Body & Mind Training Center

Biceps Femoris Tendinopathy :

The biceps femoris tendon is one of the hamstring muscle tendons. Injury to this tendon causes pain at the outside, back of the knee





Symptoms of Biceps Femoris Tendinopathy :

Tenderness and swelling over the bit where the tendon inserts onto the bone (tendonitis).
With Biceps femoris tendinopathy the tender area is to the outside/back of the knee. If the other two tendons are involved there may be tenderness medially.
Pain when you try to bend the knee against resistance.
Stiffness after exercise.
The hamstring muscles are usually tight, meaning hip flexion range of motion is limited.


What is Biceps Femoris Tendinopathy ?

The hamstring muscles consist of the Biceps femoris, Semitendinosus and Semimembranosus. These muscles are used to bend (flex) the knee and extend the hip (move the thigh backwards). Inflammation of these muscles can result from a partial rupture that has not healed properly or through overuse, particularly accelerating and decelerating. Most commonly the Biceps femoris tendon is involved. This is the one hamstring muscle which attaches to the outside of the back of the knee.




Treatment of Biceps Femoris Tendinopathy :


What can the athlete do ?

Rest and apply ice or cold therapy.
See a sports injury professional who can advise on treatment and rehabilitation.


What can a sports injury specialist do ?

Prescribe anti-inflammatory medication such as ibuprofen.
Apply ultrasound or laser treatment.
Prescribe a full rehabilitation programme consisting of stretching and strengthening exercises.
Eccentric exercises are very beneficial in treating tendinopathies.
Sports massage techniques are usually helpful
.

Prevention :

Always ensure you follow a correct warm up before training or competition.
Stretch the hamstring muscles both before and after training. Stretch every day, regardless of whether you are training or not.
Strengthen the muscles to cope with the demands placed on them.
Have regular sports massage to keep the muscles and tendons in good condition.
Avoid doing too many accelerating / decelerating runs or hill work

Tight Muscles in the Upper Back and Neck :

A lot of pain that occurs in the upper back and neck is due to tight muscles in the neck, shoulders and upper back.


Symptoms of Tight Back and Neck Muscles :

Aching discomfort in the upper back or neck area.
Relief from stretching the muscles, self massage or the use of hot packs or warm baths.
Reduced range of motion, especially of neck movement.
Tenderness around the neck or shoulder blades.


What Can Cause Tight Muscles ?

Tight muscles in the neck is a chronic condition which develops gradually, slowly getting worse until the individual seeks treatment. This is generally different to a neck strain which is most short-lived and usually resolves itself after a few days.

The tight muscles do not allow as much blood into them as is needed and therefore they do not get the energy and nutrients they need to stay healthy. Therefore tight muscles weaken and then tighten up further, so a viscous circle has begun.

Overuse causes small micro tears in the muscles. The muscles then tighten up to protect themselves.
Poor neck stretching routines, particularly after training. If the muscle is not stretched to it's natural length regularly it may adaptively shorten.
Scoliosis. If you have a sideways curve in the spine then some muscles will be put under more strain than they can cope with.
Poor posture. The head is a very heavy object and if you position it just a few centimeters the wrong way this can considerably increase the work the muscles of the back and neck have to do


Treatment :

What can the athlete do about tight muscles ?

See a sports massage therapist for regular sports massage that will help keep the muscles relaxed and toned.
Stretch properly and regularly.
Concentrate on good posture until it becomes second nature. A good taping method can encourage you to maintain correct posture.
Use strengthening exercises to strengthen the weak muscles of the back.


What can a sports injury therapist / professional do ?

Use sports massage and stretching techniques as part of a rehabilitation programme.
Use ultrasound therapy to assist in relaxing the muscles.
Give advice on posture and preventative strategies.

Deltoid Muscle Strain


An injured deltoid muscle can cause shoulder pain at the front/ side or back of the shoulder.

What is the Deltoid Muscle ?

The deltoid muscle is the big muscle on the shoulder. It has three parts - the front (anterior), middle and back (posterior). The muscle lifts the arm up sideways. The front part helps to lift the arm up forwards (flexion) and the back part helps to lift the arm up backwards (extension).





Symptoms of a deltoid rupture include :

A sudden pain in the muscle at the front of the shoulder.
Pain when you lift your arm from your side to the front keeping it straight against resistance.
Pain when you lift your arm from your side up sideways against resistance.
Tenderness and swelling where the muscle is torn.

Grade 1: What does it feel like ?

You might have tightness in the muscles.
You may be able to use your arms properly or do press ups easily.
You probably won't have much swelling.
Trying to lift your arm up sideways or to the front or back of the body probably won't produce a lot of pain.

What can the athlete do ?

Apply ice for the first 24 hours (15 mins at a time) then heat.
Light exercises - 4 sets of 10 repetitions 3 times a week (for example).
Gradually build up the weight to strengthen the muscles.
The athlete should ease down on training for a week or two but it is unlikely they need to stop unless they are getting pain.

What can a Sports Injury Specialist or Doctor do ?

Use sports massage techniques to speed up recovery (very important).
Use ultrasound and electrical stimulation.
Prescribe a rehabilitation programme.


Grade 2: What does it feel like ?

You probably cannot use your arm properly or do press ups.
You may get occasional sudden twinges of pain during activity.
You may notice swelling.
Pressing in causes pain.
Lifting your arm up to the front, side or back against resistance causes pain.

What can the athlete do ?

Ice for 3 to 5 days.
See a sports injury specialist who can advise on rehabilitation.
Apply heat (hot water bottle, hot baths, see a specialist for ultrasound).
From day 7 do light, pain free exercises (4 sets of 10 reps three times a week).
Cycling 2 to 3 times a week.
Begin stretching (hold stretches for 30 secs, 5 times a day).
From day 14 start to slowly get back into sports activities.

What can a Sports Injury Specialist or Doctor do ?

Use sports massage techniques to speed up recovery (very important).
Use ultrasound and electrical stimulation.
Prescribe a rehabilitation programme.


Grade 3: What does it feel like ?

You will be unable move your arm.
You will be in severe pain.
You will have bad swelling appear immediately.
A static contraction will be painful and might produce a bulge in the muscle.
Expect to be out of competition for 3 to twelve weeks or more.

What can the athlete do ?

Week 1: You should seek medical attention immediately. R.I.C.E. (Rest, Ice, Compress, Elevate.)
Week 2: Pain free static contractions ( if it hurts don't do it). Heat with hot water bottle, hot bath or ultrasound.
Week 3: All of the above plus increase the intensity of static contractions 4 sets of 10 reps 3 times a week.
Week 4: Pain free exercises e.g. light lateral raises and rotator cuff exercises, 4 sets of 10 reps 3 times a week. Cycling 2 or 3 times a week. Start stretching exercises, hold for 30 secs, 5 times a day.
Week 5: Build up exercises, 4 sets of 6 to 8 reps 2 days a week. Gradually build up to sports specific exercises.

What can a Sports Injury Specialist or Doctor do ?

Use sports massage techniques to speed up recovery (very important).
Use ultrasound and electrical stimulation.
Prescribe a rehabilitation programme and monitor it.
Operate if needed.

If you suspect a grade two or three injury I recommend you see a Sports Injury Specialist immediately.

Rotator Cuff Injury / Rotator Cuff Tear

Rotator Cuff injury or strain is an injury to any of the four rotator cuff muscles in the shoulder. We explain the injury and look at treatment options and rotator cuff exercises for this common shoulder pain




Rotator Cuff Tear symptoms:

Rotator Cuff Tear (Acute) :

This tends to happen as a result of a sudden, powerful movement. This might include falling over onto an outstretched hand at speed, making a sudden thrust with the paddle in kayaking, or following a powerful pitch/throw.

The symptoms of a Torn Rotator Cuff will usually include:

Sudden, tearing feeling in the shoulder, followed by severe pain through the arm.
Limited movement of the shoulder due to pain or muscle spasm.
Severe pain for a few days (due to bleeding and muscle spasm) which usually resolves quickly.
Specific tenderness (“x marks the spot”) over the point of rupture/tear.
If there is a severe tear, you will not be able to abduct your arm (raise it out to the side) without assistance

Rotator Cuff Tear (Chronic) :

A chronic tear develops over a period of time. They usually occur at or near the tendon, as a result of the tendon rubbing against the overlying bone. This is usually associated with an impingement syndrome.

Usually found on the dominant side.
More often an affliction of the 40 age group.
Pain is worse at night, and can affect sleeping.
Gradual worsening of pain, eventually some weakness.
Eventually unable to abduct arm (lift out to the side) without assistance or do any activities with the arm above the head.
Some limitations of other movements depending on the tendon affected


What is a Rotator Cuff strain ?

The rotator cuff is a group of muscles which work together to provide the Glenohumeral (shoulder) joint with dynamic stability, helping to control the joint during rotation (hence the name).

The rotator cuff muscles include:




Supraspinatus




Infraspinatus




Teres Minor




Subscapularis

Supraspinatus and Infraspinatus are the most commonly injured rotator cuff muscles. Due to the function of these muscles, sports which involve a lot of shoulder rotation – for example, bowling in cricket, pitching in baseball, swimming, kayaking – often put the rotator cuff muscles under a lot of stress.

Problems with the rotator cuff muscles can be classed into two categories – Tears of the tendons/muscles, and inflammation of the tendons (often called tendinopathy or tendonitis).

Supraspinatus Rupture :

The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm (humerus bone). It is one of the four rotator cuff muscles.

Symptoms of a Ruptured Supraspinatus Tendon :

A sharp pain at the time of injury.
Pain when you rotate the arm outwards or upwards and outwards.
Increased pain and weakness when the arm is raised between the 60 degree arc.

What is the Supraspinatus Muscle ?

The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm (humerus bone). It is one of the four rotator cuff muscles. This muscle is used to lift the arm up sideways and is also important in throwing sports as it is the muscle that holds the arm in the shoulder joint when you release what you are throwing.

There are massive forces involved in slowing the arm down after you have thrown something but few people bother to train these muscles. A heavy fall onto the shoulder can also result in injuring this muscle. Injury can occur to the tendon as it inserts into the top of the shoulder on the humerus.


Treatment of a Ruptured Supraspinatus Tendon :

What can the athlete do ?

At the time of injury apply ice. Do not apply directly to the skin but wrap in a wet tea towel to avoid ice burns. Ice can be applied for 15 minutes every 2 hours for the first day or two. From then on the frequency can be gradually reduced over a period of days.
Rest until there is no pain.
For a partial rupture, complete rest of the shoulder by immobilization in a sling or similar is usually recommended by a doctor.
See a sports injury specialist or doctor who can advise on treatment and rehabilitation.

What can a Sports Injury professional do ?

If the rupture is partial, immobilize the arm and prescribe rest.
Prescribe a rehabilitation programme.
Operate if it is a total rupture.

Carpal Tunnel Syndrome :

The symptoms of carpal tunnel syndrome are caused by compression of the median nerve which passes through the wrist and into the thumb and next three fingers as shown. Before it enters the hand, it passes through the 'carpal tunnel' which is a channel formed by the carpal bones and the flexor retinaculum (the thick ligament type structure shown blow ) .




Symptoms:

Pain which comes on gradually and slowly gets worse.
A dull ache initially in the wrist and hand.
Pain which radiates into the thumb and four fingers.
Tingling, burning or numbness.
Pain is often worse at night.


Causes :

The cause of carpal tunnel syndrome is compression of the median nerve, where it passes through the carpal tunnel. The reason for this compression is either structural (following a fracture or other injury), inflammatory (due to overuse or arthritic conditions) or fluid retention (as during pregnancy). For some people the cause can be congenital, as they have a naturally narrow carpal tunnel.

Carpal tunnel occurs more commonly in women, especially during pregnancy, and also in diabetics. Some occupations are more at risk of developing carpal tunnel syndrome, such as assembly line workers and others who repetitively perform the same hand and wrist movements.


Treatment :

If you think you may have carpal tunnel syndrome you should visit your Doctor for a diagnosis. There are several things your Doctor will be looking for, including reproduction of your symptoms on a carpal tunnel test such as tinels sign.


Treatment usually includes the following :

Immobilisation of the wrist for a period of around 2 weeks.
A splint or cast will usually be used.
If there is swelling or inflammation present anti-inflammatories may be prescribed.
Cold therapy may also be advised to reduce swelling and inflammation.
After the immobilisation period, if pain-free, exercises can begin.
Exercises should aim to strengthen the wrist to prevent a reoccurrence.
If this conservative treatment fails, other options to consider include a Corticosteroid injection. If this also fails and symptoms have been persistent for 6 months or more, surgery may be considered. A simple procedure called a carpal tunnel release can be performed, which involves cutting the carpal ligament to make more space for the median nerve.