February 13, 2023 - DX Physio

Despite it’s name, anyone can develop ‘Tennis Elbow’ – tennis players, athletes, or just anyone who vigorously use their forearm muscles or repetitively extended their wrist and hand, as ‘Tennis Elbow’ is it is caused by overuse/repetitive movements of the wrist and arm that overload the tendons in the elbow. This leads to pain and tenderness on the outside of the elbow and there is inflammation or micro-tearing of the tendons that join the forearm muscles to the outside of the elbow.

The symptoms are often worsened with forearm activities, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is more likely get affected; however, both arms can be affected.

Dry Needling is a skilled intervention performed by a physiotherapist that uses a thin filiform needle to penetrate the skin and stimulate underlying neural, muscular and connective tissues for the evaluation and management of neuromusculoskeletal pain and movement impairments.

Tendons generally have a poor blood supply, which is why they are vulnerable to vascular compromise in specific areas.

Dry needling therapy stimulates blood flow to the injured tendon, triggering stem cells recruitment, stimulating fibroblasts, and inducing the healing cascade, which facilitates tendon healing.

Current research shows that tendon needling is minimally invasive, safe, inexpensive and efficient treatment modality for tendinopathy such as Tennis Elbow and Achilles Tendinopathy.

‘Runners knee’ is a common injury causing pain at the front of the knee or around the kneecap (patella), often medically referred to as ‘Patellofemoral Pain’(PFP). Sometimes this term can also be used to describe another running injury known as Iliotibial Band Friction Syndrome (ITBFS), though this presents as pain on the outside (or the lateral area) of the knee. Both conditions are common in running populations and can be hard to get ahead of if left for too long!
PFP is often characterised by pain behind or around the patella with weight bearing activity or loaded flexion movements of the knee. This sadly means you do not have to be a runner to get PFP as we can experience it during squatting, lunging, stair climbing/descending, walking, prolonged sitting (‘movie-goers knee’ is another fun name for this condition) and (obviously) running.

Due to PFPs complex and varied nature and the vast work our knees do during exercise, the condition can develop in several differing ways.
Some of the more common factors that can lead to PFP are:
-Increased training loads or spikes (with running/gym work)
-Weakness/strength deficits of the knee (Quadriceps) or hip (Gluteus Maximus/Medius)
-Poor biomechanical (movement) patterns and/or poor running technique
All of which can contribute to increased work placed upon the patellofemoral joint, leading to pain.

Luckily, Runners knee can be managed well with good education, advice and exercise prescription from your physio. Initially, a focus on the reduction of pain or other symptoms with activity modification and treatment (massage and taping) can help to get things going in the right direction.
Your physiotherapist can then assess your movement patterns to decide if there is need for retraining any of these to unload the patellofemoral joint, along with assessing the strength around the hip and knee to help target your exercise rehab to where it is needed most! The combination of hands-on treatment, taping, strength training and load management fills out the staples of treatment for PFP in the early to mid-stages prior to returning to running or lifting heavy in the gym. From there, a specific strength and conditioning program and/or running program (+/- technique correction work if relevant) can aid the later stages of your recovery as you begin to outrun your ‘Runners knee’!
At DX PHYSIO, our sports physio Joshua is very experienced at treating all kinds of knee conditions. If you are suffering from knee pain or any sports injuries, please give us a call today at 0299493770.

You may have heard it called plantar fasciitis, plantar fasciopathy, plantar heel pain or plantar fasciosis, but all refer to the same thing!

So, what exactly is it? Plantar Heel Pain refers to pain in the heel and/or arch of the foot. The condition can be stubborn and painful to both manage and treat, and unfortunately, as many as 10-15% of us will experience it at some point in our lives. It characteristically makes those first few steps in the morning or the midnight trip to the toilet feel like we are walking over a bed of nails, and no one wants that!

Why does it hurt?
The plantar fascia itself is a thick fibrous band of connective tissue that supports the arch of the foot and helps to absorb impact and transmit force through the foot for walking and running. When this structure becomes inflamed or injured (usually at its origin of attachment to the heel bone) it can cause those classic symptoms of pain in the heel. It can also be injured acutely and torn, though this is far less common. Often instead, it simply gets irritated through repeated minor trauma that causes micro-tearing of the structure and can lead to small tearing and pain.

How do I ‘heel’ it?
Unfortunately, this condition is poorly understood and can present a stubborn challenge for both patients and clinicians in overcoming it. However, there are several different treatment options your physiotherapist can offer and guide you through that can help, such as:

Recent research suggests that in the medium to long term an individualised strength program of progressive loading for the plantar fascia (via the calf) may offer the best results, and combining this with other treatments like stretching, dry needling or massage can help to manage the symptoms in the short term. Overall, the best way to ‘heel’ it is to seek professional advice and get an individual plan prescribed by your physiotherapist that will put the right foot forward in your recovery!

At DX PHYSIO, we have successfully helped a number of patients recover from chronic plantar fasciitis. Our physiotherapists will assess your body in a holistic way to unload your plantar fascia and help you return to sports.