SCIATICA

Sciatica is the Latin word for "Pain down the back of the leg" Sciatica is referred pain usually caused by trapping the sciatic nerve in the lower back. See back pain.

TREATMENT Treatment for sciatica follows the lines of treatment for a slipped disc.

SLIPPED DISC

95% of back pain is a result of a slipped disc. The spine consists of 24 bones called vertebrae which sit on top of one another to form a column. Each vertebra has a cylindrical body in front with a wishbone-like structure sticking out behind forming the knobbly bits that can be felt down the backbone. Cradled within the arms of the wishbone is the spinal cord which carries nerve messages up and down from the brain to all parts of the body. In between every vertebra in the spine is a cushion of jelly (the disc) which acts as a shock absorber and cushions each and every step. When the disc bulges backwards it traps the nerve where it leaves the spinal canal and causes pressure and pain. Once the disc is on the move what we do with the spine changes what happens to the disc. Sitting on an easy chair like a banana allows it to bulge backwards further and cause more pain. See Referred pain, Back pain, Sciatica.

TREATMENT Treatment with Connective Tissue Manipulation and the Mackenzie Exercise Regime reduces the tension around the spine and changes the mechanics of the disc helping it to return to the normal position and resolve the problem.

SHOULDER PAIN

It is possible to do more movements with the arm than with any other part of the body. The arm is such a useful tool that its a pity that there are only two of them! The bones that make up the arm include the humerus, in the upper arm, and the two bones of the forearm, the radius and ulna, as well as the little bones of the wrist, hand and fingers. The arm is very special as it enables the hand to get into all sorts of useful positions. The shoulder joint in particular, being a universal joint, has a huge range of movement. The hand can go above the head, behind the back and even across to scratch behind the other shoulder. The elbow works like a hinge joint allowing the hand to come nearer or go further away from the body. The elbow and wrist combined allow manipulation of the hand through more than 180 degrees i.e. from palm up to palm down, the wrist helps with grip, whilst the joints in the hand, thumb and fingers allow the dexterity of finger movement.

See Frozen shoulder, Neck pain, Slipped disc, Referred pain.

SINUSITIS

The air passages of the nose, sinuses and lungs are all lined with a mucous membrane. This has a rich blood supply which enables it to warm and moisten the breathed in air. A thin film of mucous covers the whole of the airways and is kept constantly moving upwards away from the lungs by the sweeping action of the minute hair-like structures in the membrane. This forms a most effective filter for removing particles of dust from the air before it reaches the lungs. The irregularity of the nasal cavity and the air sinuses which open into it increase the area of mucous membrane the air comes into contact with making the warming and filtering more efficient. Swelling of the mucous membrane readily obstructs drainage of secretions from the sinuses and may cause sinusitis. The sinuses are like little caves with an opening halfway up the wall to let the secretions out. The mucous membrane lines the cave but if it becomes inflamed it restricts the opening and at the same time produces more mucous. This causes a build up of pressure which leads to pain. Acute sinusitis is usually caused by a virus and the patient may have a fever, a headache, and pain in the face with localised tenderness over the forehead or cheekbones. After a few days bacteria start to colonise the damp warm mucous in the sinuses and a secondary bacterial infection occurs producing a thick discoloured nasal discharge - catarrh. If the body is unable to combat the infection and reduce the swelling in the mucous membrane the condition drags on and the patient may have problems with catarrh for several days, weeks or even months.

TREATMENT Treatment with inhalations may help to improve the drainage of the sinuses. Treatment with Manual Lymph Drainage and Connective Tissue Manipulation helps by improving the circulation and reducing the inflammation and congestion in the mucous membranes thus allowing the mucous to drain out of the sinuses and combat the infection.

SLEEP DISORDERS

Sleep can be disturbed for all sorts of reasons including - mental problems - worrying about past or future happenings - illness in the family - problems at work - physical problems - pain in various parts of the body - a lumpy or uncomfortable place to sleep - the wrong temperature, too hot or too cold - needing to go to the toilet in the night - poor sleep patterns due to Increased tension in connective tissue - trauma - shift work - disturbed physical environment noise - partner on shifts etc Patients may have difficulty getting off to sleep or may wake up in the middle of the night. They may wake up and stay awake for a long time or wake frequently for short periods of time.

TREATMENT If there is a physical problem or pain this must obviously be addressed first. If there is a stress problem talking it over may well be useful. By using Manual Lymph Drainage and Connective Tissue Manipulation to treat the problem tension in the connective tissue can be released and the normal function of sleep control can be restored.

SHIN SPLINTS

Shin splints occur if there is too great a tension in the connective tissue around the muscles on the front of the shin. If these muscles are exercised, as in prolonged running or climbing stairs, especially in poor or heavy footwear, the muscle bulk increases and stretches the already tight connective tissue. This causes pain which may be constant or only during and immediately after exercise depending on the severity of the condition.Shin splints occur if there is too great a tension in the connective tissue around the muscles on the front of the shin. If these muscles are exercised, as in prolonged running or climbing stairs, especially in poor or heavy footwear, the muscle bulk increases and stretches the already tight connective tissue. This causes pain which may be constant or only during and immediately after exercise depending on the severity of the condition.

TREATMENT Treatment with Connective Tissue Manipulation reduces the tension in the connective tissue and allows it to be more elastic and forgiving.

SPORTS INJURY

Sportsmen and women get injured when they do repetitive sports in an incorrect way as well as in contact sports where they are less able to control the impact their body receives, such as when being tackled from behind. They are particularly vulnerable when they have not done an effective warm up session before starting up play their sport.

TREATMENT Injuries are not helped by "working through them" or by exercising and 'keeping it moving'. Sports injuries benefit from speedy treatment as soon as possible after the injury has occurred. It is advisable to seek the help of a Chartered Physiotherapist to restore normal function as rapidly as possible. A good rule of thumb even for sportsmen and women is 'if it hurts don't do it.' Don't try to move the joint into pain. Continuing to aggravate the area whilst it is swollen and inflamed will only serve to increase the swelling, increase the pain and reduce the range of movement still further. See Pain - see Connective Tissue Manipulation

SPRAINED ANKLE

A sprained ankle occurs when a person goes over on the ankle-joint further than the tissues can allow. The force required to sprain an ankle varies with each individual. If two people went over on their ankles one of them may just rub it better and carry on forgetting about it very quickly. The other person may be hobbling around on a stick for a few days with a bad sprain and a lot of swelling. The first person had loose connective tissue which was elastic and forgiving of a minor pull. The second person's connective tissue was much tighter and less forgiving so that it tore easily even with a slight trauma. The tighter the connective tissue becomes the less stretchy and forgiving it is. A person with tight tissue is much more likely to succumb to injury. When soft tissue is damaged connective tissue fibres are torn. Fluid leaks from the torn fibres and causes localised swelling. This works like glue when squeezed from a tube. The glue tries to repair the damage and in its enthusiasm sticks everything to everything else. The individual fibres, which are normally free to glide slightly one on the other, become stuck together and are irritated by any movement of the ankle. It is important that the ends of the torn fibres stick together but not that they stick along their whole length.

TREATMENT Sprains and strains are not helped by "working through them" or by exercising and 'keeping it moving'. Resting and keeping the leg up as much as possible will allow the body to do its own repair job much quicker than trying to carry on as though nothing had happened. Treatment with Connective Tissue Manipulation helps to decrease pain, reduce the swelling, increase range of movement and speed up the healing process.

STRESS

Stress is responsible for a large number of physical illnesses in the western world. When stress is created in the body the connective tissue tightens up and prevents the body from functioning correctly.This can cause all sorts of malfunctions. Headaches and neck pain are very common results of an increase in tension within the tissues.

TREATMENT By reducing the tension with Manual Lymph Drainage and Connective Tissue Manipulation and helping the patient to see what is causing the stress in the first place the symptoms and the cause of the problem can both be relieved.

STRETCH MARKS

Stretch marks can occur in both sexes at any age and are certainly not solely associated with pregnancy. They can occur with a sudden change in weight or even in children after a spurt of rapid growth. When the skin has to stretch for any reason the connective tissue has to be elastic enough to allow the movement of one layer of skin on the other. If the connective tissue tension is tight the tissue tears instead of stretching rather like an old elastic band.

TREATMENT Stretch marks are often hereditary but can be prevented by Connective Tissue Manipulation, which ensures that the connective tissue in the skin is elastic enough to enable it to stretch without tearing.

SUPRA-SPINATUS TENDINITIS

Supra-spinatus tendinitis is the Latin name for the commonest shoulder problem. The patient complains of pain in the muscle on the outside of the shoulder. There is great difficulty lifting the arm out to the side. Sometimes the patient can get through the pain and the arm is comfortable above the head. The pain returns as they try to return the arm to the side. The supra spinatus muscle sits in a groove just above the shoulder blade. Its tendon passes through a tunnel formed by the bones of the shoulder and attaches to the bone of the upper arm - the humerus - below the shoulder joint. This tendon glides through the tunnel every time the arm starts to move out to the side or up in front. If the tendon becomes inflamed it becomes fatter and its passage through the tunnel is more difficult and painful. Supra-spinatus tendinitis can be caused by overuse when doing activities where the arm is held out to the side for long periods of time. Falling or other trauma to the arm may cause damage to the tendon.

TREATMENT Supra-spinatus Tendinitis doesn't recover by itself. Treatment with Manual Lymph Drainage and Connective Tissue Manipulation help to relieve the inflammation and allow the tendon to return to its normal size and pass freely through the tunnel. See Tendon injury

TENDON INJURY

A tendon is just a connector, like a piece of string, between the part of the muscle that contracts and the bone to which it attaches. Tendons only need a small amount of nourishment and therefore they only have a minimal blood supply. This means that when a tendon is damaged it doesn't have a good blood supply to help it to heal quickly. When a tendon is damaged fluid seeps out of torn fibres and causes localised swelling. This works like glue squeezed from a tube; the glue tries to repair the damage and in its enthusiasm sticks everything to everything else. The individual fibres of the tendon which are normally free to glide slightly one on the other become stuck together and are then irritated by the pull of even the slightest contraction in the muscle. It is important to assess what activity or movement causes the pain so that the patient can do this activity and movement as little as possible so as not to aggravate the problem. See: RSI, Golfers elbow, Tennis elbow, Supra-spinatus tendinitis, Tenosynovitis.

TREATMENT Rest is always a sensible treatment in the acute stage. Tendon injuries are not conditions that you can exercise through. By using Manual Lymph Drainage and Connective Tissue Manipulation techniques the circulation can be improved. Tension in the connective tissue decreases and the adhesions between the fibres in the tendon are softened. This restores painless movement as the tendon fibres glide over each other. Once the pain has reduced, a programme of personal exercises designed for the patient to help the muscles regain their strength. It is important that the activity which caused the problem is not resumed until the whole area is looser, the area is completely pain free and the muscles have regained their strength otherwise the problem will just recur.

TENNIS ELBOW

One of the most frequent injuries to the arm is tennis elbow - not alas confined to tennis players. Other sports and every day activities can cause it such as gardening and lifting. The muscles on the back of the forearm, which straighten the fingers and pull the wrist backwards, merge into one tendon on the bony part of the outside of the elbow. This is the common extensor tendon which can be strained by activities which overwork or over stretch the forearm muscles, like hard gripping movements or excessive wrist movements. It can be caused by tennis usually when playing a backhand. The sudden force of the ball bending the wrist forward whilst gripping the tennis racket handle tightly damages the common extensor tendon. Once the tendon has become inflamed any use of the muscles of the forearm can cause pain at the elbow and often down the forearm. Gripping, lifting and straightening the elbow can all cause pain. The patient complains of a gradually increasing pain over the outer bony part of the elbow which is quite severe on certain movements. When tennis elbow is very acute the pain is constant and any movements that stress the tendon such as gripping, lifting and even fine movements like pinching, writing or using a knife and fork can aggravate the elbow. The tendon also feels tender and sore to touch. Patients with these early signs of tennis elbow need to seek professional medical attention as soon as possible. Even if the condition has been there a long time it can still be treated.

TREATMENT Resting the arm will help to prevent aggravation - tennis elbow is not condition that you can exercise through. Treatment with Connective Tissue Manipulation and Manual Lymph Drainage will help to reduce the pain and stiffness and restore normal movement and function. By improving the circulation to the tendon it is able to settle the inflammation down and heal more quickly. By reducing the tension in the tendon the fibres are able to glide on each other and allow movement without causing discomfort and pain. Tendon injury

TENOSYNOVITIS

Tenosynovitis usually occurs at the wrist or ankle. The gliding surfaces of the tendon within the tendon sheath become inflamed. The sheath becomes roughened and inflamed from overuse. Any activity which uses that particular muscle will cause pain because the tendon has to move through the sheath. The body's response to injury is to increase the tension in the connective tissue around the damaged part, like an Elastoplast, hindering movement even further.

TREATMENT Treatment by rest is only mildly effective because the original problem is not addressed and when the activity is resumed the problem recurs. Tablets may ease the pain but again not the problem. Treatment with Connective Tissue Manipulation reduces the tension in the connective tissue in the area, improves the circulation and settles the inflammation. This allows the tendon to slide more easily through the sheath without pain. See Tendon injury - see Connective Tissue Manipulation

TORN CALF MUSCLE

The calf muscle is often torn as a result of a sudden burst of activity, a sudden sprint or dash often without warming up first. Patients treated at the Physio Centre have torn their calf muscles playing tennis or badminton or even one lady when dashing across the lawn to get the washing in during a sudden down pour. The condition is known as tennis leg. See Muscles for information about how muscles work. After a calf injury the power in the calf muscle is greatly reduced and the patient will often limp when walking and loose the spring in their step. At first the patient needs to take small steps and not put any strain on the torn muscle fibres. Only when a return to full muscle strength has been achieved, under medical supervision, is it sensible for the patient to indulge in any form of sport, training or additional exercise by way of keep fit classes, working out in a gym, aerobics etc.

TREATMENT Rest and the use of techniques to improve the circulation, reduce swelling and the forming of adhesions between the muscle fibres are very important. Treatment with Connective Tissue Manipulation and gentle exercises, once the limb is comfortable, speeds up the repair process and helps the patient to return to normal activities as soon as possible.

TORN CARTILAGE

The knee joint has two crescent-like discs within the joint, which help it to move more efficiently. These are the cartilages or meniscii. The cartilage can be torn during a sport or during sudden trauma like a fall. The ligaments at the side of the knee, attached to the outer side of the cartilages, can be torn at the same time. The knee usually swells up and is very painful. The knee often locks and is difficult to straighten.

TREATMENT Treatment with Connective Tissue Manipulation can help to reduce the inflammation, reduce the pain and restore range of movement. Sometimes, if the tear is so great, the cartilage may have to be surgically removed.

TREATMENTS: ANIMAL

Animals respond very well to the techniques performed at Gillingham Physio Centre and we work alongside numerous vets both on animals with minor ailments and after major orthopaedic surgery. For further information please contact Jacqueline Flexney-Briscoe.

WHIPLASH

When a car stops suddenly the driver and passengers continue to move forward. The body is restrained by the seat belt but the head continues to move forward. The head then goes backwards and may be restrained by the headrest. If this doesn't happen the head continues to move back wards. All these movements puts strain on the neck joints and the associated muscles. If the connective tissue is very tight it cannot accommodate these violent movements and the whole area becomes inflamed with the neck becoming very stiff and painful.

TREATMENT Rest is important as is the avoidance of movement which causes pain. Treatment with Manual Lymph Drainage and Connective Tissue Manipulation helps to reduce the swelling, inflammation and pain as well as improving the range of movement. See Referred Pain.