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Anatomy of an Ankle Sprain

The most commonly injured structures when we twist our ankle are the ligaments on the outside of the ankle and the peroneal muscles at the side of the lower leg.

There are 3 main ligaments on the outside of the ankle, they all have quite long names so we will just call them ATFL, CFL and PTFL. Usually the ATFL gets injured, sometimes the CFL also gets injured and in the most serious ankles sprains the PTFL also gets damaged. The ligaments help to attach bones of the foot to the fibula part of the ankle joint. They also send information to the brain about how balanced we are. If they get damaged, they can be weakened and so give less stability and could send less signals to the brain causing the ankle to feel less balanced. This means that you could suffer more sprains to the same ankle.

The peroneal muscles are on the side of the ankle and lower leg. These muscles pull the foot outwards and stop it from rolling inwards. When we twist our ankle and the foot is forced inwards this can cause a strain of the Peroneals. If the ankle doesn’t get the correct treatment and you aren’t advised on the correct exercises, this strain can add to the weakness and lack of stability of the ankle.

If you sprain your ankle please give us a ring and book an appointment – it will save you pain, money, time and hassle if you do it early.

Speak to our friendly team on 01438 317037 or message us through our Facebook page.

Kerri Surman – Specialist Sports and Musculoskeletal Physiotherapist

Injury Topic of the Month – Ankle Sprain

Who hasn’t sprained an ankle at some time in their life? 

It must be the most commonly suffered injury. We see quite a few in our clinic which is a good thing for those who come to seek out physio advice, because most people just let it heal on its own and this usually leads to weakness, instability and sometimes ongoing pain. With this injury you are much better off seeing a physio once or twice early on, rather than ten or twelve times when you’ve been suffering for 6 months.

There are 2 main types of ankle sprain – medial and lateral – which basically means you either turned your foot inwards or outwards. The most common is when your foot goes inwards, and you end up with pain on the outside of your ankle.

This injury cause pain, swelling, bruising, stiffness, it makes us hobble around and can therefore cause knee pain, hip pain and back pain. A lateral ankle sprain is generally damage to one or more of the ligaments on the outside of the foot and ankle and a strain to the muscles, but it could also cause fractures to the fibula or the 5thmetatarsal. If you genuinely cannot put weight on your foot after you twist your ankle you need to go to A&E, but if you can put even a little weight on it you don’t, and you should see a physiotherapist.

We can usually see you within 48 hours of you ringing us – during these 48 hours you should ice and elevate your foot to help with the swelling and pain.

You can call to arrange an appointment on 01438 317037 or message us via our Facebook page.

Kerri Surman – Specialist Sports and Musculoskeletal Physiotherapist

Treatments for Anterior Knee Pain

There are many things a physiotherapist will do to help you with your knee pain. Certain treatments will depend on the exact nature of the problem but here are a few that might be beneficial.

Deep tissue massage for the quadricep, hamstring and calf muscles as these can become tight and stiff either causing the knee pain or as a result of the knee pain.

Taping to support the knee cap can alleviate a lot of symptoms by reducing compression on the patella tendon or fat pad, or can help to ensure the knee cap moves in a more efficient and less painful way.

Electrotherapy can alleviate pain and help to stimulate some healing within the soft tissue structures of the knee.

Acupuncture can help by reducing inflammation, stimulating healing and reducing tissue stiffness. Acupuncture also has an amazing effect on the body by encouraging it to release endorphins which are our own internal pain killers.

If you are suffering from knee pain, please don’t leave it – not only is it likely to get worse but it could lead to foot and ankle pain or hip and back pain. Call us to get an appointment – we can usually see you within 48 hours of you ringing us – 01438 317037.

Kerri Surman – Specialist Sports and Musculoskeletal Physiotherapist

Exercise for Anterior Knee Pain

Usually when someone has anterior knee pain, they also have very stiff quadricep muscles. This is the name of the group of muscles at the front of your thigh. As you have seen from the previous post the knee cap sits within the tendon of these muscles. This means that the quadriceps directly affect the knee cap and the front of the knee.

A simple solution for this problem is to work on this stiffness. You can do this in a couple of ways – foam rolling and stretching.

Here is a great stretch for the quadriceps. Pull your heel towards your buttock, keep your knees together and squeeze your glutes tucking your pelvis under (flattening the arch in your lower back).

Hold the stretch for 30-60 seconds and do at least 5 every day. If you have time to do more then you should – the more stretching you do the better the muscles will feel and the more effect you will have on the function of your knee.

If you have more knee pain due to this stretch, then stop and seek a physiotherapists opinion. We can usually see you within 48 hours of you calling us – so give us a ring and book in on 01438 317037.

Kerri Surman – Specialist Sports and Musculoskeletal Physiotherapist

Anatomy of Anterior Knee Pain

This diagram shows some of the structures described last week which can cause pain around the front of the knee.

You can narrow down where your knee pain is coming from by pressing around the knee. With quite a lot of types of anterior knee pain the pain comes exactly from the source of the problem.

If the pain emanates from the top part of the knee cap it is highly likely you have quadriceps tendinopathy, if the pain comes from the lower tip of the knee cap it is likely you have patella tendinopathy, although this needs more specialised assessment as there are several structures extremely close together that could be causing the pain. Accurate diagnosis of the structure is important because the treatment and rehabilitation is different.

If the pain is more vague you should definitely seek a specialist assessment with a physiotherapist. We can usually see you within 48 hours of you calling in, so give us a ring and let’s get your knee sorted.

01438 317037

Kerri Surman – Specialist Sports and Musculoskeletal Physiotherapist

Anterior Knee Pain

Basically, this means pain at the front of the knee! 

We see a lot of people with knee pain that seems to have come on for no reason, there was no actual injury incident, but the pain is getting worse or just won’t go away. Sometimes the pain is pinpoint specific and sometimes it is more vague. 

Anterior knee pain usually causes symptoms of pain going up and down stairs, pain when standing up after sitting for more than half an hour which eases after a few steps and difficulty kneeling on the sore knee.

The source of the pain could be the back of the kneecap itself, sometimes the cartilage on the back of the kneecap can become painful and inflamed. The pain could be coming from the patella tendon which attaches onto the bottom of the kneecap and the top of your shin bone, it could also come from various squashy tissues at the front of the knee which are there to reduce friction when the knee is moving.

Anterior knee pain can be easily helped with physiotherapy – but if it isn’t treated it tends to go on and on, not really getting better on its own. The longer it is left, the worse the pain tends to get the longer it will then take to get better once you visit a physio.

This is a pain that you shouldn’t push through and you shouldn’t ignore.

If you are suffering from any of these symptoms please get in contact with us, the sooner the better. We will absolutely be able to help.

Give our lovely reception team a call on 01438 317037 to book in.

Kerri Surman – Specialist Sports and Musculoskeletal Physiotherapist

Treatment for Low Back Pain

There are many ways to treat the causes of low back pain, the one we will focus on today is spinal manipulation. This term refers to specific positions and movements applied to the joints of the lower back to create more flexibility and freedom of movement and therefore less pain. Sometimes these manipulations result in clicking noises from the spine but not always – and not having the clicking noise doesn’t mean the treatment hasn’t worked.

Spinal manipulation has been shown to significantly reduce pain in the lower back and can reduce muscle spasm.

All of our physiotherapists are qualified in spinal manipulative techniques. If you would like treatment for low back pain or any other back pain don’t wait – call us today on 01438 317037.

Kerri Surman – Specialist Sports & Musculoskeletal Physiotherapist

Exercise for Low Back Pain

An amazing exercise for easing out muscular pain in the lower back area is the Child’s Pose Stretch. This is actually a yoga pose called Balasana and is a resting pose, meaning it is relaxed and can be held (rested in) from as little as 30 seconds up to a few minutes.

Balasana or Child’s Pose Stretch

Follow this linkfor a description of how to do this great stretch.

This shouldn’t cause your back to hurt more than it already does, if your pain increases don’t continue with the stretch and seek some further physiotherapy advice by calling us on 01438 317037.

Kerri Surman – Specialist Sports & Musculoskeletal Physiotherapist

Anatomy of Low Back Pain

Most low back pain is muscular, largely due to the muscles named Quadratus Lumborum or QL for short. The QL are 2 large muscles which attach to the top of your pelvis, 4 of your Lumbar vertebrae and your lower ribs. The QL muscles are involved in all movements of the lower back in some way although they are not really the main movement muscles, they are mostly helpers. They also help with breathing due to their attachments onto the bottom of the rib cage. 

The Quadratus Lumborum Muscle shown in red

When we sit for long periods of time the main movement muscles of the lower back become weak because we aren’t using them – this means that when they are called upon and cannot provide enough strength, the QL muscles help out more than they should do. They then get very fatigued and painful. This can also lead them to become strained or go into spasm and this is the root of a lot of low back pain.

Unfortunately, once we have had an episode of back pain it is very likely it will happen again unless we address the underlying issues causing the problems.

Our expert physiotherapists can help ease the pain of QL spasm as well as lots of other causes of back pain. We have been providing back pain treatment to the people of Stevenage for over 25 years. 

Don’t leave it and hope that it goes away, you are likely to need advice on how to reduce further episodes of back pain. 

Call us now on 01438 317037, we will be able to see you within 48 hours and usually have appointments available even sooner.

Kerri Surman – Specialist Sports & Musculoskeletal Physiotherapist