What We Treat

Biomechanical Problems

At Total Physiotherapy we feel it is important to complete thorough and in depth assessments in order to get to the route of our patients problems and not just treat the symptoms. The majority of time is through completing biomechanical analysis to discover muscle imbalances that may be causing dysfunctional movement patterns at particular joints. With dysfunctional movement patterns, we get muscle imbalance which, through overuse, can cause irritation to certain tissues in the body and eventually lead to injury.

The human body has a brilliant ability to adapt to prevent pain and irritations within the body ensuring efficiency at all times. However, it is when these adaptations become excessive that irritation and pain can occur in the body which can lead to muscle weakness and inefficiency of movement

How can biomechanical problems cause injury?

As physiotherapists we are trained to assess movement patterns to discover where they may be contributing to an injury. This may be a patient who presents with anterior knee pain which is apparent due to hip and trunk instability/weakness. With weakness at the hips and trunk, it puts the knees under extra strain causing the knee joint to work in the wrong way and cause parts of the joint to become irritated. Another example may be that a patient presents with pins and needles to the hand accompanied with pain down their arm. After a full biomechanical assessment it could be that the patient has a poor posture and it is stiffness at the upper back and neck that is the route of their symptoms.


A further example would be a patient who may present with hip pain following excessive running, walking or general activity. Again, after an in depth assessment the physiotherapist may notice the patient over pronates at their feet (flat feet), offsetting the biomechanical chain, causing the hips to rotate inwards and predispose them to impingement at the hip. This is extremely common and is easily treated with simple foot and hip exercises, as well as providing the patient with insoles that can reduce over pronation and ensure correct movement patterns.


Below are a few more examples which relate to sporting injuries and the possible causes:


  • Shoulder pain in swimming – Reduced rotation in the upper back predisposes the shoulder to injury as the joint needs to over compensate for the lack in rotation.
  • Knee pain in a runner – Weakness at the hip and quadriceps muscles, causing the knee to drop inwards and cause unnecessary irritation at the patellofemoral joint.
  • Achilles pain in a runner – Excessive pronation at the foot puts the Achilles tendon under extra strain as it is put under excessive strain.
  • Tightness of the quadriceps muscles causes reduced hip extension which means the lower back needs to compensate through excessive extension. – Tightness of the quadriceps muscles causes reduced hip flexion which means the lower back needs to compensate through excessive extension.

How can physiotherapy help correct biomechanical problems?

As physiotherapists we are extremely well trained in identifying and treating biomechanical problems through using exercise therapy and certain manual therapy techniques (soft tissue massage, joint mobilisations, trigger point release, joint manipulations to name a few).


The examples above include knee pain which is caused by weakness to the muscles surround the hip. Through prescribing specific exercises designed to strengthen and improve the neuromuscular control of the hip muscles, the mechanics of the hip can be improved which will allow the knee to work in the correct manner and reduce irritation/injury.


Another example includes a footballer who suffers with low back pain because of tight quadriceps muscles. The physiotherapist can provide soft tissue massage and a thorough stretching programme, targeting the quadriceps muscles improving their length and the range of movement at the hip. This will off load the lower back allowing it to move within its normal range and reduce the risk of injury.


Finally, the example of the runner who suffers with pain to their Achilles tendon caused by over pronation at the foot. The physiotherapist can provide soft tissue massage to the calf muscles and the fascia under the foot (plantarfascia), as well as prescribing intrinsic exercises to the foot and ankle, improving their stability. At Total Physiotherapy we can also provide foot orthotics that prevent over pronation and ensure the Achilles tendon functions in the correct manner.

Podiatry and Insoles

As mentioned previously, at Total Physiotherapy we are trained at using insoles to treat biomechanical problems in relation to poor foot posture and stability. If we feel that the patient could benefit from a further specialist assessment then we can refer to a podiatrist who can look at providing custom made insoles. However with the addition of anti-pronation insoles from our clinic, certain running injuries such as anterior knee pain, shin splints and Achilles tendonopathy can be treated successfully. This will correct the biomechanical problem through providing extra support to the foot and ankle complex and ensuring correct alignment.


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.