Sussex Physio

Tennis Elbow

admin — Mon, 05 Sep 2011 07:55:59 +0000

‘True’ Tennis Elbow is an overuse injury, usually affecting the tendons that are attached to the outside of the elbow (the epicondyle). However, the term often gets applied to any sort of elbow pain- a bit like saying ‘cooking’ or ‘gardening’, it can cover a multitude of things!!
Tennis Elbow is very common, affecting up to 1 in 100 adults. It’s usually self limiting, though rarely settles if you keep doing the activity that strained the elbow in the first place.
There is usually inflammation or damage of the Common Extensor Tendon, as it crosses over the outside of the elbow, or where it attaches to the outer tip of the humerus, just above the elbow. Sometimes, the source is the joint at top of the Radius bone, and occasionally it involves the ligaments that stabilise the outside of the elbow joint. Occasionally, there some nerve irritation higher up the arm, or near the neck, which causes the elbow pain.

After detailed questioning and physical examination to identify the true source of pain, we usually treat with relative rest (avoiding the upsetting stresses), local massage, ultrasound electrotherapy, and specific graded strengthening exercises. Some patients also need a steroid injection to settle their inflammation down, but it’s important to loosen up the tissues involved AND restrengthen them as well. We may prescribe the use of a rigid Tennis Elbow Strap support- we stock these and trial them with our patients before recommending any purchases.

Lawn & Indoor Bowls Physio Clinic

admin — Sat, 06 Aug 2011 13:08:29 +0000

Sussex Physio offers a private and professional sports injury service to support people of all ages in the pursuit of an active lifestyle.

Our physiotherapists and sports masseurs are dedicated to returning you faster after an injury, keeping you playing comfortably and improving your performance.

What do we do

We offer a fresh approach to the treatment and management of injuries to help you get the most out of your practice. Our aim is to support you medically so that you can enjoy your sport and competition more, safe in the knowledge that you are gaining the full health benefits of a healthy active lifestyle.

Benefits to you

We are skilled in providing you with an accurate and correct diagnosis of your problem to give you peace of mind and an understanding of what needs to be done to resolve it.

Call us on 01403 276272

The benefits of our individualised treatment plans are:

A faster return to sport and exercise
Reduced risk of recurrence
Enhanced performance
Increased enjoyment and participation
Improved physical activity levels
Higher levels of health & wellbeing

Call us now on (01403) 276272 or web request a call back to book an appointment or discuss your problem before booking.

Triathlon Physio Clinics

admin — Sat, 06 Aug 2011 12:36:32 +0000

At SussexPhysio we know the demands placed apon triathletes by this most challenging of events.

We have expertise in working with triathletes of all levels and skills in treating injuries caused by the disciplines of swimming, cycling and running.

Our aim is get you fit and back to training as fast as possible to keep you competing through the season. We can also help with close season prevention and performance enhancing programmes to help you prepare for future competitions.

Call us now on (01403) 276272 or web request a call back to book an appointment or discuss your problem before booking.

Call us on 01403 276272

Running Injuries Physiotherapy Clinic

admin — Mon, 01 Aug 2011 15:58:12 +0000

We offer a specialist physiotherapy running services to cater for the needs of all standards and disciplines of running.

Our Physiotherapists have extensive knowledge and experience in working with running related disorders to help get you back on the road or track fast.

We specialise in the diagnosis, treatment and rehabilitation of running injuries and focus on technique, performance and prevention to help you make the most of your training time and keep you competitive.

We also work closely with Podiatrists who can also help with running shoe advice and insoles and orthotics where required.

Call us now on (01403) 276272 or web request a call back to book an appointment or discuss your problem before booking.

Call us on 01403 276272

Physio for Golf Injuries

admin — Mon, 01 Aug 2011 14:42:15 +0000

Sussex Physios at the Bartholomew Way Clinic can help you get a little more swing into your golfing performance.
Our team can help improve your biomechanics and movement control to maximise your driving,
pitching and putting. We concentrate on alignment, stability, and control to allow you to deliver the
correct sequence of movements needed on the fairway. A top to tail approach is taken to help you
get the most out of your game whatever your handicap.

Call us now on (01403) 276272 or web request a call back to book an appointment or discuss your problem before booking.

Call us on 01403 276272

Great Tendon Rehab course

admin — Mon, 18 Jul 2011 08:02:13 +0000

On the 4th June Martin and I attended a fantastic one day course at St Thomas Hospital in London.

The course was taught by Dr Peter Malliaras, a Senior Clinical Lecturer who leads the masters programme in Sport and Exercise Medicine at Barts and the London School of Medicine and Dentistry, Queen Mary University London.

Thanks to PhysioUK and St Thomas Hospital for an enlightening day course.

An early morning in London

Physiotherapy Fee Change

admin — Wed, 06 Jul 2011 11:15:27 +0000

We are pleased to have been able to have frozen your physiotherapy consultation fees over the last five years. Our prices last increased in August 2006.

On the 1st August 2011 a one hour initial physiotherapy assessment at Bartholomew Way Clinic will increase to £55 and a 45 minute treatment appointment will increase to £35.

We want to maintain the quality of care we provide to you, and to do this have found we must increase our prices to cover what have been significant rises in our costs throughout the last five years.

We look forward to continuing to care for you into the future.

Knee Pain – Ultrasound Imaging

admin — Mon, 21 Feb 2011 08:33:31 +0000

We see lots of patients with knee pain. When the cause is due to soft tissue damage or problems, tissue changes can often be seen clearly with ultrasound scanning. However, nothing ever replaces the standard, detailed physical examination- we only use the scan to confirm our assessment findings, but it’s often fascinating to be able to ‘see’ the tissues involved.
Healing and resolution can also be monitored using follow up scans.
The images below show marked thickening and increased darkness (hypo-echoic signal) in a kneecap tendon – Patella Tendinopathy.
Whilst the patient reported improvement in his symptoms of pain and reduced function with a course of treatment (stretching, and muscle re-strengthening), repeated scans later showed very little change in the size of the tendon. He was intrigued by the early scan result, but very reassured to see the tendon was intact.

Patellar tendon scan

David is not a qualified sonographer. However like many physiotherapists in musculo-skeletal practice, he has received basic training in the use of ultrasound imaging equipment and uses it to confirm his assessment findings and measure progress in recovery from certain injuries.

Tennis Elbow – Ultrasound imaging

admin — Mon, 21 Feb 2011 08:27:16 +0000

Tennis Elbow is the term often used for pain on the outside of the elbow; technically, it is for inflammation of the local tendons (Common Extensor Tendons). However, there can be several different causes for the pain, and careful assessment is needed to make a correct diagnosis, prior to treatment. Following the usual physiotherapy assessment, David may use the dynamic ultrasound scanner to image the local tissues, gaining more information about the local condition.
On the scan below, you can clearly see in the right hand frame very significant thickening and darkening of the Common Extensor Tendons which cross over the Radial Head and elbow joint, compared with the opposite elbow, which is pain free in the left hand frame. We’ve added an anatomy drawing to help you identify the tissues involved. (David says this is the biggest one he’s seen- they aren’t all like this! We referred this patient on for a formal scan)

Tennis Elbow Ultrasound scan

Achilles Tendon – Ultrasound Imaging

admin — Fri, 18 Feb 2011 13:41:55 +0000

Achilles tendonois or Tendinitis?
There’s a huge amount of information in the ‘net about Achilles Tendonitis but you need to know for sure whether you have got inflamation (which is “-itis”) or the longer lasting, harder to treat “tendnosis”; these two conditions feel pretty similar but they’re managed very differently. You need an expert!!

When patients present with any Achilles tendon complaint, David usually completes his usual physiotherapy assessment with a dynamic ultrasound scan, comparing the affected tendon with the ‘normal’ one.
In tendonosis the tendon feels thickened and tender to palpation, and loses some of it’s pliability; an ultrasound scan shows this thickening very clearly, especially when compared with the unaffected side. The condition is one of tendon overgrowth
(In ladies, the Achilles tendon is usually 3mm to 4mm thick; in males its usually 4mm to 5mm. This can double in tendonosis.)

This longitudinal scan shows a significantly enlarged achilles tendon in the right frame, with a more normal sized tendon on the left

This transverse scan shows a significantly enlarged achilles tendon in the right frame, with a more normal sized tendon on the left

However, when tendonitis is present, much less enlargement occurs because the condition is one of inflammation; the edges of the tendon can appear darker (hypo-echoic)

(Occasionally, we may see irregularities in the tendon structure, in which case we refer back to the GP for formal scanning and reporting. If there is no tear, we can proceed with vigorous remedial exercise protocols.)

Repeat scans:
We will often repeat a scan during a course of treatment, in order to compare record any changes. Since our clinical records are digital, we can embed a detailed image of each scan into the patients notes.

As tendonitis settles, responding to rest, ice, stretching and a gradual return to exercise, the ‘darkness’ (hypo-echoicity) reduces.
In tendonosis, the patients respond well to a graded exercise scheme called “eccentric exercises”; they begin to report less pain & stiffness early in the mornings and less discomfort on exercise. However, on rescanning, we often find that the tendon size has not reduced- occasionally, it has enlarged further.
This is thought to be because the condition is not an inflammatory one, but one of overgrowth. Patients can be disappointed when the tendon still seems to be thick and lumpy but we can reassure them that it is a normal part of the condition.
What is really great is that 80% of patients with this chronic problem respond very well to our treatment protocol, returning to normal daily activity and sport (even when they’ve had problems for many months).

David is not a qualified sonographer. However like many physiotherapists in musculo-skeletal practice, he has received basic training in the use of ultrasound imaging equipment and uses it to confirm his assessment findings and measure progress in recovery from certain injuries.