Extracorporeal shockwave therapy

Read how new shockwave therapy can help those stubborn tendon problems and more!

Here at Physio on the River, we are always working to ensure we deliver the most up to date evidence based therapies to our clients.

We are very pleased to now offer Shockwave therapy . This is a very effective therapy for many chronic painful musculoskeletal problems, examples of which are: Plantar Fasciitis of the foot, Achilles Tendonopathy, Tennis Elbow and Calcific Tendonitis of the shoulder.

sourced from Complete Pain Care

This type of treatment is now recommended by the majority of Consultant Orthopaedic surgeons when muscular, connective tissue (the web of connecting tissue between structures) and tendon problems become chronic (i.e. lasting longer than 3 months).

What is shockwave therapy?

There are many different types of machines that use varying physical mechanisms to produce shockwaves. The machine manipulates these shockwaves to deliver the appropriate dosage to bodily tissues to achieve a therapeutic response.

The most recent mode of doing this is electromagnetic pulse shockwaves. Here at Physio on the River, we are excited that we can offer this type of shockwave therapy. It uses rapid electromagnetic pulses to create precise, low amplitude shockwaves directly to tissues. The major benefit of this is that it is far less painful than many other forms of shockwave production and delivery, for example compressed air.

Can it do any harm?

As well as having a large body of academic evidence for the positive outcomes of this type of therapy (e.g. Legat 2014; Loska 2017; Moya et al 2015), it has the added benefit of having very few risk factors or contra-indications.

The National Institute of Clinical Effectiveness (NICE) guidelines have been produced for the use of shockwave therapy for many common musculoskeletal conditions including: plantar fasciitis, tennis elbow, Achilles tendinopathy and trochanteric (hip) pain syndrome. As you may have read in the press NICE are a hard nut to crack and endorsement from this organisation carries weight.

At initial assessment, if shockwave is for some reason not the best clinical option for you, the physiotherapist will discuss alternative options either at Physio on the River or referring you to a different healthcare provider, as appropriate.

What does the treatment involve?

The package of care for shockwave therapy will involve an initial Physiotherapy assessment followed by a package of as many treatments as required. The number of treatments required on average vary between 4 and 10, depending on area to be treated and the reaction to treatment.

The machine has  a small hand-held device through which the shockwaves are given. The treatment is quite noisy and can sometimes feel uncomfortable but is only given in short bursts of time. We only treat to a person’s tolerance!

How much does it cost?

Sessions of Shockwave are typically charged at £150 -£200 per session throughout the clinics in London that provide it. We are offering outstanding value – a block of 4 Shockwave treatments (typically 4-10 sessions are required) for only £300 – meaning a potential saving of up to £500!

Some health insurance companies, including Bupa, are now offering cover for this treatment so if you hold a policy it is worth checking with your company first.

If you would like to book an appointment:

Call the clinic on 020 8876 5690

Book online by clicking here.

Contact us by email here.

Or pop into the clinic in person – we’d love to have a chat!

 

 

Golfers elbow and how physiotherapy can help

What is golfers elbow?

Golfer elbow causes pain for many golfersGolfers elbow is a pain on the inside of your elbow affecting the flexor tendons that flex your wrist, hand and fingers and attaches to the inside of your elbow. We used to think it was caused by an inflammation of the tendon which links the muscle to the bone. However, it is really a ‘tendinopathy’ with the tendon struggling to cope with the forces put through it because its structure has become weakened.

The good news is that although these problems can be rather persistent there are lots of things we can do to help and it is usually possible to get rid of it completely if you follow our physio’s advice!

Improve your golf swing and get rid of elbow pain for good

Dave Burnett is one of our Physiotherapists and he is a Titleist accredited Golf Rehab Physiotherapist. He is also a very keen golfer and loves helping golfers recover from injury. Dave shares his knowledge about research on elbow injuries in golfers and best practice for getting them better.

Why amateur players get more elbow pain than professionals

elbow pain in golfers

golfer demonstrating good follow through

Elbow injuries account for up to 15% of chronic golf injuries in professionals and up to a massive 30% in amateurs! This is usually because restrictions in flexibility and range of movement around your hips, trunk and shoulders mean that the club head speed in amateurs is generated more by the wrists and elbows. This extra stress on the elbows can cause the elbow pain known as golfer’s elbow.

Professionals, on the other hand, tend to be looser in their hips, trunk and shoulders. They generate forces from the ground up that are shared between all the joints of their body and the stresses are not concentrated in one area.

It is therefore important to consider your swing technique and your flexibility and strength through your whole body. This is something that our Sports Rehab Physiotherapists are trained to assess and treat. We are movement specialists and analysing technique and correcting weaknesses is all part of our role.

6 common factors of elbow pain in golfers

  • Surprisingly Golfer’s Elbow (where pain is felt on the inner point of the elbow) is less prevalent in golfers than Tennis Elbow (pain over the outer point of the elbow)!
  • It is also surprising that a right handed golfer can suffer from it on either the left or right arm!
  • Commonly the elbow pain starts within 1-2 days after hitting a lot of practice balls or playing on hard ground or mats.
  • A sudden increase in playing or practice frequency or returning to intense practice after a few weeks off can also provoke its onset
  • A change in your golf swing or grip can also cause the problem

How can Physiotherapy treatment help golfers elbow?

In the early stages:

  • In the early stages when it’s very painful we often use taping or a brace/clasp round the elbow to offload the painful tendon.
  • Resting an injured elbow may not be as effective as applying an optimal load to it. We use a process of POLICE – Protection, Optimal Loading, Ice, Compression and Elevation.

 As pain settles:

  • Exercises are the primary treatment for golfer’s and tennis elbow. We show you how to gradually load the tendon to strengthen it. This starts with isometric exercises (working the muscle without moving the joint). Then isotonic exercises (where we work the muscle through joint movement) and finally to speed work.
  • Sometimes we find the elbow joint is stiff and needs loosening up with gentle manipulation
  • We often treat the soft tissues with massage techniques

 Vital aspects for preventing a recurrence of the problem:

  • Assessing and working on restrictions in flexibility through the ankles, knees, hips, trunk, spine and shoulders
  • Assessing and working on strength through the same chain and especially addressing weakness of your core muscles
  • Considering the grip width of the club which affects the forces used as your gripping muscles attach at the elbow
  • Considering the stiffness of the shaft of the club – this can affect the forces transferred through the elbow. The stiffer the club the more force taken and the more flexible the club shaft the more forgiving on your elbow joint.
  • A good warming up routine loads the elbow gradually before a game to fully prepare muscles and tendons.

elbow pain in golfersWithout addressing these longer term issues elbow pain very often recurs so there are no short cuts to getting it completely resolved. Clients have a tendency to tail off their rehab once the pain is more under control. But the really important part is addressing the weaknesses and restrictions through the body that set professionals apart from amateurs. So completing a full rehab programme is essential. Our Physiotherapists will complete a thorough assessment of your body as a whole. They will then tailor your programme specifically to address the imbalances they find.

If you are unfortunate enough to experience golfers elbow or other elbow pain and would like to book an appointment with one of our Physiotherapy team just call 020 8876 0286, email us here or pop into the clinic for a chat.

If you have enjoyed this article, you will also like this one on avoiding and treating back pain for golfers:

Need to improve your golf swing performance and banish back pain? Physiotherapy could be the answer!

Use this link to see a good description of golfers elbow from The Mayo Clinic

 

Read our top tips for preventing tennis elbow

Tennis elbow is a very common complaint at this time of year. It’s more difficult to help once it becomes established and chronic. There are some useful steps that can be taken to reduce your chances of developing it. Read this infographic for our top tips.

We used to think that tennis elbow was a tendinitis – inflammation of the tendon. But we now recognise it as a tendinopathy – a degeneration of the tendon such that it struggles to cope with the loading put through it. Nowadays we treat the condition mainly with specific exercises to strengthen the tendon.

If you are unlucky enough to start experiencing the symptoms of tennis elbow which are typically:

  • pain and tenderness over the outer point of the elbow
  • aggravated by tennis strokes
  • aggravated by lifting a kettle or even a cup if very acute!
  • can be worse with typing
  • felt on gripping things

come and see one of our Sports Physiotherapists who can help you recover and give you tailored advice on prevention.

  • Physio on the River
    The Old Ticket Office
    Barnes Bridge
    The Terrace
    Barnes
    London
    SW13 0NP
  • Opening Hours

    Mon: 7am – 9pm
    Tues: 8am – 9pm
    Wed: 7am – 9pm
    Thurs: 8am – 9pm
    Fri: 7.30am – 7pm
    Sat: 8am – 2.30pm
    Sun: Closed

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Because of our great transport links and free on-street parking we have regular patients and exercise class participants from:
Barnes, Mortlake, East Sheen, Putney and Roehampton