Body & Mind Training Center

Frozen Shoulder :

Frozen shoulder is the common name given to the condition adhesive capsulitis. Frozen shoulder is mainly found in the 40+ age group and affects slightly more women than men. It affects the range of motion at the shoulder and causes movements to be stiff and painful. It is usually only found in one shoulder, although can spread to both





It is not known what causes a frozen shoulder, although symptoms are thought to be due to inflammation of the joint capsule. This in turn causes the development of scar tissue which thickens the capsule and restricts movement. Usually, symptoms will gradually develop with no previous injury. However periods of immobilisation following another injury, such as a fracture, have been known to contribute to the problem. Offer possible causes include changes in hormone levels, poor posture and diabetes (diabetics are 5 times more likely to develop frozen shoulder).



Symptoms :

Frozen shoulder has three phases:

Painful phase - The shoulder starts to ache, which gradually increases to pain, often worse at night.

Frozen phase - The shoulder stiffens up and full range of motion is lost. Pain usually remains the same.

Thawing phase - The shoulder begins to loosen and pain gradually decreases.

The length of time that it takes for the frozen shoulder to pass through these stages varies considerably from 10 months to between 2 and 3 years.



Treatment:

If you suspect you have this condition you should seek medical advice as soon as possible as early treatment may limit the extent of the symptoms. A Doctor or injury specialist will usually:

Prescribe anti-inflammatory medication such as Ibuprofen to ease pain and inflammation.
Give you exercises to do to keep the shoulder moving.
Give you a Corticosteroid injection to reduce inflammation.
Surgery is rarely used and generally the condition is allowed to run its course with medication and exercise used to alleviate the symptoms. In persistent, severe cases, an arthroscopic (keyhole) capsular release can be performed.

Quadriceps Tendon Rupture


Ruptures of the quadriceps tendon mainly occur in middle aged individuals during sporting activities. The most common mode of injury is landing from a jump.


What are the Symptoms ?

Inability to weight bear.
The knee may give way during movement as the tendon does not have the strength to support the weight of the body.
Lack of muscle strength when straightening the knee against resistance In more serious cases there may be a complete inability to straighten the leg or to perform a straight leg raise.
The injury is associated with swelling, pain and sometimes bruising just above the knee joint.
At the time of injury there may have been an audible 'crack' or 'pop'.
The patella may be seen to move downwards, in the direction of the foot.


What is a Rupture of the Quadriceps Tendon ?

The quadriceps muscle is composed of four different muscles: the vastus intermedius, vastus medialis, vastus lateralis, and rectus femoris. These muscles converge just above the patella (kneecap) and form an extremely strong tendon, known as the quadriceps tendon. This attaches into the upper surface of the patella.

The quadriceps muscle group function in extending (straightening) the knee joint. They are also vital for the overall stability of the legs during movement, working in conjunction with the hamstrings to keep the body balanced.

Ruptures of the quadriceps tendon mainly occur in middle aged individuals during sporting activities. The most common mode of injury is landing from a jump as this leads to excessive loading on the quadriceps tendon causing it to tear. Most ruptures occur at a point between 0-2cm above the patella.

This injury usually comes secondary to degenerative changes in the quadriceps tendon itself. These changes may be due to ageing but the risk of injury is highly increased in individuals with other medical conditions such as obesity and diabetes or those who have had previous steroid injections.


Treatment of Quadriceps Tendon Rupture :

What can the athlete do ?

Apply RICE (Rest, Ice, Compression, Elevation) immediately
Use an elasticized compression bandage around the injury
Avoid movements that make the symptoms worse
See a sports injury professional.

In less serious tears, conservative treatment may be advised. This may include:

Ultrasound and TENS electrotherapy.
Rehabilitative quadriceps strengthening and proprioception exercises (e.g. wobble board exercises)
Manual techniques, such as massage.
Heat and ice therapy.


Surgery :

In cases where there has been a severe or complete tear of the tendon, surgery is required. If the tendon has been pulled off the patella, it is sutured (stitched) firmly back in place. Following surgery the knee must remain immobilized in a knee brace and non-weight bearing is usually advised for a number of weeks. Prescribed rehabilitative exercises should be followed once the rupture has healed sufficiently.

Achilles Tendonitis


What is Achilles Tendonitis ?


The Achilles tendon is the thick tendon at the back of the lower leg. It is a common tendon for the calf muscles (Gastrocnemius and Soleus) and inserts onto the heel bone. Achilles tendonitis is an inflammatory condition of the tendon, caused by overuse.





Symptoms :

Achilles tendonitis can be acute or chronic. Acute injuries are new injuries which are easier to treat. If the condition is not treated effectively whilst it is acute it may turn chronic, which is a long-term and more difficult to treat form of the injury.


Acute symptoms include :

Pain in the tendon which gets worse with exercise and eases at rest.
There may be swelling around the tendon.
The tendon may look red and thicker than the other one.
The tendon may creak when you stretch or touch it.
Chronic symptoms are similar but may also include:

Stiffness in the tendon which is worse in the mornings.
Tender lumps, called nodules within the tendon.
Pain even at relative rest, not just in sports.


Treatment :

Rest from the aggravating activity
Apply ice or other forms of cold therapy to the tendon to ease pain and inflammation.
Try using heel raises to take the strain off the tendon.
Visit a sports injury specialist.
A specialist or Doctor may recommend taking anti-inflammatories like ibuprofen.
Use ultrasound treatment to aid healing.
Apply sports massage to the tendon and calf muscles.
Give you strengthening and stretching exercises.
Catching this injury as early as possible is important to your long-term recovery. Returning to sport following treatment should also be a very gradual process to avoid going back to square one!


Causes :

It is important that you treat the cause of the injury and not just the symptoms. Common causes of achilles tendonitis include:

Training too much too soon
Running up lots of hills
Running on hard surfaces
Overpronating (flat) feet
Wearing high heels regularly

Cartilage Meniscus Injury



What is a Meniscus injury ?

The Menisci are two horseshoe shaped rings of cartilage which are found within the knee joint. There is a medial meniscus, on the inside of the joint and a lateral meniscus on the outside of the joint.





They are positioned within the knee joint, sitting on the flat, top surface of the Tibia (shin bone). Their job is to provide shock absorption for the knee joint and providing a cushioned surface for weight distribution and interaction between the Tibia and Femur (thigh bone).

What is a meniscus injury?

Meniscus injuries are tears to these rings of cartilage. The medial meniscus is more commonly torn than the lateral meniscus. This type of injury usually occurs following a trauma to the knee, such as a tackle in contact sports or twisting force to the knee. Damage to the cartilage can also develop over long periods of time, especially in sports people, who can suffer degenerative changes to the menisci.

Symptoms of medial meniscus tear :

A traumatic incident usually causing twisting at the knee
Pain usually on the inside of the knee if the medial meniscus is torn, or the outside if the lateral meniscus is torn.
The knee usually swells up, but this can sometimes be delayed.
There may be clicking, locking or a feeling of instability.


Treatment :

The RICE protocol should be used as soon as possible after the injury (Rest; Ice; Compression; Elevation).
Consult a Doctor Sports Injury professional.
Some tests can indicate cartilage damage but you may be sent for an MRI scan.
A specialist or Doctor may prescribe anti-inflammatories such as Ibuprofen.
Some meniscus injuries are treated conservatively using rehabilitation exercises.
Surgery is used in more severe cases.


In addition to immediate first aid the athlete can do the following :

Protect the injured knee by taping or wearing a knee brace.

Surgery :

Surgery is common for meniscus injuries, especially more severe tears such as a buckethandle tear. An arthroscopy is used (keyhole surgery) to limit damage to surrounding structures. The cartilage tear is usually stitched to repair it and to remove as little of the cartilage as possible. After surgery, rehabilitation is a priority. This usually involves getting a full range of motion back in the knee and strengthening the surrounding muscles to help stabilise the knee.

Further Information :

see retail site www.return2fitness.co.uk stocks a huge range of knee supports and braces to suit any condition.

Anterior Cruciate Ligament (ACL) Injury



What is an ACL injury ?

The ACL is the anterior cruciate ligament, one of two ligaments deep within the knee joint. The other is the posterior cruciate ligament. These two ligaments are called 'cruciate' as together they form a cross shape within the knee joint.




Their main job is to keep the Femur (thigh bone) and the Tibia (shin bone) in line and prevent one or the other slipping forwards or backwards. The ACL stops the Tibia from moving forwards under the Femur.

The ACL can be torn (ruptured) when a twisting force is applied to the knee when the foot is planted on the ground. It can also occur during an impact to the outside of the knee. It is quite a common injury, especially in contact sports.

Symptoms :

You might hear a crack or pop at the time of injury.
The knee joint may feel loose and unstable.
Pain which can't be pinpointed, around the whole knee joint.
The knee will swell up, usually instantly although this can be delayed.
The movement at the knee joint will be reduced, especially when you try to straighten the knee.


Treatment :

Use the R.I.C.E protocol (Rest, Ice, Compression, Elevation) as soon as possible.
Seek medical attention straight away.
A Doctor or Sports Injury Professional will asses the joint and ask you about how it happened.
You should be sent for an MRI or X-ray to diagnose the ACL tear for definite.
In addition to immediate first aid the athlete can do the following:

Protect the injured knee by taping or wearing a knee support.


Surgery :

Most cases of an ACL tear are treated with a surgical repair or reconstruction.
This is done via arthroscopic (keyhole) surgery.
Reconstruction of the torn ACL is performed using either a small part of one of the hamstring tendons or the patella tendon.
In a repair, the two ends are usually stitched back together. This is used more commonly in partial ruptures.
The decision not to operate is usually taken if the patient is old or not very active.
In this case a rehabilitation program is followed to strengthen the muscles surrounding the knee joint.


Rehabilitation :

Rehabilitation is now becoming more accelerated, with expected return to sport within 6 months in most cases.
Rehabilitation starts from day one after surgery, with mobility exercises.
Once movement is good, strengthening can begin

Posterior Cruciate Ligament (PCL) Injury


What is an PCL injury ?

The PCL is the Posterior Cruciate Ligament which is one of two cruciate ligaments, deep within the knee joint. The other is the anterior cruciate ligament (acl). The ACL and PCL form a cross shape in the knee where they pass each other, which is why they are called cruciate.




The job of the PCL is to stop the Femur (thigh bone) from moving backwards and to keep it inline with the Tibia (shin bone).

The PCL isn't injured as commonly as the ACL because it is stronger and thicker. When it is injured it usually occurs when there is a direct impact to the front of the knee joint like during a tackle or when falling forwards. PCL tears are often associated with other injuries to the knee joint, like cartilage tears.

Symptoms :

Pain in the knee joint upon impact.
There is usually swelling.
The joint may feel unstable.
Unable to walk on it.


Treatment :

Immediately stop play or competition.
Apply R.I.C.E (Rest, Ice, Compression, Elevation) to the knee straight away.
Seek medical attention immediately.
A Doctor or Sports Injury specialist will assess the knee and ask you about how it happened.
They can send you for an MRI or x-ray to confirm the injury.
They may refer you for Surgery if required.
A lot of PCL injuries are treated using conservative methods, such as electrotherapy, massage and rehabilitation exercises to regain full range of motion and strengthen surrounding muscles.
In addition to immediate first aid the athlete can do the following:
Protect the injured knee by taping or wearing a knee support.


Surgery :

PCL injuries are not sent for surgical intervention as frequently as ACL injuries. Only those with other associated injuries such as meniscus tears are usually sent for surgery. If conservative treatment fails to provide enough support for the knee joint, then surgery may also be performed later down the road.


Rehabilitation :

Rehabilitation is now becoming more accelerated, with expected return to sport within 6 months in most cases.
Rehabilitation starts from day one after surgery or injury, with mobility exercises.
Once movement is good, strengthening can begin