Cervical Spine (Neck)

The cervical spine is extremely mobile and vulnerable to injury in road traffic accidents / sporting collisions. Whiplash injuries generally affect the muscles and ligaments of the neck and shoulder region. Musculoskeletal dysfunction in the neck can cause headaches, shoulder and arm pain and may be associated with pins & needles and numbness. This may be caused by disc protrusion. It is also susceptible to degenerative changes (cervical arthrosis/arthritis and spondylosis). The cervical spine is particularly affected by poor sitting posture or weakness to core stabilising muscles.

Jaw Pain

Jaw pain can result from poor neck posture or specific neck injuries, including whiplash. Targeted exercises, manual therapy and provision of splints contribute to the management of this condition.

Headaches

The upper neck region can often refer pain into the head and may be caused by poor posture, injury or tension in the neck muscles. Specific testing of neck structures can confirm a diagnosis of cervical headaches.

Shoulder Joint

The shoulder joint is formed by a large ball (humeral head) articulating in a small socket (glenoid fossa). It is extremely mobile and inherently unstable, leaving it susceptible to injury during falls and sporting injuries.

The extreme mobility in the joint makes it susceptible to instability and in extreme cases dislocation. These conditions are commonly associated with a weakness in the controlling muscles of the shoulder joint (rotator cuff) and the shoulder blade (scapulo-thoracic muscles).

Common conditions include tendonitis, bursitis, rotator cuff tears and adhesive capsulitis (frozen shoulder), with pain often felt down the outside of the arm.

Elbow

Overuse injuries including tennis elbow and golfers elbow are the most common problems affecting this joint. These injuries are characterized by pain around the elbow and forearm when gripping tightly or lifting a small weight.
Trauma to the elbow joint can lead to fractures or dislocations.

Wrist & Hand

Tendonitis at the wrist is a common manifestation of repetitive motion injuries, which can be caused by excessive keyboard use, poor posture or poor office set up (ergonomics). Trauma often leads to wrist fractures, the most common being a Colles fracture.

Tendonitis at the wrist is a common manifestation of repetitive motion injuries, which can be caused by excessive keyboard use, poor posture or poor office set up (ergonomics). Trauma often leads to wrist fractures, the most common being a Colles fracture.

Thoracic Spine

Pain & stiffness in this region can often be related to poor posture and can refer pain into other regions of the spine. Pain is often felt along a narrow band extending from the back out accross the ribs. Certain conditions such as ankylosing spondylitis and Sceuermann’s disease can also cause pain and stiffness in the thoracic spine.

Lumbar Spine

This area is a very common site of pain, secondary to postural and lifestyle habits.
Low back pain may be centred in the lumbar region (lumbago) or may refer into the buttock or down the leg (sciatica). More severe symptoms are associated with pin & needles or numbness in the leg or foot and weakness in the leg muscles.

Common sources of pain are the intervertebral disc (IVD), facet joint or damage to the nerve as it exits the spine (nerve root). Trauma or repetitive injury can cause slippage of one vertebra on another (spondylolisthesis).

Postural back pain is commonly associated with weakness to core back stablising muscles, such as the transverse abdominals and the gluteus maximus. Pain following injury has been shown to further inhibit these muscles, thereby leaving the back weakened and susceptible to further problems.

Pelvis

The pelvis is the platform from which the upper and lower body operates. It is most commonly injured during childbirth, road traffic accidents and sporting injuries. Pain can be felt in the low back region, buttock or groin. Pubic symphisis dysfunction (PSD) is common during pregnancy and is characterized by pain at the front of the pubic bone. CityPhysio specialises in the treatment of pelvic dysfunctions. Some of our physiotherapists specialise in the treatment of incontinence (please ask for our womens health specialist).

Hips

The hip joint is formed by a small ball (femoral head) sitting in a large, deep socket (Acetabulum) and is therefore a very stable joint. Pain from hip conditions is usually felt at the back of the buttock but will often refer into the front of the groin or the inner thigh region.

Common conditions associated with the hip include impingement (catching of the femoral head against the edge of the Acetabulum), capsulitis (tightness of the capsule surrounding the joint) or osteoarthrosis. Hip conditions are often associated with weakness of the gluteal muscles and are more prevalent in sports involving weight bearing rotation, such as golf or tennis. Any tightness or weakness will be identified and dealt with by CityPhysio’s staged managment approach.

Hamstring Strains

The hamstring muscles play an important role in all lower limb and back movements. Common postural muscle imbalances can result in reduced hamstring flexibility, increasing the risk of tears and strains.

Sports involving a rapid change in direction such as Gaelic football and hurling, soccer, tennis and gymnastics increase susceptibility to this injury. Effective management of hamstring injuries must inclue an exercise programme to correct the postural muscle imbalance

Knee

Problems around the knee joint are commonly divided into the ‘Knee joint’ itself and the joint between the knee cap (patella) and the thigh bone (femur), known as the patello-femoral joint.

The knee joint is typically injured whilst playing contact sports such as Gaelic football and hurling, soccer and rugby but is also susceptible to long term degenerative changes (Osteoarthritis/osteoarthrosis).

Common sporting injuries would be medial collateral ligament (MCL) sprain and lateral collateral ligament (LCL) sprain causing pain on the inside or outside of the knee. A medial meniscal tear (tear to the fibrous disc inside the knee) can be associated with an MCL sprain and may lead to locking or giving way in the knee. Tears to the lateral meniscus are associated with a rotation injury whilst the knee is straigh. More serious knee injuries would be tears to the cruciate ligaments and are usually characterized by an immediate swelling in the joint.

Patello-femoral pain (felt at the front of the knee cap) or anterior knee pain (AKP) is generally felt during running, but can also be present when ascending or descending stairs or driving for long periods.

It is generally caused by an abnormal alignment of the patella within the groove of the femur and can be related to any number of factors including poor pelvic muscle control, tight muscles around the knee or poor foot biomechanics (often overpronation).
A thorough assessment by one of CityPhysio’s specialist physiotherapists would identify the most significant components and employ a specific exercise programme to address the muscle imbalance or prescribe orthotics to correct the foot biomechanics.

Foot & Ankle

One of the most common sporting injuries is a lateral ligament sprain, to the outside of the ankle. If the ankle is not correctly treated and rehabilitated, then long term problems such as instability can result.

A widespread problem with the foot would be overpronation (fallen arches), frequently associated with runners. Overpronation can contribute to overuse conditions such as platar fascitis, cuboid syndrome, metatarsalgia or Achilles tendonitis or tendonopathy, It can be treated with the prescription of othotics (custom made insoles). All CityPhysio staff have advanced training in othotic prescription.