Nottingham & Derby Physio

Ankle

Ankle sprains are a fairly common sporting injury, although they can also occur during day-to-day activities. It occurs when the ankle is inverted (rolls inwards putting pressure on the outside) if you mis-step or don’t notice a kerb for example.

These sprains can vary greatly in severity, from a mild discomfort that will resolve in a few days, to significant swelling and an inability to weight bear that can take months to resolve and leave lasting deficits if not properly managed. If you cannot weight bear through the foot immediately after the injury you should seek immediate medical assessment to rule out a fracture or significant ligament rupture that would require medical input.

All management follows the principles of PEACE and LOVE. Depending on severity, this means an initial reduction in L-load to allow for healing. In severe cases, this can consist of wearing a protective boot or using crutches, but in most cases this will mean avoiding aggravating activities such as running, jumping or changing direction. Rehabilitation will usually consist of progressive strengthening and stability exercises, along with proprioception exercises, which is (re)training your body’s knowledge of its position and reactivity.

Dubois B, Esculier J. Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine 2020;54:72-73.

Hip

Hip pain can limit mobility, making everyday activities like walking, sitting, or climbing stairs difficult. Whether caused by arthritis, muscle weakness or tightness, sports injuries, or prolonged postures, physiotherapy provides targeted treatment to relieve pain and restore movement.

A physiotherapist will assess your hip joint, muscles, and movement patterns to develop a personalized treatment plan. This may include manual therapy, strengthening exercises and movement retraining to reduce strain and prevent future discomfort.

By increasing flexibility, stability, and strength, physiotherapy helps restore function, reduce stiffness, and enhance overall hip health. Whether recovering from an injury or managing a long-term condition, the right physiotherapy approach can improve mobility and keep you moving with confidence.

Hands

Hand pain can significantly impact daily activities, from gripping objects to performing fine motor tasks. Whether caused by arthritis, repetitive strain, nerve compression, or injury, physiotherapy offers effective treatments to relieve pain and restore function.

A physiotherapist will assess the underlying cause of your hand pain and develop a personalized treatment plan. This may include manual therapy to improve joint mobility, strength and flexibility exercises to support the muscles and tendons, and splinting or taping to provide stability and aid recovery.

By improving grip strength, reducing stiffness, and enhancing overall dexterity, physiotherapy helps restore normal hand function and prevents further discomfort. With the right treatment and guidance, you can regain confidence in using your hands for everyday tasks.

Shoulder

Shoulder pain can often be complex and frustrating to manage. The most common type of shoulder pain is related to the rotator cuff. It can either occur after a trauma or gradually over time due to recurrent strain. Pain is often felt around various areas of the shoulder, including some pain referring a short way into the upper arm in more severe cases. It may affect tasks involving heavy lifting and reaching overhead, and can also be aggravated by staying in one place for an extended period, for example sitting at a desk. It can affect sleep, often making us wake up if we roll onto the affected side.

Assessment to determine what is causing or contributing to the problem is followed by targeted management which often involves rotator cuff targeted strengthening along with advice around reduction of loading of aggravating activities. Small adjustments to positions can alleviate aggravating movements and specific strengthening can promote healing.

The shoulder is a really mobile joint and relies on muscles for its stability. Therefore exercise is always a staple part of any treatment. Other conditions that may manifest with similar symptoms but require differential diagnosis as they need targeted treatment include;

• Frozen shoulder (capsulitis) which causes a significant loss of movement.
• Labral tear, common following a trauma, which can cause instability and clunking of the shoulder.
• Pain referring from the neck- often causes neurological symptoms such as numbness, tingling, burning or shooting pains into the arm

Neck

Neck pain is a common issue that can affect daily life, limiting movement and causing discomfort. Whether it’s caused by static postures, muscle strain, injury, or an underlying condition, physiotherapy offers effective solutions to relieve pain and restore mobility.

A physiotherapist will assess the root cause of your neck pain and develop a tailored treatment plan to address it. This may include manual therapy to release tension and improve mobility, targeted exercises to strengthen the muscles around your neck, and advice to prevent recurring issues.

Physiotherapy not only helps reduce pain but also improves flexibility, increases range of motion, and enhances overall function. By addressing muscle weakness and restricted movement patterns, treatment can prevent further discomfort and support long-term recovery.

If you’re experiencing persistent neck pain, physiotherapy can provide the guidance needed to regain comfort and function. A proactive approach to treatment can help you move more freely and get back to your daily activities.

Knee

A typical cause of knee pain that we see in clinic is described as “Anterior Knee Pain” this is the common term for pain around the patello-femoral joint. The patella acts as a pully system for the thigh muscles (quads) and typically pain is diffuse / non-specific and changeable when irritable. This is a really annoying condition, depending on how severe things are depends on how effective treatment strategies are.

One things for sure, patience and perseverance are key. Its worth seeing whether there’s tightness / weakness in the lower limb especially that might be contributing to mechanical forces.

The main management for AKP usually involves activity modification and a load overview. i.e. gradually changing our activity levels over time and considering speed, time, surface and general life events alongside a gradual increase in distance.

Pain is not the best way to monitor whether things are better / worse as many factors influence pain. Noticing if you get any swelling / heat around the joint is more useful, especially if there’s a change in these symptoms.

Strengthening / stretching trends seem to vary, but essentially maintaining or regaining a robustness in the body is essential.

We’re happy to work with you to help if you struggle with knee pain. Knowing what’s causing any pain and what you can do about it is empowering. Hopefully you can then do the activities you enjoy without having to avoid them.

Back

Mechanical lower back pain can muscular or joint related among other things. It is often related to changes in levels of activity and loading through the back. Doing unfamiliar activities or much more of what our bodies are used to are often the main causes.

There are commonly other factors involved also, such as lifestyle, poor flexibility, strength and high levels of stress or anxiety.

If you are concerned then it is important to be assessed to confirm a diagnosis. Management often involves improving levels of activity within your pain tolerance. Specific progressive exercises are usually indicated, as well as moving more generally, “motion is lotion” Most people will benefit from some exercises aimed at improved loading through the back along with some mobility work.

Integrating activities that are sustainable within your lifestyle is the best way to reduce the risk of your pain returning. Exercise such as pilates, yoga, going to the gym or parkrun / walk are some ideas. It is important to do what you love though so you are more likely to stick at it.

There can be other causes of back pain. If you notice any of the below, it is best to seek further medical assessment:

• Pain across multiple joints in the body, particularly if accompanied by significant stiffness or swelling.
• Pain after a significant trauma e.g. a fall down the stairs.
• Pain that refers into one or both legs, particularly if there is accompanying weakness, pins and needles or numbness.
• A sudden onset of pain that is accompanied by feeling particularly unwell or sudden weight loss

Elbow

Lateral Elbow Pain

Tennis elbow tends to be painful around the lateral epicondyle on the outside of your elbow which serves as the attachment point for the extensor muscles of the wrist and hand. These muscles allow you to straighten your fingers and lift your wrist up if your palm is facing downwards.

Although it is most commonly caused by overuse, it can sometimes be tricky to pinpoint when this overuse occurred. Unlike a strain or a sprain, there is not always a specific memorable action or moment when the pain started.
Usually, very few people actually get this injury from playing tennis, its more likely every day activities, or typically with an unusual increase such as doing some DIY / gardening.

Medial Elbow Pain

Commonly referred to as Golfers Elbow, pain is on the medial epicondyle on the inside of your elbow which serves as the attachment point for the flexor muscles of the wrist and hand. These muscles allow you to bend your fingers and bend your wrist down if your palm is facing downwards.

How can Physiotherapy help?

Your physiotherapist will assess your elbow to determine the cause of the pain, and then will be able to advise on what may be best for you depending on your goals and normal activities. This will usually involve guided exercises to help make the affected tendon more resilient and advice on adjustments that can be made to your normal activities to help your elbow recover as quickly as possible.