on the outer side of the leg or pain in the hip. Some lumbar hernias cause pain in the legs. Sometimes the problems go beyond pain, and a loss of sensation or tingling may appear and in more severe cases, paralysis in the foot or knee. Akshay Gadia et la (2018) pointed out on their study findings that “LDH presented in elite sports athletes obtains an outstanding clinical result following whether non-surgical management or operatively process, regardless the sports which the elite athlete performs” On the other hand, if the hernias are cervical the symptoms will show up as cervicalgia (pain in the upper extremities), from the arm to the fingers, tingling, pricking, loss of sensitivity or paralysis in either the upper limbs.DOES THE HERNIATED DISC ACTUALLY WEAR OFF ON ITS OWN? The appearance of these herniated discs is usually associated with physical effort, and it is essential to be conscious of that although this information may seem alarming but you have to know that the vast majority of herniated discs symptoms vanish on their own for a while but it doesn’t mean that the condition is healed, on the other hand more than 80% of herniated discs heal without surgery. “Around 30% of every elite athlete has experienced pain/ailments in the lower back during their pro sports career at least once” Abhay Nene et la (2018). MY SPORTS INJURY PHYSIOTHERAPY CLINIC IN MANCHESTER CITY provides an advanced physiotherapy set guidelines specially designed for back problems. The most important thing, even if it is physiotherapy, is to have a precise diagnosis and based on this fact. Then we know whether or not physiotherapy management is going to be appropriate for the patient in order to provide an optimal treatment approach.HOW CAN WE AVOID FROM HAVING A DISC HERNIATION?Do exercises, strengthening the trunk muscles stabilises and supports the spine.Maintain good posture, this reduces pressure on the spine and discs. Keep your back straight, primarily when you are sitting for extensive periods.Maintain a healthy weight; over-weight puts more pressure on the spine and discs, making them more susceptible to herniation. WHAT ARE TREATMENT OPTIONS INDICATED TO DISC HERNIATION? Above all a conservative treatment modifies routines to dodge movement that produces pain and stop from taking pain medication. It can reduce symptoms in most people within weeks or a few days. “Overall, the conservative approach of herniated disc condition management in elite athletes possesses an extraordinary rate of success having up to 90% and more” Affirmed by Kunal Shah, Akshay Gadia and Abhay Nene (2018). Ice and heat therapy to lighten pain. ·      Physical Therapy it helps to reduce the pressure laid on the nerve, physical therapists can show positions and exercises designed to minimise the pain of a herniated disc. Exercises and very slight stretching. NSAID medicine administration. Epidural injections.Deep tissue massages. Surgery is required in severe cases (microdiscectomy or lumbar fusion).Manipulation such as chiropractic. Serafin Leemann et la (2014) made a study of 148 individuals’ lumbar herniated disc confirmed via MRI producing back and sciatic nerve pain “79 of them were dealing with chronic LHD with an average duration longer than three months and the rest of them (37 patients) had this condition for less than 4 weeks duration at the beginning of the investigation, all the patients were being treated with chiropractic adjustments and customised care. 70% of the participants were having meaningful progress as regard as inability and pain after two weeks of non-operative treatment, later on three months 90% they were presenting sizeable amelioration.”WHAT SPINAL MANIPULATION CONSISTS? – CAN IT TRULY HELP TO THE PATIENTS TO RELIEVE THE PAIN? The prime aim of this particular procedure, also called as spinal manipulation, is to improve and increase spinal movement and enhance physical function. “You can improve the symptoms of functional disability and pain considerably from the herniated disc duly confirmed by the study of magnetic resonance by passing the five sessions of lumbar manipulation technique” Fahimeh Kamali et la (2018). HOW A HVLA MANIPULATION BENEFITS ME TO EASE DISC COMPRESSION PAIN? You might have found that high velocity and short amplitude manipulation techniques (HVLA) and mobilization techniques described by chiropractors, osteopaths and manual therapists, with the intention of generating a general effect in all tissues through the vascular system and the nervous system providing to the patients: Bone articulation improvement. Disc pressure reduction. Recovery of mobility. Reduction of pain and disability. “HVLA techniques have more scientific evidence supporting their effectiveness, both applied to the dorsal and cervical regions, although they are associated with rare neurovascular risks. The mobilizations are also effective for this purpose. Both manipulations cervical - back/dorsal and mobilizations achieve analgesia, and improve mobility of the cervical spine and patient gratification, as well as their disability in the short, medium and long term, compared to the use of medications. Manipulation has a greater effect, at least in the short term, on neck pain” Gogorza Arroitaonandia Kristobal et la (2013).REFERENCES Auvinen JP, Tammelin TH, Taimela SP, Zitting PJ, Mutanen PO, Karp-pinen JI. Musculoskeletal pains in relation to different sport and exer-cise activities in youth. Med Sci Sports Exerc. 2008;40:1890-1900.2. Bartolozzi C, Caramella D, Zampa V, Dal Pozzo G, Tinacci E, BalducciF. The incidence of disk changes in volleyball players. The magneticresonance findings. Radiol Med. 1991;82:757-760.The Orthopaedic Journal of Sports Medicine The Lumbar Spine of Professional Beach Volleyball Players 5 by guest on May 8, 2015. Bono CM. Interspinous process devices in the lumbar spine. J SpinalDisord Tech. 2007;20:255-261.Bono CM. Low-back pain in athletes. J Bone Joint Surg Am. 2004;86-A:382-396. Herniated disc. American Association of Neurological Surgeons. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc. Accessed Aug. 20, 2019. AskMayoExpert. Herniated disc. Mayo Foundation for Medical Education and Research; 2019. Levin K, et al. Acute lumbosacral radiculopathy: Treatment and prognosis. https://www.uptodate.com/contents/search. Accessed Aug. 20, 2019. Herniated disk. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk/. Accessed Aug. 20, 2019. FAQs before EDX testing. American Association of Neuromuscular & Electrodiagnostic Medicine. https://www.aanem.org/Patients/FAQs-before-EDX-Testing. Accessed Aug. 20, 2019. Herniated disk in the lower back. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk-in-the-lower-back/. Accessed Aug. 20, 2019. Shelerud RA (expert opintion). Mayo Clinic. Aug. 26, 2019.

HOW SPORTS PHYSIOTHERAPY l MY SPORTS INJURY CLINIC MANAGEMENT CAN ASSIST COMMON PERONEAL NEUROPATHIES WITH EVIDENCE BASED CLINICAL STUDIES Peroneal Entrapment neuropathies are common in sports injuries, which involve a rapid change in direction, high-impact sports, or endurance sports such as Running, Football, Rugby, Hockey, Baseball, or Tennis. This Article gives an overview of Common Peroneal Nerve dysfunction or / entrapment the occurrence and when there is damage over the peroneal nerve causing loss of movement or sensation in the lower leg / foot. Most of the symptoms of the patients who actually get to MY Sports Injury | Physiotherapy Clinic in Manchester are characterised by: Foot drop, lower leg discomfort and numbness and reduced range of movement at the foot & ankle / or knee Joint. Pain is not a distinctive feature of this dysfunction (CPN) but may be latent when a peroneal neuropathy takes place as an outcome of trauma/collision/tackles/slide or sudden change of direction in high intensity sports activities. It would be essential to visit a professional certified practitioner to help diagnose CPN whether attending a Physical therapy clinic in Manchester or your local sports injury clinic to help identify the source of pain, measuring the extent of injury and examining any internal soft tissue damage amongst other limiting factors to prevent the injury worsening. MY Sports Injury provides pain management services with clinical expertise in manual therapy treatment & active release therapy to help cure identify & cure nerve disorders / musculoskeletal dysfunction that may prevent the individual from partaking activities of daily living or limit their sports performance. “Peroneal nerve injuries in professional hockey players, a clinical study based on 26 back to back hockey player cases stemmed by traumatic impact showed that 19,2% of them had a full recovery with physical therapies and 26.9% displayed partial return within 15.5 months as the ultimate time to recover” Periphereal nerve injuries related to Hockey by Greg Strange Et la. (2002). HOW CAN BE A COMMON PERONEAL NERVE DYSFUNCTION CAUSED?   “Peroneal nerve injury can record up to Fifteen percent (15%) amongst all the mononeuropathies in grown-up patients” Dtsch Arztebl Int. (2019)   This type of dysfunction requires a multidisciplinary team that diagnoses it in an early onset, taking into account experienced sports injury therapists, sports physicians, sports physiotherapist, which will assess and tackle the patients’ issues.  WHAT IS A COMMON PERONEAL NERVE ENTRAPMENT EXACTLY? The entrapment of this nerve occurs as it passes through the neck of the fibula, when it is introduced below the fascia of the peroneus longus muscle, forming an osteofibrous tunnel. “There are several atraumatic and traumatic sources of CPN injury: Injury to the knee (dislocation), traumas in general, laceration, direct impact, fractures of the fibula, habitual leg crossing, tight splint, prolonged bed rest and other causes. Common Peroneal Nerve injury can reach up to forty percent (40%) of patients” Published by Bradley Lezak ET la (2020). Compressive neuropathy of the common peroneal nerve may be more common than described and is very common to be confused with a lesion in the lumbar spine, such as radiculopathy due to a stenosis (narrowing of the nerve root) or a herniated disc. WHAT IS THE CONDITION? – WHAT DOES CPN ENTRAPMENT LEAD TO? Common Peroneal Nerve (CPN) Common fibular nerve dysfunction are most commonly referred most often leads to foot drop, when we discuss about foot drop, we are referring to the weakness for the dorsiflexion of the foot, which causes the inability/discomfort to stand on the heels, permanently caused by stenosis narrowing of nerve root acute cases and reduced supply of blood in severe cases. As a consequence, when walking, the patient  over-flexes the knee and hip to allow withdrawal of the affected limb to compensate. WHAT IS ITS PREVALENCE WITHIN SPORTS ACTIVITIES?  “CPN is also known as the commonest neuropathy found out in the lower extremities. A report of young patients such as elite athletes (football) and older patients (car accidents survivor) are frequently diagnosed with CPN entrapment after a traumatic event, and the patients who have Knee dislocations will be prone to sustain CPN with a rate of incidence of 16% to 40%” Reported by Matthew Varacallo ET la (2020). WHAT ARE NEUROPATHIES INJURIES? - WHY DO THESE INJURIES OCCUR? The entrapment neuropathies constitute a lesion where the peripheral nerve is compressed in its course, either in its passage through the bone, around the long muscles or through the fibrous tissue structures. Imprisonment can be the result of extrinsic body compression such as tight clothing, inadequate sleeping position, prolonged contact with hard surfaces, application of tourniquets, and muscle hypertrophy from exercise. It is more common to find this type of affections when there are previous systemic alterations. WHAT TREATMENTS ARE BENEFICIAL TO CURE PNE? – REHABILITATION PROGRAMS In rehabilitation, as in any other medical specialty, a medical history should be taken directed to the affected segment by your sports phyisiotherapist / physiotherapist / healthcare provider that include: Reason for consultation: for conservative or post-surgical management, type of surgical approach identified with the orthopedic joint specialist Good questioning: emphasis on type of work, and how to reduce sensitivity to pain ·      Physical Therapy Treatment & Strength Rehabilitation Program aimed at reducing sensitivity of the nerve, or nerve gliding mechanisms. Electromyography. “An extent practice of sports activities such as football, which is an endurance sports brought about a significant delay in the parameters of the nerve conduction study, which it is considered as a nerve entrapment injury diagnosis” Published by Gowthaman, G (2018) about a Study of nerve conduction in footballers’ lower limbs. MY SPORTS INJURY | Sports Physiotherapy clinic is an established clinic Located in Manchester City Centre, our Sports Injury Clinic offers high end Manual physical therapy, soft tissue massage, sports injury rehabilitation and myofascial active release therapy. Treatment aims to improve joint mobility and restore independence. Identifying the causes of neuropathy before providing adequate treatment plans / rehabilitation programs. Some initial guidance can be beneficial by placing knee pads or knee supports to prevent further damage when crossing your legs, while also stability to the legs. In some more complex cases, corticosteroid injections into the area can reduce inflammation and pressure on the nerve. You may need surgery if: The disorder does not go away and presents trouble with movement. Surgery to relieve pressure on the nerve can reduce symptoms if the disorder is caused by pressure on the nerve. Over-the-counter or preion pain relievers may be needed to control pain. If the pain is severe, a physio specialist in this field can help you explore all options for relief. Physical therapy exercises can help you keep muscle strength up. Orthotic devices can improve the ability to walk and prevent contractures. They may include splints, orthopedic shoes, or other equipment. Vocational counseling, occupational therapy, or similar programs can help maximize mobility and independence and home self-management techniques. HOW LONG DOES PERONEAL NERVE ENTRAPMENT INJURY TAKE TO HEAL? – WHAT’S THE PROGNOSIS? Patients generally see small signs of PNE recovery within 3-6 months after surgery along post-surgery physical therapy care, according to MY Sports Manchester Therapy Clinic. In most cases, the return of movement takes 6 to 12 months in more severe cases of PNE. “A study of the effectiveness of non-conservative management of Common Peroneal Nerve Entrapment was made and the result displayed a rate of 62% of neurological functions recovery, in the other hand 38% of patients assessed in the study had a full return at 12 months after surgery” Dustin H. Massel ET la (2020). If you do opt for Common Peroneal Nerve Entrapment treatment without surgery applied in acute cases, it is not known how long recovery will take. However, it is understood that as long as physical therapy exercises/assignments are practiced daily, the results will come faster than with inconsistent therapy. “Physical therapy for PNE dysfunction considers a scheme of balancing exercises, mobilization, icing, stretching, tapes/braces and manipulation which it’s completely beneficial and effective in order to manage this nerve entrapment injury and accomplish a thorough rehab.” Bradley Lezak; Dustin H. Massel; Matthew Varacallo (2020). (CPNE) recovery is a long process, so it is important to stay safe in the meantime. (CPNE) recovery can be a long process, so it is important to stay safe in the meantime. Wearing foot and ankle splints and home modification kits can help you get around. Good luck! REFERENCES ·       Hardin JM, Devendra S. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 10, 2020. Anatomy, Bony Pelvis and Lower Limb, Calf Common Peroneal (Fibular) Nerve. ·      Garrett A, Geiger Z. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 10, 2020. Anatomy, Bony Pelvis and Lower Limb, Superficial Peroneal (Fibular) Nerve. ·      Baima J, Krivickas L. Evaluation and treatment of peroneal neuropathy. Curr Rev Musculoskelet Med. 2008 Jun;1(2):147-53. ·      Poage C, Roth C, Scott B. Peroneal Nerve Palsy: Evaluation and Management. J Am Acad Orthop Surg. 2016 Jan;24(1):1-10. ·      Moatshe G, Dornan GJ, Løken S, Ludvigsen TC, LaPrade RF, Engebretsen L. Demographics and Injuries Associated With Knee Dislocation: A Prospective Review of 303 Patients. Orthop J Sports Med. 2017 May;5(5):2325967117706521. ·      Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma. 1998 Jul;45(1):116-22. ·      LaPrade RF, Terry GC. Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med. 1997 Jul-Aug;25(4):433-8. ·      Gloobe H, Chain D. Fibular fibrous arch. Anatomical considerations in fibular tunnel syndrome. Acta Anat (Basel). 1973;85(1):84-7. ·      Marciniak C. Fibular (peroneal) neuropathy: electrodiagnostic features and clinical correlates. Phys Med Rehabil Clin N Am. 2013 Feb;24(1):121-37. ·      Katirji B. Disorders of peripheral nerves. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 107. ·      Toro DRD, Seslija D, King JC. Fibular (peroneal) neuropathy. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 75.  

FOOT PAIN BY NERVE COMPRESSION: HOW TO TACKLE TARSAL TUNNEL SYNDROME: THE EFFECTIVENESS OF SPORTS PHYSIOTHERAPY TREATMENT & PREVENTIONA SPORTS PHYSIOTHERAPY BASED APPROACH ON LOWER LIMB INJURY & REHABILITATION. Sports injuries occur when you practice a sport or perform some type of physical exercise under high intensity, extended durations of competition or extreme speeds of movement, such acute injuries or overuse injuries can stem into more complex lower limb conditions. The most common body parts which sustain acute injuries are the pelvis, groin, and legAthletes are usually more likely to experience these types of injuries, most commonly are Abductors strains, Plantar Fasciitis, Shin Splints, Anterior Ankle Impingement, Hamstrings, Rectus Abdominal Muscle strain, Hip dislocation amongst others.  “Muscles strains injuries are the principal ones amid sports practitioners, representing up to 31% of patients who attend seeking help, and the Adductor muscle injuries represented the second most commonly injury sustained by European football players reaching up to 23% so letting the top spot to Hamstrings injuries which reach up to 37% of prevalence, in other study the results found were that adductor strain/pain accounted 9% to 18% of whole lower limb injuries in pro footballers” John Kiel; Kimberly Kaiser(2020). In which sports are more likely to go through those kinds of injuries? Cross fit, Rugby, Soccer, Martial Arts, Running, Basketball and Hockey. Although it is common for lower limb injuries to be sustained in these sports, injury can occur whether by practicing such activities or by doing regular day-to-day tasks during normal lifestyle, it’s completely usual to get injured without having practiced sporting activities too.Gürhan Dönmez, Savaş Kudaş ET la (2016) stated out on their article about Posterior Ankle Impingement in professional footballers that “Conservative management i.e Physical therapy modalities were greatly efficacious over 2/3 of this (PAI) syndrome among elite footballers, which means 69.2% (18 football players of 26) of reduced complaints treated by non-surgical process whilst the rest 8 individuals (five chronic cases and three acute cases) did not recover completely and surgical management was performed, in as much as posterior ankle arthroscopy is a gold standard procedure when a conservative management does not meet the expectations, every athlete put back to their prior level of proficiency” In this Case Onward referrals to orthopaedic surgeons or musculoskeletal joint specialist are essential in reducing the athletes return to sport. Lower limb pain within sports can be unbearable and debilitating, you always wonder how the extent of damage caused by such blow / tackle it makes you hesitate to decide what to do next? MY sports Injury | Manchester cityMY SPORTS INJURY | Sports Physiotherapy clinic is an established clinic Located in Manchester City Centre, our Sports Injury Clinic offers high end Manual physical therapy, soft tissue massage, sports injury rehabilitation and myofascial active release therapy.This blog manu encompasses all the follow-up steps and insights you need as with regards to nerve compression injuries in this particular case the tarsal tunnel syndrome. When the patients show up at MY Sports Injury | Manchester, have team of qualified sports injury professionals and experts in musculoskeletal disorders, efficient and capable sports physiotherapist & sports Therapist practitioners at your assistance to help get the pain away and impairments out to a manageable state in order to live a pain free unrestricted lifestyle and move around with ease.What's the structure of the tarsal tunnel? –This looks to be very interesting, let me explain to you briefly. The tarsal tunnel is a narrow space located within the ankle next to the ankle bones. The tunnel is overlaid by a thick ligament known as (flexor retinaculum) that protects and holds back the structures (nerves, arteries, tendons, and veins) inside the tunnel. One of those elements is the posterior tibial nerve, a primary focus to tarsal tunnel syndrome. To put it another way, what’s a tarsal tunnel syndrome about? – What does it appear like? Tarsal tunnel syndrome is the compression or the pinching of the posterior tibial nerve that produces symptoms anywhere to all the way down the nerve. The tibial nerve rear runs inside the ankle towards the foot. Tarsal tunnel syndrome is similar to carpal tunnel syndrome presented on the wrist. Both of these disorders arise from compression of a nerve in a limited space. Even though tunnel syndrome tarsal is not as well-known as the carpal tunnel syndrome, it is still a cause of foot and ankle pain in adults or elite athletes.“When the Carpal Tunnel Syndrome is tackled and diagnosed ere it becomes an advanced stage, a conservative management as an approach procedure would be prescribed and recommended because its effectiveness, at first moment, the patient has to be aware to stop wrist movements that caused symptoms pain, for example, to place the keyboard height on a sustainable and reasonable elevation and dodge the flexion, abduction, adduction and extension of the damaged hand at typing. The recommendation is to avoid unnecessary motion as much as possible, the use a wrist night-splint can be suggested as well, these advices and recommendations got to be attached to a hand therapist specialist counselling, besides turn up to manual physical therapy sessions, in the other hand in cases were the pain is not being eased a short string doses of non-steroidal anti-inflammatory drugs will be referred, last shot to get rid carpal tunnel syndrome off is surgical management which it’s effective, too” Cited from Matthew Varacallo, Justin O. Sevy (2020).What are the signs and symptoms of TTS? – How to recognise them. Patients suffering from the syndrome tarsal tunnel sustain one or more of the following symptoms:  • Burning, • Tingling, a sensation alike an electric shock.  • Numbness.  • Pain, even stabbing pain.Symptoms are generally perceived inside the ankle and / or on the sole of the foot. In some people the symptoms can be isolated and appear only in one place. In others, they can extend to the heel, arch, toes, and even the calf. Sometimes the symptoms of the syndrome come on suddenly. They are often caused or aggravated by abusive use of the foot, such as standing, walking or exercising for a long time, or starting a new exercise program.It is essential to start treatment early on at your local Manchester sports physiotherapy clinic if it occurs any of the symptoms of tarsal tunnel syndrome. If not treated, the condition progresses and can result in permanent nerve damage. Additionally, since the symptoms of (TTS) can be confounded with other conditions, an adequate evaluation is key to make a correct diagnosis.According to D L Jackson and B L Haglund (1992) “(TTS in runners) diagnosis method needs to be extremely accurate in order to stand out and evidence the difference from other similar conditions symptoms presented such as Achilles Tendinitis and Plantar Fasciitis, its treatment generally is a conservative management which normally is acutely successful and effective”What to know about the causes of TTS? – There’s a large variety of causes, such as:TTS is produced by anything that causes tightness of the posterior tibial nerve, for examples: · An injury, such as a sprain, a tackle, a blow can cause inflammation and swelling in or near the tunnel, resulting in compression of the nerve. ·An overweight person is prone to experience pressure on the posterior tibial nerve. ·Systemic diseases such as diabetes or arthritis can cause inflammation and thus compress the nerve.MY sports Injury | Manchester city provides a high quality level of expertise and experience within professional sports, allowing the sports player / patient to get an accurate clinical diagnosis. MY Sports Injury & physiotherapy clinic allows you to assist your tarsal tunnel syndrome to finally have a full sports recovery, enabling the patient to recover efficiently and safely in accordance to self-management protocols post tarsal tunnel syndrome condition.Can TARSAL TUNNEL SYNDROME go away on its own?Compression of the tibial nerve can occur when the ankle is fractured, due to rheumatoid arthritis, foot deformities or demanding physical exercise such as football, basketball, running, rugby and others. Same as Plantar fasciitis which is the inflammation of the fibrous tissue (plantar fascia), which covers the sole of the foot, from the heel to the toes. Prolonged standing, running, and excessive weight can damage the fascia. According to the (FHSQ) Foot Health Status Questionnaire a study was made about what is Plantar Fasciitis’ effect on the lifestyle’s quality of female and male patients, presented by Patricia Palomo-López, Ricardo Becerro-de-Bengoa-Vallejo ET la (2018) “One hundred patients were recruited 49 males and 51 females with (PF) inflammation, the results of the female patients showed greater vulnerability and worse quality of life than the results shown by the male patients related to foot function, foot pain, general foot health, physical activity, vigor and social capacity”. Rheumatic syndromes of the soft tissues of the lower limbs (tarsal tunnel syndrome and plantar fasciitis) are very common in people who are rather healthy. Sometimes they go away on their own over time. In most cases, the sports physiotherapy specialist practitioner can treat these types of disorders. Some athletes / patients will need to see a rheumatologist (a specialist in arthritis, rheumatic conditions, and related musculoskeletal conditions) for treatment.So What are its treatment choices? – Treatment options for TTS When it’s assessed, diagnosed and tackled at an early stage the treatment options for excellence indicated to this syndrome are rest, ice, compression, and elevation known by its acronym (RICE).Medicine without a preion such as (NSAID) non-steroidal anti-inflammatory drugs, ibuprofen and acetaminophen can be administered to decrease the pain and the symptoms will be more handle-able.   In some chronic pain severe cases, there are other ways to tackle the tarsal tunnel syndrome such as, corrective devices, physical therapy, sports physiotherapy in Manchester or sports massage clinics and in the worst cases must be an onward referral to an orthopaedic  surgeon fellow which will continue to perform a  non-conservative management.   “Tarsal tunnel syndrome incidence is undefined. This is an often undiagnosed and rare affection with a higher rate of prevalence amid female patients and could be sustained at any age. The non-conservative process success ranking varies from 46% to 96% of the cases and it’s indicated when the non-operatively management such as physical therapy, sports massage. Corrective devices shown to be less effective, it was proven that the outcomes were better in younger individuals who underwent minor symptoms and had a clear etiology and in those when the condition was treated at an early phase, and no prior ankle pathologies, so an early and accurately diagnosis is key” quoted from John Kiel; Kimberly Kaiser (2020).How long does TARSAL TUNNEL SYNDROME take to heal? – Shall be I back on the sports field /work soon? It’s a frequent question that our patients have in their mind.Non-severe cases can be treated with (RICE) and without preion medicine, (OTC) also known as over-the-counter medicine. These minor cases of Tarsal Tunnel Syndrome can get better within 48 hours meaningfully with the previous treatment options touched on.   Meanwhile, if you do not seek assistance when there are symptoms at a premature phase and let the time pass by then the nerve damage will be permanent.   “108 ankles distributed 72 patients were assessed; the rate age was forty-nine years. The symptoms of the previous surgical process had a 31 months recurrence.  Average time for return to an utterly and painless level of capacity was 9 months, every individual had a twelve months follow up” Pointed out by G James Sammarco, Laurette Changon (2003) Outcome, Follow-up and Outlook of Tarsal Tunnel Syndrome approached by surgical management.Tarsal Neuropathy and how is it caused? – Is there any difference between TTS and Anterior Tarsal Tunnel Syndrome?Anterior Tarsal Tunnel Syndrome is an uncommon and seldom entrapment neuropathy dysfunction of deep peroneal nerve situated beneath the extensor retinaculum of the ankle. Also called as (DPN) deep peroneal nerve entrapment brought about by the tight fascia band located in the anterior ankle.   “Yassin and others notified that twelve out of thirteen patients (92.31%) presented a greatly amelioration of DPN condition after carrying out the surgery” Michael D. Gibboney and Mark A. Deyer (2020).How do you fix TARSAL TUNNEL WITH SELF MANAGEMENT TIPS?As we mentioned it before the most common options to fix TTS are: RICE, OTC, Full immobilization as self-management tips but when pain starts to worsen you should be able to look for other possible treatments such as Injection therapy, Physical Therapy, Corrective shoes and Orthopaedic devices, Ultrasound Therapy, Reducing Foot Pressure, Acupuncture sessions at physical therapy centre, Taping or Bracing, Manual Therapy, sports massage / deep tissue massage.  Moreover, you can include some exercises to your self-management routine to enhance your TTS and relieve pain such as ankle pumps, eversion or inversion circles, balance exercises, pencil toe lifts, plantar fascia strength, and many more which will be explained in detail by sports physiotherapy specialist / physician practitioner at the moment you attend to your medical consultation at sports physiotherapy clinic in Manchester City Centre.“Achilles tendinopathy (AT) has a tremendous prognosis with an early initial driving, its management can be divided into two options: conservative and non-conservative. One of these chances must take into account depending of the pain scale whether acute or chronic, but when it’s whole torn there is not another way except for surgery management, conservative therapy is indicated in first line of management and add in the next recommendations: shortening of physical activity levels, preion of (NSAID), eccentric stretching exercises as a complementary tool of physiotherapy can reach up to 40% of pain reduction” Usker Naqvi and Miguel A. Medina Pabón (2020).How to identify nerve damage within the foot? – What are the tests to run in order to diagnose correctly TTS?   A meticulous assessment will be performed by your healthcare team providers such as manual therapy givers, sport massage practitioners, physical therapy clinicians and acupuncture practitioners at Manchester city physical therapy centre. MY sports Injury which team can assist in a clinical diagnose without any doubt your condition and to assess the nerve damage inner your foot. diagnostic tests will run, those are; nerve conduction velocity (EMG/NCV), magnetic resonance imaging or MRI, X-ray and electromyography which require an onward referral.REFERENCES ·Calvo-Lobo C, Painceira-Villar R, López-López D, García-Paz V, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Palomo-López P. Tarsal Tunnel Mechanosensitivity Is Increased in Patients with Asthma: A Case-Control Study. J Clin Med. 2018 Dec 12;7(12) ·      Stødle AH, Molund M, Nilsen F, Hellund JC, Hvaal K. Tibial Nerve Palsy After Lateralizing Calcaneal Osteotomy. Foot Ankle Spec. 2019 Oct;12(5):426-431.·      Zuckerman SL, Kerr ZY, Pierpoint L, Kirby P, Than KD, Wilson TJ. An 11-year analysis of peripheral nerve injuries in high school sports. Phys Sportsmed. 2019 May;47(2):167-173. ·      Rinkel WD, Castro Cabezas M, van Neck JW, Birnie E, Hovius SER, Coert JH. Validity of the Tinel Sign and Prevalence of Tibial Nerve Entrapment at the Tarsal Tunnel in Both Diabetic and Nondiabetic Subjects: A Cross-Sectional Study. Plast Reconstr Surg. 2018 Nov;142(5):1258-1266. ·      Hong CH, Lee YK, Won SH, Lee DW, Moon SI, Kim WJ. Tarsal tunnel syndrome caused by an uncommon ossicle of the talus: A case report. Medicine (Baltimore). 2018 Jun;97(25):e11008. ·      Komagamine J. Bilateral Tarsal Tunnel Syndrome. Am J Med. 2018 Jul;131(7):e319. ·      Schuh A, Handschu R, Eibl T, Janka M, Hönle W. [Tarsal tunnel syndrome]. MMW Fortschr Med. 2018 Apr;160(6):58-59.·      Mansfield CJ, Bleacher J, Tadak P, Briggs MS. Differential examination, diagnosis and management for tingling in toes: fellow's case problem. J Man Manip Ther. 2017 Dec;25(5):294-299. ·      Tu P. Heel Pain: Diagnosis and Management. Am Fam Physician. 2018 Jan 15;97(2):86-93.

MY SPORTS INJURY | Sports Physiotherapy clinic is an established clinic Located in Manchester City Centre, our Sports Injury Clinic offers high end Manual physical therapy, soft tissue massage, sports injury rehabilitation and myo-fascial active release therapy.   HOW MY SPORTS INJURY CAN IMPROVE PHYSIOTHERAPY BASED OUTCOMES - KNOW WHAT IT IS ABOUT   Sports physiotherapy can improve the performance of athletes through rehabilitation after suffering an injury or by strengthening muscles and joints that prevent possible reoccurrence of injury.   Athlete sports physiotherapy develops its activity in three different phases: MY Sports Injury & Physiotherapy provides the fundamental framework to excel athlete sports recovery & performance.·         Postural Correction approach to Rehabilitation of Soft Tissue Injuries: such as sprains, Joint mis-alignment, muscle tears, overloads, muscular imbalances etc.   ·         Rehabilitation Post operation: Through sports physiotherapy, a rehabilitation plan is designed based on the characteristics of the injury, the athlete and their particular needs.   ·         Injury prevention: The analysis of the athlete and their discipline allows us to detect possible improvements in their physical sports performance and enhance them through personalised exercises in accordance to their physiology and performance test indicators.   “The findings gathered from the studies made, have helped to guide variety of athletes and coaches concerning the benefits and advantages of sports physiotherapy , a study revealed that it was more specific to have sports massage and including this kind of therapy into competition and training” Holly Louisa Davis, Timothy James Ainsley Chico and Samer Alabed (2020) published: Effects of sports massage on recovery and performance sporting events. "In order to improve your sports injury you’ve got to build sustainable habits through gradual progression"   How does physical Manual therapy at My Sports Massages Injury Clinic in Manchester City Centre prevent future injuries?   Many injuries are caused by involuntary habits or gestures that damage our body biomechanics and we have not even noticed it.   ..But, Can we injure ourselves just by doing sports practice?   Sports activities, due to their physical demands, are one of the factors that most influence when suffering an injury; but in our day-to-day life, it is true that there are many occasions when it is easy to damage our body.   For a few years we can already say that a computer, a laptop or a smartphone are elements that are not lacking in many jobs, and that they are found in practically every home.   Some out of obligation, and others for fun, the truth is that we end up spending hours in front of these devices, and this can take its toll on our body. Some of the Most Common non-sporting injuries are: Back and neck injuries.Carpal tunnel syndrome. Repetitive Strain Injuries from the Mouse / keyboard / LaptopSports physiotherapy can find the factors that can lead us to suffer certain injuries and correct them to ensure good physical condition and improve sports performance.   Is physical Manual therapy job only to improve your contractures and overloads?   Sports physiotherapy is responsible for analysing what are the specific needs of each athlete and individual within their discipline to optimize their physical condition and prevent injuries or minor discomfort that may affect their performance. In this sense, physical manual therapy does much more than relieve contractures and overloads. Your sports physiotherapist or / Sports Injury Therapist in Manchester City Sports Massage Centre can help you correct postures, optimize movements and strengthen the muscle areas that the athlete needs to perform as well as possible.“Hamstring injuries often impact elite sports practitioners such as professional footballers and have high-rise reappearances rate. Through a thorough workup and comprehending its risk factors and how the injury works, physicians and physiotherapist specialists in the case would be able to make the decision how manage it with the most adequate and customised treatment approach. Appropriate rehab must tackle muscular strength, neuromuscular control, physical manual therapy, flexibility, sports physiotherapy, eccentric strengthening, lumbopelvic stability and neuromuscular control. These procedures have displayed to be essential therapeutic target to get back an athlete’s successful return, with a significant low risk of reappearance” stated by Gabriel Amorim Ramos, Moises Cohen, Diego Acosta Astur, Alberto de Castro Pochini, Gustavo Goncalves Arliani and Benno Ejnisman (2017).What do you need to do to prevent injuries?   There are rehabilitation and re-education treatments so that the athlete understands how his body works and how it needs to work so that his performance is optimal. This involves muscle power exercises, stretching, movements, and postures. Each element has its influence on the final result.   According to Bruno T. Saragiotto, Alexandre D. Lopes and Carla Di Pierro (2014)“ The principal factors notified by the