Senior Chartered Physiotherapist Jeelna joins BOOST

BOOST PHYSIO in Hendon.  Jeelna is an outstanding match for BOOST- she has the right mix of excellent sports experience, is a great “Hands-On” manual therapist, has qualifications in Pilates Rehab and has a warm bubbly personality! Perfect for us at BOOST.

Jeelna also works part-time for Queens Park Rangers FC, where she helps to look after their youth players both pitch-side and in clinic.  I am sure she will be putting her football physio skills to great use with all our football injuries here at BOOST PHYSIO.

Jeelna’s hours are:

• Monday: 12-8pm
• Tuesday: 8am-4pm
• Wednesday: 1pm-9pm
• Thursday: 12pm-8pm
• Friday: 8am-3pm
• Weekend appointments available

Please call the clinic on 020 82017788 to arrange an appointment with Jeelna.

Gaitscan computerised pressure plate and gait analysis system

ligaments and 38 muscles! The foot is in contact with the ground for about 0.8 of a second when walking and 0.25 of a second while running! That’s alot going on with each and every step! 

When examining and assessing patients with foot, ankle and even knee pain looking at the mechanics of the feet is essential.  BOOST PHYSIO has invested in a GAITSCAN system to better enable us to examine our patients’ gait and walking.

The GAITSCAN system is a sophisiticated pressure plate with over 4000 sensors that is connected to a computer system.  When we perform a GAITSCAN gait analysis our patient walks over the pressure plate which takes over 300 readings every second and feeds this to our computer system generating a very detailed report.  The report shows us and our patient where most pressure is occuring under their feet, if the foot alignment is correct, we can even look  the pressure under each of the toes!

If you are having persistent foot, ankle or even knee pain GAITSCAN analysis will help your physiotherapist to identify the role of faulty mechanics in your feet and ankles.  This can be addressed in a number of ways- often corrective remedial exercises will be prescribed for you.  Call us to book a GAITSCAN appointment now on 020 82017788.  GAITSCAN assessment is discounted to £48 when you pay immediately on the day, otherwise it is charged at our standard rate of £55.  As this is a physiotherapy assessment it is fully covered by most health insurance policies.

In certain cases it may be advisable to invest in a pair of prescription customised orthotics (innersoles) to improve the foot mechanics and to relieve the pain.  Your GAITSCAN data is sent to the GAITSCAN Lab in Canada where the scan data and prescription is used to produce your customised prescription orthotic to help correct and improve your foot function.

What allows 1 sports person to escape injury free- and the other to be beset by injury troubles?

A couple of weeks ago I conducted an injury screening for 2 members of the Great Britain Judo team.  I concluded that Judo is a dangerous sport!  This was the week before they were representing GB in a Judo tournament- who knows they may be representing GB at the 2012 Olympics!  How did we come into contact with these Judo players?  Well…

At BOOST PHYSIO we are privileged to be a Talented Athlete Scholarship Scheme  physio clinic (TASS- click here for more info about TASS).  What’s TASS I hear you ask- it is a Government funded programme to support and fast-track young sporting talent, the potential medal winners of the future- and BOOST PHYSIO is one of the clinics looking after these athletes.  Click here to view a Video about TASS.

So during this athlete screening I had to screen 2 female judo players which left me with the philosophical question- why do elite athletes have so many injuries and what leads some to succeed and others not?

One of the girls had broken her arm and her wrist  previously and had a thumb injury, the other had a dislocated thumb – all from Judo.  But these girls were tough- training hard in conjunction with their strength and conditioning coaches.  I wondered to myself- are these injuries simply the consequence of contact sport, or is it something else, perhaps the extreme lengths to which elite sports people push themselves to achieve excellence?  Could an ability to recover better from injury allow one to  to succeed while another fails?

I’ve never seen a 19year old athlete who’s had a steroid injection for an injury before (usually it’s over 30’s and sometimes those in their 20’s), so when I did this hit home and reminded me the extremes to which sports people push their bodies in pursuit of their dreams.

Rafael Nadal’s poor performance at the Australian Open seems to be put down almost entirely to injury from pushing himself too much, some critics even wonder if he’s going to be able to come back in the same way because of his injury problems.  I’ve had to treat injuries of various county level tennis players ranging from 10 to 17 years old.  The one who I think gets pushed the hardest is the 10 year old boy- whether it is him or his mum who does the pushing I am sometimes not too sure- but when kids under 14 come regularly for physio for various injuries one asks the question- is this simply the cost of the pursuit of excellence or is this abnormal.  Furthermore could it be that what dictates whether he will ever make it to Wimbeldon is actually his physical make-up and pre-disposition to injury that may make him miss 1 or 2 critical seasons of training and competition?

A recent article in the Telegraph talks about the mounting concern over the Winter Olympics casualty list and safety of the various sports- it would seem that the sports and events themselves are becoming more extreme, not only the athletes themselves who are pusing the boundaries all the time.  Clearly there is a huge psychological element to why and how athletes push themselves to the extremes.

Enough philosophising- to sum up it is clear to me that to even aspire to elite sporting success requires enormous physical sacrifice and dedication, along with mental tennacity and extreme focus.  But that to succeed in achieving the pinnacle of one’s sport will almost always be dictated by the ability to ward off  serious injury. I firmly believe that those athletes on the winners podium have their genetic code to thank in warding off career stopping injury in what Darwin would call survival of the fittest!

So the reason why I have always achieved sporting mediocrity must be down to my genetic code- it just aint good enough

This is an image of the front of the right shoulder showing examples of some tears to the rotator cuff of the shoulder

written by Jolene Sher, Senior Physio

What is the Rotator Cuff?

• The shoulder joint is a ball and socket joint, formed by the ball-shaped end of the upper arm (the humerus) and a shallow socket on the edge of the shoulder blade (scapula). This allows for a large range of movement in many directions. Stability within the joint is provided by the muscles, with some support from the ligaments. The main muscles that give this stability are the Rotator Cuff muscles.

•  The rotator cuff is made up of a group of four muscles (called the subscapularis, supraspinatus, infraspinatus and teres minor) and their tendons. The tendons wrap around the shoulder, forming a cuff around the ball of the humerus providing the stability during movement of the arm.

• On top of the shoulder joint is a bone called the acromion. In the gap between the shoulder joint and the acromion is a space that some of the rotator cuff tendons run through.

Types of rotator cuff injury

Rotator cuff injury is a general term to describe inflammation or damage to one or more of the muscles or tendons that make up the rotator cuff.

Rotator cuff tendonitis

• The tendons of your rotator cuff can become inflamed. It most often affects the tendons which run underneath the acromion. When a tendon becomes trapped or squeezed, it’s known as impingement syndrome. Pain usually comes on gradually.
• This is when the muscles or tendons that make up your rotator cuff become completely or partially torn. It may be a result of a trauma, such as a fall, or due to tiny tears to the tendon through use and wear over time. Pain usually comes on suddenly.

Rotator cuff tear

 How does it start and who is affected

Rotator cuff injuries may occur due to one or more of the following:

• Poor movements (e.g. repetitive or overhead activities) or poor posture around the shoulder are usually factors that can cause adverse strains and stresses in the rotator cuff.

• Lifting or pulling an object that is too heavy for you or lifting it in the wrong way.
• Landing on an outstretched hand to break a fall. Rotator cuff injuries often occur if you dislocate your shoulder.
• Wear with age.
• Muscle imbalance (When some of the muscles in your rotator cuff are stronger than others).
• Musculoskeletal disease (e.g. rheumatoid arthritis)

Shoulder pain affects around one in five people in the UK and rotator cuff injury is the most common cause.

Symptoms

Symptoms of a rotator cuff injury may include:

• Pain and tenderness over your shoulder (it may radiate down the arm) especially when you raise your arm out to the side, reach behind you or lift or pull a heavy weight
• Pain at night, particularly when you sleep on the affected side
• A feeling of weakness in your shoulder
• A limited range of movement in your shoulder
• Clinical findings from the Doctor or Physiotherapist. This includes special tests to pick up signs of shoulder impingment.
• Medical treatment: Commonly used interventions are advice (e.g. rest and ice), medication (e.g. anti-inflammatories or analgesics), corticosteroid injections and/or referral for physical therapy.

Diagnosis

• MRI
• Ultrasound scan
• X-rays cannot diagnose rotator cuff injuries. 

Treatment

Conservative Treatment (Non-surgical treatments)

Physiotherapy Treatment

• Appropriate initial assessment- NB history and observation.
• Initial treatment is to help alleviate pain and inflammation. This can be achieved with ice, rest, soft tissue release and the use of electrotherapy modalities.
• Identifying predisposing factors such as posture or ergonomics (work/sport positions) and pre-injury level of function.
• Appropriate referral to a specialist if need be.
• Rehabilitation to return to work/sport:

ü      Stabilisation – to ensure that the shoulder joint can remain stable under increased tension.

ü      Strength – to make the shoulder strong in all movements (using gym based exercises)

ü      Function – enhancing the shoulder’s ability to cope with the demands needed to get back to pre injury level

Surgical treatments

If unable to treat it conservatively surgery may be indicated, for example to repair a tear in your rotator cuff or to remove calcium deposits.

Prevention

To prevent rotator cuff injuries, make sure you:

• have the correct technique when playing sports or doing activities that use your shoulder, particularly overhead motions
• do exercises and stretches to keep your rotator cuff muscles strong and supple