Recovery & Beyond: Elbow Pain & Wrist and Hand Treatment in Cardiff
The elbow, wrist and hand allow us to perform precise movements with great dexterity. We regularly treat injuries to these areas due to overuse and trauma. Tennis elbow occuring on the outside , and Golfer’s elbow , on the inside , are degenerative conditions of the tendons and quite often arise in individuals who do not play these sports. They seem occur for no apparent reason but careful assessment should always be able find an underlying contributing factor which results in the tendons not being able to deal with the stresses placed upon them.
Overuse – Muscle and nerve entrapements around the elbow are common in those who weight train or climb regularly. Other overuse injuries at the wrist and hand come under the collective title of Repetitive Strain Injuries (RSI) and are far more prevalent in office worker’s and those regularly at a desk and / or PC for long hours. These overuse injuries are also becoming more prevalent due to the length of time people are spending on their phones texting and emailing etc…
Trauma – Traumatic injuires in the elbow , wrist and hand occur either following a fall , certain sports or after being immobilised following a fracture , where quite often there would have been some soft tissue injuries sustained at the same time as the fracture , due to the immobilisation enabling the fracture to heal the soft tissues can stiffen up during the time in the cast and need to be addressed to restore normal movement and function. We often treat MMA fighters , crossfitters and climbers after some kind of overstretching to the wrist or fingers during training or competition .
Due to the sometimes slow onset nature of these conditions we mainly see people when they have had a problem for a while and it has not managed to resolve with time. We encourage early assessment for any elbow , wrist or hand problem as appropriate intervention should mean a quicker return to full movement and the ability to rehabilitate more effectively. Also early intervention in overuse conditions should prevent the developments of chronic conditions which are notoriously difficult and time consuming to resolve.
You can expect a structural assessment of the local areas involved as well as an analysis of any potential problems contributing to these injuries , for example whole body movement should be looked at if specific to sport . For RSI injuries assessment can also include an on site assessment of the work station if required .
The knee is composed of the tibio – femoral joint , between the tibia and femur , and the patello – femoral joint , between the patella and a groove on the front of the femur.
Injuries to the tibiofemoral joint tend to be traumatic , commonly due to to excessive twisting and turning motion, and may result in damage to any of the 4 stabilising ligaments and the menisci.
The Anterior Cruciate Ligament (ACL) rupture is the knee injury that usually takes the longest time to return to sport and is commonly seen at Recovery & beyond. ACL rupture results in instability of the knee , for many people the most appropriate intervention would be surgical ACL reconstruction but for some conservative management may be more suitable. Rehabilitation after ACL reconstruction takes time , is very specific , and is done under the guidance of a Physiotherapist. We will liase closely with your surgeon , we have very good working relationships with the local Surgeons and regularly receive referrals directly from them . Non operative management has similar principles to post operative rehabilitation , increasing the functional control and strength of the affected knee. Specific protocols and careful progression is needed to ensure a successful outcome.
Injuries to the front of the knees tend to be overuse injuries. Anterior Knee Pain is a term used for pain in this area due to a combination of mainly biomechanical factors while Jumper’s knee is overuse condition of the tendon between the kneecap and the leg. These conditions need careful assessment by an experienced Physiotherapist as identification of the faulty mechanisms which can be anywhere through the kinetic chain that affects the knee is key to resolving the issue. These biomechanical factors can occur in combination with growth spurts and may result in children and adolescents developing excessive traction from the patella tendon resulting in Osgood – schlatter’s disease , or less commonly Sinding-Larsen and Johansson syndrome. There is much that can be done to improve function and movement , and maintain the clients sporting goals . We regularly see young people in the in clinic and understand how frustrating it can be , we are on hand to offer treatment and advice and to provide the support needed to keep up with training schedules.
Some traumatic knee injuries such as to the posterolateral corner need urgent surgical referral to prevent further long term damage , while other traumatic injuries leading to instability need early assessment to determine the appropriate management and referral if appropriate.
Our staff have extensive experience in assessing knee injuries , which is needed to ensure an effective treatment plan can be formulated. Asessment needs to encompass testing of the structures of the knee as well as the biomechanical factors that may lead to overuse on parts of the knee. This analysis would include the effect of other parts of the body on the knee and vice versa.
Depending on the findings of our assessment the primary goal would normally be to achieve better movement through the lower limb. This could include joint and soft tissue treatment directly to the knee and/or to other areas in the body causing excessive stress on the knee. Some form of exercise or movement correction would also be included. Other treatments could include
Strapping / kinesiotaping
Locking or giving way
Pain – would normally be related to specific movements which stress the injured area or in response to repetitive activites