|
|
BACK PAIN
|
Back pain is one of the most common causes of long- term disability causing many days to be lost from work. With the correct treatment early on, many of these days off work can be prevented.
Why do people get back pain?
There are many factors contributing to the onset of back pain, including posture, poor muscle strength and ageing. Each person will have different symptoms and different contributing factors. It is important to relieve the symptoms and address the underlying cause or causes for the pain. If the symptoms are treated, but the underlying cause is not, the pain will simply return.
How can we help people with back pain?
At the Sussex Centre for Sport and Exercise Medicine, our philosophy is not only to treat the pain, with a combination of manual therapies, intramuscular stimulation and medications, but to identify and treat the underlying causes. This may involve imaging of the back such as using MRI scanning to identify any structural problem such as a slipped disc, but also looking at posture, muscle strength (particularly the so-called 'core' muscles which help to support the back) and other factors such as sporting technique (for example in a golfer with back pain).
|
ACHILLES TENDINITIS
|
What is it?
A tendon is a strong structure that joins a muscle to a bone. The Achilles tendon attaches the calf muscles to the heel bones. Achilles tendinitis is inflammation of this tendon and can affect any part of the Achilles tendon.
Why does it occur?
Achilles tendonitis most commonly occurs in people who are involved in sports requiring repeated jumping such as basketball. However, it can occur in people who do not participate in any regular sport. In many people, Achilles tendon pain may be due to degeneration in the tendon (tendinopathy) the treatment of which is slightly different.
The onset of pain may correspond to an increase or change in training eg running up more hills or a change of training shoes eg to a pair which is high at the back. It is more common in runners who tend to 'overpronate' (roll their feet inwards as they run)
What symptoms may I get?
Achilles tendinitis usually presents with pain at the back of the ankle or heel. This is usually a dull ache which is worse first thing in the morning. It often eases during exercise but then feels more sore a while after the exercise ceases and sometimes the following day. If the aggravating activity continues the symptoms progressively worsen until pain is constant and worsened simply by walking. The tendon may be thickened and tender to touch.
What should I do?
The important thing is to avoid any aggravating activities and seek professional advice early. Identifying and correction of underlying causes such as training errors will help to prevent the injury from returning after it has been treated. An ultrasound scan be help to diagnose the condition and exclude any degeneration or tears of the tendon.
Ice can help to reduce swelling and physiotherapy treatments can be used to reduce pain and swelling. Anti-inflammatories such as Ibuprofen, when taken regularly for 3- 5 days may also be beneficial.
As pain is often worse in the morning due to the position of the foot during the night when the muscles are relaxed, sometimes a splint is worn at night to control this foot position.
A walking boot cast can also be used to 'rest' the Achilles tendon for a short period of time in the early stages of the injury.
Before returning to sport is important to correct any underling cause, which may include a biomechanical assessment. It is also necessary to strengthen and improve the flexibility of the calf muscles to minimise the stress on the tendon during activity and an exercise programme may therefore be recommended.
If treated early Achilles tendonitis can often resolves within 2 weeks. However, if aggravating activities are not stopped or treatment is delayed, this can be a difficult condition to treat and may continue for several months.
|
MEDIAL COLLATERAL LIGAMENT INJURIES
|
The medial collateral ligament is the most commonly injured ligament in the body. The ligament provides stability for the knee by running between the shin bone and the thigh bone on the inner aspect of the joint. It is most commonly injured as the result of a stress from the outer aspect of the knee whilst it is slightly bent and occurs most commonly in contact sports and sports such as skiing.
What are the symptoms?
Usually there is a clear history of injury and pain is usually felt along the inner aspect of the knee. However some of the more severe injuries can be the least painful as a partly torn ligament often causes more pain than a completely torn ligament.
Swelling if the knee joint itself is unusual and usually means a more serious injury has occurred involving other structures and assessment should be sought from a physiotherapist or sports physician.
It may be difficult to put full weight through the knee but in minor injuries it may be possible to walk with little difficulty.
What should I do?
As with all injuries, a correct diagnosis is important and initial treatment by a physiotherapist, may include ice, ultrasound and interferential. It is important too move the knee as early as possible to prevent stiffness but also limit strain on the injured ligament. A physiotherapist will be able to supervise a rehabilitation programme. A brace may be recommended during rehabilitation to prevent re-injury and allow exercises to be performed.
Will I need surgery?
It is unusual for even the most severe medial collateral ligament injuries to require surgery provided no other structures are injured. Most people are able to return to full contact sports in 2-3 months.
|
|
|
|
|
