Month: April 2024

Tennis elbow Vs Golfer’s elbow

Tennis elbow and golfer’s elbow are overuse injuries that result from repetitive stress on the tendons and muscles around the elbow joint, leading to microtrauma, inflammation, and tissue degeneration. Despite their distinct anatomical locations, both conditions share common risk factors and clinical manifestations, including pain, tenderness, and functional impairment.

Tennis elbow, or lateral epicondylitis, involves inflammation and degeneration of the tendons attached to the lateral epicondyle of the humerus, primarily affecting the extensor muscles of the forearm responsible for wrist extension and radial deviation. In contrast, golfer’s elbow, or medial epicondylitis, affects the tendons attached to the medial epicondyle of the humerus, involving the flexor muscles of the forearm responsible for wrist flexion and ulnar deviation. While both conditions result from repetitive stress, they differ in their biomechanical mechanisms, anatomical involvement, and specific activities that exacerbate symptoms.

Individuals engaged in activities requiring repetitive wrist and forearm movements are at increased risk of developing tennis and golfer’s elbow. Specific demographic groups susceptible to these conditions include:

• Athletes: Tennis players, golfers, baseball players, and other athletes engaging in racquet sports or throwing activities are prone to developing tennis or golfer’s elbow due to the repetitive nature of their sport and high-intensity wrist and forearm movements.
• Manual Laborers: Workers involved in occupations such as construction, plumbing, carpentry, and painting are at risk of developing tennis or golfer’s elbow due to the repetitive use of hand tools and sustained wrist positions.
• Office Workers: Individuals performing repetitive typing, mouse clicking, and other computer-related tasks are susceptible to tennis or golfer’s elbow, as prolonged wrist extension or flexion can exacerbate symptoms.
• Age and Gender: Middle-aged individuals are more commonly affected by tennis and golfer’s elbow, although these conditions can occur in individuals of all ages. Golfer’s elbow tends to be more prevalent in men, while tennis elbow affects both men and women equally.

Manual therapy interventions play a crucial role in the conservative management of tennis and golfer’s elbow, aiming to reduce pain, improve tissue healing, and restore functional mobility. Common manual therapy techniques employed in the treatment of these conditions include:
• Soft Tissue Mobilisation: Manual manipulation of the muscles, tendons, and fascia surrounding the affected elbow aims to reduce adhesions, improve tissue extensibility, and alleviate pain and inflammation.
• Joint Mobilisation: Gentle mobilisation of the elbow joint and adjacent joints, including the wrist and shoulder, can help restore normal joint mechanics, reduce stiffness, and optimise biomechanical function.
• Stretching and Strengthening Exercises: Specific exercises targeting the muscles of the forearm, wrist, and shoulder aim to improve flexibility, strength, and neuromuscular control, thereby reducing strain on the affected tendons and promoting tissue healing.

Listed below are some details of a client dealing with tennis elbow who is seeking treatment here at HBM, which may also serve as a case study:

Age: 35+
Gender: M
Symptoms: pain in R elbow from tennis 3x/week
Medical history: MRI showing disc herniation in C6-7
Lifestyle: Plays tennis 3x/week 2 hrs each for the past 2 years. Doesn’t stretch much and isn’t very flexible.

The client has received fortnightly treatments here at HBM over 8 months to manage his symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating him on the importance of compliance to treatment due to his active schedule has made a big difference on his quality of life, and after educating him on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, he’s been able to get back to his daily activities with much improvements on symptoms.

If you or someone you know are dealing with tennis or golfer’s elbow, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

Femoroacetabular Impingement (FAI) Syndrome

Femoroacetabular Impingement (FAI) Syndrome

Femoroacetabular impingement (FAI) is a mechanical hip disorder resulting from abnormal morphological interactions between the femoral head and the acetabulum. This condition is often associated with hip pain, restricted movement, and the potential for early-onset osteoarthritis. FAI is classified into three types: cam, pincer, and mixed impingement, each defined by specific anatomical abnormalities.

FAI arises due to anatomical variations that cause abnormal contact and friction within the hip joint:

1. Cam Impingement: Characterised by an aspherical femoral head that creates abnormal contact with the acetabulum during hip movements. This results in cartilage and labral damage.
2. Pincer Impingement: Occurs when there is excessive coverage of the acetabulum over the femoral head, leading to labral compression and damage.
3. Mixed Impingement: Combines features of both cam and pincer impingement, resulting in more complex pathomechanics and greater joint damage.

FAI commonly affects young and middle-aged adults, particularly those who are physically active. Specific demographics and risk factors include:

1. Athletes: Individuals involved in sports requiring repetitive hip flexion, such as soccer, hockey, and dance, are at increased risk due to repetitive stress on the hip joint.
2. Age and Gender: FAI typically presents in individuals aged 20-40 years. Males are more likely to develop cam impingement, while females are more prone to pincer impingement.
3. Genetic Predisposition: Family history of hip disorders may increase the likelihood of developing FAI.
4. Developmental Conditions: Conditions such as Legg-Calvé-Perthes disease or slipped capital femoral epiphysis during adolescence can predispose individuals to FAI.

Manual therapy is a critical component of FAI management, focusing on alleviating pain, improving hip mobility, and addressing muscular imbalances. Key manual therapy interventions include:

1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for FAI include:

• Reduction of Muscle Tightness: Targeting trigger points in the hip flexors, adductors, and gluteal muscles can alleviate muscle tightness, enhancing hip mobility.
• Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce hip pain.
• Improved Muscle Function: Enhancing muscle function around the hip joint can aid in stabilising the joint and reducing abnormal stress.

2. Myofascial Cupping

Myofascial cupping involves the use of suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

• Enhance Blood Circulation: Improved blood flow aids in nutrient delivery and waste removal, promoting tissue healing and reducing inflammation.
• Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility and reduce hip pain.
• Reduce Muscle Spasms: Cupping can relax muscle spasms, improving muscle tone and hip joint function.

3. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the hip:

• Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
• Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the hip flexors, adductors, and iliotibial band.

4. Joint Mobilisation

Joint mobilisation involves applying controlled forces to the hip joint to improve range of motion and alleviate pain:

• Hip Joint Mobilisation: Techniques to mobilise the hip joint can enhance joint mobility, reduce stiffness, and correct abnormal joint mechanics.
• Manual Traction: Applying gentle traction to the hip joint can reduce joint compression, alleviate pain, and improve joint space.

5. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the hip:

• Hip Flexor Stretching: Stretching the hip flexors can relieve tension and improve hip extension.
• Adductor Stretching: Addressing tightness in the adductors can restore balance and reduce stress on the hip joint.
• Gluteal Stretching: Stretching the gluteal muscles can enhance hip mobility and stability.

Listed below are some details of a client dealing with FAIS who is seeking treatment here at HBM, which may also serve as a case study:

Age: 70+

Gender: F

Symptoms: Right Hip pain

Medical history: Arthritis

Lifestyle: Yoga at least once a week, walks and stands quite a lot while working.

The client has received 6 treatments here at HBM over the period of 6 months to manage her symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating her on the importance of compliance to treatment due to her active schedule has made a big difference on her quality of life, and after educating her on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, she’s been able to get back to her daily activities with much improvements on symptoms.

If you or someone you know are dealing with FAIS, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

Repetitive strain injury (RSI)

Repetitive strain injury (RSI)

Repetitive strain injury (RSI) refers to a spectrum of conditions caused by repetitive movements and overuse of particular body parts, often leading to pain, discomfort, and functional impairment. RSIs are common in occupations and activities involving repetitive motions, prolonged exertion, or maintaining awkward positions.

RSI manifests in several forms, each affecting different anatomical structures:

1. Carpal Tunnel Syndrome (CTS): Compression of the median nerve within the carpal tunnel of the wrist, leading to numbness tingling, and weakness in the hand.
2. Tendinitis: Inflammation of tendons, commonly affecting the shoulders, elbows, and wrists. Examples include tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis)
3. Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion bones and tendons, typically occurring in the shoulder, elbow and hip.
4. De Quervain’s Tenosynovitis: Inflammation of the sheath surrounding the thumb tendons, causing pain and swelling at the base of the thumb.
5. Thoracic Outlet Syndrome (TOS): Compression of nerves or blood vessels between the collarbone and first rib, causing pain in the neck, shoulders, and arms.

The primary causes of RSI include:

• Repetitive Movements: Continuous, repetitive actions such as typing, using a mouse, or assembly line work.
• Forceful Exertions: Activities requiring significant physical effort, including lifting heavy objects or using tools.
• Sustained Postures: Maintaining fixed positions for extended periods, such as sitting at a desk or standing without adequate breaks.
• Poor Ergonomics: Inadequate workstation setup, improper body mechanics, and poor posture.

Demographic Analysis:

RSI predominantly affects adults aged 25-50, particularly those in occupations involving repetitive tasks or prolonged static positions. Office workers, assembly line workers, musicians, and athletes are among the most vulnerable groups. The prevalence is higher in women, potentially due to differences in occupational roles and physical structure.

Manual Therapy encompasses a range of hands-on techniques performed by physical therapists or myotherapists to alleviate RSI symptoms. Key techniques include:

• Massage therapy: Targets soft tissues to reduce muscle tension, improve circulation, and promote relaxation.
• Joint mobilisations: Gentle, controlled movements of joints to restore range of motion and alleviate pain.
• Soft tissue mobilisations: Techniques such as myofascial release to break down scar tissue and adhesions in muscles and connective tissues.
• Trigger point therapy: Applying pressure to specific points to relieve muscle knots and referred pain.
• Stretching and Strengthening exercises: Personalised exercises to improve flexibility, strength, and posture, reducing risk of future injury.

Listed below are some details of a client dealing with a shoulder RSI who is seeking treatment here at HBM, which may also serve as a case study:

Age: 35+

Gender: M

Symptoms: Shoulder pain after cricket match

Medical history: MRI showing slight oedema in subacromial bursa

Lifestyle: Sitting for work mainly, but workstation is not set up ergonomically; recently started playing cricket again.

The client has received 4 treatments here at HBM over 3 months to manage his symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating him on the importance of compliance to treatment due to his active schedule has made a big difference on his quality of life, and after educating him on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, he’s been able to get back to his daily activities with much improvements on symptoms.

If you or someone you know are dealing with RSI, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

Temporomandibular Joint (TMJ) Syndrome

Temporomandibular Joint (TMJ) Syndrome

Temporomandibular Joint Syndrome (TMJ Syndrome), also known as temporomandibular disorder (TMD), is a condition affecting the temporomandibular joint (TMJ), which connects the jawbone to the skull. TMJ Syndrome is associated with pain, restricted jaw movement, and clicking or popping sounds in the jaw. The multifactorial nature of TMJ Syndrome makes its diagnosis and treatment challenging.

The development of TMJ Syndrome is attributed to various factors, including:

1. Muscle Dysfunction: Overactivity or imbalance in the masticatory muscles can lead to pain and dysfunction in the TMJ.
2. Joint Degeneration: Osteoarthritis or other degenerative joint diseases can affect the TMJ, leading to pain and limited movement.
3. Trauma: Direct injury to the jaw or TMJ can result in acute or chronic TMJ Syndrome.
4. Bruxism: Teeth grinding or clenching, often related to stress or anxiety, can cause excessive strain on the TMJ and surrounding muscles.
5. Malocclusion: Misalignment of the teeth or bite can lead to abnormal stress on the TMJ, contributing to dysfunction.
6. Psychosocial Factors: Stress, anxiety, and other psychological factors can exacerbate TMJ symptoms through increased muscle tension and altered pain perception.

TMJ Syndrome can affect individuals of all ages but is most commonly seen in adults aged 20-40 years. Specific demographics and risk factors include:

1. Gender: Females are more likely to develop TMJ Syndrome than males, possibly due to hormonal influences and greater sensitivity to pain.
2. Age: Young and middle-aged adults are more commonly affected, potentially due to higher stress levels and more frequent bruxism.
3. Stress and Anxiety: Individuals experiencing high levels of stress or anxiety are at greater risk of developing TMJ Syndrome due to increased muscle tension and bruxism.
4. Occupation and Lifestyle: Occupations and lifestyles involving high stress or repetitive jaw movements can predispose individuals to TMJ Syndrome.

Manual therapy is a critical component of TMJ Syndrome management, focusing on alleviating pain, improving jaw mobility, and addressing muscular imbalances. Key manual therapy interventions include:

1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for TMJ Syndrome include:

• Reduction of Muscle Tightness: Targeting trigger points in the masticatory muscles, such as the masseter and temporalis, can alleviate muscle tightness and improve jaw function.
• Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce jaw pain.
• Improved Muscle Function: Enhancing muscle function around the TMJ can aid in stabilising the joint and reducing abnormal stress.

2. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the TMJ:

• Massage Therapy: Techniques like deep tissue massage or trigger point therapy can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
• Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the jaw and neck muscles.

3. Joint Mobilisation

Joint mobilisation involves applying controlled forces to the TMJ to improve range of motion and alleviate pain:

• TMJ Mobilisation: Techniques to mobilise the TMJ can enhance joint mobility, reduce stiffness, and correct abnormal joint mechanics.
• Manual Traction: Applying gentle traction to the TMJ can reduce joint compression, alleviate pain, and improve joint space.

4. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the TMJ:

• Jaw Stretching: Stretching the jaw muscles can relieve tension and improve range of motion.
• Neck and Shoulder Stretching: Addressing tightness in the neck and shoulder muscles can reduce referred pain and improve overall posture, benefiting TMJ function.

5. Proprioceptive Neuromuscular Facilitation (PNF)

PNF stretching combines stretching and contracting targeted muscle groups to enhance flexibility and strength:

• PNF Techniques: Effective for improving the flexibility and strength of the jaw and neck muscles, promoting better joint mechanics and reducing pain.

Listed below are some details of a client dealing with TMJ syndrome who is seeking treatment here at HBM, which may also serve as a case study:

Age: 50+

Gender: F

Symptoms: Left TMJ pain

Medical history: None pertinent

Lifestyle: Seated for work mostly. Does Kieser 3x/week as exercise and does a bit of jogging.

The client has been receiving fortnightly treatments here at HBM over a period of 3 months to manage her symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating her on the importance of compliance to treatment due to her active schedule has made a big difference on her quality of life, and after educating her on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, she’s been able to get back to her daily activities with much improvements on symptoms.

If you or someone you know are dealing with TMJ syndrome, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.  Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a common peripheral nerve disorder resulting from compression of the median nerve as it passes through the carpal tunnel, a narrow passageway in the wrist formed by the carpal bones and transverse carpal ligament. The compression of the median nerve leads to a constellation of symptoms, including pain, numbness, tingling, and weakness in the thumb, index, middle, and radial half of the ring finger. While CTS can have multifactorial etiology, manual therapy has emerged as a promising adjunctive treatment modality to alleviate symptoms and improve hand function.

The pathophysiology of CTS is complex and involves mechanical compression, ischemia, and inflammation of the median nerve within the carpal tunnel. Predisposing factors such as wrist anatomy, repetitive hand movements, trauma, hormonal changes, and systemic diseases contribute to the development of CTS. Compression of the median nerve leads to impaired nerve conduction, demyelination, and axonal degeneration, resulting in sensory and motor deficits in the affected hand.

CTS predominantly affects individuals engaged in repetitive hand and wrist movements, as well as those exposed to occupational or recreational activities that involve prolonged wrist flexion or extension. Thus, certain demographic groups are more susceptible to developing CTS, including:• Working Professionals: Occupations that involve repetitive or forceful hand movements, prolonged computer use, or vibrating tools predispose individuals to CTS. Office workers, assembly line workers, musicians, and those in the construction industry are at increased risk.
• Women: Studies have shown that women are more likely to develop CTS compared to men, possibly due to hormonal factors, smaller carpal tunnel dimensions, and increased susceptibility to soft tissue swelling during pregnancy.
• Aging Population: Older adults are at higher risk of developing CTS due to age-related changes in soft tissues, decreased nerve elasticity, and underlying degenerative conditions such as arthritis and ligamentous laxity.
• Individuals with Comorbidities: Systemic conditions such as diabetes, obesity, thyroid disorders, and rheumatoid arthritis are associated with an increased risk of developing CTS due to their effects on nerve health, tissue inflammation, and fluid retention.

Manual therapy encompasses a variety of hands-on techniques aimed at addressing musculoskeletal dysfunctions, improving joint mobility, and reducing soft tissue restrictions. In the context of CTS, manual therapy interventions target the underlying anatomical and biomechanical factors contributing to median nerve compression. Common manual techniques employed in the treatment of CTS include:
• Soft Tissue Mobilisation: Manual manipulation of the muscles, tendons, and fascia surrounding the carpal tunnel aims to reduce adhesions, improve tissue extensibility, and alleviate pressure on the median nerve.
• Nerve Gliding Exercises: Specific exercises designed to mobilise and stretch the median nerve can help reduce neural tension, improve nerve conduction, and alleviate symptoms of CTS.
• Joint Mobilisation: Gentle mobilisation of the wrist, hand, and adjacent joints aims to improve joint mobility, reduce stiffness, and optimise the biomechanics of the upper extremity.
• Therapeutic Exercises: Strengthening and stretching exercises targeting the muscles of the forearm, hand, and wrist can help improve grip strength, enhance proprioception, and promote functional recovery in individuals with CTS.

If you or someone you know are dealing with CTS, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.