Sports Injury Physiotherapy

Tennis elbow or lateral epicondylitis is a common injury causing pain on the outside of the elbow, where the muscles on the upper forearm attach onto the bony part of the elbow. Despite its name, this condition is not only seen in tennis players but any activity where repetitive stress is involved.

Symptoms of tennis elbow are:

• Weakness in the wrist due to pain over the outside of the elbow. Simple tasks such as opening jars, shaking hands with someone could be painful
• Pain over the outer elbow when the wrist and/or middle finger are extended backwards against resistance
• Significant pain when pushing down on the muscle of the forearm where it attaches in the bony part of the elbow

Treatment includes: rest from the aggravating activities, soft tissue release to promote improved circulation to the injured area, dry needling, strapping and strengthening to the affected area. Read more about the Tennis elbow condition…

Shoulder impingement involves injury/compression of the rotator cuff tendons which are located in the area underneath the outside edge of the collar bone. This condition can be due to degeneration of the rotator cuff tendons or due to repetitive strain. This occurs with repeated throwing or heavy lifting. Trauma can also occur to the rotator cuff when the shoulder is forced into abnormal positions, which can happen in contact sports.

Pain occurs when the rotator cuff is compressed between the upper part of the arm (humerus bone) and the underneath surface of the acromion (bone which attaches to the outer edge of the collar bone (clavicle). This causes a sudden sharp pain, making it difficult to lift up the arm

Symptoms of shoulder impingement are:

• Sharp, catching pain which makes it difficult to pick up the arm. If there is significant weakness, one or more of the rotator cuff tendons could have a tear.
• There might be a painful arc of pain especially when lifting the arm out to the side.
• Pain  when sleeping on the painful side
• Difficulty when doing activities like taking off your shirt, where your arm needs to lifted up or taken behind the back

Treatment includes first finding the cause of the shoulder impingement. Often there is a postural component to the condition where certain muscles may be tighter and others weaker. The key is to identify which muscles (commonly posture and core muscles) are weaker and strengthen these muscle groups. Tighter muscles would then also need to be released to bring balance back to the shoulder mechanics. If the injury is due to trauma, treatment usually involves rest, followed by progressive mobilisation and strengthening of the rotator cuff muscles. Read more about shoulder impingement…

Achilles tendinopathy is a condition that causes pain along the back of the calf, just above its attachment into the heel. The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, and jump. Pain results from repetitive strain to the tendon. This can occur when we are pushing our bodies too hard in training, or suddenly increase the load on the tendon in training. Factors that can contribute to Achilles tendinopathy are: not allowing the body enough time to rest during training sessions, having tight calf muscles which put extra strain on the Achilles, wearing incorrect footwear or running on hard surfaces.

Symptoms of Achilles tendinopathy are:

• Sharp pain along the back of the heel when running or walking
• Marked stiffness over the heel especially in the morning
• Difficulty raising onto the toes due to pain
• A swollen, warm Achilles tendon which is very tender to touch

Treatment of Achilles tendinopathy includes: rest from the aggravating activities, soft tissue release to the calf muscles, strapping, stretching and strengthening of the calf muscles and wearing the correct foot wear.

Iliotibial band syndrome (ITB) is a common overuse injury among runners and cyclists. It occurs when the iliotibial band, a thick band of tissue which runs down the outside of the thigh from the hip to the outer shin bone, is tight or inflamed. This then causes friction on the underlying bone. The iliotibial band attaches to the outside knee and helps stabilise and move the knee. When the iliotibial band is tight, movement of the knee during running/cycling becomes painful.

Symptoms of Iliotibial band syndrome (ITB) are:

• Pain on the outer surface of the knee. This can become worse when climbing stairs
• Tightness and tenderness in the muscles on the outside of the knee
• Stiffness in mobility of the knee cap (patella)

Treatment of ITB includes: activity modification, soft tissue release to the tight structures to minimise the friction of the ITB as it slides over the bone above the knee (femoral condyle). Stretching is important as well as correcting running/ cycling biomechanics to minimise strain on the ITB. Read more about the Iliotibial Band Syndrome (ITB)…

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