Horley Clinic 01293 784200 • Crawley Clinic 01293 400218 info@thecarltonclinic.co.uk
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Where does it hurt?

 

Find out how osteopathy and massage can help you with a wide range of injuries and pain.

Shoulder

Rotator Cuff Injuries

The rotator cuff is a group of four muscles that play a part in lifting and rotating the upper arm, as well as a role in stabilising the shoulder to avoid dislocation. The muscles run along the upper shoulder blade where they are very susceptible to injury.

A tear may result suddenly from a single traumatic event or develop gradually.

When patients present with rotator cuff tears, either to the tendons or muscles, they are unable to lift or rotate their arm with the same range of motion as before and also experience severe pain when using the arm. Pain is commonly felt at night and radiates down the arm.

Our osteopaths can help you keep your shoulder strong and flexible, and reduce the pain and weakness.

If symptoms persist or worsen, surgery may be required, and you may be referred for an X-ray or MRI to confirm diagnosis.

Treatments include:

  • Osteopathy
  • Dry Needling
  • Ice to reduce inflammation and pain
  • Avoiding strenuous activity
  • Kinesio Taping
  • If there is no improvement with the above, your Osteopath may refer you for further treatment like steroid injections.

Shoulder injuries

Shoulder injuries are often associated with sport, but can also be caused by everyday knocks, bumps and falls.

They include dislocations, Acromioclavicular joint (AC) injuries, the previously mentioned rotator cuff injuries, labral tears, ligament strains, muscular injuries, bursitis and fractures.

Your Osteopath will be interested in the mechanics of the injury to help understand what structures may be affected.

We advise early assessment from a doctor or osteopath, and in some cases, we refer where necessary for x-rays and scans.

Treatments include:

  • Osteopathy
  • Sports massage
  • Dry Needling
  • Ice to reduce inflammation and pain
  • Avoiding strenuous activity
  • Kinesio Taping
  • If there is no improvement with the above, your Osteopath may refer you for further treatment like steroid injections.

Frozen Shoulder

A frozen shoulder is an extremely painful condition in which the shoulder completely or partially stiffens.

The lining of the shoulder joint, known as the ‘capsule’, is a very flexible elastic structure, giving the joint a huge range of motion. If this capsule and its surrounding structures become inflamed and contracted then that elasticity is lost, and it leads to pain and stiffness.

Frozen shoulder can appear from nowhere or is triggered by a seemingly mild injury.

The return to full movement may take several years, often going through “freezing”, “frozen” and “thawing” phases.

We recommend early diagnosis and osteopathic treatment to increase the shoulder’s range of movement and prevent further stiffness.

Treatments include:

  • Osteopathy
  • Dry Needling
  • Ice to reduce inflammation and pain
  • Exercise & Rehab
  • If there is no improvement with the above, your Osteopath may refer you for further treatment like steroid injections.
woman with shoulder pain

Sub-acromial Impingement

Patients who are suffering from subacromial impingement usually have difficulty in reaching behind their backs, and experience pain using the arm above their head.

One of the rotator cuff muscles lies under the roof of the shoulder in a space known as the acromion. Between the tendons and the acromion is a fluid-filled sac which allows tendons to work comfortably when the arm is raised.

Simply put, if there is a subacromial impingement, the rotator cuff can’t work effectively, movement is impaired, and it is very painful.

We see this condition linked to:

  • Rotator cuff strain or tears
  • Calcific tendinopathy
  • Chronic overuse
  • Shoulder instability
  • Abnormal movement patterns


Treatments include:

  • Osteopathy
  • Dry Needling
  • Ice to reduce inflammation and pain
  • Avoiding strenuous activity
  • Kinesio taping
  • If there is no improvement, then steroid injections may be offered by a doctor

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Elbow

Tennis Elbow & Golfers Elbow

Tennis Elbow is clinically termed “lateral epicondylitis”. Golfers’ Elbow is clinically termed “medial epicondylitis”.

As the names suggest – Golfers and tennis players are susceptible to these conditions, but in reality most people don’t play sport but are subject to repetitive strains in their every day lives, such as from desk work or decorating.

Tennis & Golfers elbow is usually caused by overusing the muscles that attach to your elbow and move the wrist. If the muscles and tendons are strained, tiny tears and inflammation can develop near the bony lumps (the lateral/medial epicondyles) of your elbow. This can cause a lot of pain and may take a long time to resolve.

For tennis elbow, pain is mostly felt on the outside of the elbow, whereas golfers’ elbow is mostly felt in the inside of the elbow. The pain can be aggravated by lifting things like a cup of tea, twisting the wrist and gripping tightly.

Our osteopaths will fully assess your elbow to understand the cause and condition before making recommendations about treatment. This may combine deep soft tissue massage, articulations and stretches, as well as joint manipulation.

Ligament Injuries

Ligaments that stabilise the elbow can become sprained or torn. This can lead to instability and pain. Our osteopaths will fully assess your elbow to understand the structures affected before making recommendations about treatment.

Treatments: 

Woman holding painful elbow

Bursitis

A bursa is a fluid-filled sac that surrounds bony protrusions of the skeleton that come into contact with surfaces, such as the shoulder, knee, and elbow. Bursitis refers to inflammation of the bursa.

The bursa in the elbow is located around the tip of the elbow. This bursa can become inflamed, painful, red and warm to touch.

Bursitis can be caused by prolonged pressure on the elbow, trauma, infection, or linked to other medical conditions like rheumatoid arthritis and gout.

Treatments:   

  • Osteopathy
  • Dry Needling
  • Kinesio Taping
  • Ice to reduce inflammation and pain 
  • Avoiding strenuous activity 
  • Self-massage on the affected area 
  • Gentle stretches and exercises to be recommended by your practitioner

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Hand & wrist

Sports Injuries of the Hand & Wrist

Hand and wrist injuries can occur to athletes and non-athletes alike. Most of the commonly identified hand sports injuries do occur in athletes and are specific to the type of activity or sport that causes them.

However, even daily activities can cause or worsen injuries to the hand or wrist. Anyone who uses their bodies every day is at risk for overuse injuries.

  • Bowler’s Thumb
    If your thumb fits too tightly in the bowling ball, you may be at risk for injury. Your ulnar nerve, located on the inside of your thumb, may become compressed and cause numbness, weakness, pain, and tingling.
  • Tendonitis
    Tendonitis is a common ailment that affects athletes in just about every sport.

    Tendonitis also affects non-athletes from overuse of tendons in their daily lives. This ailment is inflammation, swelling, and irritation to a tendon. It’s usually caused by overuse or starting a new activity that a tendon is not used to.

  • De Quervain’s Tendonitis
    This is a specific condition where the tendon that runs down the forearm to the thumb becomes inflamed.

    This injury is especially common in golfers and fishermen. The affected tendon also runs through the wrist, causing pain all down the arm.

    Participating in fly-fishing puts you at greater risk for this type of injury.

  • Boxer’s Fracture
    This serious hand injury typically occurs in boxers who fail to wear boxing gloves or punch an object with improper technique, causing injury.

    With this injury, the bones in the hand that form the knuckles suffer a break. This is an injury that warrants an immediate trip to the doctor.

  • Finger Jams
    This type of injury is also known as “basketball finger,” but it can occur during any athletic activity that involves the hand coming in contact with a ball.
    The severity of the injury can range from a sprain or dislocation that can be corrected by pulling on the finger, to a fracture or more serious dislocation.
  • Wrist Fractures
    Wrist fractures are commonly seen in athletes such as snowboarders or skiers, who fall backwards and use their hands to catch themselves.
    However, wrist fractures can occur with just about any athletic activity.
  • Skier’s Thumb
    This is also known as an ulnar collateral ligament tear.

    Skier’s thumb occurs when the ligament that helps your thumb with grasping becomes torn. This causes pain and weakness of the thumb, particularly when attempting to grasp.

  • Handlebar Palsy
    Also known as cyclist palsy, this condition occurs commonly among cyclists and mountain bikers.

    The technical name for this injury is ulnar neuritis or ulnar neuropathy. The injury is caused by irritation to the ulnar nerve caused by holding the handlebars of a bike.

    Cyclists can adjust the height of their bicycle seat and reposition their wrists to see if this helps. If they continue to experience tingling, numbness, pain, and a weak grip, they might need medical treatment.

Treatments include: 

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is caused by the compression of the median nerve which travels through the carpal tunnel, a narrow space in the wrist. 

Treatments: 

man with wrist pain

Tendon disorders (Depuytren’s contracture)

Depuytren’s contracture is when one or more fingers bend in towards the palm. 

Treatments include:  

  • Steroid/Enzyme injection 
  • Surgery

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Hips

Arthritis

When joint surfaces become rough and irregular due to bony growths (known as osteophytes), it is known as osteoarthritis. This can happen in any joint such as the shoulder, knee and hip. 

There are four stages in arthritis: minor, mild, moderate, and severe. 

It is only when osteoarthritis becomes severe that hip replacement surgery may be warranted due to the bone–on–bone contact. 

In the minor, mild and moderate stages, however, the majority of pain is caused by the soft tissue surrounding the joint. In this case, the hip joint.  

Our osteopaths can assess and treat the soft tissues such as the ligaments, tendons and muscles surrounding the hip to help alleviate some of the symptoms.  

This can include deep soft tissue massage, articulation, stretching while also addressing other issues that may have been caused by the arthritis, including exercise and rehab advice.  In chronic cases, we may use shockwave therapy to relieve some of the symptoms.   

Treatments include:  

Trochanteric bursitis

Trochanteric bursitis is inflammation (swelling) of the bursa (fluid-filled sac near a joint) at the outside point of the hip known as the greater trochanter.  

When this bursa becomes irritated or inflamed, it causes pain in the hip and can be red and warm to touch. 

Treatments include:  

  • Osteopathy
  • Ice to reduce inflammation and pain  
  • Avoiding strenuous activity 
  • Kinesio Taping 
  • If there is no improvement then steroid injections may be offered by a doctor 
man with back pain

Tendinopathies & Muscle Strains

Tendinopathy is a term used to describe an inflamed tendon that has failed to heal. 

A muscle strain is tiny tears in the muscle. These can however lead to bigger tears and eventually a full rupture. 

Treatments include:  

  • Osteopathy
  • Dry Needling
  • Ice to reduce inflammation and pain 
  • Avoid strenuous activity 
  • Kinesio Taping 
  • Exercise and rehab  

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    Knee

    Arthritis

    When joint surfaces become rough and irregular due to bony growths (known as osteophytes), it is known as osteoarthritis. This can happen in any joint such as the shoulder, knee and hip. 

    There are four stages in arthritis: minor, mild, moderate, and severe. 

    It is only when osteoarthritis becomes severe that hip replacement surgery may be warranted due to the bone–on–bone contact. 

    In the minor, mild and moderate stages, however, the majority of pain is caused by the soft tissue surrounding the joint. In this case, the hip joint.  

    Our osteopaths can assess and treat the soft tissues such as the ligaments, tendons and muscles surrounding the hip to help alleviate some of the symptoms.  

    This can include deep soft tissue massage, articulation, stretching while also addressing other issues that may have been caused by the arthritis, including exercise and rehab advice.  In chronic cases, we may use shockwave therapy to relieve some of the symptoms.   

    Treatments include:  

    Ligament injury

    Ligaments stabilise the knee but can become sprained or torn. This can lead to instability and pain. 

    Treatments: 

    Bursitis

    Bursitis in the knee is also called goosefoot bursitis or Pes Anserine bursitis. The Pes Anserine bursa is located between the shinbone and the three tendons of the hamstring muscles, on the inside of the knee. This type of bursitis may be caused by lack of stretching before exercise, tight hamstring muscles, being overweight, arthritis, or out-turning of the knee or lower leg.

    Treatments include:   

    • Osteopathy
    • Dry Needling
    • Kinesio Taping
      Ice to reduce inflammation and pain
    • Avoiding strenuous activity
    • Self-massage on the affected area
    • Gentle stretches and exercises to be recommended by your practitioner 

    Meniscal injuries

    The meniscus is tough, rubbery cartilage that acts as a shock absorber between your tibia (shinbone) and femur (thighbone). 

    It is easily injured if you apply a rotating force while your knee is weight-bearing. A partial or total tear can occur when you quickly twist with the upper leg whilst the foot remains still – so this is a common injury for footballers, rugby players etc. 

    Your symptoms are likely to include, pain when straightening knee as well as on/around the knee, swelling, and the knee can feel like it locks, or it might give way suddenly when you put weight through it. 

    Treatments include: 

    • Osteopathy
    • Sports massage
    • Exercise and rehab 
    • Kinesio Taping 
    • Avoid overuse 
    • Stretching 
    • Diagnostic imaging 
    • Surgery 
    Painful knee

    Osgood Schlatters Syndrome

    Osgood Schlatters Syndrome is caused when the tendon that attaches underneath the kneecap pulls on the bone, causing inflammation and severe pain. This is most common in teenagers.  

    Treatments: 

    Muscle & tendon strain

    Muscles and tendons of the knee can become strained or torn, usually caused by overuse. 

    Treatments: 

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    Foot & ankle

    Arthritis

    When joint surfaces become rough and irregular due to bony growths (known as osteophytes), it is known as osteoarthritis. This can happen in any joint such as the shoulder, knee and hip. 

    There are four stages in arthritis: minor, mild, moderate, and severe. 

    It is only when osteoarthritis becomes severe that hip replacement surgery may be warranted due to the bone–on–bone contact. 

    In the minor, mild and moderate stages, however, the majority of pain is caused by the soft tissue surrounding the joint. In this case, the hip joint.  

    Our osteopaths can assess and treat the soft tissues such as the ligaments, tendons and muscles surrounding the hip to help alleviate some of the symptoms.  

    This can include deep soft tissue massage, articulation, stretching while also addressing other issues that may have been caused by the arthritis, including exercise and rehab advice.  In chronic cases, we may use shockwave therapy to relieve some of the symptoms.   

    Treatments include: 

    person rubbing painful foot

    Plantar Fasciitis (Policeman's heel)

    Plantar Fasciitis is pain felt in the sole, across the connective tissue between your fore and hindfoot.  

    This can be a debilitating condition. 

    Treatments:

    • Osteopathy
    • Sports massage  
    • Insoles and appropriate footwear 
    • Exercise and rehab 
    • Kinesio Taping   
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity 
    • Self-massage on the affected area 
    • Gentle stretches and exercises to be recommended by your practitioner 

    Achilles injury

    The Achilles tendon is the largest and strongest tendon in the body. It plays an important role in many sports and is vulnerable to overloading.  

    Ignoring a partial Achilles strain can lead to a complete rupture several weeks later. Scar tissue begins to build up around a partial rupture, which can cause a debilitating condition that can lead to chronic pain. 

    Treatments:

    • Osteopathy
    • Exercise and rehab  
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity 
    • Self-massage on the affected area 
    • Gentle stretches and exercises to be recommended by your practitioner 
    • Kinesio Taping  
    • Sports massage

    Ligament Sprains

    Ligaments act as stabilisers for the foot and ankle but they can get damaged or torn. This can lead to instability and may need manual treatment or surgery if it is too severe.  

    If you do not properly rehabilitate your ligaments, you may suffer with chronic pain and permanent instability.  

    Treatments:

    • Osteopathy
    • Dry Needling
    • Kinesio Taping 
    • Sports massage
    • Exercise and rehab 
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity 
    • Self-massage on the affected area 
    • Gentle stretches and exercises to be recommended by your practitioner

    Shin splints

    Shin splints refers to a pain felt in the inside or outside of your shin bone. The pain is usually described as pressure, tightening or cramping.   It reaches a point where running can be unbearable.  

    Shin splints are often caused by muscle overload, usually from running.   

    Treatments: 

    • Osteopathy
    • Insoles and appropriate footwear 
    • Exercise and rehab  
    • Kinesio Taping  
    • Sports massage
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity 
    • Self-massage on the affected area 
    • Gentle stretches and exercises to be recommended by your practitioner 

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    Neck

    Whiplash

    Whiplash is caused by a violent jolting of the head back and forth, usually as a result of a sudden impact. 

    Treatments:  

    • Osteopathy
    • Ice to reduce inflammation and pain  
    • Avoiding strenuous activity such as lifting and twisting 
    • Gentle stretches and exercises to be recommended by your osteopath
    woman with neck pain

    Muscle strain

    A muscle strain or pulled muscle occurs when your muscle is overstretched or torn. This is usually caused by fatigue, overuse, or improper use of a muscle. 

    Minor muscle strains can take a few days to a couple of weeks to heal. 

    Treatments: 

    Disc injury

    Between each vertebra there is a gel-like structure, called a disc (or intervertebral disc). This disc acts like a cushion between the vertebrae to absorb shock. 

    Sometimes, however, this disc can become damaged. To make it simple, think of the disc like a “donut” with jam in the middle.  

    If there is pressure put upon the disc it can “bulge”.  

    As the bulge increases, the dough part of the donut (annulus fibrosus) can become torn, often caused by lifting and twisting injuries.  

    This can then allow the jam part of the donut (nucleus pulposus), to escape. We then call this a herniated or prolapsed disc (sometimes referred to as a “slipped-disc”). 

    This jam can, in some cases, end up pushing on a nerve, causing more pain, often down the arms. 

    Osteopathic treatment combines deep soft tissue massage, articulation and stretches to decompress the spine and take some of the compression off the disc and/or the nerves. Joint manipulation may also be warranted.  

    Treatments include:

    • Osteopathy
    • Ice to reduce inflammation and pain  
    • Avoiding strenuous activity such as lifting and twisting 
    • Gentle stretches and exercises to be recommended by your osteopath 

    Note: Long-term, severe disc injuries may need imaging to determine whether steroid injections or surgery are warranted.

    Facet joint

    In every vertebra there are small joints called facets. These allow movement to occur in the spine. 

    Sometimes these joints can become “locked”.  This usually occurs from an injury, or from repetitive bad posture, such as sitting at a desk badly for a long period of time.  The vertebra’s movement then becomes restricted, and the muscles surrounding it become tight and may even spasm. This can cause a huge amount of pain.  

    Osteopathic treatment combining deep soft tissue massage and possibly joint manipulation means this can often be significantly improved or resolved within a few treatments. 

    Treatments:  

    • Osteopathy
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity

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    Thoracic spine & ribs

    Muscle strain

    A muscle strain or pulled muscle occurs when your muscle is overstretched or torn. This is usually caused by fatigue, overuse, or improper use of a muscle. 

    Minor muscle strains can take a few days to a couple of weeks to heal. 

    Treatments: 

    Rib pain

    Pain in the mid–back can be caused by the ribs.  

    The ribs attach to the spine at a point called a “rib head”.  The rib head can move slightly and become locked, which then causes the muscles around the rib (called the intercostal muscles) to tighten and spasm to protect the rib.   

    This can be very painful, especially when you take a deep breath.  

    Osteopathic treatment can be very beneficial in combining deep soft tissue massage and possibly joint manipulation. Manipulation of a rib head to correct the problem, can often cause very quick relief although it may take a few treatments to completely resolve.  

    Treatments: 

    • Osteopathy
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity

    Facet joint

    In every vertebra there are small joints called facets. These allow movement to occur in the spine. 

    Sometimes these joints can become “locked”.  This usually occurs from an injury, or from repetitive bad posture, such as sitting at a desk badly for a long period of time.  The vertebra’s movement then becomes restricted, and the muscles surrounding it become tight and may even spasm. This can cause a huge amount of pain.  

    Osteopathic treatment combining deep soft tissue massage and possibly joint manipulation means this can often be significantly improved or resolved within a few treatments. 

    Treatments:

    • Osteopathy
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity

    Chest/Sternal Pain (Costochondritis)

    Costochondritis is inflammation where your ribs join your breastbone. It causes sharp pain in the middle of your chest, when moving or breathing.

    Costochondritis often gets better after a few weeks. Resting, holding a warm cloth to your chest and taking painkillers can help while it heals.

    It’s not exactly clear what causes costochondritis. It’s been linked to severe coughing, chest injury and strain from exercise

    Treatments: 

    • Osteopathy
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity

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    Lower back

    Muscle strain

    A muscle strain or pulled muscle occurs when your muscle is overstretched or torn. This is usually caused by fatigue, overuse, or improper use of a muscle. 

    Minor muscle strains can take a few days to a couple of weeks to heal. 

    Treatments: 

    Facet joint

    In every vertebra there are small joints called facets. These allow movement to occur in the spine. 

    Sometimes these joints can become “locked”.  This usually occurs from an injury, or from repetitive bad posture, such as sitting at a desk badly for a long period of time.  The vertebra’s movement then becomes restricted, and the muscles surrounding it become tight and may even spasm. This can cause a huge amount of pain.  

    Osteopathic treatment combining deep soft tissue massage and possibly joint manipulation means this can often be significantly improved or resolved within a few treatments. 

    Treatments:

    • Osteopathy
    • Ice to reduce inflammation and pain 
    • Avoid strenuous activity

    Piriformis Spasm

    Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).

    Most patients describe symptoms of acute tenderness in the buttock and sciatica-like pain down the back of the thigh, calf and foot. Typical piriformis syndrome symptoms may include:

    • A dull ache in the buttock
    • Pain down the back of the thigh, calf and foot (sciatica)
    • Pain when walking upstairs or inclines
    • Increased pain after prolonged sitting
    • Reduced range of motion of the hip joint

    These symptoms often become worse after prolonged sitting, walking or running, and may feel better after lying down on the back.

    Treatments: 

     

    Pregnant woman with backpain

    Disc Injury & Sciatica

    Between each vertebra there is a gel–like structure, called a disc (or intervertebral disc). This disc acts like a cushion between the vertebrae to absorb shock. 

    Sometimes, however, this disc can become damaged. To make it simple, think of the disc like a “donut” with jam in the middle.  

    If there is pressure put upon the disc it can “bulge”.  As the bulge increases, the dough part of the donut (annulus fibrosus) can become torn, often caused by lifting and twisting injuries.  

    This can then allow the jam part of the donut (nucleus pulposus), to escape. We then call this a herniated or prolapsed disc. (Sometimes referred to as a “slipped-disc”). 

    This jam can, in some cases, end up pushing on a nerve, causing more pain, often down the leg (sciatica). 

    Treatments:  

    • Osteopathy
    • Sports massage
    • Ice to reduce inflammation and pain  
    • Avoiding strenuous activity such as lifting and twisting 
    • Keeping mobile – try to get up and move every 20-30 minutes if possible. Gentle walking can also be helpful 
    • Gentle stretches and exercises to be recommended by your osteopath 


    Note: Long–term, severe disc injuries may need imaging to determine whether steroid injections or surgery are warranted. 

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    Contact The Carlton Clinic on 01293 784200 or click here to book your therapy session.

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