At Total Physiotherapy we see a large number of patients who suffer with injuries that are related to repetitive strain and as a result of overloading a particular muscle or body part. These injuries are typical in patients who have recently increased their workload, increased their training intensity (in sport), or started a new activity (gardening/DIY).
Overuse injuries are extremely common and if they are treated early then they can be easily cured. However if an overuse injury becomes chronic (lasting over 6 weeks), then further problems may arise which will be more problematic to treat. An example may be a patient who has developed elbow pain since they started gardening in early spring time.
The pain slowly gets worse and the patient thinks it will get better soon with taking some pain relieving tablets. However, the pain to the elbow increases and the individual starts to favour the other arm when completing certain activities (cooking, washing, at work, getting dressed etc). As the injured arm becomes more and more disregarded it weakens, causing the shoulder joint to weaken and lose its stability. As a consequence the movement pattern of the injured arm will change causing the individual to develop biomechanical problems and possibly impingement syndrome to the shoulder. It is therefore important to receive treatment for an injury before the problem becomes chronic and affects problems elsewhere.
Repetitive strain injuries are commonly caused by injuries to tendons. This is due to the tendons structure and due to its poor blood supply it is unable to repair itself in an efficient way. There are a number of different theories for the cause of tendon pain and disrepair. It was believed that the reason for pain was due to inflammation of the tendon itself, known as tendonitis, with inflammation at a cellular level contributing to the pathological process. However a large amount of scientific research has shown that there were no inflammatory cells present in patients who underwent surgery for tendon pain.
As well as tendons becoming injured with repetition, it is also common to injure particular joints and muscles. When any part of the body is overloaded in a repeated manor, the area will be more susceptible to injury, especially when the movement is completed ineffectively (poor biomechanics). A good example is with a runner who is experiencing knee pain after iincreasing their training intensity. If the runner has weak hip muscles, it will cause the thigh bone to rotate inwards when they are running, affecting the mechanics of the knee joint.
This will cause the knee cap (patellar) to be out of line as the knee bends and straightens, causing the knee joint (patellofemoral joint) to become irritated and painful. As this movement is repeated the joint will become more and more irritated and the individual will need to stop running because of the pain.
How can physiotherapy help with repetitive strain injuries?
All the physiotherapists at Total Physfiotherapy are extremely well trained in identifying and treating overuse injuries. Firstly the physiotherapist will need to complete a thorough assessment to determine the nature and severity of the injury before developing a treatment program. The physiotherapist will then advise the patient to modify the certain activity/movement that is causing the injury. Once the source of the problem has been identified the physiotherapist may use a combination of treatments, such as: Ultrasound, exercise therapy, soft tissue massage, joint mobilisation, trigger point release and postural correction.
Podiatry and Insoles
At Total Physiotherapy we are trained at using insoles to treat overuse injuries 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 overuse 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.