There are common causes of knee pain in children but it can be difficult to determine which aches and pains need medical attention and which they may “grow out of”.

Osgood Schlatters

A common cause of knee pain, particularly in boys, is Osgood Schlatters. Your child may complain of pain and tenderness below their knee cap and could recently have had a growth spurt. The pain is due to irritation of a ligament, called the patellar ligament, which connects the kneecap to the shin bone. This is sensitive to touch and your child may have pain with walking or jumping activities or on the stairs.

The initial treatment for Osgood Schlatters is “RICE” Rest Ice Compress Elevate which can help ease pain symptoms. Symptoms usually subside when the growth spurt ends…unfortunately this could take 1-2 years! Gentle stretching of the quadriceps muscle is also advised as it can reduce the tension on the patellar tendon. It is also important to consider lower limb biomechanics and gluteal/ hip muscle strength and intervene with Physiotherapy treatment where necessary to help accelerate the healing process.

With Wimbledon fever well under way and a particularly injury prone year among the top seeded players I thought it might be interesting to have a look at the most common tennis relates sports injuries. Research has shown that there are 54 injuries per 1000 games played (Pluim et al 2006). Among the most common injuries are a sprained ankle, shoulder strain, calf strain, tennis elbow and back injuries. 

Let’s take a closer look at the sprained ankle.

The sprained ankle is highly common in both the elite and the recreational sportsperson. The sudden sprinting, side movements and change of direction as required in tennis can cause the ankle to twist, particularly if the player is becoming fatigued or are playing on a slippery surface. The likes of Andy Murray and Roger Federer will wear ankle braces during matches in order to reduce the risk of such injuries.

Exercise will in most cases form an essential part of your Physiotherapy treatment programme. The reason we prescribe you exercise is not to take up more of your valuable time, but to use these exercises to assist us in bringing about pain relief as well as restoring movement, strength and function to the injured part of the body.

There is a vast amount of research supporting the benefit of exercise, and as Physiotherapists we would not be doing our job properly if we did not use this wealth of knowledge to your benefit.

As Chartered Physiotherapists, we have been trained in the use of exercise as a medical treatment and are able to compile a programme of very specific, tailored exercises to suit you as an individual with an injury that is specific to you.

The pain process is a complex and intelligent signalling system between the affected area of the body and the brain. This system is ultimately trying to protect us but it seems we can trick ourselves by making the pain sensation far worse relative to the injury.

In a recent article called "What happens when we feel pain?" I explored this pain process including questioning why pain can become persistent, how unhelpful thoughts play a role as well as best treatment and pain management techniques.

Here are two excellently presented, intriguing and entertaining videos by Professor Lorimer Moseley, a clinical scientist investigating pain in humans.

These are well worth a watch. Enjoy.

Can I exercise too much?

Sure you can. There is such a thing as ‘chronic cardio’ where the amount of exercise you do can actually have negative long term consequences on your health.

Although in my experience, those I meet who are chronic exercises are often aware of what they are doing and are driven by something else rather than the pursuit of optimal health.

Another quote I recall from a runners forum:

I run to add life to my years not years to my life

Good quality sleep is really important. Sleep not only enables the body to recharge physically but is also essential for helping us stay mentally alert and balanced. In fact, poor quality and not enough sleep over prolonged periods can affect our health in many negatively ways.

This infographic describes The Dangers of Sleep Deprivation

My client has been doing very well in treatment for a right sided adhesive capsulitis, otherwise known as a ‘frozen shoulder’. Following a successful integrated treatment approach my client has progressed to the third stage of the frozen shoulder continuum where stiffness as opposed to pain is the main problem.

In this article I demonstrate the effectiveness of treating this condition with a combination of medical acupuncture, also known as dry needling, and manual therapy techniques.

I recently received my first pair of custom made orthotics. I have to admit I felt as though this purchase decision was a bit of a leap of faith on my part. Other than my structured-cushioning running shoes designed for over-pronators I have previously taken no further consideration for my tendency to walk and run with flat feet which liked to roll inwards.

I share a few photo's of my new orthotics below as well as a comparison photo of my inward ankle roll with and without the orthotic in place. 

Why I opted for a pair of custom orthotics

There were a few reasons - the first; an ache and frequent twinge in both of my knees that was hanging around long enough to cause some concern. In the absence of any recent trauma I considered what might be causing the discomfort. I had recently switched to a new brand of trail running shoe which could have been a contributing factor.

I also have never forgotten the video-recorded running gait assessment I completed at the Asics store in London last year which revealed my relatively severe ankle misalignment on foot strike. Hence my choice to wear structured-cushion running shoes.

So you think you know how to tie your shoes laces? Maybe not. 

I remember many years ago an assistant from a specialist running store in South Africa showing me this lace tying technique. I had forgotten so was chuffed to discover this article and video. Over at Chris Johnson PT the article describes how and why lace tying can be an important factor in post injury running. Although, I bet it is a good technique to use generally. Take a look at this short video here...

A client of mine has adult-acquired flat foot and presented with significant pain along the outside of the ankle and foot region when walking. She had been to see a surgeon who had suggested surgery but she was keen to see if there was anything Physiotherapy could do to assist with the view to possibly avoiding having to go down the surgical route.