Conditions Treated

This is a common cause of heel pain and usually comes on gradually. It is more common in runners, people who have a high BMI and in those who wear footwear that is not supportive to the foot.

The plantar fascia is a thick band of tissue that runs from the heel to the toes on the inner side of the sole of the foot and it becomes painful in plantar fasciitis. The pain often varies in severity, typically being worse first thing in the morning when the foot and ankle feel stiffer and improving as the foot becomes stretched out. This early morning pain can be helped by using a splint that holds the foot and ankle in a neutral position overnight. Standing and even walking can be made difficult and painful by this condition.

Achilles tendinopathy can affect the tendon where it inserts into the heel bone (insertional tendinopathy) or in its middle (mid-substance tendinopathy).  This causes pain and swelling of the tendon and often results in a limp, lack of function and stiffness. This common tendinopathy seems to be becoming more common as people participate more in sports activities, particularly if they train heavily or incorrectly. It is seen particularly in runners and in those with abnormal foot posture.

Sometimes called lateral epicondylitis, this is an overuse injury that is one of the commonest causes of pain in the elbow. It causes pain over the outer side of the elbow especially when objects are gripped, when the wrist is cocked back and when heavy objects are lifted. Sometimes the pain also radiates along the forearm.

It occurs when the muscle that attaches to the outer elbow (lateral epicondyle) becomes overworked. Although its name comes from the fact that it can be seen in tennis players who have poor back hand stroke techniques, it is also commonly seen in people who perform repetitive wrist and elbow movements of a similar type, such as other racket sports players, manual workers and people who use computers for long periods.

Sometimes called medial epicondylitis, this is an overuse injury similar to tennis elbow except that the pain and stiffness is felt on the inner side of the elbow.  Sometimes the pain also spreads along the forearm.

It occurs when the muscle that attaches to the inner elbow (medial epicondyle) becomes overworked due to repetitive activity or excessive force. Its name comes from the fact that it can be seen in golfers who grip their clubs incorrectly, but it is also seen in those who play other sports and can occur after certain manual activities.

A tendinopathy occurs when a tendon fails to heal after an overuse injury. This causes pain and swelling of the tendon and often results in a limp, lack of function and stiffness.

The patella tendon lies below the knee-cap and connects it to the front of the top of the shin bone.  Patellar tendinopathy can affect the tendon where it attaches to the knee cap (insertional tendinopathy) or in its middle (mid-substance tendinopathy).  Patellar tendinopathy, sometimes referred to as jumpers knee, causes pain directly over the tendon and this can be worse with activity, jumping(hence “Jumpers Knee”) and with kneeling.  The tendon is tender when pressed and may be a little swollen.

This common tendinopathy is seen in people who participate in sports activities that involve a lot of jumping. It is seen particularly in runners and in basketball and netball players.

A bursa is a thin-walled sac filled with a very small amount of fluid that is usually found over bony prominences and functions to help soft tissues to glide over these prominences.

The trochanteric bursa lies over the bony greater trochanter in the upper outer thigh. Trochanteric bursitis, sometimes called Greater trochanteric pain syndrome, causes pain in this region that can vary from mild pain to disabling pain that requires the use of crutches to walk.

It can be caused by a number of things. Anything that causes an alteration in the way that a person walks can cause the condition. This includes anything that causes a limp, such as a foot injury, foot surgery, knee problems etc. It can also be caused by a fall directly onto the greater trochanter. As an overuse injury it can also occur in runners and other sports-active people. It can also occur in people who have had hip surgery, for example a hip replacement.

The condition can occur in association with iliotibial band (ITB) syndrome, where pain is felt along the outer thigh especially at the outer aspect of the knee. The pain occurs along the path of the fibrous iliotibial band which is a structure that is important in knee movements.

The hamstring tendons run from a bony prominence in the buttock area down the thigh and attach to the tibia (shin bone) just below the knee.

Hamstring tendinopathy is often seen in runners and in others whose sport involves repetitive running, jumping or kicking, such as football.  Football also predisposes people to this condition as it involves frequent acceleration and deceleration, another risk factor for this condition.

The condition often develops gradually but we see cases where sudden-onset symptoms are provoked by an episode where the tendon is suddenly overloaded, such as a forceful kick in football or sudden acceleration or deceleration whilst running.

Pain is felt in the buttock and sometimes down the back of the thigh.  Symptoms can be made worse by sitting.  If the tendons are affected further down the leg, pain may be felt at the back of or on the inner side of the knee.

Iliotibial band (ITB) syndrome is one of the commonest overuse injuries and is seen commonly in runners.  It causes pain in the line of the ITB.  The ITB is a thin band of tissue that runs down the outer side of the thigh from the pelvis to the outer shin just below the knee.  It can cause pain predominantly at its lower end or at its top end where the condition often coexists with trochanteric bursitis / greater trochanteric pain syndrome.

Biceps tendinopathy causes pain at the front of the shoulder.  The biceps tendon is sensitive to overuse injuries especially in those doing repetitive lifting, reaching, or throwing.  This can lead to biceps tendinopathy or in severe cases tears of the upper biceps tendon.

“Shin splints” is a general term used to describe a painful condition affecting the shins.  It is caused by a number of conditions, the commonest of these being medial tibial stress syndrome.  Other causes are stress fractures of the tibia or chronic compartment syndrome.

Medial tibial stress syndrome is commonly seen in athletes especially those who over train or who suffer from overpronation.  It can be difficult to treat especially when it has been present for a long time.