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Grace Cowley

Grace has been working as a Physiotherapist since graduating from the University of Nottingham in 2011. Always having a passion for musculoskeletal conditions, she initially gained experience working with British Swimming at the Loughborough Intensive Training Centre, working alongside elite athletes and the Loughborough University Swimming Team, prior to gaining employment at Loughborough General Hospital.

Following a change in sport, Grace started working with the local RFL Regional Rugby League Academy, Midlands Hurricanes. Providing services for both U16 & U19 clinics and match days, she was then picked to provide therapy services for a combined regional team versus Australia School Boys in Nov 2014.

Whilst continuing to develop her immediate medical management skills in Rugby League, Grace has since developed in her NHS career and is now working in a specialised musculoskeletal rotational role in Nottingham. This has helped further her interests in complex Orthopaedic cases and rehabilitation, including ligament reconstruction and shoulder biomechanics.

Grace has worked in private practice since graduating which she thoroughly enjoys! She is fully trained in Acupuncture and Trigger Point needling, and has a keen interest in many sports, recently working alongside Athletics providing education in Injury Prevention and management and injury prevention screening.

Grace is available for appointments on Monday 4.30 – 8.00 , Thursday 4.30 – 8.00 and every 4th Saturday.

Back and Neck Pain

At Total Physiotherapy the majority of patients we see suffer with lower back and neck problems. Low back pain is the most common cause of sickness in the workplace in the UK with up to 80% of the UK population experiencing back pain at some point in their lifetime. It affects approximately one third of the adult population each year with 20% of people consulting their GP. Neck pain is also extremely common, and can have a negative impact on an individual’s daily life.

There are a number of different guidelines for both low back pain and neck pain, with those proposed by the National Institute for Health and Care Excellence (NICE) being most commonly used in the UK. These provide clinical guidance regarding the most appropriate treatment methods and assessment tools. At Total Physiotherapy we follow such guidelines in order to provide evidence based treatments for back and neck pain.

back-pain
At Total Physiotherapy the majority of patients we see suffer with lower back and neck problems. Low back pain is the most common cause of sickness in the workplace in the UK with up to 80% of the UK population experiencing back pain at some point in their lifetime. It affects approximately one third of the adult population each year with 20% of people consulting their GP. Neck pain is also extremely common, and can have a negative impact on an individual’s daily life.

There are a number of different guidelines for both low back pain and neck pain, with those proposed by the National Institute for Health and Care Excellence (NICE) being most commonly used in the UK. These provide clinical guidance regarding the most appropriate treatment methods and assessment tools. At Total Physiotherapy we follow such guidelines in order to provide evidence based treatments for back and neck pain.

What is the main cause of neck and low back pain?
The actually causes of neck back pain are poorly understood, however it is believed that symptoms develop due to multiple factors. Only 15% of cases are thought to have an identifiable cause, with the remains 85% of cases classed as non-specific.

Both neck and low back pain can be caused by genetics, a lack of fitness, muscle weakness, poor posture, muscle imbalance, damage to the vertebrae or intervertebral discs, repetitive movements, or medical conditions such as scoliosis.

An increase in sedentary lifestyles and static working conditions is thought by many to have increased the prevalence of neck and low back pain. This is often related to office based working conditions where the individual is sat in a static position with poor posture and ergonomics. Poor posture and ergonomics increase the risk of muscle imbalances developing, causing muscles to become overactive and painful. Lifting with an unstable lower back/trunk can also cause damage to the facet joints and intervertebral discs. If the vertebra or intervertebral discs are damaged (in the form of a disc prolapse) the muscles overlying the area will go into spasm causing pain and restricting the individual’s mobility.

Low back and neck pain can also become evident when playing sport, usually as a result of a twisting or bending movement at the spine whilst the spine is loaded. Spondylolisthesis is a condition which mainly affects children and it is caused by a vertebrae slipping out of position. This can be as a result of sudden injury, particularly during sport, or as a birth defect. The physiotherapist will be able to determine if this condition is likely through a thorough assessment and they may feel it would be appropriate to refer the patient back to their GP for an X-Ray. It is also common for athletes to develop trigger points within the muscles around the lower back and neck region when playing sport. These can be treated successfully with trigger point release massage and stretching to allow the muscle to be restored to its previous function.Due to the mechanism of road traffic accidents, some people develop what is known as a ‘Whiplash Associated Disorder’. Whiplash associated disorders involve a sudden change in movement in the cervical spine, causing excessive extension and flexion, injuring the facet joints and ligaments at the spine.

Symptoms can typically persist for longer than 6 months, however it is important to speak with a physiotherapist early for advice on how to treat the neck pain. If following the road traffic accident you suffer from prolonged dizziness, fainting or problems with your speech, swallow or vision, you need to speak to a doctor as soon as possible.

How can Physiotherapy help my neck and back pain?
Physiotherapy is extremely beneficial for neck and low back pain with a large amount of research available which supports its effectiveness as a treatment method. There are a number of different treatment methods which can be used for low back pain which will depend on its presentation and severity. At Total Physiotherapy the physiotherapist will complete a thorough assessment, ruling out any sinister cases through asking specific questions. Once the physiotherapist has completed a thorough assessment, they will then be able to provide hands on treatment which again, will depend on the severity of the patient’s symptoms.

Treatment methods include soft tissue massage, acupuncture, exercise prescription, joint mobilisations, joint manipulations, stretching and trigger point release therapy. The physiotherapist’s at Total Physiotherapy use an evidence based approach and the above treatment methods have recommended in the NICE Guidelines for low back pain. We also have immediate access to MRI scans, if further investigation is deemed necessary.

As well as providing treatment, the physiotherapist will be able to advise with your desk set up and lifting postures when at work. They may also be able to advise you with your activity levels at work, encouraging certain movements to reduce your pain levels. This may be as simple as standing to have a stretch every 10-20 minutes if you sit at a desk all day. This will reduce the strain your back is put under and allow the soft tissues to lengthen.

Red Flags
Red Flags is a term used by health care professionals to highlight signs and symptoms of a serious underlying pathology. If the individual is suffering with back pain and they experience any changes in their bladder or bowel symptoms, radiating pins and needles or numbness down their legs to the toes, or numbness around the groin region, they need to visit their local A+E department for an immediate MRI scan. If the individual is suffering with neck pain then they need to be aware of any dizziness, problems with swallowing or speaking, changes in their vision (double vision) and fainting episodes. If they do experience these symptoms then they need to seek medical attention.

If you would like to discuss your problem before booking an appointment please give our physiotherapy team a call, we will do our best to help.

Acupuncture

Acupuncture originates from traditional Chinese medicine but is today widely accepted by the western world as an effective tool to relieve pain and treat a range of medical conditions.

What is Acupuncture?

Traditional practitioners believe that an energy force known as Qi flows through the body; when Qi is insufficient, unbalanced or obstructed, it can lead to illness or injury. Acupuncture is about restoring the balance of Qi to bring you back to full health.

Western practitioners base their treatment on evidence that acupuncture stimulates nerves and muscle tissue, resulting in a change to the patient’s perception of pain.

The practice causes the body to produce natural, pain-relieving hormones such as endorphins, reduces muscle spasm, stimulates the immune system and generally relaxes the person.

What is involved?

The therapist will insert sterile, single use, disposable needles (typically 25 – 50 times thinner than a small syringe used by a doctor) into the skin at particular points of the body. Exactly where on the body will depend on the person’s specific symptoms. Treatment tends to last 20 – 30 minutes but can be longer.

Are there any side effects?

Acupuncture is recommended by many health care professionals because it has few side effects. Acupuncture is most effective when undertaken as course of treatment (usually 8 – 10 sessions as per NICE guidelines)

Is it right for me?

There is conclusive, scientific evidence to show that acupuncture can offer relief to people of all ages, suffering from a wide range of conditions including:

Back pain
Tendonitis
Neck pain and sprains
Foot pain
Headaches and Migraines
Soft tissue injuries
Arthritis

Does acupuncture actually work?

Many of our patients have experienced great benefits from acupuncture treatment and we believe strongly in its use as a complementary therapy. Do not hesitate to contact us to discuss whether it could be the right option for you.

Musculoskeletal Physiotherapy

Musculoskeletal Physiotherapy incorporates an in-depth assessment and diagnosis, followed by a wide range of techniques and treatments designed to reduce or eliminate pain in the muscles, bones, joints or soft tissue areas of the body, whether caused by injury or degeneration.

A multi-dimensional physio treatment plan is created to ensure the body is not only rehabilitated in the safest possible way, but also to prevent re-occurrence through stretching, stabilising and strengthening the affected area.

Physiotherapy treatment plans can include the following techniques:

Manipulation/mobilisation techniques
Deep transverse frictional massage
Muscle energy techniques
Ultrasonic therapy
Acupuncture
Massage
Pilates
Heat therapy
Cold therapy
Gym rehabilitation
Specific taping techniques
Mechanical traction

Our 25 years of experience providing physiotherapy services in Manchester and beyond means we have seen pretty much every type of injury to every part of the body.

Musculoskeletal Physiotherapy can be used to treat:

Back pain
Shoulder pain
Elbow pain including Tennis Elbow
Neck pain
Headaches
Wrist pain and hand pain
Knee pain including cartilage tears
Achilles, ankle and foot pain
Calf and shin pain
Ligament sprains/tears
Arthritis
Sports injuries
Fracture rehabilitation
Trapped nerves
Muscle strains
Cartilage tears
Pre and post surgery rehabilitation

Louise Richardson

Louise has been working as a physiotherapist since graduating from the university of Brighton in 2011 .

With a passion for musculoskeletal Physiotherapy, she initially started working within a private practice, treating a variety of MSK conditions and building her skills within Matwork Pilates, dry needling, taping and manual therapy.

After working in the UK for a few years, Louise decided to broaden her horizons and relocated to Singapore. Here she worked within a government hospital, treating neurological and rehab patients before returning to her passion of treating MSK conditions.

During her time in Singapore Louise was able to enjoy another passion of traveling and experiencing different cultures within South East Asia.

Naomi Sargent

Naomi graduated from the University of Nottingham in 2014 with first class degree honours in physiotherapy.

Since then Naomi has been completing her junior rotations within the NHS at Nottingham University Hospitals Trust, where she is developing her skills and practice within all areas of the wide scope of physiotherapy.

The musculoskeletal setting is where her interests lie, assessing and treating various injuries and conditions with an individualised, patient centred approach. Naomi aims to offer a combination of hands on treatment as well as providing home exercises to ensure carry over from any therapy, in conjunction with education and advice into their problem and it’s causes to increase insight and aid with self management of their condition, for more effective long term results.

Having attended a number of courses post graduation, Naomi is keen to keep up to date with current practice and widen her personal scope as a practitioner.

Naomi is available Tuesday and Thursday evenings 5pm-8pm.

Alistair Exon

Professional Memberships

Chartered Society of Physiotherapy (MCSP) 69293
Health and Care Professions Council (HCPC) PH64934

Alistair graduated from Huddersfield University with a First Class Honours Degree in 2003.
He worked for 7 years within the NHS, primarily in Musculoskeletal clinics whilst gaining specialist knowledge in Emergency Care (A&E), Hand Therapy and Rheumatology. He moved in to Private Practice in 2009; joined the team in Nottingham in 2015 and has been a popular external lecturer on the MSC course in Sports Medicine at the University of Nottingham over a number of years.

Alistair has numerous post graduate qualifications; notably he is a member of the McKenzie Spinal Institute and has completed courses in Mechanical Diagnosis and Therapy including advanced spinal problem solving in the neck, mid and low back. He has also completed in-depth courses on assessment and rehabilitation of the shoulder and knee.

He is a qualified Kinetic Link Trainer which helps to develop core control and strength via simple functional based resistance training techniques. He holds a Level two award from the British Safety Council in Display Screen Equiptment (DSE) assessment; is a qualified Pilates instructor and has certification in Western Acupuncture (Dry needling).

Alistair is a keen runner and is as passionate about fitness as he is about his physiotherapy; he has completed two 50 mile ultra -marathons in the Lake District hills and thus, has a good understanding of pain!

You will find Alistair friendly and approachable and whilst he is a very ‘hands on’ therapist, he will tailor his sessions to reflect your individual requirements and tolerance levels.

Alistair Exon

Professional Memberships

Chartered Society of Physiotherapy (MCSP) 69293
Health and Care Professions Council (HCPC) PH64934
Career History

Alistair graduated with a first class honours degree in 2003. He commenced his Physiotherapy career within the NHS and moved into private practice in 2008.
He is comfortable treating any musculoskeletal problem/sports injury.

Alistair is passionate about helping patients to understand the causes of their particular musculoskeletal issues and problems and will work hard to ensure you ‘get back to normal’.

Alistair is a keen runner and cyclist. He has number of Post Graduate qualifications, including Spinal Mechanical Diagnosis, Pilates and is a qualified Kinetic Link (functional movement) trainer.

You will find Alistair friendly and approachable and whilst he is a very ‘hands on’ therapist, he will tailor his sessions to suit your individual requirements.

Alistair is available Monday 8:00am-4:00pm and Friday 10:00-6:00pm.