The medical epicondylitis, also known as Golfer’s Elbow, is a painful condition to the main tendon of the wrist flexors. This tendinitis creates huge discomfort inside the elbow from the edge of the bone to the forearm and sometimes up to the wrist. It provokes a throbbing or burning sensation in the elbow, usually when moving or holding an object.
The medial epicondylitis is generally caused by regular and repetitive movements to the hand and wrist. It often occurs in golfers, baseball pitchers, tennis players and manual workers. If you’ve initiated a new activity of the sort or have suddenly spent more time practising one of these activities, the risks of suffering from a medial epicondylitis would be high. For instance, it could unfold after a golf trip, home renovations or landscaping.
When a medial epicondylitis is cared for in its early stage by a physiotherapist, the pain and the worsening can be stopped before needing to take a break from work, sports or home improvements. Manual therapy treatments and custom exercises will accelerate the healing process, restore joint mobility and correct the biomechanic movements of the arm.
The lateral epicondylitis, also known as Tennis Elbow, is a painful condition to the main tendon of the wrist extensors. This tendinitis creates huge discomfort on the surface of the elbow, from the edge of the bone to the forearm, and sometimes up to the wrist. It provokes a throbbing or burning sensation around the elbow, usually when holding an object like a coffee mug, or when closing and rotating the hand at the same time, like when turning a door knob or a screwdriver for example.
The lateral epicondylitis is generally caused by regular, forceful and repetitive movements of the hand and wrist. It often occurs in manual workers and tennis players. If you’ve done manual work for a long time or have suddenly used your forearm muscles more than usual, the risks of suffering from a lateral epicondylitis would be high. For instance, it could unfold during home renovations or when resuming the play of a racket sport that you had stopped for a while.
When a lateral epicondylitis is cared for in its early stage by a physiotherapist, the pain and the worsening can be stopped before needing to take a break from work, sports or home improvements. Manual therapy treatments and custom exercises will accelerate the healing process, restore joint mobility and correct the biomechanic movements of the arm.
A post-fracture ankylosis is the stiffness that occurs around the static articulations of a recovering limb (immobile) due to a fracture or dislocation. The lack of movement causes the muscles and motor control to weaken. Joint stiffness and muscle impairment start on the first days of immobility and are relatively proportioned to the recovery period. The longer that a limb is immobile, the higher are the chances of suffering from post-fracture ankylosis.
If treatments and exercises haven’t been initiated as soon as possible during recovery, the articulation would lose range of motion. For example, a shoulder wouldn’t rotate over the head or a knee wouldn’t fully extend anymore. This could significantly impact work or sports due to a perturbed technique. Moreover, another region of the body would highly compensate for the impaired articulation, working harder than it should and then being at risk for injuries too. For example, if a shoulder doesn’t allow the hand to move an object over the head, the body would compensate by arching its back. This natural adaptation could still let you do the task at hand, but it would endanger the back in addition to the shoulder. When a wrongful movement is done repetitively, it provokes lesions, muscles tensions and pain.
It’s important to start physiotherapy treatments and home exercises as soon as possible to avoid post-fracture ankylosis and long-term complications. We’d identify the limiting factors in the muscular and ligamentous structures, correct the displacements and reinforce the articulation. Progressive and monitored exercises would give you back the strength, range and motor control that you lost.
A ligament sprain is when a ligament is damaged or torn due to an isolated movement or contact. Ankle and knee sprains are the most common, particularly in contact sports with fast changes of direction. Many signs can indicate the presence of a sprain. Three categories separate them based on the severity of the impaired ligament.
1st deg. : A 1st degree sprain means that the ligament has been slightly affected but not its stability, though. This type of sprain is generally characterized by pain in the same movement that caused it. There’s no internal bleeding and sometimes, almost no inflammation.
2nd deg.: A 2nd degree sprain means that the ligament has been stretched and partially torn; its stability being diminished. In addition to feeling pain in rest and movement, there’s presence of internal bleeding and inflammation, particularly in ankle sprains. Depending on the severity of the impaired ligament, a wobbly sensation can occur. Physiotherapy treatments are necessary as soon as possible to accelerate the recovery process and prevent further sprains, by resetting the biomechanic of the articulation as well as the strength and motion control.
3rd deg.: A 3rd degree sprain means that the ligament has been torn completely; its stability being completely lost–almost. Surgery is needed for this type of sprain to reconstruct the ligament. If the sprain is caused by a powerful impact, it would likely be associated with another lesion like a meniscus tear or fractures to the adjacent tissues, but it could also be local.
All sprains can be diagnosed and treated by a physiotherapist, except for 3rd-degree ones; only they must be diagnosed by medical imaging with magnetic resonance (MRI) or ultrasound (sonography).
Know that the recovery of an impaired ligament is limited because there’s low blood flow in the ligaments. A stretched or partially torn ligament will heal but never gain back its original stability. In addition, if you’ve noticed a great amount of pain, internal bleeding and inflammation and haven’t gone to a clinic yet, your injury could affect the receptors of your nervous system and limit your motion control permanently. To avoid further complications, your impairment needs to be treated on as soon as possible. Strengthening the muscles around the articulation and pushing its range of motion will set new signals for your nervous system–it’d read new information and adapt to it.
A torn meniscus is when there’s injury to one or both menisci of the knee. The knee articulation is composed of the medial meniscus and the lateral meniscus. They’re made of bones and fibrocartilage for stabilizing the knee and reducing pressure. Different sorts of lesions can occur, and with magnetic ultrasound, we could see up to a small tear, total rupture or even floating particles in the articulation. A torn meniscus is traumatic for the knee when caused by contact or a sprain. It can also be less traumatic, being the result of small accumulated tears over the years. Know that the recovery of an impaired meniscus is limited because there’s low blood flow in cartilage. Knee surgeries tend to directly replace a part of the meniscus since it takes forever to heal depending on the size on of the tear.
However, despite the surgical reconstruction, absence of pain isn’t guaranteed afterwards. The stability and biomechanics of the knee are still to be impaired. Pressure and friction on the superficial bones are probable and would elevate the risks of suffering from early osteoarthritis. A meniscus surgery would only be considered if the physiotherapy treatments aren’t making a difference.
Know that you don’t need to book an MRI scan to assess if you’re suffering from a meniscal lesion. Even though the official diagnosis of a torn meniscus must be done by medical imaging, many clinical signs can also be identified by a physiotherapist beforehand, to determinate if there’s an impairment or not. A torn meniscus would provoke blockage in the knee during movements like going down the stairs, sitting on a chair or squatting.
The pain related to a torn meniscus is generally caused by the pressure of the bones on the lesion or by the lesion itself–the stretching of the tissue. However, because the menisci are attached to ligaments and muscles, they can sometimes get jammed in the articulation due to misalignment or a false move. Physiotherapy can physically correct the misalignment and prescribe exercises to diminish the pressure under the menisci. You don’t need to consult a doctor and wait for medical imaging results before starting treatment. When a torn meniscus is quickly taken care of by a physiotherapist, pain and deterioration can be stopped, avoiding the chances of surgery.
Groin pain is the result of muscle impairment or limited range of the groin, more specifically muscle tensions, muscle pulls or impaired hip biomechanic. A pinching sensation would happen when the hip is bent, like when crossing the legs sitting down for example. It often occurs in hockey players due to the physical efforts of skating that cause stress on the small stabilizing muscles of the hip. When these muscles are sore or stiff, they limit hip mobility and provoke change in the movement of the articulation.
The hip articulation is spherical, allowing movement in all directions. Muscular tensions can impair the articular alignment and provoke friction between the head of the femur and the anterior region of the acetabulum; in other words, where the leg locks inside the hip. This round cavity holds a cartilaginous membrane (labrum) that also helps with the femur’s stability. Similar to a misaligned meniscus, the femur’s head can sometimes get stuck and provoke pain. Physiotherapy can reinitiate the hip’s suppleness and range of motion, for an optimal biomechanic that won’t provoke pain.
Know that other types of impairment can provoke groin pain too. If you’re experiencing two discomforts simultaneously, like to the groin and to either the knee, back or genital area for example, you should consult a physiotherapist or a doctor to eliminate the possibility of further, more severe complications.
A muscle strain is when a muscle is torn or stretched due to intense physical effort and expansion at the same time. Despite the variable severity, muscle strains provoke an extremely painful snapping sensation that forces the immediate stop of physical activity. Three categories separate them based on the severity of the impaired muscle.
The first grade means that the muscle is stretched but not torn. Pain is felt when the impaired muscle is contracting and expanding, the loss of strength being somewhat noticeable.
The second grade means that the muscle is partially torn, usually distinguishable from the first grade with sonography. Intense pain is felt when the muscle is contracting and expanding, the loss of strength being evident. Depending on the severity and the type of strain, surgery is sometimes needed to reattach the torn sections together, so the muscle fibres can bridge the tear.
The third grade means that the muscle is completely torn linked with internal bleeding, the loss of strength being total. Immediate surgery is needed to reattach the torn sections together, so the muscle fibres can bridge the tear. This calls for a medical emergency, with surgery in the following hours to ensure the optimal healing of the tear.
In all cases, muscle strains need rest in proportion to the severity, to heal and avoid further damage. The rest must be active, including circulatory exercises to maintain blood flow in the impaired area for allowing better recovery. Know that a muscle strain should be treated by a physiotherapist to avoid the complications of reduced strength due to disproportionate muscle mass. Other muscles and areas of the body would compensate for the impairment, putting themselves at risk for being overused. Moreover, when resuming the physical activities, for compensating and not allowing the recovering muscle to strengthen, they’d also lead the strain to relapse if the musculature isn’t proportionate.
Postoperative orthopedic rehabilitation is the physiotherapy treatments following any surgical intervention on the feet. Orthopedists trust the knowledge of physiotherapists when it comes to finding mobility, strength and function of the feet after a fracture, a prosthesis implant or any other surgery. Physiotherapy treatments can accelerate the recovery with progressive exercises that’ll strengthen the tissues and eliminate the possibility of compensations.
Know that Public Health offers its own physiotherapy treatments for anyone going through the process of post-op orthopedic rehabilitation. Hence, these services are limited in terms of availability and are mostly specialized in residential autonomy and in the safety of day-to-day activities. Also know that physical activity and sports are vital to proper recovery, regardless of your age and post-op state. In this sense, physiotherapy is really valuable, not only for avoiding the existing risks of new injury, but also for recovering actively in the safest way possible. Letting a physiotherapist monitor your feet’s range of motion, motor control and strength would be wise, surely if you’re planning on returning to sports.
Our sport physiotherapists can help you navigate a shorter post-op orthopedic rehabilitation that supports your autonomy at home, work and in sports.
A discal hernia is when there’s a lesion to one of the intervertebral disks of the spine that fails to cushion a vertebrate. Commonly in the neck and lower back, symptoms of pain can be local or in the limbs like the arm or leg. Blockage in the lower back would be the sign of a discal hernia if it stops the spine from straightening normally. When in pain, laying down is encouraged since most of the upper body weight is lifted off the intervertebral disks.
A discal hernia can also cause neurological symptoms like tangling or numbness in the limbs and loss of strength or skin sensitivity. If these symptoms impair the spinal cord, they need medical emergency and to be diagnosed by a physiotherapist or a doctor immediately. If these symptoms occur simultaneously or bilaterally with a urinal or fecal deficiency, genital numbness or lower motor control of an entire limb, they also need medical emergency and to be brought to the ER immediately.
Know that the symptoms of a discal hernia are similar to the ones of a lumbar sprain or of sciatica, so you could be suffering from one or all of these conditions. The clinical evaluation of physiotherapy would tell you if medical attention and magnetic resonance imaging is needed or not. Custom treatments for your condition would control and relieve the pain as well as give you the tools for improved mobility and optimal posture.
Low back pain (LBP) is a general term used to describe the many possibilities of impairments in the lower back. The causes of LBP are varied, but they’re usually due to low range in the spinal articulations, to muscle tensions, a sudden physical effort or a combination of all cases. Countless and sometimes unseeable factors play a role in LBP. Thus, a physiotherapist can demystify them by overviewing your posture in your main activities like sleep, work, sports and leisure and by prescribing new drills and positions for you to try in those activities.
LBP could also be the result of sciatica, a painful condition of the sciatic nerve going from the spinal cord to the feet. This would be linked with numb, burning or hefty sensations, descending in the leg or foot. Often, LBP is stopped when muscle tensions, mobility and motor control are taken into charge, in the back and hips area. Know that LBP can affect anyone, whether you’re an office worker, manual worker or an athlete, a physiotherapist can treat any pain.
The first symptoms of LBP and sciatica are occasional and never enabling, really. The pain will be bearable until it’s not. Since mobility and posture are at the source of LBP, rest would temporarily ease the pain, while treating the alignment in the articulations would actually improve your condition more durably. The cumulated discomforts of LBP and sciatica can only get worse because they affect movement by changing the physiognomy of nervous connections. Over time, blockage and pinching sensations would occur after a physical or prolonged activity like working out, happy hour (standing) or a road trip (sitting), for example.
It would be wise to treat the pain at its source by consulting a physiotherapist who’ll help you change your patterns, not learn to live with them. Because LBP is sometimes inevitable, our goal is to show you how to take care of your body in the best way possible.
A tendinitis and a tendinosis are the impairment of a tendon, the fibrous structure of a muscle that attaches to the bone. Since all tendons of the body could be subject to a tendinitis or a tendinosis, it’s important to know the difference between the two terms.
A tendinitis is the inflammation of a tendon being overused on a short period of time. It’s often linked with lower articular range, muscular imbalance or inadequate form during physical activity. For instance, an amateur runner would suffer from a tendinitis (Achilles tendon) if his frequency and intensity is too high to begin with. A burning or stretching sensation would occur when contracting and expanding the muscle, say in the morning and after the triggering activity. Even though icing the tendon locally can help in relieving pain, scientific evidence show that it doesn’t really help in healing the tendon. An active recovery, with progressive exercises in mobility and strength, would be much more effective than a complete stop with ice and anti-inflammatories.
A tendinosis is when a tendinitis becomes degenerative or in chronic state, due to an overuse or harmful habits over the years. In this case, the fibres would’ve lost their optimal alignment and have changed the physiognomy of the tendon. For instance, the tendinopathy of the shoulder cuff, also known as a shoulder tendinitis, is the combination of overuse, bad posture and impingement syndrome. The tendons would’ve been overworked while being stuck between the shoulder blade and the humerus, creating more stress and damage. The degeneracy or small cumulated tears would eventually lead to a total rupture of the tendon.
The treatment for tendinopathy is mostly related with pain management and movement corrections. A physiotherapist would target the articulation’s biomechanic, strength, range and motor control as well as the tendon’s resistance. Custom exercises would improve posture and strengthen the muscles around the tendon to avoid the need for painkillers, the weight of any lifted load being then dispatched to the other structures of the articulation, putting less stress on the impaired tendon.
A bursitis is the inflammation of the bursa, the tissue between the bone and the tendons. The bursa is thicker in big articulations like the knee or shoulder, making the shoulder bursitis the most common impairment of the sort. With similar symptoms to the ones of a capsulitis, a shoulder bursitis progresses a lot quicker though, and is treatable with ice application and anti-inflammatories.
A bursitis can occur after an isolated trauma, overuse or repetitive micro-traumas. For instance, the Student bursitis is the inflammation of the elbow, due to the weight of the head being supported by the wrist and elbow, after spending hours leaning on a desk.
A bursitis could turn into a bursopathy if it isn’t treated properly, in similarity to a tendinitis turning into a tendinopathy. Persistant pain and movement limitations would occur.
An adhesive capsulitis, also known as a Frozen shoulder, is the impairment of a shoulder with very limited range and mobility. It progresses slowly in three stages over a 30-months time. There’s the painful stage, the adhesive stage and then, the recovery stage. Since an adhesive capsulitis doesn’t cause permanent damage, the risks of relapse to the same shoulder are very low. It occurs more in women than men, between 50 and 70 years of age, and targets usually the non-dominant shoulder. Even if its deterioration is totally manageable, an adhesive capsulitis remains bothersome and needs the proper solutions to reduce pain and improve function.
The first stage consists of the first symptoms of pain, not really linked to any obvious factors. They could happen during sleep, daily chores, rest or shoulder movement. This 2 to 9 months stage doesn’t limit the shoulder’s range of motion. A physiotherapist would optimize the stability, mobility and strength of your shoulder to avoid the potential complications leading to an adhesive capsulitis diagnosis and more pain. Physiotherapy treatments would reduce the stiffness and recovery time. Painkillers are sometimes recommended for tolerating the prescribed exercises.
The adhesive stage consists of muscle stiffness, in addition to the pain. This is when the diagnosis is usually given because it’s when daily activities are the most affected. Sleeping on the shoulder or reaching high becomes extremely painful. This 3 to 9 months stage does limit the shoulder’s range of motion. Injections of corticosteroids with physiotherapy treatments would improve the shoulder’s range of motion and the arm’s function. Painkillers are recommended for the specific drills of stretching, strength and articular mobility.
The recovery stage consists of the pain and stiffness disappearing. With better range, a progressive and active rehabilitation is put forth. This 12 to 42 months stage encourages movement in the shoulder with strength and conditioning exercises. Physiotherapy treatments in the final stage will get you back in the shape you once were.
Know that a complete stop in daily activities and sports is strictly forbidden, mostly in the adhesive stage, because it elevates the risk of developing an ankylosis. It’s better to trust a physiotherapist to see the amount of rest you actually need, even though the pain and stiffness can be extremely inconvenient. Plowing through your symptoms daily and during the prescribed exercises is the best way to speed up the recovery.
Cervicalgia is a painful condition to the neck of various symptoms like head aches or local soreness along the top half of the spine. Cervicalgia can be felt in different ways, subsequently or simultaneously, during similar activities or not. It’s usually a combination of muscle tensions around the neck, causing stiffness, blockage and sometimes nerve pain. Good vertical posture is the best way to prevent cervicalgia since it limits the stress on the upper body.
The soreness of cervicalgia is kind of mechanical, kicking in during movement and disappearing during rest. It causes a pinching or blocking sensation when moving the head, like when checking your blind spots in the car or the birdie during a badminton game, for example. When pushing through the pain repetitively with an impaired mobility, this would provoke new symptoms or accentuate the existing ones. In this sense, a tolerable pinch at the start of your badminton game would become an agonizing blockage at the end, causing head aches and maybe descending pain in the shoulder or arm.
The nerve pain associated with cervicalgia is comparable to sensations like burning, freezing or electrical discharges. This type of nerve pain, cervicobrachialgia, tends to worsen by the end of the day, after triggering activities, fatigue and stress. Know that it’s different from the neurological pain of a cervical disc hernia that’s paired with lower skin sensitivity and strength, in both legs or arms at the same time. In this case, it’d be important to visit a doctor or physiotherapist as soon as possible. It becomes even more endangering if these symptoms are accompanied by dizziness, difficulty in seeing or hearing, migraines or loss of conscious.
Cervicobrachialgia can cause nerve pain anywhere from the neck to the hand, depending on the nerves that are compressed. For example, it could impair both the shoulder and arm or only the arm. Since the compression is due to stiff muscles and not the misalignment of a vertebra, manual therapy and clinical drills can easily treat the pain.
Physiotherapy will reduce pain and tensions, improve neck mobility and correct posture. The goal during treatment is to identify your triggers to cervicalgia and cervicobrachialgia, so you can avoid them in the future.
The carpal tunnel syndrome is when the median nerve is repetitively compressed inside the carpal tunnel (wrist), causing ongoing pain or discomfort. It leads to numbness and pain, characterized by icy or burning sensations in the hand and fingers. Carpal tunnel syndrome is usually bothersome at night and during manual work. It could even provoke a loss of strength so big that you couldn’t hold an object anymore.
This chronic impairment is due to either years of forceful manual work or limited space in the carpal tunnel, showing unfavourable physiology. The median nerve being crushed or more sensitive, any slight compression between the structures on its way to the spine would be felt in the wrist. Treating all sections of the arm, such as the elbow, shoulder and back, is necessary to avoid a double-crush syndrome. Physiotherapy treatments would be the most viable option since it’s not as invasive as surgery.
Wearing a brace at night in the short term is good for relieving the symptoms. If the physiotherapy treatments and brace don’t improve your condition after 6 months of consultation, a surgery to decompress the nerve would be envisaged.
A plantar fasciitis is the impairment of the plantar fascia, the wide band under the foot that attaches to the muscles and supports the foot arch. It usually causes pain in the first steps of the day or when walking or running. The foot arch is for absorbing the impact of walking, running and jumps, so when it flattens, the plantar fascia stretches too and causes a lot of pain. This impairment is gradual and generally affects runners and flat-footed people.
The causes of plantar fasciitis can be from running or conditioning in high volume, especially with poor technique, or even due to switching shoes. For instance, if your new running shoes don’t support your arches as much as your old shoes, this would change your feet’s biomechanic, the fascia facing more stress than usual. If you’re someone who stands or walks all day long, you’d also be more at risk of developing plantar fasciitis, even if you’re not really into training.
Orthotic devices are like prescribed feet crutches and can really improve the situation, but it’s important to treat the impairment at the source as well. Physiotherapy treatments would reset the leg and the foot’s biomechanic, while contract-and-release exercises would maximize the recovery, in intervals with rest.
The patellofemoral syndrome is a mobility impairment of the kneecap on the femur. Typically, pain is felt on the front or extremity of the kneecap, but the causes are varied and don’t affect everyone the same way. Since the knee physiology is different from one individual to another, the pressure points’ tolerance to movement is different too. It can occur at any moment during activities like going down the stairs, running, swimming or hiking, but is usually provoked by a specific amount of usage every time. For example, someone could run 5 km while another could only run 1 km, before feeling the soreness of their patellofemoral syndrome. The pain can also occur after sitting for a prolonged period, in a classroom or car, for example. Someone could drive for 2 hours, while another could only sit for 30 minutes, before needing to wiggle their legs.
In general, the patellofemoral syndrome is due to a muscular imbalance between the buttock and the thigh. This elevates the pressure and the friction against the other structures, leading to irritation and pain in the knee. It could also be linked with articular stiffness or bad posture that modifies the alignment in the knee or hip. If you’ve suffered from a knee trauma or have reinforced bad technique in sports over the years, the risks of developing a patellofemoral syndrome would be likely as well.
Rest, painkillers and ice can reduce the irritation and control the pain, but only in the short term. For a more durable rehabilitation, physiotherapy can help in identifying the triggers of your condition, before the knee bones erode each other permanently. Motor control and strengthening exercises would be done over several weeks, combined with rest in intervals, so the body can adapt progressively to new movement and return to sports.
The iliotibial band syndrome is when the fascia of the thigh, going from the hip to the knee, is in repeated friction with the other structures of the leg during movement, causing debilitating pain on the surface of the knee. Depending on the impairment’s severity and placement, there could also be inflammation. Iliotibial band syndrome is usually provoked by a sudden change in volume, intensity or surfaces in stride-like activities like running or cross-country skiing, for example.
The ones who suffer from iliotibial band syndrome are often athletes or people with the following predisposition: muscular imbalance, articular stiffness, poor technique and overtraining. For instance, small buttocks combined with overly developed quadriceps and a lack of sturdiness when stepping onto the ground would be the interrelated factors of a runner’s iliotibial band syndrome. A physiotherapist would evaluate your condition and see how it relates to your recent changes in physical activity.
Treating the interrelated factors of the irritation with clinical drills, active recovery and a controlled return to sports would eliminate the symptoms. This formula allows jumping back into training a lot sooner than if you were to rest completely, without losing as much performance.