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Physios are able to help with a wide range of ailments and physical problems. There are four main areas that they work on: musculoskeletal, neuromuscular, cardiovascular, respiratory. Musculoskeletal refers to the bones, joints and soft tissue in the body. Neuromuscular is the brain and the nervous system, cardiovascular is the heart and blood circulation, and respiratory refers to any part of the body which are used to help you to breathe, such as the windpipe and lungs. Some physio clinics in Joo Chiat are able to help in these areas:
• Mental health
• Intensive care
• Long-term conditions
• Orthopaedics and trauma
• Workplace health
• Elderly care
• Education and health care promotion
• Womens problems
Once the physiotherapist has seen the effects of repeated movements on your pain picture and tested the neurological status of your affected body part they will have a more detailed idea of which structures need more detailed examination to clarify the exact nature of the problem. It is time for the individual muscles, joints and ligaments to be stressed to assess their reaction and add to the understanding of what is going on. The physio may just feel and grip the area firmly first to get an idea of the state of the tissues. Are they very sensitive? Is there muscle spasm, thickened tissues, or pain?
During your physiotherapy session the therapist will often put you on your side and move your spine backwards and forwards as they feel the movement occurring between the individual spinal levels. After this you may be placed on your front as the physiotherapist palpates (prods and pokes) your spinal levels with varying degrees of force but often quite firmly to see if any particular level reacts by bringing on the pain you normally complain of. All the tests for pain in your neck, back, elbow, knee or ankles will help diagnose the issue.
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Golfer's elbow, more technically called medial epicondylitis, is a similar type of condition to tennis elbow or lateral epicondylitis, but is less common. Since there is little or no inflammation present in these syndromes, they are known as tendinopathies, where degeneration of the tendon occurs and gives symptoms. Typical aggravating factors are racquet sports, golf and sports which involve throwing, although other sports people may be affected such as weight lifters, archers and cricket bowlers.
The muscles which flex and rotate the forearm originate over the medial epicondyle, the bony prominence on the inside of the elbow, with the tendon anchored into the bone by the tendinous insertion. The pain occurs close to this and may be due to a degenerative process occurring in the tendon, as little inflammation has been noted in these cases.
High stresses occur in the cocking phase of a throw and during the subsequent acceleration, and in the golf swing from high backswing down to near the ball strike. Golfers are more likely to have their dominant hand affected and tennis players who use heavy topspin in their forehands are also more at risk.
Golfer's elbow is not as common as tennis elbow but is the commonest cause of medial elbow pain with about half as many women affected as men. The third to fifth decades of life are the commonest periods for pain onset and 60% of golfer's elbow occurs in the dominant hand. An acute onset of pain is reported in a third of patients, with the other two-thirds developing over a period of time.
Patients complain of aching pain over the front of the inner epicondyle, worse with repeated wrist flexion and better with rest. Pain can occur in the shoulder, elbow, forearm or hand, with weakness in the lower arm and hand also. The physiotherapist will examine the bony areas and joints of the elbow, check the muscles and their tendinous insertions. The physio palpates the ulnar nerve in the groove behind the elbow, called the "funny bone" when it's hit. The nerve can give pins and needles or weakness in the forearm and a neurological examination excludes other causes of pain or weakness.
The main treatment of golfer's elbow is conservative, including anti-inflammatories, wrist and forearm splinting, corticosteroid injection and physiotherapy. Modifying the provoking activity is a first line of management, making patient education about the condition and the eliciting factors vital. An example is modifying the golf swing mechanics to avoid setting the problem off continually. The patient is taught to avoid aggravating positions and activities, such as leaning on the elbow if there is nerve involvement.
Non-steroidal anti-inflammatory drugs are used in the initial acute phase to reduce pain and inflammation along with avoiding painful movements, use of ice, gentle stretches, friction massage and ultrasound. As the problem settles and becomes sub acute the aims change to improving flexibility by stretching, increasing strength and normal activities. A forearm brace may also be used or a wrist brace to rest the wrist muscles. Once the problem is chronic the programme continues with reduced use of the splint and re-introduction of sporting activities.
Scientific work shows that steroid injections can be useful in the early stages of golfer's elbow to reduce pain and the time to recovery, but they are also used in chronic situations. There is no evidence that shockwave or laser therapy has any effectiveness and surgery is contemplated when a significant period of physiotherapy has been attempted without success. The surgeon removes the abnormal tendinous tissue and if the ulnar nerve is involved may move it around to the front of the elbow from its posterior groove.
Correction of sporting technique, such as the golf swing, is best achieved by engaging a professional instructor who can also advise on stretches, fitness work and muscle strengthening. Athletes should warm up well before sport and stretch effectively afterwards, choosing good technique and selection of appropriate equipment. Doctors and therapists may need to monitor patients, especially athletes, very carefully as they tend to continue to perform through the pain.
Being an exhilarating and awe-inspiring field doesn't make sports an invincible world. One common downside of playing sports is the high susceptibility of the players to injuries. Being limited by injuries is not something any sports enthusiast would wish for.
This scenario can be prevented in its entirety if you are careful about the training rules and adhere to appropriate precautionary measures. Granted injuries are an inevitable part of sports but inserting some efficient avoidance tactics while you play can diminish your injury prone state considerably.
Sports injuries are generally caused due to overuse or trauma. Of the two causes, overuse is the most common injury reported in athletes.
Here are 10 expert tips to help avoid the common sports injuries you see routinely.
Tip #1 Give due importance to physical conditioning
While professional athletes know the significance of physical conditioning, kids and adults who play sports of any kind casually plunge into the play without any adequate training. Contrary to popular opinion, a sport doesn't make you fit. You need to have proper training and fitness to play without succumbing to injuries. While sports physiotherapists help treat mild to moderate injuries, for severe injuries, you may need surgical and prolonged rehabilitation treatment.
Tip #2 Rules are there for a reason
Rules help to enforce safety and prevent mishaps. Following rules is the first line of defence you put up against injuries. When you abide by the rules, you will not have to contend with injuries that may keep you off the game temporarily or perpetually. With innovative and target sports massage and other physiotherapy treatments, it is now possible to recover from injuries more quickly.
Tip #3 Get your technique right
When you practice incorrect techniques, you are more likely to be injured. Injuries during resistance training are the common examples.
Tamping down the overzealous manoeuvres and concentrating on the precise technique is the way to be free of injury and improve your performance.
Tip #4 Insure yourself with the right sports gear
Helmets, gloves, mouth guards, protective pads, and other sports equipment are available for every sports player. Sports gears are designed to provide excellent safety. Make sure you wear gear that is specified for the particular sport you are involved in.
Tip #5 See a sports therapist
Professional sports physiotherapists are highly recommended as they can
• Help with proactive sports massage and injury therapy that is essential for restoring your body to the original pre-training condition
• Give valuable information on assessing, diagnosing, and treating various physical issues before the injury occurs
In addition to the above tips, keeping your body hydrated and taking the necessary proteins will help maintain your health and limit the occurrence of muscle cramps. The indomitable nature of a good diet which complements your workout regimen the desired manner should never be overlooked. Also, incorporating a consistent stretching and strength training routine will help in making the body accustomed to the exacting training sessions. All the very best with your endeavours!