Archive for category Common Injuries & Conditions

What is a Chilblain?

Erythema pernio, also known as perniosis or chilblain, is a lesion located on the surface of the skin that usually arises after being in contact with cold or humid environments for a long time.

What causes it?

The main cause of chilblains on the feet is exposure to cold. Experts affirm that they can appear after having an abnormal response of our body to low temperatures, combined with poor regulation of the blood flow to our skin.

After being exposed to the cold, if we put our feet or hands close to intense heat, this painful inflammation occurs which causes the blood vessels in our skin to expand, causing Chilblains. This can happen to your hands, ears, and nose as well as your feet.

It should be noted that there are certain groups of people who, due to their physiological characteristics, are more vulnerable, such as children, women, and the elderly, but there are also various factors that increase the risk of chilblains, including:

1. Sex and weight

Women are more likely to get chilblains than children and men, as are people who are underweight.

2. Poor blood circulation

Those who have poor circulation are more sensitive to changes in temperature so it is more likely that they may have this injury.

3. Alterations in the connective tissue

One risk factor is connective tissue disorder, such as rheumatoid arthritis, vasculitis, or cryoglobulinemia.

4. Reynaud’s disease

Raynaud’s disease is a disorder of the blood vessels, which narrow when the person feels cold or stress, and affects the toes and fingers. People with this problem are more likely to get chilblains.

Symptoms of Chilblains

• Reddened and well-defined patches on the skin of the feet
• Appearance of blisters
• Itching and burning sensation in the affected area
• Pain and swelling in that part of the feet
• Color changes, from red to dark blue, in the painful area
• In most severe cases it can become an ulcer.

Prevention of Chilblains

• Use on waterproof footwear to avoid the rain or snow contact with our feet
• Wear suitable insulating clothing such as cotton or wool socks
• Do physical exercise regularly
• Follow a diet rich in foods with vitamins A, C and D
• Apply specific moisturizers
• Reduce prolonged exposure to cold or very humid environments
• Avoid wearing clothes that expose the skin to cold
• Try not to wear ballet flats, very thin socks, or go out without socks
• Avoid tobacco, as nicotine amplifies the vasoconstrictor response to cold
• Do not put your hands or feet directly to sources of heat such as a radiator as sudden changes in temperature increase the risk of Chilblains

Treatment for Chilblains

In addition to taking the relevant precautions mentioned above, you’ll need to have a clear diagnosis first so we recommend you visit a Podiatrist or a vascular doctor if it mainly affects your feet as they can accurately diagnose and recommend the appropriate treatment for you.

If you’d like to book in to see one of our Podiatrists, please do so by calling 01380 730473 or book online here. 

Over a quarter of the population experiences neck pain at some time each year. Over half of these resolve on their own, however, a large proportion does require treatment to aid recovery, particularly those that frustratingly persist or that recur time and again.

Neck pain can be short-term (acute), or a long-term (chronic) problem and can be the result of a number of factors – with a singular origin, or from weaknesses in numerous minor areas that add up to cause your symptoms. These can manifest in sudden pain, or gradual onset of symptoms that may at first remain unnoticed but build to cause discomfort.

What are the symptoms?

Pain or discomfort is not solely isolated to the neck but can also include:

• Radiation into the shoulder and arm
• Pins and needles or numbness in the arms/hands
• Mid-back discomfort
• Reduced movement of the neck
• Headaches

What causes it?

These are equally varied, examples may include but are not limited to:

• Impact/trauma
• Sudden and vigorous neck movement
• Prolonged awkward position
• Long-term posture
• Disc protrusion
• Joint related – e.g. stiffness, inflammation, degeneration
• Muscular spasm
• Wry/cricked neck (also known as Torticollis)

How can we help you?

Our highly qualified and experienced physiotherapists can provide you with different methods of pain relief to suit your needs, and a variety of appropriate treatment techniques so that you can make a full recovery.

What types of treatment are available?

Manual Mobilisation Therapy – These are passive movements that the therapist applies to the joints in and around the neck to increase the range of movement, reduce stiffness and pain.

Manipulation Therapy – Can help to release joints that have become stiff and painful

Soft Tissue Massage Therapy – Can reduce muscle tension, improve tissue mobility, enhance muscle contraction and desensitise any painful and overactive areas.

Acupuncture – Can stimulate the body’s natural healing response, release pain-killing endorphins and improve the functioning of the hormonal system

Electrotherapy – Used to assist the natural healing process and reduce pain via an increase in energy (electrical, sound, light, magnetic, or temperature).

Exercise and Rehabilitation – A tailored exercise programme will be designed to target the right areas in order to regain strength and range of movement for normal function and long-term management.

Ergonomic and Postural Advice – Can help you manage your day-to-day activities whether you’re sitting at a desk, performing leisure activities, or trying to get a good night’s sleep.

If you’re suffering from neck pain and would like some help, please get in touch on 01380 730473.

Knee pain is not solely isolated to sporting injuries but affects people of all activity levels and ages. The knee is, in simplistic view, a hinge joint, however, there are a huge number of components that go into making this joint work effectively every day, and with every step.

Symptoms

Pain can be at different points in or around the knee and potentially radiate down into the shin or up into the thigh. The symptoms may range from a mild hindrance of one’s activities, through to the severe limitation of normal daily life.

Causes

Knee pain can either be directly related to the integrity of the joint and supporting structures or be a result of problems elsewhere that place abnormal pressure on the knee joint. Common knee injuries include:

Ligamentous damage or rupture – There are four main ligaments in the knee which work to limit excessive movement of the joint. Two that sit within the knee joint limiting forward and backwards movement, and two that sit either side of the knee limiting sideways movement. At times, these ligaments can tear or completely rupture if the knee joint is over stressed in certain directions.

Torn or worn meniscus – The meniscus is a wedge-shaped structure made of cartilage located within the knee, which act as shock absorbers. Damage to the meniscus can occur from an acute injury – for example if the knee is twisted when the foot is planted on the ground, or with long-term over-use

.

Patellar tendinopathy – This injury occurs as a result of damage to the strong connective tissue which attaches the quadriceps (thigh) muscle to the shin bone. Excessive jumping or landing strains the patella tendon which over time can cause Patellar tendinopathy.

Chondromalacia patellae – The cartilage under the kneecap is a natural shock absorber. Deterioration or breakdown of this cartilage, often as a result of imbalances at the hip or foot can cause Chondromalacia patellae

Arthritis – Most commonly with osteoarthritis or rheumatoid arthritis which can cause swelling, stiffness and knee pain as you flex and extend your knee.

Iliotibial band friction syndrome – The iliotibial band (ITB) is a tight band of fibrous tissue that runs down the outside of the thigh, from the hip to just below the knee joint. ITB friction syndrome is caused by the ITB rubbing over structures on the side of the knee, often a result of imbalances at the hip or foot.

Apophysitis – Generally found in adolescents, particularly those who are very active and/or have recently had a growth spurt, apophysitis is an inflammation of the bone where strong tendons attach. The most common types of apophysitis at the knee are Osgood Schlatters disease – where the patella tendon attaches to the tibia bone, and Sinding-Larsen-Johansson disease – where the patella tendon attaches to the bottom of the patella.

How we can help you?

Physiotherapy can be extremely beneficial. Our qualified and experienced Physiotherapists will provide you with a diagnosis and create an individualised treatment programme so that you can make a full recovery as soon as possible. They will provide you with all the advice necessary, and even if you are in training they will advise you on any modifications to keep up your routine as much as possible during your rehabilitation. If an onward referral to a doctor or consultant (both private and NHS) is required, this will also be organised.

We also run Rehabilitation classes where you are led through bespoke exercises suited to your needs and recovery.

When control of the limb is an issue, this can be addressed by Pilates. We provide classes and one-to-one sessions to aid with this.

If the cause of your knee pain is related to imbalances in your feet, you will be referred to one of our excellent Biomechanical Podiatrists. They can assess and treat you as necessary, which may including casting and fitting of orthotics to address any imbalances.

If your condition requires muscular relaxation to aid recovery, Massage Therapy is an excellent treatment option.

If you’re suffering from knee pain, please get in touch on 01380 730473 and we’ll get an appointment booked for you. 

Back pain is a very common condition affecting 7 out of 10 people at some point in their lives but it can be treated effectively.

The largest cause of work-related absence in the UK, back pain can affect anyone at any stage in life but has the highest prevalence during adolescence, and then again in middle age.

Low back pain can be very uncomfortable, but it is usually not serious. It can also be the cause of pain, numbness, weakness, or tingling sensations in the legs, often called sciatica. In the majority of cases, the cause of your back problem can be linked to the way in which the bones, muscles, and ligaments in your back work together and how you have been using them.

If during your episode of low back pain you notice changes to your bladder or bowel function you should go straight to your local Accident and Emergency Department as this could indicate a more severe problem.

The lower part of your back, known as the ‘lumbar region’ supports the entire weight of your upper body and is under constant pressure, particularly when you are bending, lifting, and twisting. The complex structure of your lower back means that even small amounts of damage to any part of the lumbar region can cause pain and discomfort. Back pain will usually last from a few days to a few weeks but can be longer in more severe cases.

Aside from a muscular strain, which is the most common cause of low back pain, one of the more common injuries, or causes of pain, in the lower back originates from the discs. When enough pressure is applied to one side of the disc, the paste-like nucleus on the inside can protrude or bulge out from the disc. This is otherwise known as a prolapsed or herniated disc. Disc injuries most commonly occur when a person bends over to lift a heavy object incorrectly.

How can we help you?

Physiotherapy can be extremely beneficial for someone suffering from back pain. Our aim will be to reduce your pain and stiffness, increase your core stability and flexibility, and provide you with education and advice to prevent any future occurrence. Treatment may consist of hands-on therapy, acupuncture, exercises, as well as ergonomic and postural advice.

Pilates classes are also a great exercise option for improving core strength and movement patterns and are appropriate for someone experiencing back pain.

Our Rehab classes can also be beneficial in building your general strength and fitness which will aid in the long-term care of your back.

Regular Massage can also aid in reducing muscle tension, improving flexibility, and relieving any painful and overactive areas.

If you’re suffering from back pain and would like to see a Physio, please call us on 01380 730473 or book online here. 

What are the symptoms?

The symptoms of shoulder impingement include:

• Weakness and loss of movement
• Possible swelling in the shoulder area
• Pain and difficulty lying on the affected side when sleeping.
• Pain in the shoulder and upper arm when lifting the arm above shoulder height.

What are the causes?

It is important to recognise that shoulder impingement is not in itself a diagnosis, as there can be many different causes for its occurrence. Four common causes for shoulder impingement are:

Bony changes to the acromioclavicular joint

The acromioclavicular joint is a bony arch positioned just above the shoulder joint, formed by the acromion process (part of the shoulder blade) and the clavicle (or collar bone). After years of wear and tear to this joint, the body lays down bony spurs (or osteophytes) in an attempt to protect the area. These bony changes can then impinge the tendons and soft tissues that lie in between the shoulder joint and the acromioclavicular arch.

Inadequate muscular stability

The shoulder is extremely dependent on the muscles around it to move the scapula (shoulder blade) out of the way of the shoulder joint, in order to give the shoulder its full range of movement. When these muscles become weak, they lose control of the scapula and this can impinge on the tendons of the shoulder.

Postural Changes

Our posture can be a common cause of shoulder impingement. This is typical of a patient with thoracic kyphosis (or slumped posture). Increased thoracic kyphosis can cause the scapula (shoulder blades) to move forwards making the shoulders more rounded. The altered position of the scapula reduces the range of movement in the shoulder joint and this predisposes the joint to impingement.

Acute Tendon Tears

People who perform repetitive arm movements above their head such as throwing, shelf stacking, or hedge trimming can be at risk of shoulder impingement. As you raise your arm the space between the head of the humerus (the “ball” of the ball and socket joint) and acromioclavicular arch becomes less. This increases the potential for impingement of the tendons that run through the subacromial space (the space between the acromioclavicular arch and the shoulder joint). In addition to this, a sudden overhead arm movement may cause these tendons within the subacromial space to tear, the tendon then becomes inflamed and this can lead to further shoulder impingement.

How can we help you?

Our highly experienced physiotherapists can provide you with a thorough examination and a diagnosis. From our findings, we will create a personal treatment programme that will focus on areas such as reducing pain, regaining range of movement, strength, and stability. As you progress we can adapt your treatment so that your rehabilitation will be specific to your work tasks and/or sporting activities.

What types of treatment are available?

The following are some of the treatment options we can offer to those suffering from shoulder impingement.

Manual mobilisation therapy – These are passive movements that the therapist applies to the spine to increase the range of movement, reduce stiffness and pain.

Soft tissue massage – Can reduce muscle tension, improve tissue mobility, enhance muscle contraction and desensitise any painful and overactive areas.

Ultrasound Therapy – Can speed up and optimise the healing process.

Acupuncture – Can stimulate the body’s natural healing response, release pain-killing endorphins and improve the functioning of the hormonal system.

Interferential Therapy – Can provide pain relief, muscle stimulation, enhance blood flow and reduce oedema.

Exercise and Rehabilitation – We can provide you with exercises that can safely target the right muscles in order to regain both strength and stability.

Ergonomic and Postural advice – This can help you manage your day-to-day activities whether you’re sitting at a desk or trying to get a good night’s sleep.

If you’re experiencing shoulder pain, get in touch by calling 01380 730473 and we’ll get you booked in for an appointment. 

Children can often experience aches and pains in the evenings or during the night commonly known as growing pains – that can be uncomfortable for them, but also make parents feel helpless to ease their child’s discomfort.

The good news is there are a lot of different things that can be done to help with growing pains.

So we’ve asked one of our Physios to shed some light on this topic and clarify what growing pains really are and what you can do about them.

What are growing pains?

Growing pains are aches experienced by children in their legs, typically at night and during periods of rapid growth. Children with growing pains:

• Occasionally wake up feeling stiffness in their legs
• Can wake up in the middle of the night with leg pain
• Often feel discomfort in their legs after playing sport
• Sometimes feel discomfort in their legs when resting
  

Why do they occur?

There isn’t any conclusive research to show why growing pains occur, but there are a number of factors that can contribute to it – such as the rate of your child’s growth, the volume and intensity of physical activity, tight muscles, weight,  foot posture, and many other factors. Growing pains tend to be more prevalent in active children and they can be common amongst siblings.

So what can you do?

Physiotherapy can help assess, diagnose and recommend the best treatment options to help alleviate growing pains. This may include regular Massage, the use of orthotics (custom-made insoles), a strengthening programme, anti-inflammatories, and much more.

Children can often continue with their sports or activity during treatment, and our Physios will advise them on how best to do this.

At the Clinic, all our Physiotherapists are experienced in treating children, so if your child or grandchild suffers from growing pains, don’t ignore them. Call our friendly team to book in for an assessment on 01380 730473 or click here to learn more about Physiotherapy at Hatts

Why do heels crack?

Cracked heels are caused by cracking or splitting of the skin – this may be due to dryness or callus build-up which splits when under pressure.
When skin becomes thickened or dry, it loses its elasticity and becomes less supple. When day-to-day pressures are placed on the heel from activities such as walking, it can cause the skin to split which can be painful. Additionally, there are many medical conditions that can cause dryness of the heels such as diabetes, psoriasis, lichen planus, heart disease and many more.

How can I get rid of this?

With some minor cracks or dryness to your heels you should be able to treat this at home but for the best results and especially more extensive cracking, seeing a Podiatrist is your best option.

The Podiatrist will be able to provide a diagnosis of any underlying medical condition which may have been causing the cracked heels. They will also remove any dry or thickened skin in a quick and easy manner. By seeing a Podiatrist get this excess skin removed, will then make it much more manageable to treat at home in between podiatry appointments through filing regularly; around 3 times a week, and creaming daily with a urea-based cream.

If you would like to see one of our Podiatrists, you can book an appointment online or give us a call on 01380 730473

What is Achilles Tendinopathy?

Achilles Tendinopathy is a common condition that presents itself typically as a sharp pain in the heel of the foot. The Achilles tendon is a large tendon located at the back of the heel which connects your calf muscles to your heel pain. When this tendon is injured, it is referred to as Tendinopathy. It occurs most commonly in middle-aged adults and in athletes.

What are the symptoms of Achilles Tendinopathy?

The most common symptom is a sharp pain at the back of the heel, but can also present itself as burning pain or a constant dull ache. It is usually worse when you get out of bed and put weight on your feet first thing in the morning, or if you walk or run after a period of inactivity. During an acute injury, there is often noticeable swelling around the tendon which may also be inflamed, which is characterised by redness and heat. It is often painful when gently squeezing the tendon compared with the non-affected side.

What causes it?

There is no single cause but instead a likely combination of risk factors. These can be described as 2 main factors; intrinsic and extrinsic:                                                                                        

Intrinsic factors include: 

• Feet with very high arches or very low arches
• Feet that roll inwards while walking
• Tight Achilles tendons or calf muscles
• Being overweight

Extrinsic factors include:

• Standing on your feet for a large part of the day – such as is the case for Teachers and Factory Workers
• Wearing footwear that does not support the foot correctly

How we can help with treatment:                                                                                                                                                                                                                                                             

Achilles Tendinopathy is definitely a treatable condition, with many different options available depending upon individual circumstances. A Gait Analysis appointment our Biomechanics Podiatrist will determine the causes of your Achilles Tendinopathy and recommend a treatment plan that is bespoke to you. This could include:

Orthotics: custom orthotics or insoles can be an excellent treatment option for Achilles Tendinopathy. Orthotics are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your Achilles Tendinopathy.

Shockwave Therapy: This is an excellent treatment option for chronic or resistant cases and helps increase your healing capacity. This treatment works best alongside other treatments listed here:

• Physiotherapy: This is a crucial part of the treatment plan if you suffer from Achilles Tendinopathy. Physiotherapists may provide manual therapy, therapeutic ultrasound, acupuncture, and an individually prescribed exercise programme to help build strength in weak muscles that could be causing your Achilles Tendinopathy.
• Massage: If your Achilles Tendinopathy is caused due to tight calf muscles, our massage therapists can help to ease the tension in your muscles, thereby addressing the cause.

You can find more about our Gait Analysis service along with what to expect at your first appointment here

If you’re suffering from Achilles Tendinopathy, we can help. Book your Gait Analysis appointment online or by calling us on 01380 730473. Appointments are available at any of our clinics in Devizes, Marlborough, or Frome.

A Morton’s Neuroma is a swelling of one of the nerves in the ball of the foot. Typically you will know you have a neuroma if you start to experience pain the ball of your foot. People describe the pain as shooting, numbness, burning or stabbing. It is intermittent, meaning that it comes and goes. Generally the pain gets worse with time. At first, the area may become a little bit numb for a few minutes in a pair of tight shoes, but this could develop over weeks or months to the point where you have an intense stabbing pain in the foot every time you stand or walk for more than a few minutes.

There are a number of theories on what causes a neuroma. However, the cause is not well understood and there is very little evidence to suggest a consistent cause. What we do know is:

• The swelling is thought to be from trauma of the nerve i.e. pressure from surrounding bones
• The swelling is benign, not cancerous
• It is more common in women
• It is made worse by certain shoes or activities

DIAGNOSIS

A diagnosis of a neuroma can often be achieved by a podiatrist by taking a thorough history of symptoms and a range of clinical examination tests. A podiatrist can also differentiate your condition from a range of other common and more rare causes of pain in the ball of the foot. Achieving a correct diagnosis is very important in formulating the correct treatment plan for you.

Most neuromas affect the area behind and between the third and fourth toes. However, they can also affect the second and third toes and more rarely the fourth and fifth toes. Diagnostic imaging tests are sometimes required if the diagnosis is not clear enough from a clinical examination alone. The most common imaging test is an ultrasound which can help aid the diagnosis if required. It is important to mention that sometimes the neuroma cannot be detected with an ultrasound machine and therefore an alternative test may be considered such as an MRI.

TREATMENTS                                                                                                                                                                                                                                                        

There are many treatments available for neuromas. Here at Hatts, we can support you with the following:

1. Injection therapy – Sometimes an injection of steroid and local anaesthetic into the neuroma and around it, can relieve the pain and stop the neuroma from developing.

2. Orthotics – These can be of benefit when alleviating pressure from the nerve. To assess whether this is a viable option, a podiatrist will perform a biomechanical assessment and gait analysis to help determine whether an orthotic may be a suitable treatment for you.

3. Footwear choice – This is the simplest. If your neuroma only hurts when you dance in your favourite 4inch heel Jimmy Choos, then take them off to dance. This is a ‘no brainer’ and can stop your neuroma from getting worse.

After having seen one of our podiatrists, if necessary we can also refer you on for:

1. Surgery – When the pain warrants it, you can have the neuroma removed by a small operation. This is often done under local anaesthetic as an outpatient setting.

2. Cryosurgery – This is a new treatment and is used as an alternative to the traditional surgical method of excision. This procedure is less invasive and involves putting a small needle through the skin and into the neuroma which is frozen whilst it is in the foot. This is done under local anaesthetic. The success rate of this procedure seems to be equivalent to surgical excision and is thus, gaining increased popularity. There is only a small amount of clinical research compared with the excision option, therefore it is currently unknown whether there is a better option at present.

If you think you may have a neuroma or you have pain in your feet, please seek help from one of our podiatrists before it gets worse by calling 01380 730473.

However, if you are a keen runner there is also every chance that you have had a frustrating layoff with one or more of the most common injuries, which can interrupt your training.

The four most common running injuries we tend to see are:

1. Runners Knee
2. Shin Splints
3. Plantar Fasciitis
4. Achilles Tendonopathy
   

Let’s briefly deal with each in turn:

Runner’s Knee

This is a lay term that can lead to some confusion as it can encompass injuries such as iliotibial band syndrome (ILTB) anterior knee pain (AKP) and patella tendon injuries, all of which are completely separate injuries that may be chronic (gradually appear over time with overuse) or acute (due to sudden injuries).

ILTB 

The pain occurs on the outside of the knee joint, is worse during running but eases when you relax. This can be caused by tightness in the ilio-tibial band, poor foot function, i.e., over-pronating feet, unsuitable shoes and excessive training.

AKP or Chondromalacia Patella 

The pain is mostly around the kneecap, often just on the inside or below but can also radiate to the back of the knee. It occurs because the tracking of the kneecap within the femur as you bend your knee is altered. This can be due to muscle imbalances in the thigh or hip – some muscles are pulling too strongly and some are simply too weak. Inflexibility is another common factor here as is overpronation or poor foot function.

Patella Tendinopathy 

Even the casual runner can suffer from this although it tends to be more common in more high-impact sports injuries involving bursts of activity. The pain is usually localised to the tendon and starts with pain after exercises but can progress to debilitating pain through exercises. Most recent research has shown inflexibility of the hamstrings and quadriceps is very common; also the alignment of the patella (the kneecap) and the biomechanics of the feet can have a significant impact on this condition.

Shin Splints

This is another lay term that can encompass any of the conditions described below:

• Compartment Syndrome
• Stress Fractures
• Medial Tibial Stress Syndrome

All of these commonly experience pain on the inner side of the shin during exercise and even at rest in more chronic cases. The individual history needs to be carefully taken to distinguish between them. The individual’s training, lower limb biomechanics, flexibility, and muscle strength must all be carefully assessed in addition to their running shoes in order to determine the cause and appropriate solution to the runner’s pain.

Plantar Fasciitis

This refers to pain on the underside of the heel which often radiates down the inside of the sole of the foot. Pain is usually worse on activity and also after prolonged inactivity, particularly on getting up in the morning the first few steps can be very sore.

The most common cause of this is often the biomechanics of the foot due to overloading of the plantar fascial tissue. This is often described as over-pronating seen in people with flattened medial arches, or under-pronating seen in people with higher more rigid arches. Overload of the tissues can all occur if the footwear does not have adequate shock absorption or is worn out. Plantar fasciitis is common in runners and by replacing running shoes can sometimes resolve spontaneously. On other occasions, it can be very persistent which could be due to the wrong type of running shoes being worn or that an orthotic is needed to improve the biomechanics. Tight calf muscles and Achilles tendons can increase the strain on the plantar fascia. To resolve this the individual needs a full biomechanical lower limb assessment and advice about their shoes and self-help measure including stretches, ice etc.

Achilles Tendonopathy

This is due to the degeneration of the tendon above the heel and forms part of the lower calf muscles. This means the tendon is not as strong and may be liable to rupture with continued excessive sporting activity.

The pain comes on gradually and is worse on activity and any focal area of degeneration can be very tender to touch. The tendon is very stiff first thing in the morning and is often thicker on the affected side.

Again training should be looked at, muscle strength, flexibility and foot biomechanics are all factors that need to be addressed. Specialist eccentric exercise programmes are often very successful for these types of tendon problems although they need to be continued for at least 3 months.

We have only outlined the 4 most common running injuries that we see here at the Clinic. Our thorough initial assessment would enable us to identify whether you were suffering from any of these conditions or from one of the many other running injuries that we also treat.

Your treatment can include if appropriate, individual training advice, strengthening and stretching exercises, joint mobilisations, pain relief, and goal setting through a complete rehabilitation programme. We would also be able to identify and correct any abnormal lower limb biomechanics, which may predispose you to injury.

However it is important to realise that the most frequent cause of running injuries is overtraining or what could be termed the “terrible toos”: Too much, too soon, too often, too fast, and too little attention paid to pain all too often lead to injury.

If you’re suffering from a running injury and would our help. Please get in touch by calling 01380 730473.

What is Upper Limb Disorder?

Upper Limb Disorder (ULD) can affect the neck, shoulder, arm, forearm, elbow, wrist, fingers, and thumb with symptoms of tenderness, ache, pain, stiffness, weakness, tingling and numbness.

What can cause Upper Limb Disorder?

Risk factors include repetitive or prolonged tasks such as a computer or manual work. The risk is increased if these repetitive or forceful movements are allied with a poor posture.

How can ULD be prevented? 

• Changing your way of working can considerably relieve symptoms of ULD. Often, those that work in an office are prone to carrying out repetitive, uncomfortable actions or sustained positions. It is important to work with your employer to identify and change conditions that may lead to or exacerbate your condition. Take an office chair, for example, one size does not fit all and individuals have different needs related to their body size, age, abilities, and health.

• Your employer needs to encourage regular short and frequent pauses in intensive work. Display Screen Equipment Regulations require employers to train employees incorrect use of display screen equipment (DSE), provide suitable furniture, and periodic assessments if DSE is used for more than one hour daily. This may include adjustable chairs, platforms, and footrests. If the equipment is provided specifically for you, make sure you use it correctly.
  

Who can help?

Physiotherapists are the best medical practitioners for you to see if you suffer from Upper Limb Disorder. Physio is an extremely effective treatment for this condition and the earlier we tackle the ULD, the better,  to reduce your pain and stop your symptoms from becoming difficult to manage.

At Hatts, we can offer you an ergonomic assessment that will help to identify ergonomic risk factors, quantify them, and make measurable improvements to your workplace, ensuring that your jobs and tasks are within your physical capabilities and limitations. We can also offer you an effective treatment plan that will relieve your pain, restore your movement, and finally get you moving better than ever before.

For more information or to book an appointment give us a call on 01380 730473 or use online booking.

The fight/ flight response is designed to get you out of a dangerous situation. It involves increased steroid hormone releases such as adrenaline and cortisol.

This affects blood pressure, insulin release, immune function and inflammatory response. These changes result in increased heart rate, respiration rate, blood pressure and loss of digestion. Ideal when faced with a sabre-toothed tiger. Not so ideal when stuck in a traffic jam!

In a chronic situation, these stress responses affect cognitive performance, suppress thyroid function, slow down wound healing and immune response, contribute to loss of bone density, muscle strength and increase abdominal fat.

Frequent colds result from the loss of ability to fight infection. The sufferer may also notice poor sleep, loss of ability to cope, decreased confidence, difficulty concentrating and making decisions, headache, stomach upset, butterflies, irritability and lowered energy levels.

The best treatment is a multi-pronged attack on the causes of stress:

Try to address your priorities – It’s easy to get uptight about relatively trivial matters if you don’t stop and check your perspective

Social support is critical – A close friend, partner, family member or pet can provide the reassurance needed at vulnerable times

Physical exercise – Exercise changes the focus from mind to body, relieves tension and uses up excess adrenaline

Be aware that some people are more sensitive to stress than others – Monitor your mind and body for warning signals that you are starting to feel overloaded. Take action before everything gets on top of you.

You may like to try the following exercise as an instant stress buster. It is based on techniques used for meditation but you can work at whatever depth feels right for you:

Find a time and place that you can be sure you will not be disturbed and get into a comfortable position using pillows and cushions to support your body as needed. Bring your mind to your breathing. Do not try to change it; just observe your inhalation and exhalation. When your mind wanders bring it back to the breath. Initially try 10 minutes, notice how much more relaxed you feel afterwards.

Physiotherapists can provide relaxation techniques and advice on safe and enjoyable exercise programmes to build back mental and physical well being, so if you’re struggling to cope with stress, please reach out to us by calling 01380 730473 or booking an appointment online. 

Most of the research that has been conducted on glucosamine and chondroitin relates to people who are experiencing the symptoms of knee osteoarthritis.

What is osteoarthritis?

An imbalance of physiological processes leads to inflammatory cascades at a molecular level which affects the synovium, bone and cartilage and produces joint degeneration. Risk factors for knee OA include age, genetics, trauma, knee alignment and obesity. (see our OA article for more information)

What does the research say?

Reviews published in respected journals (including the British Medical Journal) in the period from 2005-7 have suggested that there is no clear benefit of oral glucosamine or chondroitin as compared to placebo. However, glucosamine is as safe as a placebo.

There have been some less rigorous studies that have suggested that glucosamine is superior to placebo with regard to effects on pain or function but this depends on which system of scoring pain and function is used. Some studies have argued that glucosamine and chondroitin affect subchondral bone remodelling and decrease structural change in the knee- this is still open to debate.

How much to take?

The Arthritis Campaign advises that it is reasonable to trial 1500mg of glucosamine sulphate daily if you have been experiencing chronic knee pain as this may reduce the progression of some aspects of OA shown on XRay and it is unlikely to cause you any more harm than taking a placebo (except to your wallet).

However, it is important to remember that it is possible to have OA changes on XRay but with no discomfort and equally a relatively clear XRay with a lot of discomforts.

Can physio help?

There is general agreement that exercise does have beneficial effects on pain and disability particularly that caused by knee OA.

Physiotherapy advice on a programme of exercise can help you get back on your feet. Generally, it is possible to advise and develop an individual exercise programme with a minimum of two sessions of physiotherapy. You can then use your exercises to maintain and improve the muscular support of your joints.

To book an appointment with one of our Physios, please call us on 01380 730473 or book online. 

Plantar fasciitis affects approximately 10% of the population. Find out about this condition, its causes, symptoms, and how a Gait Analysis at the clinic can help.

What is Plantar Fasciitis?

Plantar fasciitis is a condition that presents itself as a sharp pain in the heel of the foot. It is caused when the strong fibrous tissue that joins the heel to the ball of the foot gets irritated and inflamed. The condition is derived from the words plantar which is the bottom of the foot, and fascia which is the fibrous connective tissue responsible for supporting the arch and transmitting weight across the foot as you walk or run.

Plantar fasciitis is most commonly seen in middle-aged adults and in athletes.

What are the symptoms of Plantar Fasciitis?

The most common symptom is a sharp pain at the bottom of the heel, which can sometimes feel like walking on a marble. It is usually worse when you get to your feet first thing in the morning, or if you walk or run after a period of inactivity. In some cases, pain can also extend along the bottom of the foot where the plantar fascia extends to join the ball of the foot.

What causes it?

Irritation or inflammation of the plantar fascia can be caused by 2 main factors; intrinsic and extrinsic.

Intrinsic factors include:

– Feet with very high arches or very low arches

– Feet that roll inwards while walking

– Tight Achilles tendons or calf muscles

– Being overweight

Extrinsic factors include:

– Standing on your feet for a large part of the day – such as is the case for Teachers and Factory Workers

– Wearing footwear that does not support the foot correctly

How we can help with treatment?

Plantar fasciitis is definitely a treatable condition, with many different options available depending upon individual circumstances. At your Gait Analysis appointment, our Podiatrist will determine the cause of your plantar fasciitis and recommend a treatment plan that is bespoke to you. This could include:

Orthotics: The most effective treatment for plantar fasciitis is the use of custom orthotics, or insoles. Orthotics are are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your plantar fasciitis.

Shockwave Therapy: This is an excellent treatment option for chronic or resistant cases and helps increase your healing capacity. This treatment works best alongside other treatments listed here.

Corticosteroid Injection: This can be effective at relieving symptoms in the short term. Our Podiatrist will use Corticosteroid injections in combination with other treatment options such as stretching or orthotics.

Physiotherapy: You may also see one of our team of Physiotherapists for manual therapy and an individually prescribed exercise programme to help build strength in weak muscles that could be causing your plantar fasciitis.

Massage: If your plantar fasciitis is caused due to tight calf muscles, our massage therapists can help to ease the tension in your muscles, thereby addressing the cause.

Night splint: The use of a night splint may be recommended to help prevent overnight tightness of the Achilles tendon and plantar fascia.

Find out more about a Gait Analysis and how it can help you here >

Shin splints is the term used to describe pain along the inner edge of the shin bone usually caused by repeated trauma to the area. Common amongst runners, footballers, and rugby players, find out more about this condition, its causes, symptoms, and how we can help.

What are Shin Splints?

Shin splints are medically known as medial tibial stress syndrome (MTSS) due to the anatomical location of pain which is located along the inside of the shin starting approximately 5cm above the ankle extending up to one-third of the shin bone. It often presents as a deep bruise-type pain.

It is a specific overuse injury-producing pain on activities such as running. Shin splints are more common in females than males with a 4:1 ratio but are still prevalent in men.

What are the symptoms of Shin Splints?

Shin splints typically present themselves as a deep bruise or aching pain. It is often present at the start of running which subsides after a few minutes but then can return towards the end of a run due to fatigue and a change in running biomechanics. It can also be painful first thing in the morning the day after a run. Normally, day-to-day function and walking is unhindered, but shin splints can progress if left untreated. If you experience pain during walking it may suggest a more severe bone injury such as a stress fracture.

What causes it?

Historically there have been a number of popular theories on the causes of shin splints, however, the most recent research findings suggest it is a bone stress injury and is believed to be linked to an increase in bending stress placed on the bone. The bending stress on the bone is greatest at the lower shin and this can be exacerbated due to abnormal biomechanics. There are many reasons why a person may have abnormal biomechanics which may include:

• Increased foot pronation (flat feet)
• Poor core stability
• Poor glute or hip muscle strength
• Tibial varum (abnormal bone alignment of the lower leg)
  

How we can help with treatment?

Many different options are available to treat shin splints and these will depend upon your individual circumstances. At your Gait Analysis appointment, our biomechanics Podiatrist will determine the cause of your shin splints and recommend a treatment plan that is bespoke to you. This could include:

Orthotics: Custom orthotics or insoles are one of the most effective treatments for shin splints. Orthotics are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your shin splints.

Running Analysis: As shin splints is nearly always linked to running we provide specific running gait analysis to look at your technique which may highlight abnormality or technique issues which can then be worked on via various methods.

Shockwave Therapy: This is an excellent treatment option for chronic or resistant cases and helps increase your healing capacity. Shockwave therapy works best alongside other treatments listed here.

Physiotherapy: You may also see one of our team of Physiotherapists for manual therapy and an individually prescribed exercise programme to help build strength in weak muscles that could be contributing to your shin splints.

Massage: If your shin splints is due to tight leg muscles, our massage therapists can help to ease the tension which provides effective relief of symptoms.

Find more about a Gait Analysis and how it can help you here >

Flat feet is the term used to describe feet with low or no arches. In this blog article, you’ll learn about what causes flat feet in children & adults, when you should seek professional help, and what treatment options we can offer you.

Flat feet in children

Children have flat feet from birth until the foot develops, usually between 6-8 years of age. However, after this period not everyone develops an arch. This can be down to genetics and may run in the family and be inherited from parents. If there is a genetic link, this rarely causes problems.

In many cases of flat feet, the feet tend to roll inwards too much during standing and walking which causes flattening of the arches. This may be due to ligament laxity in the foot joints. This is known as pronation. This is a common reason why children have flat feet as they tend to have looser joints than adults. In rare cases, the flat foot shape can also be due to the way the foot formed in the womb, where for example, a joint may be malformed or two or more bones may be fused together. Children’s feet in these cases are stiff and flat, and the problem is usually obvious in childhood.

Flat feet in adults

The people referred to above have always had flat feet. However, occasionally a flatfoot develops later in life. This is known as adult acquired flatfoot. This is most often caused by a ruptured or weakened tendon (the tibialis posterior tendon), ligament laxity in adult life, arthritis or an injury-causing stiffness and distortion of the joints of the foot. In all these cases there is often pain and limited daily function. Some people with neurological conditions such as spina bifida, muscular dystrophy, or cerebral palsy may develop flat feet due to muscle weakness secondary to disease of the nervous system. In neurological cases, the feet are stiff and the deformity tends to get worse over time.

When should I consult professional help?

You should consult a podiatrist if:

• Your feet cause you a lot of pain when standing or walking
• Your shoes wear out very quickly
• Your foot or feet seem to be getting flatter
• Your feet seem very stiff
• You cannot feel your feet normally, or they seem weak

What can be done about flat feet?

In many cases, no treatment is needed. This is when there are no symptoms such as pain. If you have pain in your foot, ankle, or lower limbs, it may be due to your flat feet. If you or your child experience pain you should consult a podiatrist for a professional opinion. If your pain is due to your flat feet a podiatrist may prescribe custom-made orthotics, which are medical insoles made specific to the needs of the individual. In some cases, surgery is required to straighten the feet. If you require surgery your podiatrist will refer you to a podiatric surgeon or orthopaedic surgeon

How we can help with treatment?

Orthotics: Orthotics are an excellent treatment for people with painful flat feet or flat feet that are causing pain elsewhere such as the knees due to poor biomechanical control. Our orthotics are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your pain. To assess if orthotics are suitable for you, book in for a Gait Analysis appointment.

Physiotherapy: If your flat feet are caused by muscular tightness, injury, or weakness, you may also see one of our team of Physiotherapists for manual therapy and an individually prescribed exercise programme to help build strength in weak muscles that could be causing your flat feet.

If you suspect you’re suffering from flat feet, we can help. Book your Gait Analysis appointment online or by calling us on 01380 730473. Appointments are available at any of our clinics in Devizes, Marlborough or Frome