COVID-19 UPDATE NOVEMBER 2021

ALL Face to Face Physiotherapy Consultations can now be made online as well as directly with our Reception team - 0131 447 9990. Our Reception Team will discuss our COVID-19 procedures with you prior to your first visit to the clinic. Our procedures are in place to minimise the spread of COVID-19 and to reduce risk to our clients, staff and therapist. All our Physiotherapists are fully vaccinated and will be wearing PPE. We thank our clients for their loyalty and support and we hope you keep safe and well.

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0131 447 9990

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382 Morningside Road, Edinburgh EH10 5HX

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Jill Kerr Physiotherapy Ltd, based in Morningside, Edinburgh, Specialises in all Musculoskeletal Injuries & Pathologies such as Sports Injuries, lower back and neck pain, ligament sprains, muscle sprains, tendon pathology and joint arthritis. Our Physiotherapists also specialise in the rehabilitation of clients recovering from broken bones (fractures), peripheral joint replacement as well as helping clients with persistent (chronic) pain.

The musculoskeletal system will be examined using a detailed clinical assessment and the diagnosis explained, then each client will be given Physiotherapy/rehabilitation appropriate to their specific injury and lifestyle.

If you are unsure whether Physiotherapy is suitable for your problem, then please contact our team. Our Physiotherapists offer Telephone, Virtual and Face to Face Consultations.

Below is a list of just some of the common conditions our Specialists Physiotherapists can assist you with:

Lower Limb (Hip: Knee: Ankle)

Hip

Osteoarthritis hip joint

Early indicators of osteoarthritis in the hip are pain in the groin, buttock and thigh on weight bearing activity such as running or walking. You may notice the hip feels stiffer in the morning and it becomes more difficult to get your socks and shoes on.

Your Physiotherapist will be able to assess the amount of joint restriction and whether it has the potential to improve with mobilisations, stretching and strengthening programme and perhaps some acupuncture for pain relief. We regularly see significant reduction in pain and increased movement and function when we treat hips with early degenerative changes.

An x-ray can be requested from your GP if needed. Early Physiotherapy intervention can delay the need for referral for more invasive treatment such as injection or surgery.

Hip joint impingement

Impingement in the hip typically presents with a catching pain in the groin region of the hip. It can be caused in younger clients with irritation of the joints’ cartilage known as the hip labrum whilst in older clients there may be a loose particle of cartilage floating within the joint space. Your Physiotherapist has the knowledge of differentiating between the diagnosis of hip impingement.

Recent research advises on rehabilitation rather than surgery for hip impingement in the younger client for the better long-term outcomes unless the hip is blocked. Your Physiotherapist can advise on the best rehabilitation for this and use mobilising techniques to reduce pain and symptoms of catching.

Greater Trochanteric Pain Syndrome (GTPS)

Pain is felt over the lateral aspect of buttock and thigh- this is a common problem in menopausal women and in athletes. It is thought to be an overload of the gluteus medius tendon as it attaches to the greater trochanter (bone on lateral aspect leg just below the pelvis) and the underlying trochanteric bursa. Sleeping on the affected side can be painful as well as standing all the weight on the affected side.

A physical assessment can ascertain the involvement of the tendon and/or the bursa. Your Physiotherapist can advise of pain relief options available and a start a loading programme. Stretching tends to irritate this problem and advice on not crossing your legs is likely to be given.

Hamstring Muscle Strain / Tendinopathy

Hamstring muscles strains and tears commonly occur in sprinting and a sudden onset of pain is felt in the muscle at the back of the thigh. The alternative is an overstretch of the muscle. The client will normally remember the mode of onset. The muscle is highly vascular so bleeding can occur at onset resulting in bruising down the leg. Your Physiotherapist will be able to assess the extent of the lesion by testing the muscle strength and flexibility. Muscles benefit from active recovery to encourage the healing process and mimic the normal function of the muscle.

In contrast tendinopathy can occur at origin of the hamstring tendon on the ischial tuberosity- the bone we sit on. This can be irritated with a gradual overuse of the tendon or an increase in the load demanded from the tendon e.g training for a running event. The site of the pain will be local to the base of the buttock skin crease and a progressive loading programme and reduction in stretching advised with treatment to reduce the pain.

Knee

Anterior Knee Pain

Anterior knee pain can be a challenging pathology for diagnosis and for clients to get a fast clinical outcome. The pain may come from the patella-femoral joint (kneecap) or from its surrounding muscles attachments from the quadriceps muscle. There may be problems with the cartilage behind the kneecap (patella) or degeneration of the joint (wear & tear). Cause of this pain may be unknown by the client.

In contrast the contractile component is more likely linked with a change in loading e.g running, hills, uneven ground.

Your Physiotherapist can assess and advise on the best options for your rehabilitation and pain relief. This will include strengthening exercises for the hip and the knee as well as treatment for pain relief.

Osteoarthritis Knee Joint

The knee joint (tibiofemoral joint) is prone to degenerative change (wear & tear) as we advance in years or earlier as a direct result of previous trauma to structures within the joint. Medial joint pain is most common location for pain and when there is active irritation to the joint there can be visible swelling. An x-ray can inform us if the changes to the joint are mild, moderate or severe. The pain is at end range knee bend and straightening and tends to be aggravated with load bearing such as stairs, walking and running.

Your Physiotherapist can assist in reducing the swelling, increasing the range of movement, strengthening the muscles and gaining pain relief. One of our options for mild to moderate change can be the Hyaluronic Acid Injections.

Medial Collateral Ligament Sprain

Skiing and contact sports increase the potential for pain and strain of the medial ligament of the knee. This is due to the mechanism of injury- the medial ligament supports the medial aspect of the knee and undue force on this ligament can lead to injury. The MCL injury can be graded clinically from a grade 1 (mild sprain), 2 (partial tear) and 3 (complete Sear).

Grades 1 and 2 respond well to Physiotherapy and a 3 will require an Orthopaedic Opinion and either splinting or surgical intervention. Early pain free movement is key and if a recent injury facilitating the healing process to ensure the fastest return to full activity. The joint loses mobility, can be swollen and pain is felt locally over the medial ligament. Your Physiotherapist will be able to fully assess the knee testing all the structures and explain the diagnosis to you- it is not uncommon in the knee to injure more than one structure depending on the mechanism of injury and the forces involved.

Hands on soft tissue work, K taping, electrotherapy and strengthening are part of the rehabilitation process. Your exercise programme will be devised depending on the activities you will be returning to keep it as functionally relevant as possible.

Ankle:

Ankle Ligament Sprains

This is a common injury from “going over” or “twisting” the ankle. The lateral ligaments are susceptible to trauma. There are 3 main ligaments that can be involved (ATFL/CalcFib/ CalcCub) in the injury and diagnosing which of these are involved early on is important as sometimes aspects of the injury are missed. This enables the treatment to address all the structures involved.

If there is any suspicion that there could be a fracture your Physiotherapist can refer you for an x-ray unless it’s already been done at Minor Injuries. Immediate swelling, being unable to weight bear and having local bony tenderness are indicators an x-ray is required.

On occasion the use of crutches/taping or ankle supports is important to facilitate a normal gait pattern. Limping is not good for facilitating the healing process or for the circulation. Your Physiotherapist will introduce balance and proprioceptive exercise as soon as possible as this is important for prevention of injury recurrence.

Less commonly there is pain over the medial ligaments- these are either injured in conjunction with the lateral ligament sprain where there is compression medially- or with over stretching usually associated with poor biomechanics such as dropped arches and unsupportive footwear. During the clinical assessment your Physiotherapist will assess all structures in the ankle and foot, diagnosing the structres at fault.

Gastrocnemius Muscle Strain (Calf Strain)

A gastrocnemius muscle injury (calf strain) is a common soft tissue injury often occurring during activities such as tennis or squash where there are many acceleration and deceleration movements.

The onset is sudden and immediate pain felt in the muscle belly itself, often on the medial side. Ensuring a good walking pattern early is key, sometimes crutches are needed to prevent limping and normalize gait. Wearing a higher heeled shoe can reduce the stress on the healing zone.

Early physiotherapy intervention can facilitate the healing process and get you back to full function as soon as possible. Active recovery is essential for muscle recovery and avoiding stretching too early. As deep vein thrombosis (DVT) can occasionally be a rare complication of muscle strain here you will be given advice on circulatory exercises and what to do if you suspect a DVT.

However, the vascularity of the muscle belly does mean that recovery can be progressive, and rehabilitation will get you back to your activity as soon as pain-free on testing.

Achilles’ Tendinopathy

Achilles’ tendinopathy is a challenge for Physiotherapists worldwide- the tendon is one of the biggest weight-bearing tendons in the body and the anatomy of the structure and demands put upon it lead to a high incidence of pain within it particularly if you make a sudden increase in demand on the tendon. This is known as a Reactive Tendinopathy and the tendon may feel thickened on its surface or sides and tender to touch.

Pain is often associated with a change or sudden increase in running or hillwalking activities. Physiotherapy is beneficial to ascertain where within the contractile unit the problem comes from and then how you can help to settle the pain and get the tendon loading to get it ready for the forces it needs to be subjected to within your daily routine.

Plantar Fasciitis (Fasciopathy)

Do you wake up in the morning and have a sharp pain in your heel, finding it difficult to put your foot to the ground? You may have plantar fasciitis and a Physiotherapy assessment of the cause of this pathology. Various other components add to the challenge of solving this problem- footwear/weight gain/terrain.

The current literature suggests that it present similarly to a tendinopathy and therefore should be loaded in a similar progressive way.

There are many interventions that can aid recovery including soft tissue work, biomechanical assessment, strengthening/loading, strapping and acupuncture. Your Physiotherapist will be able to facilitate your rehabilitation.

For more information about the injuries & pathologies we treat and the treatments we offer, or to book an appointment please call 0131 447 9990 or email us at info@jillkerrphysiotherapy.co.uk