You may experience some or all the following:

• Difficulty while walking or going down stairs.
• knee pain mainly during movement and physical activity.
• In some cases pain can be present even at rest depending on the severity of the inflammation.
• Tenderness around the affected area alongside swelling (significant in some cases).
• Warm sensation due to the inflammation, particularly if pressure is applied on it.
• If bursa gets infected, you may have fever. Hence, if you have fever or generally feeling unwell while experiencing patellar bursitis you should contact your GP.

Patellar Bursitis main causes are:

• Prolonged kneeling position specially on hard surfaces
• Overuse due to occupation or physical activity
• Direct blow to the knee (sports like football, volleyball, rugby, martial arts).
• Complications from osteoarthritis, rheumatoid arthritis, or gout, bacterial infection, obesity.

The most common tests to diagnose Patellar Bursitis (carpenter´s knee) are:

First approach:

• what symptoms you’re experiencing
• when they started
• how long you’ve had them

Imagery test

• a MRI scan
• an ultrasound scan
• a CT scan

Home Treatment

This condition can take weeks or months to settle. You can play an active part in speeding up your recovery:

• Rest: avoid the strenuous pain triggering activity and overuse
• Activity modification
• Ice
• Compression (use elastic bandage to support the knee)
• Pain relievers

Traditional treatments

• Crutches-limit the amount of weight over the knee.
• Knee brace- Stability to the knee.
• Physical therapy
• Surgery (severe cases)

Hands on treatment

Physiotherapy and Osteopathy: manipulation to improve range of movement, often the joint is restricted so the muscles have to work harder and from a disadvantaged position

 Return to activity gradual when: 

• Pain free in all range of movement 
• Pain free load bearing on knee
• No swelling 

You may experience some or all the following according to the damage in your bursa:

• Pain (gets worse with time)
• Swelling and inflammation
• Warm sensation
• Tenderness and swelling when pressure is put on the knee
• Difficulty while walking or going down stairs

Knee bursitis main causes are:

• Knee trauma (specially in the front of the knee).
• Sharp blow.
• Friction and irritation due to prolonged kneeling position.
• Overuse (sports like football or volleyball).
• Condition complication such as: osteoarthritis or rheumatoid arthritis.
• Bacterial infection
• Obesity

The most common tests to diagnose Kneecap Bursitis are:

First approach:

• what symptoms you’re experiencing
• when they started
• how long you’ve had them

Imagery test

• an X-ray
• a MRI scan
• an ultrasound scan
• a CT

Home Treatment

This condition can take weeks or months to settle. You can play an active part in speeding up your recovery:

Home treatment

• Rest: avoid the strenuous pain triggering activity and overuse
• Activity modification
• Ice
• Knee elevation
• Compression (use elastic bandage to support the knee)
• Pain relievers

Traditional treatments

• Corticosteroid injection
• Aspiration
• Surgery (severe cases)

Hand on treatment

There are a few studies on Knee bursitis . The following treatment have been proved to help

• Physiotherapy and Osteopathy: manipulation to improve range of movement, often the joint is restricted so the muscles have to work harder and from a disadvantaged position

 Return to activity gradual when: 

• Pain free in all range of movement 
• Pain free load bearing on knee
• No swelling 

You may experience some or all the following:

• “Popping” sensation in the knee when it happens
• Pain (gets worse with time)
• Swelling and inflammation
• Knee instability
• Loss of range of motion

• Sudden switch in direction
• Unstable landing after jumping
• Knee collision
• Knee trauma

The most common tests to diagnose ACL are:

First approach:

• what symptoms you’re experiencing
• when they started
• how long you’ve had them

Imagery test

• Physical exam (medical history)
• an X-ray
• a MRI scan
• an ultrasound scan
• CT scam

Home Treatment

• Rest
• Ice
• Pain reliever
• Rehabilitation exercises (strength/stability)
• Knee support

Hands on Treatment

• Sports therapy
• Osteopathy

Traditional treatments

• Crutches-limit the amount of weight over the knee.
• Knee brace- Stability to the knee.
• Physical therapy
• Surgery

Common symptoms of Jumper’s Knee include:

• Dull knee pain.
• Stiffness at the front of the knee, just below the kneecap. during a physical activity or walking up or down the stairs- or when standing up from sitting.
• Tenderness of the patella tendon.

Patellar tendinopathy is caused by repetitive stress placed on the knee joint and muscles often caused by overusing the area in sports or exercise.

Factors that contribute to development of the condition include:

• tight legs muscles,
• muscle imbalance,
• altered biomechanics of the feet, ankles or hip.
• Patellar tendinopathy can also be predisposed by wearing a poorly fitted footwear.

The most common tests to diagnose Patellar Tendinopathy are:

First approach

Jumper’s knee can be diagnosed thorough physical examination:

• what symptoms you’re experiencing
• when they started
• how long you’ve had them

Imagery test

• a MRI scan
• an ultrasound scan
• a CT

The treatment for the patellar tendinopathy (jumper’s knee) depends on the severity and chronicity of the condition.

Home treatment:

• Ice
• knee support
• rest can also be suggested if symptoms are severe.

Hands on treatment:

• Initially, releasing the overly tight muscle,
• moderating physical activity
• strengthening
• stretching
• foam rolling

Medical treatment:

If patellar tendinopathy does not respond well to conservative treatment, corticosteroid injection or even a surgery can also be considered.

Despite much research, the precise causes are still unknown. The joint capsule becomes inflamed and gets tighter. There are links to

• post surgery,
• diabetes,
• heart disease
• and Parkinson’s.

The most common symptoms of frozen shoulder are:

• Pain and stiffness 
• Pain worse at night 
• Unable to move arm/ shoulder in most ranges of movement 

This condition can take months and up to two years to settle. It’s important you see an osteopath or physiotherapist to have a thorough assessment and determine the stage you are at.  If you are not improving enough we might suggest stronger pain relief, a corticosteroid injection or joint distension to reduce the pain and inflammation so the manual treatment has a chance to work. In general, you have better chances after the freezing stage. 

• Pain relief avoid pain provoking movements, painkillers.
• Improving movement once the pain has subsided enough.
• Ongoing hands on treatment including stretching, exercises, posture re-education.

What we can do for you:

We have seen all sorts of presentations and everyone heals at different rates. Treatment is aimed at increasing movement in all ranges and combinations. We will address adjacent restricted joints and tight areas that might contribute to limiting movement. We will check all muscles and joints that influence shoulder range of movement to give you the best chances to heal and restore full range of motion as quickly as possible. 

Frozen shoulder goes through 3 phases: 

Freezing stage, 6-9 months: severe pain, limited in all movements, getting worse, worse at night 

Frozen stage, 4-12 months: less pain, stiffness worse, all movements difficult

Thawing stage, 6months-2 years: less pain, range of motion improving, on way back to normal

You may experience some or all the following:

• Neck pain and stiffness on and off
• Headaches from  back  of neck

Complications: getting worse, loss of coordination, weakness in arms, legs, pins and and needles and pain in arms, problems walking, loss of bladder control. These signs suggest more severe damage to the spine and you must see a GP asap. 

In the cervical region the spinal cord is expanded and in some people the canal is narrow so they may develop compression, even with mild degenerative changes. The neck is very mobile and when you flex (look down) the cord must stretch and can give symptoms of tingling or electroshock down the back, arms and legs.

A job with repetitive neck movement overhead like painting and decorating, a previous neck injury, whiplash, family history can inflame the spinal cord with neck extension, it shortens and maybe squeezed between the bars.

It tends to affect the over 50’s but it can happen much younger as well.

Diagnosis is based on full medical history, physical examination to test muscles strength and reflexes. Images test, will allow the therapist or professional to determining the severity of  the Cervical Spondylosis.

The most common imagery test are:

• Confirmed by X-ray
• TC scans
• MRIs

Medical

• Physio exercises.
• Muscle relaxants
• Nsaids.   

Most people have success with conservative therapy. If nothing works surgery is the last resort.

Natural

Hands on treatment

Manual therapy: You can try Physiotherapy, Osteopathy, Acupuncture. These are evidence based interventions proven to work.

A combination of manual therapy techniques will be selected by our experts after taking into account your past medical history, spinal mechanics, aggravating and maintaining factors, lifestyle.

• Posture improvement 
• Don’t sleep on your front with the neck rotated. Keep the neck in line with the body
• Don’t stay in the same position for a long time
• Shoulder rolls

There is conflicting evidence about wearing a collar, but you may want to try it at night to protect the neck from slumping in a relaxed position when you can’t control your movements.

Timeline

Symptoms subside in a few weeks but provocative activity must be avoided.

You may experience some or all the following:

• Pain on outside of forearm around elbow
• Tenderness at bony bump, sometimes swelling  
• Worse for bending, lifting, griping, twisting, turning handles  
• Difficulty to extend arm 
• Usually unilateral

Overuse of muscles around forearm that let you grip, rotate, flex. Tendons attaching to bones at the elbow are strained and subject to tears due to constant tugging from flexing, gripping, swinging. Initially inflammation is present.

• Sporting activities: golf, tennis, bowling, basketball (pitching) archery 
• Non sporting activities with repeated stress: using tools, screwdrivers, hammers, raking, painting, carpentry, plumbing etc.
• Repetitive movements > 2 hours
• Loads > 20 kg

The most common tests to diagnose Golfer´s Elbow are:

First approach:

• what symptoms you’re experiencing
• when they started
• how long you’ve had them

Imagery test

• an X-ray
• a MRI scan
• an ultrasound scan

Home Treatment

This condition can take weeks or months to settle. You can play an active part in speeding up your recovery:

• Avoid the strenuous pain triggering activity and overuse
• Activity modification
• Rest for a few days
• Ice cubes in cling film/thin towel around the lateral epicondyle only, 20 min every 3 hrs 3 days

Hand on treatment

There are a few studies on golfer’s elbow. The following treatment have been proved to help:

• Elbow strap to create a false attachment site so tendons are not strained at their anatomical attachment and allowed to rest and heal 
• Stretching and strengthening arm and wrist
• Manual therapy mobilisation, massage, mobility exercises, eccentric exercises three times a day 1-3 months as soon as pain allows
• Therapeutic ultrasound
• Physiotherapy and Osteopathy: manipulation to improve range of movement, often the joint is restricted so the muscles have to work harder and from a disadvantaged position

 Return to activity gradual when: 

• Pain free in all range of movement 
• Pain free load bearing on arm 
• No swelling 
• Don´t forget to check racquet strings, head, too heavy or too large, golf club and technique 

You may experience some or all the following:

• Pain on outside of forearm around elbow
• Tenderness at bony bump, sometimes swelling  
• Worse for bending, lifting, griping, twisting, turning handles  
• Difficulty to extend arm 
• Usually unilateral

Overuse of muscles around the forearm causes tendons attaching to bones at the elbow to be strained and subject to tears due to constant tugging. Initially inflammation is present. The most damage is in extensor carpi radial brevis with microtears and gradual wear.

It can be caused by sporting activities:

• Tennis, squash, fencing
• Non sporting activities with repeated stress at the elbow:  
• Using tools, screwdrivers etc., kneading bread, plumbing, typing, knitting, car mechanics, chefs, musicians etc.  

The most common tests to diagnose Tennis Elbow are:

First approach:

• what symptoms you’re experiencing
• when they started
• how long you’ve had them

Imagery test

• an X-ray
• a MRI scan
• an ultrasound scan

Home Treatment

This condition has a high success rate of recovery but it can take months to go back to normal, up to 2 years. You can play an active part in speeding up your recovery.

• Avoid the strenuous pain triggering activity 
• Rest for a few days  
• Ice cubes in cling film/thin towel around the lateral epicondyle only, 20 min every 3 hrs 3 days, ice massage 
• Elbow strap to create a false attachment site so tendons are not strained at their anatomical attachment and allowed to rest and heal 

 Treatments have been proven to help 

• Stretching and strengthening arm and wrist
• Manual therapy: mobilisation, massage, acupuncture, mobility exercises, eccentric exercises three times a day 1-3 months as soon as pain allows 
• Therapeutic ultrasound 
• Physiotherapy and Osteopathy: manipulation to improve range of movement, often the joint is restricted so the muscles have to work harder and from a disadvantaged position 

What can you do to help with the recovery?

Check racquet strings, head, too heavy or too large, golf club and technique, check your equipment and use ergonomics when appropriate.    

Return to activity gradual when: Pain free load bearing on arm, Pain free in all range of movement and No swelling 

Maintain a good posture all the time to avoid recurrence  

You may experience some or all the following:

• Pain, tingling, numbness in buttock
• Pain can extend down gluteal area, posterior thigh and leg, lateral foot 
• Worse after sitting for a long time, running, cycling, stairs, or vigorous activity 
• Usually unilateral

Anatomic: sciatic nerve passing through it

Primary: 15% of patients 

Secondary:  due to precipitating causes like trauma, local ischemia, trauma to buttock (injection), inflammation, muscle spasm.  

• After lumbar or sacroiliac joint injury or overuse 
• Shortened muscle due to lower limb mechanics, altered low back/pelvis torsions, malalignments.
• Long distance walk/run
• Direct compression from sitting on hard surface for long time 
• Ischial bursitis   

Other possible causes must be ruled out for sciatic nerve compression from spine injuries.

Many spinal consultants do not believe in this injury as a standalone and state there are always some spinal components around the L5-S1 segment involvement or an underlying disc injury.

Diagnosis is based on full medical history, physical examination to test muscles strength and reflexes. Images test, will allow the therapist or professional to determining the cause and severity of Piriformis syndrome.

The most common imagery test are:

• Confirmed by X-ray
• TC scans
• MRIs

Home treatment

• Avoid pain triggering activities 
• Rest, ice pack
• Stretch 
• Neural flossing 

The aim is to reduce the sciatic nerve compression and a health professional needs to test and establish where the compression starts, if it’s only in the gluteal area or if there is a spinal component and what other structures are involved in causing or maintaining the injury.

Hands on treatment

Osteopathic manipulative technique has been proven to relieve pain, increase range of movement in restricted areas and rebalance the pelvis.

Medical

• Anti inflammatories 
• Pain killers