What is Patellar Tendinopathy?

What’s patellar tendinopathy?

Patella tendinopathy or jumper’s knee, is an overuse injury affecting the tendon below the kneecap. This is usually characterised by a localised pain from the inferior surface of the kneecap to where the tendon attaches to the shin. It is one of many possible causes of anterior knee pain. Commonly this occurs in people who participate in sports such as basketball, volleyball, tennis, football or athletics (jumping events); particularly with men in the 15-30yr age bracket.

The patella tendon works to transfer the force from the quadriceps (front of thigh) muscle to the shin bone. Its role is to extend the knee or stop it from bending. Pain is caused from an increased demand or load on the quadriceps especially in activities which require repetitive loading particularly jumping and landing.

Clients often present with:

  • Pain in the anterior knee, below the knee cap
  • Load-related pain that is activity dependent i.e. pain is rarely experienced while resting

At Oxford Circus Physiotherapy, your physiotherapist can help to identify the diagnosis and examine and treat the factors that may contribute to such pain or injury with the patella tendon. Contributing factors may include:

  • Hip, knee or ankle movement restrictions
  • Muscle weakness or imbalances
  • Posture or poor biomechanics of the lower limb
  • Poor flexibility
  • Training schedules, surfaces or equipment

Depending on the stage of your injury rehabilitation may vary. Physiotherapy will help with advice in regards to rest, activity load, pain relief and an exercise programme specific to your needs. Below is an example of a strapping technique that can be used to help reduce pain.

The most common question of ‘when can I return to sport’ depends on the stage and severity of the injury. At first the damage may be minor. However, with excessive jumping or landing (straining the tendon further), the damage occurring may exceed the rate of repair. This is why it’s best to get advice from your physiotherapist for a thorough assessment and get started on a management plan as quickly as possible.

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Preventing neck pain and stiffness at work

There are many reasons for experiencing neck pain and stiffness, but poor sitting postures at work are one of the most prevalent. On average, office workers spend 10 hours sitting each day, and this begins to take its toll on your back and neck.

This happens because if you are not sitting in an optimal position, over the course of a few hours, days or weeks, pressures build up in the spine and surrounding muscles.

There is a natural S-shaped curve in the spine. This can easily become exaggerated if you are in a seated position for prolonged hours throughout the day. The upper back and shoulders tend to round, leaving the chin poking forwards in order for the head to look up at the computer screen.

This then can start to load too much through the joints at the bottom of your neck, and the muscles have to work over-time to support the weight of the head as it sits out in front. In addition, this poking chin posture can load a lot more through the structures in the back and top of the neck, in some cases causing headaches or a referral of pain into the back, shoulders and arms.

There are a number small adjustments which can be made to the way you sit at work to minimise the build-up of such tightness and pain:

  1. Perching on the front of your chair can increase poor postures. Try to sit with your bottom right to the back of the chair, sitting upright and use the back rest for support. Keep your shoulders back and avoid slumping forwards.
  2. Make sure your computer is at a good height. You want the middle of your screen to be at about eye level. Raise it up onto some books or a stand if necessary, so you are not looking up or down to see the screen.
  3. Make sure your chair isn’t too low. This can cause you to shrug up through your shoulders, leading to more overactivity of the muscles around the neck and increased tightness.
  4. Try not to hold a phone between your ear and shoulder – again, this can lead to increased tightness of the neck and shoulder muscles. If you need to use the phone and computer simultaneously, try getting a headset.
  5. If you have multiple screens or refer to documents, make sure they are in as best position as possible to minimise repetition of head movements. Consider getting a stand for your documents.
  6. Aim to get up and have a walk around the office every couple of hours if you don’t already. Stretch and twist through your back and neck to keep mobile.

Try this stretch to help mid back flexibility:

If you need further advice about work station set up, then please get in touch.

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Hamstring Strains and Returning to Running

Hamstring strains and returning to running

A hamstring muscle strain refers to a tear in the muscle group which covers the back of the thigh. Most commonly occurs during running and sprinting activities, particularly during sport. This is because the muscle is contracted with excessive force in a stretched position.

Clients describe the sensation as a sudden sharp pain in the back of the thigh and sometimes a “Popping” sensation can be felt. Bruising may also appear around the area or lower down the leg following the injury.

Initially, it’s important to follow the PRICE protocol (as seen in our previous blog here ), avoid any excessive stretching of the hamstring and avoid changing the way you walk.

During a physiotherapy assessment, we can identify any factors that increased the risk of the hamstring strain to occur.

Examples of factors that increase the risk of a hamstring injury include:

  • Limited hamstring flexibility
  • Poor core stability
  • Muscle imbalance

Physiotherapy treatment will be focused on improving hamstring strength and correcting any muscle imbalances that may have contributed to the injury. Manual therapy is also used to increase hamstring flexibility.

Approximately one-third of hamstring strains will recur, with the highest risk for injury recurrence being within the first 2 weeks of return to sport. The consequences of recurrence are high as recurrent hamstring strains have been shown to result in significantly more time lost than first time hamstring strains. For these reasons, it’s important to ensure a graduated strengthening and stretching protocol has been followed. At Oxford Circus Physio, we can assess to see when you’re ready to return to sport and create a return to sport plan.

To prevent hamstring strains it’s important to regularly stretch and strengthen the hamstrings. Below are some examples of exercises that may be used to stretch and strengthen the hamstrings:

Why Physiotherapy is important following an ankle sprain

Ankle Ligs-Compressed

Ankle sprains are a very common injury and majority are caused by rolling the ankle in.

Immediately after the injury you should follow the P.R.I.C.E protocol as explained in our previous blog:  This will help minimise swelling and pain. It is also important to try move the ankle as soon as pain allows to help maintain range of movement.

It is important to see a physiotherapist or a sports medicine professional following the injury to check the severity of the sprain and rule out a fracture.

The recovery period following an ankle sprain can depend on the severity of the injury, most ankle sprains take between 4-6 weeks to recover. Unfortunately, there is a reoccurrence rate of 70% in first time lateral ankle sprains. For this reason, it is very important to have a good rehabilitation program following the injury to prevent another injury.

To prevent instability of the ankle, it is important to strengthen the muscles around the joint. A Physiotherapist can provide a home exercise program to regain full range of movement, improve strength and develop balance to prevent recurrence.

Following an injury to the ankle, your balance will be affected as your sense of where your ankle is in space will be impaired. This can cause your ankle to feel unstable and may even give out. Proprioception / balance exercises will help teach your body to control the injured joint, therefore reducing risk of reinjuring the ankle.

A healing ligament also needs a certain amount of stress to heal properly, so it’s important that the exercise program is progressive and gradual to promote stress to the ligament. Your Physiotherapist can help with this process too by using manual therapy to reduce stiffness in the joint and help promote healing.

Please contact the team at Oxford Circus Physiotherapy on (0)207 636 5774 or reception@oxfordcircusphysio.co.uk should you wish to discuss your injury with one of our team further.

What causes my heel to hurt in the mornings?

If you notice your heel is sore when taking the first few steps in the morning as you first get out of bed, you might have “Plantar-fasciopathy”. The Plantar Fascia is the band of tissue that runs from your heel to your toes. It supports the arch of your foot and provides shock absorption.

Plantar Fasciopathy (Often referred to as Plantar Fasciitis)  can be caused by overloading the plantar fascia, causing collagen disruption and sometimes micro-tears to the tissue.

The pain is commonly felt in the heel and can refer along the inside arch of the foot.

Pain is usually worse first thing in the morning or the first few steps after inactivity, but gets worse after prolonged walking or standing.

Plantar Fasciopathy is commonly caused by excessive walking in non-supportive footwear.

The following factors increase your risk of developing this injury:

  • Flat foot or high arch
  • Excessive pronation of foot (rolling in of the foot during walking)
  • Tight calf muscles
  • Poor biomechanics, which may be due to muscle weakness around hips

What you can do to help?

  • Avoid aggravating activities
  • Avoid walking barefoot and wear well cushioned / supportive shoes, a silicon gel heel pad may help.
  • Regularly stretch the plantar fascia, and calf muscles –  as shown below.