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Pains Physiotherapy Can Help With

Pains Physiotherapy Can Help With - If you're not sure how we can help you, we've created an inexhaustive list to guide you. It's from the head-to-toe approach, so zoom in to where your pain or discomfort is, and let me know if there's anything I can add to the list ya.

  • Head Pains
  • Neck or Cervical Spine Pains
  • Shoulder Pains
  • Elbow Pains
  • Wrist and Hand Pains
  • Thoracic Spine and Rib Pains
  • Pelvic / Pelvis Pains
  • Hip and Thigh Pains
  • Knee Pains
  • Foot and Ankle Pains

Head Pains

Many individuals experience neck-related headaches, which are caused by very tight knots in the muscles of the neck (termed as tension headaches, or trigger points) especially in the C2 and C3 spinal levels, which irritates the nerves and blood vessels that supply the head. Common causes are daily stress, poor postural habits, poor ergonomics and even whiplash accidents and injuries.

How physiotherapy can help to relieve these tension headaches is to combine manual therapy, deep tissue release, ultrasound therapy as well as computerized and gradual traction to "release" the tight muscles and stiff joints. Of course, we will also combine it with stretching exercises and strengthening exercises to prevent it from coming back.

Neck and Cervical Spine Pains

The main goal of physiotherapy for all neck pains and injuries is predominantly to decrease pain and restore pain-free neck-related movement, on top of teaching patients how to stretch and strengthen neck muscles as well as building good posture to prevent unnecessary neck sprain. A combination of deep tissue massage, manual therapy and computerized traction is often clinically effective. Adopting good ergonomics at home and at work will also help to keep your neck pain free.

Usually, neck pains are related to either poor postural habits such as a very forward neck (think how people straining to read) as well as prolonged ergonomically awkward neck positions at work or at rest including sleeping. You see, by having an awkward neck position for a prolonged period of time will lead to asymmetrical contraction and shortening and lengthening of neck muscles and ligaments, leading to stiff muscles and joints.

Also, many of our patients with neck pains often have poor ergonomics at work (eg having their computer screens too high or too low or too left or right) or with not-so-good habits of being on the phone and squishing the phones between their ears with their shoulders - convenient, but leads to massive neck issues.

Often, patients experience shoulder and arm pain and sometimes with numbness, tingling and even weakness that "travel" to their arms, hands and fingers.

Cervical Spondylosis

This condition is usually caused by the head being overly stretched forward for extended hours - which builds up cumulative trauma and strain on the neck muscles, ligaments and joints. Over time, the neck becomes increasingly sore and stiff, and in the mid to long term, leads to recurring neck pain and degenerative changes.

Whiplash injuries

Whiplash injuries often happens during a road traffic accident where there is a sudden brake/deceleration and causing a sudden snap/jolt to the neck. This causes the soft tissues to be stretched beyond their natural limit, and depending on severity, can cause a lot of inflammation, swelling, tissue tearing and scar formation. More severe cases may lead to giddiness, chronic pain and stiffness, and for severe whiplash, rehabilitation may be slow and take longer time for recovery.

Shoulder Pains

Rotator Cuff Injuries

Our shoulders can be easily strained if we held or used it with poor alignment, which is really common with the "high and forward" posture of shoulders, which often is caused by muscle tightness, postural habits as well as not-balanced strengthening programs. Of course, some sports that has more overhead movements and activities such as badminton, golf tendinopathy, tennis, workouts that emphasize more on upper body or lifting...or even a poorly placed mouse and keyboard can also cause rotator cuff injuries.

It's often the combination of poor biomechanical alignment with repetitive movements that causes and contributes to pain and muscle imbalance around the shoulder joint; and pain reinforces poor movement patterns, leading back to rotator cuff muscle reinjury, shoulder tendonitis, impingement and even more pain - continuing the vicious cycle.

What we do is we break this vicious pattern by firstly correcting the improper posture and muscle imbalance by correcting the gleno-scapulo-humeral rhythm, a fancy word for the movement of the shoulder blade, shoulder and scapula, as well as strengthening the rotator cuffs.

Frozen Shoulder

Also known as adhesive capsulitis, this condition often has a lot of tightness/stiffness, pain and loss of movement in the shoulder.

Most of the time, frozen shoulder is more common in women between 50s to 70s, and unfortunately, the main causes are still not fully understood medically at this point in time. But we do know what happens, which is it starts with inflammation that leads to the thickening and tightening and gradual contracture of the capsule in the shoulder. For a start, we focus a lot on pain relief to get pain under control...and then we use modalities such as heat therapy, tissue and joint mobilization,  gentle and gradual stretch therapy, slowly progressing towards range of motion (ROM) exercises and into strengthening later.

Shoulder Subluxations and/or Dislocation Pains

If there is a strong force transmitted on or into the shoulder such as in the incidence of a road traffic accident, or a fall or a sports injury, our shoulders can experience partial dislocations (termed as subluxation) or complete dislocations.

And usually, individuals with history of subluxations or dislocations are definitely more prone to re-subluxations or re-dislocations, due to the increased instability. Of course, contact sports such as rugby, basketball and football all have contact sports risks.

Physiotherapy in the beginning involves a lot of trauma rehabilitation and stabilization as well as pain management - once the shoulder is post-trauma, we will gradually shift to strengthening the muscles of the shoulder that will increase the stability of the shoulder, which includes the rotator cuff muscles  as well as scapular muscles.

Elbow Pains


Tennis Elbows and Golfer's Elbows

Many patients develop pains in their elbows because of overuse injuries as well as trauma from sports such as golf, tennis, cricket and squash. Of course, it's not just sports people who develop this injuries - anyone who often engage in activities such as lifting and carrying, gripping, improper or excessive use of keyboard - can develop these conditions. What increases the chances of developing these injuries is if the individuals have weak or tight forearm muscles.

When the pain is located on the "inner" side, closer to the body, most of the time it is golfer's elbow (sometimes it may be something else such as a medial collateral ligament sprain, or worse, a fracture); when the pain is on the outside, the condition is usually tennis elbow.

Of course, it's not just people who plays tennis or golf who develops these conditions - we have many patients who do not play any tennis or golf who also develops these conditions - much to their disbelief when we diagnose the condition to them. They will often say "but we don't play tennis/golf!"

Tennis elbow is very much more common than golfer's elbow, occurring five time more than golfer's elbow. In either cases, what happens is that the tendon of the muscles of the forearm gets injured, inflammed and in worse case, degenerates or changes physiology from chronic pain.

Early hand therapy intervention often means quicker and more importantly, a more complete recovery. Any patients who has had this condition for more than 6 months with on-off aggravations and inflammations has poorer rehab prognosis. Main goals of hand therapy is pain relief, reduce the inflammation and swelling, gradually decrease scarring, stretch out shortened or overstretched forearm muscles, progress to strengthen the overused muscles - all with the goal of you being able to use your hand again with minimal to zero pain.

Wrist Pains and Hand Pains

Strains, Hand & Wrist Sprains and Wrist Fractures

Our hands and wrists are one of the more frequently injured body parts during trauma from sports or accidents, or repetitive trauma from sports such as racquet sports, golf, basketball. Finger injuries and trauma is more common in sports that involves catching such as baseball, basketball, and softball.

Often its either due to improper technique during the sport instead of a complete coordinated force from trunk that causes the small muscles, ligaments and tendons of the hands and wrist to be overused and easily injured; other than the contact sports injuries.

Repetitive strain injuries, abbreviated to RSI, in the wrists and hands is often from repetitive trauma, such as in typing and mouse use, lifting and handling babies and children, playing musical instruments as well as in activities that involves strenuous wrist and finger activities.

There are several types of RSI in the hands and wrists and fingers, the most common being

What increases the risks of developing RSI in the hands are usually attributed to weakness or tightness of the muscles of the forearm, wrists and hands, leading to compensation by the tendons and ligaments, which then becomes inflamed from overused, and slowly get scarred over time.

Effective hand therapy interventions will combine sound hand therapy clinical reasoning, ultrasound therapy, deep tissue release for tight muscles, stretching shortened muscles and progressively move towards strengthening. If joints are stiff, we will also include manual therapy as well as tissue and joint mobilizations. If the injury is too acute or unstable, we will also prescribe customized hand splints to provide support for rest of injured structures.

Thoracic Spine And Rib Pains

Similar to neck pains, individuals can also develop pains and tightness in the thoracic spine (thoracic spine is the spine where your rib cage and lungs are), and these pains are usually associated or caused by slouched posture.

What happens is that if we keep our backs rounded in a hunched posture of prolonged periods of time, it causes an increased tension on ligaments and joints. And gradually, as the structures get more and more weakened, a seemingly "safe" task such as bending to pick up an object such as coins to remote or babies can cause a very, very, very acute pain. Sometimes, even deep breathing can lead to pain as well.

Physiotherapy intervention will require skilled manual therapy techniques to directly loosen tight and stuck thoracic and rib joints, then gradually move toward restoring normal alignment as well as soft tissue release for long term prevention and maintenance. Slowly we will also progress towards strengthening of the core muscles of the body that helps to keep the body upright - a stronger core will protect your posture and body.

Rib Pain and Rib Fractures

Rib fractures are one of the most common injuries to the chest, and happens more in the middle and lower ribs due to their location and movement patterns. Most of these fractures are either caused by trauma or very violent muscle contractions.

Good news is that even though rib fractures are rather painful, they do not lead to complications with lungs and other internal organ damages, and heal in a few weeks with conservative treatment.

Lower Back Pains and Lumbar Spine Pains

Low back pain or lower back pains affects both sporty and non-active individuals, and is fundamentally connected to poor posture, flat back or overly arched low back. Over-curved spines leads to muscle imbalances, overly-stretched ligaments and leads to unnatural and overloading of discs and joints, and this leads to accelerated wear and tear.

For the active sports and sport individuals, their low backs undergo intense physical stress to move and withstand extreme positions and strains to provide stability for actions in the body, arms and legs. Because of this, the low back can be compromised if the hips, legs and upper body limits the lower back's mobility, or if there is imbalance of muscle strength or if the core muscles of the body is weak and unable to support the body's movement effectively.

Physiotherapy for low back pain lies predominantly in identifying and correcting these issues and progress towards strengthening for a stronger and more stable back.

Sciatica Pain and Pains That Travels

Our backs are complex structures with many overlaying and overlapping muscles, ligaments, discs, joints and nerves - there is a nerve called the sciatic nerve that extends from our low back, through the buttock and down the back of our leg that often becomes compressed or overly stimulated, leading to pain, tingling or numbness. What compresses the sciatic nerve is either a prolapsed intervertebral disc (also known as "slipped disc"), or tightness in the piriformis muscle in the buttock or swelling that compresses the sciatic nerve, leading to sciatica.

The focus of physiotherapy is primarily for pain relief, by relieving the compression or irritation on the sciatic nerve through a combination of manual therapy techniques, tissue and , deep tissue release of the piriformis muscles, computerized spinal decompression traction and exercises that relieves the compression.

Up to 95% of patients with sciatica can be treated, managed and resolved with conservative methods such as physiotherapy, and only 5% of severe spine cases requires invasive surgery.

Slipped Discs and Prolapsed Discs

Individuals who are mainly desk-bound and spends most of their time in sitting position increases spinal stiffness and chronic trauma build up of their back muscles. Sitting also multiplies the compressive force on the lumbar vertebral up to 3 times as compared to standing. If you add in the twisting, lifting and even sneezing motion for a seated individual - it can lead to a prolapsed disc in an already-weak back.

In the earlier stages, the additional pressure just causes the disc to be pressed and pushed to a side, forming a bulge - with additional load, the disc then can burst, causing the outer fibers to tear and its jelly-like contents to spill out - the additional pressure of these items increases pressure to ligaments and nerves, causing back pain that may or may not have pain, numbness, weakness or tingling, or all of the above.

The focus of physiotherapy is primarily for pain relief, by relieving the compression or irritation on the sciatic nerve through a combination of manual therapy techniques, tissue and , deep tissue release of the piriformis muscles, computerized spinal decompression traction and exercises that relieves the compression.

Up to 95% of patients with sciatica can be treated, managed and resolved with conservative methods such as physiotherapy, and only 5% of severe spine cases requires invasive surgery.

Treatments and Prevention

For spinal physiotherapy to be truly effective, a detailed and thorough assessment to fully understand and diagnose the condition is required, factoring in issues such as joint stiffness, degrees of muscle imbalance and/or tightness, core weakness level, poor posture, and mal-alignment issues - all of which needs to be factored in and addressed for complete recovery. The focus of physiotherapy on back pain management is mainly hands-on manual therapy, computerized spinal decompression traction, deep tissue massage, back-specific exercises as well as ultrasound therapy.

Unfortunately, recurrences for back pain is very common and they tend to get worse, especially when left alone "to heal by itself" - it is very important to get your back treated and rehab done as well as maintain a regular back exercise program - even I do my back exercises, and I've been doing them since 2012.

Pelvic Pains and Pelvis Pains

Sacro-Iliac Joint Dysfunction (SIJ)

Our sacro-iliac joints are located lower than the sides of your tailbone. SIJ problems in the pelvis and pelvic areas is usually focused around the sacro-iliac joint; of which the pain may travel downwards to the buttocks and even sometimes down the thigh.

If there is a shifting of your pelvic bones as a result from a fall onto your buttocks, or from a traumatic accident that led to a twisting force that strained on your SIJ, this can lead to SIJ dysfunction. SIJ dysfunction can also happen during pregnancy because your ligaments becomes more "relaxed" and "stretchable" due to hormones preparing your body for childbirth.

So what happens is that the pelvic bones on either side can shift, upwards or downwards, rotate forwards or backwards, and/or the tailbone can also rotate out of it usual place; and any one of these happenings will cause asymmetry, imbalance and pain to your sacro-iliac joint. For this special issue, you'd benefit most from a special manual technique called "Muscle Energy Technique" (MET) which helps to provide pain relief using your muscle's own contractions to guide the bones and ligaments back into a balanced symmetry.

Hip Pains & Thigh Pains

Hip Pains

Most patients complaints of hip pains are usually located either on the "outside" of the hip bone, deep within their groin or within the inner thigh muscles (deep quadriceps).

When the pain is on the "outside" of the hip, it's usually the ilio-tibial band (ITB tightness), which is a thick, fibrous band that stretches over the hip joint and connects all the way downwards to the knee. What happens is that a tight ITB can become inflamed as it "snaps" or rubs over the hip bone, especially prevalent in cyclists and runners. A combination of regular deep tissue massage, stretching and correction of running or cycling patterns are usually pretty effective.

If the hip pain is deeper in the groin, it signals that there is a potential problem with the hip joint or the capsule within the hip, such as in the case of osteoarthritis (OA) of the hip, but there are other conditions that causes pain in the hip as well. Physiotherapy will focus on providing pain relief and decreasing the stiffness with gradual stretching, tissue and joint mobilizations, loosening tight muscles aggravating the condition, as well as strengthening the direct hip muscles and its supporting muscles.

In the case of Groin Strains, what actually occurs is that the inner thigh's adductor muscle is strained (over stretched with partial tearing to the muscle fibers). It is a very common condition in sports such as rugby and soccer where there is a lot of burst-type runnings. Characteristics are pain when one tries to bring the thigh inwards towards the other thigh, kicking, side stepping and lunging. What contributes and aggravates to this condition is having overly tight adductor muscles and decreased stability in the lower back and pelvis. Physiotherapy often consists of ultrasound therapy, therapeutic massage therapy, stretching and a gradual return to sports. It is never a good idea to ignore the pain and aggravate-reaggravate the injury by playing sports as usual, as it not only will cause significant delay to recovery, but it can also lead to physiological changes and scarring, which may cause chronic pains.

Quadricep Tears and Hamstring Tears

Our quadriceps and hamstrings are very easily injured, especially common in sports that includes jogging and running. Most of the time, it is tight muscles or weak muscles that are not properly warmed up first that experience such injuries. When a muscle is strained, it basically means that some of the muscle fibers are torn. As it heals, it tends to heal into a jumbled, tight, painful scar tissue - only combination of gradual gentle to deep massage, stretching and strengthening will engage the fibers and facilitate them to heal complete and able to work as a whole again. If you have a mild muscle strain, your healing can take days to 2 weeks; more severe strains will take more weeks to recover.

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Our Physio & Rehab Expertise

Specialist Rehab Group works with specialist physiotherapists and specialist rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.

Areas of specialization

  • physiotherapy: back and neck (spine), sports, shoulder, hip, knee, ankle
  • hand therapy: forearm, wrist, hand and fingers
  • podiatrist: leg, calf, ankle, foot and toes
  • read more on our specializations here

All our therapists are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCM). See our entire team here by location and specialization.

Initially, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover. They then provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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Disclaimer
We are a wholly Singapore Private Limited group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth.

The range of rehabilitation results vary from patients to patients, depending on a variety of factors and reasons such as severity of condition, genetics, gender and age. However, we will still deliver the best evidence-based-practice of physiotherapy, hand therapy, TCM, sports training and deep tissue release therapy that we can deliver.

The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy and occupational therapy, please schedule an appointment with us by contacting our staff by Call/SMS/WhatsApp at 96402670, thanks!

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