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What's wrong with me ?

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Calf

The gastrocnemius and soleus are the primary plantar flexors of the ankle. During the push off phase in vigorous walking and running the gastrocnemius is one of the most powerful muscles in the body and the Achilles tendon which forms the insertion point for both muscles is very thick and strong. The soleus also contracts statically to maintain stance. As well as plantar flexion, the gastrocnemius flexes the knee and because it crosses over two joints is more susceptible to strain. Many over-use problems arise in the lower leg. Imbalances can occur, for example, if the gastrocnemius is stretched well with a straight leg stretch and the soleus due to its attachment below the knee is not stretched out fully with a bent knee stretch, then adherence of these two muscles can develop.

Foot

The foot is a vital area to maintain. Strong, flexible musculature will enhance its shock absorbency minimising the risk of injury. Control and good movement of the joints in the foot are possible where the soft tissues are strong and supple. All this encourages efficient and correct foot plant and reduces the possibility of repercussions elsewhere. Whilst standing still, the arches of the foot are maintained primarily by strong ligaments in the sole. There are four layers of intrinsic muscles on the plantar surface which help support the arches of the foot as well as to move the toes. These muscles, together with the long tendons which cross the ankle, maintain the arches during movement.

There are many injuries which occur in the toes such as; turf toe, which is a sprain to the first metatarsaophalangeal joint (MP joint) and metatarsalgia which refers to general pain in the forefoot.

Knee

The knee has a good range of movement. It is made stable by strong ligaments and certain musculotendinous structures, in particular; the quadriceps muscles. The knee is constantly under stress as weight is transferred from the body to the ground in running and walking. Over-use can develop and the knee is vulnerable to traumatic injury from twisting and turning.

The quadriceps, hip flexors and adductor muscles all cross over the joints except the popliteus. The knee flexors control extension to prevent hyper extension of the knee during walking and standing. Pain behind the knee can be due to any of these muscles being tight, often the hamstrings. Commonly they can be strained through running, kicking or dancing. Congestion in the sartorius and gracilis can cause medial knee pain, but it is important that all of the tendons around the knee are treated as well as the entire muscle.

Quadriceps

The quadriceps are a powerful muscle group and are exercised significantly in walking, running, and jumping. The rectus femoris goes over two joints (it is also involved with hip flexion) so is more susceptible to strain. Separating and localised stretching will help to rebalance the four muscles and ensure that full function and strength are maintained minimising the possibility of impairment or breakdown to the quadriceps but also preventing over-use injuries to the knee. There is a danger in working too early on the quads after a direct trauma in that the formation of myositis ossificans is a possibility.

Hips

The enormous strength and musculature of the hip joint is necessary to cater for dynamic and controlled propulsion. The hips support the weight of the body and also transfer the weight powerfully, to the opposing leg, in a range of different weight-bearing activities from walking to running and jumping. Full range of movement and strength in the hips will encourage a biomechanically efficient and smooth gait.

Wrist

As with the ankle there is a band of connective tissue which supports the many tendons that attach across the wrist joint. The space created underneath the flexor retinaculum is known as the carpel tunnel. Many muscles and the median nerve all pass through this tunnel. Wrist sprains are common in contact sports.

A common injury is Carpel syndrome, where congestion occurs in the tunnel. Any repetitive actions involving the flexors such as gripping, can cause inflammation in the tendons. If numbness and tingling are present then the median nerve is also affected.

Shoulder

The structure of the shoulder joint allows for an excellent range of movement but, because of this, it lacks passive stability and has to rely heavily on the strength of its surrounding muscles. Any muscular dysfunction, therefore, will affect the strength of the joint itself. The rotary cuff muscles are vulnerable to overuse and traumatic injury. Loss of a particular rotation is a common symptom in shoulder pain. People often take up activities such as throwing, tennis or decorating without any thought of the problems of acute overuse.

A most common injury is Frozen shoulder. This refers to capsulitis of the shoulder joint and this painful condition severely affects rotation and abduction. When diagnosing a shoulder injury, careful examination is needed as pain arising from the shoulder can in fact be referred from the neck.

Neck

Neck flexors are generally weaker than the extensors which have to hold the heavy head in an upright position, against gravity. The extensors are constantly under tension contracting statically and eccentrically to maintain posture. Postural deficiencies can occur especially with repetitive activities or positions such as sitting at a computer for long periods, painting a ceiling or sporting pursuits such as cycling. The soft tissues can become micro torn and tense and, as the activity persists, holding patterns and imbalances prevail. An increase in the cervical curve, forcing the head forwards, is a common result. Problems manifest as movement restrictions, muscle, joint and nerve pain, head aches, vertigo and tinnitus.

Head

There are many reasons why head pain occurs. If you suffer from headaches, you might like to check with your doctor before consulting us. However, if you choose to approach us, you will be assured that a detailed history and a careful examination will occur.

Spine

The spine consists of 26 vertebras. Although only small movements occur between each vertebra the combined action of all of these facilitates good overall spinal mobility. The vertebral column is maintained in its upright posture by strong ligaments and muscles, is has three natural curves (four including the sacral curve) which together with the intervertebral discs, are responsible for absorbing shock. Flexible, strong muscles will enhance the fluid content of the discs and allow for efficient maintenance of the spinal curvature.

Many people will suffer with back ache at some point in their lives, although maintenance of correct posture would reduce the likelihood of injury problems. Good spinal posture places minimal strain on the muscles which maintain the body’s stance. If the body sways from its neutral position, it is counteracted by muscles that contract eccentrically. If an inefficient posture is continued, then adaptive responses lead to hypertonicity in the muscles, loss of spinal mobility and dysfunction. Postural adaptation often develops over many years and people are not aware of a problem until the tension and imbalance give rise to a traumatic injury, such as a prolapsed disc. Occupational factors such as driving for long hours or sitting behind a keyboard. If sports are the cause it could be repetitiveness, for example long distance cycling, or overload on one side such as golf or tennis.

Elbow

Joint stability at the elbow is predominately provided by the collateral ligaments and musculature around the elbow. The neck should be considered during treatment of any overuse injury to the elbow. Inflammation on the lateral and medial elbow is related to the muscles producing wrist movements. Common over-use problems originate in faulty technique and repetitive gripping and extension of the elbow such as racquet sports and intensive gardening. A common injury is tennis elbow or lateral epicondylitis. This is when pain occurs at the lateral side of the elbow. The pain can include nerve entrapment, bursitis and tendonitis.

Pelvic Girdle

The pelvic girdle is strong and stable with minimal mobility; it joins the lower limb to the spine transferring the weight of the body to the legs. The maintenance of good pelvic posture during sitting, standing or moving is critical in ensuring the efficient functioning of the area. Balance and strength in the trunk and hip muscles are the key to achieving this.

Gluteus Maximus

The gluteus maximus is a very stron muscle involved with powerful hip extension particularly from a flexed starting position. Movements such as stair climbing, rising from a seated position or squat, walking uphill and running, especially fast running which requires great drive and power, employ this muscle. As the gluteus maximus arises from the lower fascia of the back, it is consequently involved with trunk extension from a flexed position. It is also an important lateral rotator so will affect foot plant. Static build-up of tensions can also occur in the gluteus maximus because of its contribution to supporting the body’s weight in the seated position; contraction will take the body’s weight off the ischial tuberosities. Strains to this muscle are more likely to occur at its origin along the sacrum and iliac crest.

Hamstrings

The hamstrings work with the gluteus maximus to extend the hip if the knee is mostly or completely extended. They also assist the gluteus maximus in extending the spine from a flexed position. If hip extension is not occurring then the hamstrings are also powerful knee flexors.