Article of the week:

Cervicogenic Headache

What is it?

Cervicogenic headaches are a form of headache where pain is referred into the head from either the bony stuctues, nerves or soft tissues of the neck.  It can present very similarly to other headache forms, however, a physiotherapist is usually able to make a diagnosis after a thorough assessment.

Causes and symptoms

Cervicogenic headaches are most commonly caused by mechanical disfunction and stiffness of the joints in the neck.  This can arise from poor habits, sustained postures, arthritic conditions, tight or weak muscles and muscle imbalance.  It is also common after a whiplash injury.

Symptoms can include neck stiffness and vague pain in the neck, shoulder or arm.  The headache is usually non-throbbling and on the same side as the neck pain or stiffness.  It will usually present around the base of the skull, temple and/or eye region on that side.

Treatment

Treatment for headaches is dependant on the type of headache.  Physiotherapy treatment for a cervicogenic headache will include a combination of exercise and manual or manipulative therapy.  This may include soft tissue mobilisations; acupuncture; joint mobilisations; postural retraining exercises and advice.

Sophie Cook M.C.S.P M.H.P.C
Physiotherapist

 


Ask Doctor Rosemary: Getting to the heart of medical matters....................

Question:
I have been diagnosed with tennis elbow and my doctor has suggested treatment with a steroid injection.  I have a dreadful needle phobia and just the thought of this brought me out in a cold sweat.  Is there something else I could try instead?

Answer: 
The pain of tennis elbow occurs on the outer side of the elbow and is caused by inflammation of the tendons that connect the arm muscles of the forearm to the bone. The inflammation is usually triggered by over-using the forearm muscles in repeated actions such wringing clothes or using a screwdriver.  Despite the name, tennis and oth

 er racquet sports are only thought to account for about five per cent of cases.

A steroid injection into the inflamed area can certainly be helpful but there are other treatments that you can try. Taking anti-inflammatory tablets can ease the discomfort but for best effect they need to be taken regularly for a couple of weeks.

Consult your doctor about this first if you have any problems with your digestion or are taking any other regular medication.  Resting your arm is also very important, especially avoiding lifting, gr

 ipping and twisting as much as possible.  Wearing an elbow splint can also help to rest the affected area and remind you not to do certain movements.  It is also worth asking for a referral for physiotherapy as in some research trials this has been shown to give better results in the long term than a steroid injection.

By Doctor Rosemary Leonard

 

Topics Covered on this page include:

Patellar Tendinitis
Anterior Cruciate Ligament
Acupuncture
Kinesiology Taping
Tennis Elbow

  

Patellar Tendinitis

What is it?

Patellar tendinitis (sometimes called jumper's knee) presents as pain in the tendon directly underneath the patellar or knee cap.  It is due to inflammation of the patellar tendon, which may progress to tearing or degeneration of the tendon.

Causes

 Commonly it is an overuse injury from repetitive overloading of the knee.  It is common in sports of higher impact such as running, football, volleyball, basketball, squash and tennis etc.

Treatment

Initially a break from the sport combined with ice, compression and elevation may settle symptoms.  If it does not settle down physiotherapy may be required.  Treatment may include the use of: electrotherapy (ultrasound); joint and soft tissue mobilisation; acupuncture; home exercise program (incorporating stretches and strengthening exercises); possible use of taping or knee support to unload.

Simon Howard M.C.S.P Member HPC
Senior Physiotherapist

 

Anterior Cruciate Ligament

The anterior and posterior cruciate ligaments are the two (cross) ligaments that essentially stabilise the knee joint. They are named anterior and posterior in relation to their attachment to the tibia and are extremely important in sporting activity.

The primary role of the ACL is to stabilise the leg and the thigh and to control rotational movment that might occur. It is vitally important for control in pivoting movements, often seen in sports such as netball, football, rugby, tennis and many more.

Injury to the ACL can be acute and traumatic, usually it can occur due to poor landing from a jump, pivoting sharply or a sudden deceleration movement, however on the odd occasion it can go unnoticed. In the likely case of the ACL tearing or rupturing, common signs and symptoms include;

 

 

• Immediate pain/swelling
• Often a 'pop' or 'snap' can be heard
• A significant degree of disability
• Poorly localised pain

Surgery is generally required to repair a torn ACL. These days different grafts are used to replace the ligament, both hamstring and patellar tendon's are used as are artificial ligaments if deemed necessary.

In any case, physiotherapy will play an important role over the next 6 months post surgery 

to assist with return to sport and activities of daily living.

Todd Anderson
B.Sc.Hons.(Physiotherapy) M.C.S.P S.R.P

Acupuncture

I think it is correct to say that physiotherapists are the largest body of health care professionals practising acupuncture (apart from acupuncturists themselves) in the UK today.  Here are answers to some questions which we are commonly asked.

1. What is Acupuncture?
The insertion of needles over specific points on the body, resulting in a physiological effect for therapeutic benefit.

2. How does Acupuncture work ?
Stimulation of an acupuncture point yields a local mechanical tissue response which may be one of energising muscle or conversley to relax or release muscles.  Moreover and perhaps more importantly is the reponse in the central nervous system (the brain and spinal cord) to set in motion the body's natural healing mechanisms.

3. What effect can I get from Acupuncture?
The effects are myriad but physiotherapists typically use acupuncture to relieve pain, reduce inflammation, re-absorb oedema, improve movement and reduce anxiety or stress.

4. So what type of injury is Acupuncture used for ?
Just about anything you go to see your physiotherapist for! Acupuncture is not a last resort treatment but an effective and powerful adjunct to your manual "hands on" therapy and your physiotherapy exercises.

Roberto Colombini
B.Sc.Hons.(Physiotherapy) M.C.S.P - A.A.C.P. 
Registered member of the H.P.C

 

 

Kinesiology Taping

For those of you who may not be familiar with this term, Kinesiology essentially relates to human movement. I'm sure some of you who have an interest in sport have seen Premier League stars such as the likes of Gareth Bale or maybe on the tennis court with the likes of Serena Williams who are often seen wearing the bright, flourescent tape during sport.

Kinesio taping is a popular, effective, innovative taping method influencing joints and muscles, especially muscle tone during both movement and sport. 

The earlier people can move there limbs after an injury in a functional way, the better the microcirculation of blood and lymph to the area, hence the faster the healing process.

Depending on the taping technique, flexotape itself is not restrictive, but aims to improve motion with lasting effects on rehabilitation and injury prevention. It is ultimately designed to reflect the properties of human skin.

Some important effects of Kinesio Taping

Tennis Elbow

Summer's here (?).... well sort of, so before you dust off your trainers, find your racquet and head to the courts read on...

What is it?
Tennis elbow (or lateral epicondylitis) is a condition where the outer part of the elbow becomes painful.  It is an overuse injury and whilst often associated with racquet sports, can also be caused by other actvities of daily living (eg. use of keyboard, blackberry etc).

Signs and Symptoms
Pain (and occasional swelling) radiating from outside of the elbow and sometimes into the forearm, wrist and hand.  Gripping, lifting and repeated hand/wrist movements can be sore.

Prevention
Stretches and strengthening exercises can help prevent this condition.  Other things to consider are: grip size; having string tension reduced; use of string vibration dampers; racquet with more flexible shaft; use of newer balls; poor technique.

Treatment
Initially a break from tennis and icing may settle things.  Various physiotherapy treatments such as joint and soft tissue mobilisation; acupuncture; ultrasound; graded home exercise program (incorporating stretches and strengthening exercises) and prescription of a 'tennis elbow strap'.

If you feel you may have tennis elbow please feel free to call one of our physiotherapists at the clinic.

Simon Howard M.C.S.P Member HPC
Senior Physiotherapist