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Bearwood Physiot​herapy

Get Better with Bearwood - For Every Body that Moves!

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Heel Hurting?

Posted on 16 May, 2021 at 13:05 Comments comments (1602)

 

 

 

Pain under underfoot? Is your heel hurting? Or pain running underneath your arch? You may well be suffering with Plantar fasciitis and this week we’re focusing on what this is and how we can heal it quickly.


Plantar fasciitis has alternative names such as plantar fasciosis and policeman’s heel and has been a problem recorded for decades. Plantar fasciitis is pain underneath the heel and arch of the foot and is described as a self-limiting condition which means if we adapt our activities, we can recover from this on our own! With over 10% of the entire population suffering from plantar fasciitis in our lifetimes it’s important to understand how to manage this condition, especially if we can do things to help speed the recovery on.

 

Unfortunately, some of us are more at risk of developing plantar fasciitis than others. As we get older, the risk increases, if we’re obese this risk also increases and if we spend a long time on our feet with work or sports. Now there’s not a lot we can do about ageing, but we can work on maintaining a healthy weight. Not only will this help us with plantar fasciitis but knee, hip and back pain alongside our overall health.

Also, try and break down long periods of standing, if you can, by sitting. If not consider shoes with a padded heal or adding a cushioned heel cup to try and offload some of the pressure.

It’s really important for us to modify the activities that cause us pain. If our pain is worse after a run, we need to consider reducing how long we run for, if we walking the dog makes things worse, we need to consider doing more frequent shorter walks. This should limit how much we aggravate the plantar fascia and help it to settle down. If this isn’t enough, we might need to consider a 2-week break from certain activities to really give the plantar fascia a chance to settle down and heal.


Now seeing a healthcare professional, like a Physiotherapist, is important to ensure you have plantar fasciitis (and not another condition) and to fully assess your foot/ankle and leg. Plantar fasciitis is often associated with foot postures and these are complicated and have an impact on the entire leg. You’ll probably need some guidance on how to address these issues but there are things we can do ourselves to help reduce pain and improve function fairly quickly.

Taping, self-massage and stretching all provide fairly immediate results and can leave you feeling much better within a week! Use a massage ball underneath the foot, rolling from your heel to toes, for a few minutes throughout the day can help relieve tension. It’s important to stretch the plantar fascia and surrounding tissues/muscles that might be tight, make sure you consult your Physiotherapist to learn which stretches are best for you.


Taping can be really useful, but if you’re not confident with using tape it may be best to save this for your therapist to do! If you’re use to taping, check out this video for a quick guide: https://youtu.be/hzqY6E_oufM" target="_blank">http://https://youtu.be/hzqY6E_oufM

Now if you’re still struggling with symptoms after this, orthotics or heel caps can be really useful at improving foot posture and cushioning the heel and these can help symptoms over a period of a few months. I often think it’s worth considering orthotics if you’re very active, spend a lot of time on your feet or play sports regularly. It can be hard to work on our foot control during activity, sports or whilst we’re busily running around trying to get all our jobs done.

For those of you who may have been struggling with plantar fasciitis for over 6 months, you may need to consider wearing night splints. These help to stretch the plantar fascia whilst you sleep improving your symptoms, night splints can improve symptoms by 88% in the first month of use and its often recommended to wear them for 1-3 months until your symptoms have fully settled.


Now these are all great things we can do on our own and you may have already tried some but not seeing any improvement? This could be linked to those more complex issues we spoke off earlier; foot posture, lower limb biomechanics and the kinetic chain of the leg. To target these, you will need a Physiotherapist (unless you are one!) so they can determine areas of muscle imbalance and provide you with a specific program to treat these.

Physiotherapists will be able to offer you some hands-on therapies such as massage, plantar fascia glides and myofascial release. A Physiotherapist can also help guide you in which orthotics would be best, a podiatrist can also help with this. A Physiotherapist can also give you exercises to help strengthen your foot and improve your lower limb biomechanics, addressing weak and tight structures which may be contributing to your symptoms.


Make sure you have seen a healthcare professional who’s diagnosed you with plantar fasciitis before embarking on any of the self-management tips above and make sure you seek help from a Physiotherapist to progress your recovery and make sure you’re less prone to developing issues in the future. Stay happy and healthy!

Niggling Knee?

Posted on 10 May, 2021 at 11:55 Comments comments (601)

 

 

 

This week as part of our #homeworking series we’re talking about patella tendinopathy. This is a type of anterior knee pain (pain at the front of the knee), specifically at the bottom of the knee cap. Patella tendinopathy can be complex and can take a while to recover from!


If you’ve been checking out our Instagram Page @bearwoodphysiotherapy you’ll have seen some of the snap shot information about patella tendinopathies this week so go and check us out for some quick info. Below we’ll be talking about patella tendinopathies in more detail.

 

Patella tendinopathy is usually aggravated by tasks that load the tendon, straightening the knee, jumping or running, but it is also aggravated by prolonged sitting. Perhaps you had a knee issue a few years ago, it bothered you when you played tennis or squash, so you stopped and it’s been a year of working from home and being sat for far too long and your knee hurts again – it doesn’t make sense, right? It hurts when you’re using the knee, it hurts when it’s rested too. This is problem with tendons, they need a balance of use and rest.


Patella tendinopathy is a complex condition as with all tendons, they can be difficult to heal. This is to do with blood supple, healing factors within our bodies and how much our tendons are loaded. The patella tendon can be affected by underloading as well as overloading. Now if you’re like me, the last year has been a mix of spending way too much time on the sofa with a few weeks here and there of a new fitness regime trying to lose those lockdown pounds, and you probably know this isn’t too great for you. When we look at recovery for tendons, we need to get the balance right. Tendons need to be loaded and used at a level that improves strength, tensility and proprioception but not so much that the tendon is used beyond it means and as such inflames. This balance is so important for tendon healing, it’s been named the tendinopathy continuum:


As you can see, tendons are complex! Now add in the fact that the whole tendon won’t necessarily be in the same condition. You may have parts of the tendon that look and function well whilst there are other parts/islands within the tendon that are inflamed and not able to repair themselves. This makes it harder to get the balance right for the entire tendon and can lead to us over-using/overloading or under-using/underloading the tendon making our recovery far for difficult than we expected.

It’s important to remember that patella tendinopathies are usually seen in those people who use this tendon often, these are typically adolescents or younger adults who are athletic or very physically active. Now occasionally we see patella tendinopathies as a side effect of the knee cap/patella maltracking and this can be because of a biomechanic issue at the foot or hip so we can’t just look at the knee. Then you have people with patella tendinopathy which has been recurrent over many years, settling for short periods but easily flares up, this is likely because the tendon has never returned to a “normal” tendon (see tendinopathy continuum pic) and you continue to battle between these for a longer period of time.

Getting yourself back on track with a thorough management plan is key! You need to make sure you’ve been fully assessed and your whole leg has been reviewed to ensure any contributing factors are looked at and incorporated into a comprehensive rehab plan. A mix of treatments and therapies to help calm inflammation, improve pain and muscle tension alongside a strengthening and muscle training program.

I tend to find a mixture of massage, acupuncture, taping the knee cap and addressing other biomechanics can be really beneficial in settling down the knee before moving onto a strengthening regime.

When we rehab a tendinopathy it’s key to balance to load the tendon enough to promote strength and muscle function without overloading and setting you back. There are a few programs out there specifically designed for strengthening in patella tendinopathy; heavy slow resistance, decline squat program and the 4-stage approach – check out the links in our reference for more details.


If you think you have a patella tendinopathy, make sure you get yourself checked by a Physiotherapist who looks at your entire leg and can support you in addressing contributing factors throughout the entire leg. Make sure you take it slow when you start introducing strengthening and rehabilitation so you don’t flare the knee (and this can be a lot easier said than done!), if you’re keen to push ahead your physiotherapist should help rein you in to make sure you get the best recovery possible in the shortest time.

Stay tuned for more in our #homeworkingseries and keep happy and healthy!

References

Rudavsky, A. and Cook, J., 2014. Physiotherapy management of patellar tendinopathy (jumper's knee). Journal of Physiotherapy, 60(3), pp.122-129.

Malliaras, P., Cook, J., Purdam, C. and Rio, E., 2015. Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations. Journal of Orthopaedic & Sports Physical Therapy, 45(11), pp.887-898.

Brukner, P. and Khan, K., n.d. Brukner & Khan's clinical sports medicine.

 

Bad Back

Posted on 26 April, 2021 at 13:45 Comments comments (532)

This week on the https://www.instagram.com/bearwoodphysiotherapy/" target="_blank">#homeworkingseries we’re talking about backs! As a Physio, many of my patients will come to clinic for low back pain, whether it's been something they've struggled with for years or have just tweaked their back recently getting something out of the trunk of the car. Before adding in the effects of the pandemic, it's estimated that 70-90% will experience low back pain at some point in our lives!


Now if we add in the effects of the pandemic, moving less, working from home and not being able to treat ourselves to a massage or swim (which we probably didn't even realise was helping our backs to stay mobile and healthy) the number of people who suffer with back pain increases further! 

A recent study looking into the effects of home working due to the pandemic on musculoskeletal disorders reports low back pain has affected 41.2% of people. So, there’s the possibility if you’ve never had back pain, you may well be suffering with it now following a year working at home over your kitchen island or dining room table! Or if you’ve suffered with low back pain before, it’s likely home working during the pandemic has flared this up.

Low back pain is often classed as pain occurring from the base of our ribs to just below the glutes. Now there are many conditions/pathologies affecting the low back such as spondylolisthesis, intervertebral disc herniation, facet joint degeneration, stenosis and spondylosis. Today, however, we’re talking about mechanical/non-specific low back pain. This term is used when the above conditions aren’t thought to be causing the back pain and this accounts for 85% of low back pain! This 85% is due to multiple reasons such as muscle overloading, posture, ergonomics, stress and many more.

The back is extremely complicated with both large spanning muscles, tendons and ligaments alongside smaller integrate muscles and ligaments in between each vertebra and their respective discs and nerves.


Now most acute episodes of back pain will resolve within 4-8 weeks. However, there is a large proportion of recurrence and up to 40% will go onto to develop Chronic Low Back Pain (back pain that persists for over 12 weeks and can recur over the years). This might already sound familiar to some of you, for others experiencing their first episode of back pain you’ll want to avoid developing a chronic problem.

Research has shown that mechanical low back pain responds best to staying active and maintaining normal activity or getting back to these as soon as possible. It’s important to understand what is causing your back pain and to do this, you’re probably going to need to seek the advice of a Healthcare Professional such as a Physiotherapist who will be able to assess your back, diagnosis the condition and provide you with the correct treatment.

Now this may sound simple but as the back is so complicated and plays an important role in our day-to-day function, back pain can become a huge hinderance and impact the quality of our lives. This impact means each of our backs need to be treated differently, individually to us and our specific set of circumstances.

For pain relief:

  • Acupuncture can help relieve pain and improve function
  • Avoid bed rest! Years ago we use to advice people with low back pain to rest in bed until the pain had subsided, evidence has now shown us this makes back pain worse! Our muscles weaken and decondition, we become stiffer and when then when we come to move it hurts more. Meaning we become more reluctant and afraid to move because of the pain!
  • Exercise! I’m a physio and could talk about how important exercise and moving is for us all day long but it really can help reduce the impact of injury, aid healing and prevent back pain recurring in future.
  • Massage can help give you short term relief to help get you moving initially. But this isn’t a magic cure so make sure you follow this up with regular exercise and stretches

Ideally, when trying to help people recover from their back pain and prevent further episodes, you need to combine manual therapies to help reduce pain and muscle tension initially, give you exercises to help get you moving and back to your usual activities and provide you with information and understanding as to how your back works and how to manage your specific symptoms to prevent future episodes. So, make sure you seek out a therapist who can help you with all of these and avoid anyone who’s offering you a quick fix! We know back pain takes weeks to heal and if you’re trying to avoid longer term problems your better investing in learning how to look after your back than keep ending up on the therapist’s table!


For some practical advice you can use right away:

  • Take pain relief (as long as you are safe to do so and under the advice of your local pharmacist). This means your body will be more relax and comfortable to move
  • Move regularly. Even if you can’t get away from your desk, make sure you move your back, hips and shoulders gently throughout the day. This stops your joints and muscles from ceasing up which just adds to the pain


Keep healthy, stay active and be happy!


References 

Moretti, A., Menna, F., Aulicino, M., Paoletta, M., Liguori, S. and Iolascon, G., 2020. Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis. International Journal of Environmental Research and Public Health, 17(17), p.6284.

Burdorf A., Naaktgeboren B., de Groot H.C. Occupational risk factors for low back pain among sedentary workers. J. Occup. Med. 1993;35:1213–1220

O’Sullivan, P., 2005. Diagnosis and classification of chronic low back pain disorders: Maladaptive movement and motor control impairments as underlying mechanism. Manual Therapy, 10(4), pp.242-255.

Will, J., Bury, D. and Miller, J., 2021. Mechanical Low Back Pain. [online] Aafp.org. Available at: [Accessed 26 April 2021].

Furlan, A., van Tulder, M., Cherkin, D., Tsukayama, H., Lao, L., Koes, B. and Berman, B., 2005. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews,.

Dahm, K., Brurberg, K., Jamtvedt, G. and Hagen, K., 2010. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews,.

Choi, B., Verbeek, J., Tam, W. and Jiang, J., 2010. Exercises for prevention of recurrences of low-back pain. Cochrane Database of Systematic Reviews,.

 

Tingling Fingers? Typing too much?

Posted on 18 April, 2021 at 3:45 Comments comments (657)

This week in our https://www.instagram.com/bearwoodphysiotherapy/" target="_blank">#HomeWorkingSeries we’re talking about Carpal Tunnel Syndrome. Check out our Instagram https://www.instagram.com/bearwoodphysiotherapy/" target="_blank">@bearwoodphysiotherapy for the highlights or keep reading to learn a bit more about it.

With 1 in 10 of us experiencing Carpal Tunnel Syndrome at some point in our life times it’s a fairly common issue, now add-in typing away on your laptop all day or spending hours on that DIY project and there’s a fair chance you could get some wrist and hand pain.

Carpal Tunnel Syndrome often causes pins and needles, numbness and odd sensations in the wrist and hand, particularly within the first 3 digits and as time goes on the hand, wrist and forearm can become weaker. The nerve affected in Carpal Tunnel Syndrome is the median nerve, it’s the main nerve along the front of the forearm, into the wrist and down into the first 3 digits.


Capral Tunnel syndrome is the most common compressive neuropathy, it’s caused by pressure on the median nerve as it passes through the carpal tunnel. The carpal tunnel is a tunnel between the small carpal bones of the wrist and the flexor retinaculum (thickened band of fascia tissue to help stabilise tissues).


Carpal Tunnel Syndrome is one of the most frequently reported occupational health concerns, it is linked to many different professions and those particularly affected are those where you use your hands a lot; labourers, fabricators, operators, care and leisure workers (beauticians, therapists, etc.) and those who send a lot of time typing (administrators, sales, etc.)

It’s not surprising that this condition is so common and adding in those long hours typing on your laptop (rather than an ergonomic keyboard) and those DIY projects your embarked on and it’s not surprising that your wrist and hand may hurt.

Alongside this, Carpal Tunnel Syndrome can be caused by medical conditions such as Diabetes, Hypothyroidism and Arthritis. You’re also more likely to get Carpal Tunnel Syndrome if you’re overweight or obese, if you’re overweight your 1.5x more likely to suffer with Carpal Tunnel Syndrome and if you’re obese this rises to 2x more likely.

Carpal Tunnel Syndrome is more common in women, particularly when going through hormonal changes such as the menopause as well as pregnancy. Up to 43% of women will suffer with Carpal Tunnel Syndrome during their pregnancy and this is due to increase fluid and oedema in the hands and feet.


It’s important to make sure you have Carpal Tunnel Syndrome rather than another condition which may look similar, such as Cervical Radiculopathy. Make sure you get checked by a Healthcare Professional to be sure but typically Cervical Radiculopathy includes neck pain and can be made worse by neck movements whereas Carpal Tunnel Syndrome is usually localised to the hand, wrist and forearm.

Common features of Carpal Tunnel Syndrome are:

• Paraesthesia

• Dysesthesia

• Weakness of the wrist and hand

• Difficulty gripping and pinching

• Night pain (often caused by lower oxygen levels and cooler temperatures)

Carpal Tunnel Syndrome is often diagnosed clinically with positive Tinel’s and Phalen’s tests. Alongside these it can be diagnosed with ultrasound and electromyography (EMG).


Treating Carpal Tunnel Syndrome can take some time and some people will need to have surgery to resolve the compression. Before reaching that point, it’s important to ensure you have trialled all conservative (non-surgical) options first.

The most effective conservative treatments are considered to be splinting, particularly overnight. Splints can be worn at the times your symptoms are most aggravated however they shouldn’t be worn continually for prolonged time periods.

 

It’s also important to help reduce inflammation and some times a course of Steroids or Non-Steroidal Anti-Inflammatories (prescribed by your Doctor) as well as making sure your hand, wrist and forearm remains strong and mobile. This is important as overtime Carpal Tunnel Syndrome can lead to muscle weakness and wasting make your recovery much more difficult. A Physiotherapist will be able to provide you with an exercise regime to do this as well as help ensure the median nerve and tendons of the hand are moving well and help reduce your pain.

Alongside these, myofascial release can be really helpful in reducing tightness in our connective tissues. Our median nerve is protected by connective tissues along the arm, wrist and hand and these connective tissues can thicken and tighten for many reasons. Myofascial release is a slow sustained treatment which helps relax and lengthen the connective tissue again which often results I more movement and less pain almost immediately!


Now get in contact with your local Healthcare Professional to start your recovery.

 

References:

Burton, C., Chen, Y., Chesterton, L. and van der Windt, D., 2018. Trends in the prevalence, incidence and surgical management of carpal tunnel syndrome between 1993 and 2013: an observational analysis of UK primary care records. BMJ Open, 8(6), p.e020166.

GEOGHEGAN, J., CLARK, D., BAINBRIDGE, L., SMITH, C. and HUBBARD, R., 2004. Risk Factors in Carpal Tunnel Syndrome. Journal of Hand Surgery, 29(4), pp.315-320.

Huisstede, B., Hoogvliet, P., Randsdorp, M., Glerum, S., van Middelkoop, M. and Koes, B., 2010. Carpal Tunnel Syndrome. Part I: Effectiveness of Nonsurgical Treatments–A Systematic Review. Archives of Physical Medicine and Rehabilitation, 91(7), pp.981-1004.

Padua, L., Coraci, D., Erra, C., Pazzaglia, C., Paolasso, I., Loreti, C., Caliandro, P. and Hobson-Webb, L., 2016. Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology, 15(12), pp.1273-1284.

Cdc.gov. 2021. Work-Related Musculoskeletal Disorders & Ergonomics | Workplace Health Strategies by Condition | Workplace Health Promotion | CDC. [online] Available at: [Accessed 18 April 2021].

 

Feeling Tense?

Posted on 6 April, 2021 at 13:05 Comments comments (613)

This week in our #HomeWorkingSeries we’re talking about neck tension, mechanical neck pain and trigger points!

Our Home Working Series will be covering a head-to-toe guide of muscle and joint problems experienced as a side effect from working from home during the pandemic and this is a topic, I’m sure you’ll be familiar with! That tight, tense, heavy sensation across the tops of your shoulders to your neck also known as mechanical/non-specific neck pain.

Specifically, we’re talking about the link between neck pain and trigger point tension. Trigger points occur in taut bands of muscles, causing tightness, tension and pain (including referral pain). Below you’ll see there’s a lot of trigger points across the tops of the shoulders and into the neck.

 

Illustration typifies myofascial trigger points in a man's neck, mid-back and low back musculature. Photo Source: 123RF.com.

With 85% of us experiencing issues with trigger points at some point in our lifetimes it’s important to understand their role in muscular conditions. Alongside this, the pandemic has led to an 70% increase in muscular conditions and of these 23.5% of people are experiencing more neck pain.

Now it might be hard to believe that working at home would affect our muscles and joints this much but a year working off your dining room table could well leave you in a lot of trouble! If you’re like me, you haven’t gotten around to setting up (or finishing) your home office. I’ve definitely taken my work-office for granted, I’ve forgotten how well setup it is, the comfy yet support chair and work table (rather than working of my lap on the sofa which I’m doing right now...eek!).

If we don’t setup our workstations (whether at home or in the office) we’re asking for a lot of trouble. We might spend 6-9 hours sat working per day, that’s a long time to be sat badly. With our heads weighing just under a stone it’s really easy to strain and overload your neck and shoulder muscles.

This is because our muscles are constantly working to maintain our posture whether we’re in a good or bad posture. If we have our screens too high or too low, we put a strain on our neck muscles. If our table is too high, we elevate our shoulders and cause our muscles to work harder and if it’s too low we stoop and round our upper back and shoulders making our chest muscles tight and stretching out the muscles at the front of our neck.

Have you heard of workspace ergonomics? This is where our workstations are setup to help the body (and us) work efficiently. This is often already done before we get to our workstations but each person may need their workstation adjusted to suit them specifically which is why most workplaces have an Occupational Health department or service to ensure you’re not putting your body at risk whilst working.

Below is a picture to give you an idea of how your workspace should be setup to minimise these risk:

 

Have you moved much today? If you’re like me, working from home has meant you can spend hours at working before moving, there’s no colleagues to talk to or coffee round to grab or meeting to run to. The most I do now is answer the door to the Amazon delivery person!

It’s important to realise this lack of regular movement throughout the day also puts us at risk of overloading our muscles leading to increased muscle tension and trigger points. Even now as I write this, my shoulders achy, I keep fidgeting to get comfortable and to be honest I could do with a massage and a spa day!

I tend to find the muscles that cause the most trouble are the Trapezius and Levator Scapulae muscles. They are filled with trigger points that can refer pain throughout the muscle and elsewhere around the neck, shoulders and back. They span across a large portion of your mid-back to neck, shoulders and from your neck to shoulder blade.

 

Now imagine these are overworked and tense so you can’t move your neck easily. Then here’s the kicker – when you try and move, be good and stretch it hurts! The muscles get tight and forget how to relax leaving you with longer lasting pain.

This is why managing muscle tension and posture is so important! Let’s start off with easy things you can do at your desk, set an alarm for every hour and stand-up, move around, stretch. If that doesn’t help, go and get yourself booked in with Physiotherapist, get them to set you up with an individualised exercise regime, this helps address the muscle strains and provides long-lasting pain relief. Your Physiotherapist can also perform Soft Tissue Therapies (massage, myofascial release, trigger pointing) and some will also do Acupuncture. Now if you find your neck is too sore to have a massage, acupuncture might be the way to go.

Research has shown that a combination of all of the above helps gives you the best outcome when it comes to this type of neck pain. The hands-on therapies help the muscles to relax whilst the exercises help length and strengthen your muscles and improve your posture (and most of these can be done at your desk!).

Now try moving more, re-working your work space and if you’re still struggling get yourself booked in with your local Physiotherapist for a specific program to meet your needs.

 

References

Lluch, E., Nijs, J., De Kooning, M., Van Dyck, D., Vanderstraeten, R., Struyf, F. and Roussel, N., 2015. Prevalence, Incidence, Localization, and Pathophysiology of Myofascial Trigger Points in Patients With Spinal Pain: A Systematic Literature Review. Journal of Manipulative and Physiological Therapeutics, 38(8), pp.587-600.

Cerezo-Téllez, E., Torres-Lacomba, M., Mayoral-del Moral, O., Sánchez-Sánchez, B., Dommerholt, J. and Gutiérrez-Ortega, C., 2016. Prevalence of Myofascial Pain Syndrome in Chronic Non-Specific Neck Pain: A Population-Based Cross-Sectional Descriptive Study. Pain Medicine, 17(12), pp.2369-2377.

Gross, A., Kay, T., Paquin, J., Blanchette, S., Lalonde, P., Christie, T., Dupont, G., Graham, N., Burnie, S., Gelley, G., Goldsmith, C., Forget, M., Hoving, J., Brønfort, G. and Santaguida, P., 2015. Exercises for mechanical neck disorders. Cochrane Database of Systematic Reviews,.

Llamas-Ramos, R., Pecos-Martín, D., Gallego-Izquierdo, T., Llamas-Ramos, I., Plaza-Manzano, G., Ortega-Santiago, R., Cleland, J. and Fernández-de-las-Peñas, C., 2014. Comparison of the Short-Term Outcomes Between Trigger Point Dry Needling and Trigger Point Manual Therapy for the Management of Chronic Mechanical Neck Pain: A Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy, 44(11), pp.852-861.

Walker, M., Boyles, R., Young, B., Strunce, J., Garber, M., Whitman, J., Deyle, G. and Wainner, R., 2008. The Effectiveness of Manual Physical Therapy and Exercise for Mechanical Neck Pain. Spine, 33(22), pp.2371-2378.

Moretti, A., Menna, F., Aulicino, M., Paoletta, M., Liguori, S. and Iolascon, G., 2020. Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis. International Journal of Environmental Research and Public Health, 17(17), p.6284.


Have a Headache?

Posted on 20 March, 2021 at 13:20 Comments comments (523)

Have you seen our latest health series on instagram?

Due to the ongoing pandemic, lockdowns and changes to our working lives, we’ve developed our Home Working Series to tackle all your aches and pains from working on your laptop, over your kitchen counter or dining room table and commuting from your bedroom to living room.

If you’ve checked out our Instagram post “Have a Headache?” you’ll already we're talking about Cervicogenic Headaches which are a type of headache caused by dysfunction in our necks. 


These headaches feel like a pressing or tightening sensation and can be on one or both sides of our head and are often in the presence of neck pain and even pain that radiates down one arm. These headaches affect our occipital, frontal, retro-orbital and temporal regions.

Around 2.5% of people will suffer with cervicogenic headaches with around 15-20% of people who suffer from chronic headaches suffering with these.

They often cause dizziness, nausea, light-headedness, inability to concentrate, retro-ocular pain and visual disturbances.

Cervicogenic headaches are often unresponsive to common headache medication so if you’re suffering with any of the above and finding that headache medication isn’t working, you could have cervicogenic headaches. As these headaches don't respond to the usual headache medications, you're probably wondering how we get rid of them, right? Well we need to treat the neck problems. 

Now many people will suffer from these types of headaches following some form of trauma, a car accident, falling over, a rugby tackle and so on. However, we can get them from spending too long with our necks flexed/bent and poor posture. Bending over your laptop screening or staring at your smartphone in your lap? This could well cause cervicogenic headaches! 


Now you may not have injured neck but in theory any discomfort, aches or pains in the neck could lead to cervicogenic headaches. This is because the sensory input (input from our nerves controlling sensation throughout the body) from the neck structures meets the spinal nucleus of the trigeminal nerve. This nerve is very complex and consists of three branches; opthalmic, maxillary and mandibular nerves which covers the area's that are most commonly affected by cervicogenic headaches. 


Cervicogenic headaches are cured by treating the problems within the neck and they respond well to Physiotherapy treatments such as acupuncture, massage, myofascial release, TENs, exercise and spinal mobilisations and manipulations. This is because these therapies help release muscle tension, improve connective tissue mobility and help joints move more freely...exercises then help to maintain the regained movement and mobility. 

The first recordings of cervicogenic headaches were noted in 1860 however the term wasn’t coined until 1983. Any disorder or dysfunction to the neck bones, muscles, joints, ligaments, discs and soft tissues can lead to cervicogenic headaches. The International Headache Society has over 14 subcategories of headache classifications, with cervicogenic headaches being classed as a secondary headache as they result from another source such as inflammation, head or neck injuries.

In general, these headaches are caused by the trigeminal and upper three cervical spine nerves, upper cervical vertebrae, discs, ligaments and soft tissues. Muscle tenderness plays a huge role and is more pronounced on the pain site vs the non-pain site. The therapies listed above help to address the muscle tenderness and local spinal factors alleviating pain.

Studies have found the 8-12 weeks of therapy can result in effects lasting a year! Meaning less frequent headaches, less intense, less work or school days missed.


It’s important to ensure your headaches, neck and spine are thoroughly assessed and a treatment plan is designed specifically for you to ensure you have the best result.

In the meantime, make sure you move regularly – ever 30-60minutes, wiggle around in your chair, stretch or get up and move away from your laptop/desk. Make sure your computer/laptop is set up correctly so you’re not putting yourself at risk of additional neck strains (remember you head weighs just under a stone, that’s 11lbs hanging off your neck muscles and joints!)


References

10102 BASH - Guidelines update (2)_v5.1.indd (ihs-headache.org)

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition (sagepub.com)

Cervicogenic headaches: a critical review - ScienceDirect

untitled (nih.gov)

s10194-012-0436-7.pdf (springer.com)

 


 

Home Working Series

Posted on 20 March, 2021 at 13:05 Comments comments (668)

Introducing our new health series - Home Working Series

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Posted on 28 February, 2017 at 16:20 Comments comments (2211)

When we suffer with pain, we can often struggle to complete our day-to-day tasks, especially if we have had pain for sometime which can lead to deteroriation in our physical ability.

 

Check out our Simple Guide to Pacing to learn about an effective way to reduce pain and build upon your daily activity. It's also a useful way to build on any sporting activities following return from injury!

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Posted on 21 February, 2017 at 16:10 Comments comments (1859)

In Physiotherapy, we often meet patients who have been suffering with pain for some time and are now limited with what they are able to do within day-to-day life.

Check out our post below on Boom-Bust Pain Patterns to shed some light on why these limitations occur.

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Posted on 3 February, 2017 at 16:05 Comments comments (5181)

Take a look at our 5 R's for managing pain that flares up!



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