Spinal, Back & Neck Pain
A lot of back problems and neck problems are caused
by poor foot biomechanics, so, at times the patient may be prescribed
orthotics, and these will be specially made moulds of the patients
feet which will then be made into individually tailored shoe inserts
- these help correct and maintain the alignment of the body, reduce
pain and prevent injury.
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Sports & Dance Injuries
All
injuries differ, depending on the sport. For example, the most
typical injury for a rugby player is an injury to the knee where
they tear a meniscus or an ACL ligament. Some need surgery, where
as others do very well with a specific programme of tape and gym
work. A runner, and irish dancers, often have problems with "shin
splints" - pain down the front of the shin. This needs to
be treated aggressively with a combination of manipulation, massage,
taping techniques and orthotics.
People who have pain, because of their biomechanical
problems will have to undergo a full biomechanical evaluation.
Basketballers have a lot of ankle injuries, as they are always
going over on their ankles, and tearing ligaments. With ankle
injuries, which are very common in most sports , it is important
that they are fully rehabilitated to prevent it recurring.
Any
recurring injury most go through a proper preventative programme
- for all body parts. Golfers commonly get a tennis elbow. This
is pain of the outside of the elbow. they also get golfers elbow,
which is pain on the inside of the elbow. It is a type of a tendonitis
of the extensor muscles of the forearm, and needs to be treated
with a combination of joint mobilisation to the whole of the arm
and the neck, and soft tissue massage. I also use a lot of taping
techniques. Musicians often have very complicated conditions,
and are prone to RSI, which is an overuse injury from repitition
of playing. Their treament addresses the muscle imbalances of
their body, and uses a treatment which aims to restore normal
neurodynamics ( movements of nerves).
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Muscle Imbalances
Muscle
imbalances are a major problem for a lot of people and these can
in turn cause pain. For example, sitting at computer all day,
uses one set of muscles repetitively, tightens the chest muscles
and neck muscles, whilst other back muscles become overstretched
and weak. One group of muscles becomes overused and another underused.
Athletes have the same problems.
For example a tennis player, or a dancer, who is
doing the same action over and over again, can develop severe
muscle imbalances, which not only cause their performance to deteriorate,
but also causes injuries. A Muscle Balance programme aims to correct
muscle imbalances and restore correct and normal movement patterns.
It aims to change the harmful patterns - the bad habits.
The Pilates "reformer" which is a special
machine, also works on balancing the muscle system. These sessions
last one hour and are one on one. Often this treatment is combined
with the use of the large exercise ball, which is also very good
for restoring muscle balances. The Pilates method works on the
deep stabilising muscles of the body, which are the main postural
muscles. They are important for good posture, correct body alignment
and pain free activities. It is very important when doing any
task to have the correct breathing technique, and pilates incorporates
this into the technique. Originally developed for rehabilitating
dancers and army personnel with injuries, so there are a series
of exercises which the individual performs, all of which emphasise
free flowing smooth movements, co-ordination, concentration, physical
control and precision of movement. It is good for anyone - it
lengthens and tones, and is an excellent way to keep pain away.
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Facial Pain and Headaches
Many
patients complain of headaches and facial pain. It is very common
for headaches to be caused by the neck, and often people are told
that they have migraines, when in fact they have a cervicogenic
headache - a headache caused by the neck. There are little joints,
called facets, which lie between the vertebra, and a stiffness
in these facets can cause headaches, as there are nerves that
go from the spine and neck to the head and the face. Often people
get face pain as well with the headache. Very weak neck muscles,
the deep neck flexors of the spine, can also contribute to headaches,
as the spine isn't receiving any support from the muscle system
, so the joints are being loaded and cause referred pain to the
head.
Facial pain is another common problem. Pain in the
face can come for a variety of reasons - teeth, cysts , ulcers
etc. It can also be caused by the TMJ - the temperomandibular
joint. This is a small joint which you have either side of your
face and it opens and closes your mouth, allows you to yawn, to
chew, to talk etc. Sometimes this joint can be strained, or the
joints may be stiff, therefore preventing normal joint movement.
This can in turn lead to pain. Sometimes, if the person clenches
or grinds their teeth, this also will lead to pain. Often the
muscles around the face, the cheek muscles, and the forehead muscles,
go into spasm, causing further pain. The treatment involves manipulation
of the joint and release of all the soft tisuues in the area.
The neck must also be treated. The client must also undergo a
muscle balance programme to off load the TMJ's. The movement patterns
of the joint need to be restored, and that even includes the details
such as the correct tongue position in the mouth. Your tongue
should rest on the roof of your mouth, behind your top teeth.
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Chronic Pain
Chronic
pain clients, are people who have been in pain for months and
years. They may have been in a road traffic accident, had a fall,
been hit, or simply started with a severe back pain for no apparent
reason. The pain can be anywhere, but it is generally in the back
or neck. Often, there are several things causing the pain, and
this in turn leads to lifestyle changes.
Often, the person may have to give up work or change
their job as they can no longer do their job because of their
pain. Simple household tasks and basic functional needs, such
as showering and sitting, become very difficult as all movements
are painful. Very often chronic pain sufferers cannot sleep because
of the pain, they wake up exhausted, are further exhausted by
the pain, and get into a cycle where their whole quality of life
is affected. It affects their relationships, as they often are
unable to do things that they once could do. This can lead to
depression and in turn is very stressful for families and partners.
Chronic pain sufferers have often been to countless
doctors, clinicians and others, in search of a diagnosis and a
cure. It is a very difficult condition to treat, and each person
is completely different to the next, so no two people can be treated
in the same way.
Treatment involves firstly hands-on treatment, to
restore normal joint movement and muscle function, and in particular
movement patterns. It is very important to correct these, as often
when people are in pain they start to adapt their movements, and
change them, so that they end up using their bodies in the wrong
way, and this leads to further pain. For example a chronic pain
person, when moving from sitting to standing, may have to completely
change the way that they do that activity, just to make it easier.
So after a time of hands on, they will then progress to the MET
gym where they only do pain free activity. This is very important
that all movements are pain free, as the aim is to break the pain
cycle and not reinforce it.
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Exercise
Exercise
is also a very important part of injury management and prevention.
The clinic has aspecially equipped gym which uses a Scandinavian
type of equipment, specifically designed for people with injuries.
It differs from other gym equipment in that it can off-load joints
as well as loading them. So for example, if a client finds it
difficult to do a certain exercise without pain ie a rugby player
who experiences knee pain when performing a squat, then they will
be attched to an appartus that actually reduces the amount of
body weight going through the knee. This enables the client to
perform the squat well, therefore ensuring that the correct movement
pattern is occurring, therefore promoting good joint glides and
muscle activation patterns. With time they will progress to doing
the exercise with full body weight and then with extra kilos.
Other exercises given will also include yoga , pilates, Ball programmes,
and other medical exercises.
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