Physiotherapy Services

Neck, shoulder and back pain can be caused by postural weakness, often by sitting with inadequate support or at an unsuitable workstation. Sitting at a desk for many hours a day can gradually cause stiffness, weakness and pain to develop. Manual therapy by a physiotherapist is then required to restore normal movement, reduce pain and improve your postural endurance. Postural training with a physiotherapist is essential to ensure you know how you should sit. Common mistakes when correcting posture are to tense the wrong muscles or over activate the correct postural muscles, causing them to fatigue. Add stress to the equation and the upper trapezius will tense, creating more pain in the neck and shoulders. Postural training will enable the trapezius, serratus anterior and deep neck flexors to work together efficiently to reduce pain and improve posture

Pilates is often helpful for low back, neck and shoulder pain. However, there are a few reasons why it might not help you if you have only attended a group class. Activating your core (tensing the Transversus Abdominis and Lumbar Multifidus muscles) can be very difficult to achieve without the close supervision of a physiotherapist. Until you get it right you won’t get optimal benefit from Pilates. Another problem with a group class is that your back/neck/shoulder might need to avoid certain movement initially or it can aggravate your pain. I always suggest individual lessons initially, either with myself or a good Pilates instructor. I start with specifically activating the core muscles and nothing else. It can take some time to become familiar with these muscles as we are not usually conscious of them working. Once you have mastered this then you can start some basic Pilates exercises, initially only in positions that alleviate your pain. Once you have progressed through a series of Pilates exercises you can join a class to help keep you motivated

The deep neck flexors are like the core muscles for your lower back and pelvis that are mentioned above. These deep neck flexor muscles help to stabilize neck and head. If they are weak you may be prone to getting recurrent neck pain. People with neck pain find it difficult to activate these muscles and need individual instruction from a physiotherapist and time to improve this. Exercises are progressed from there on to improve your neck strength and coordination including strengthening rotators and lateral flexors of the neck. This is often used in conjunction with posture improving and manual therapy techniques

The sacroiliac joint, which joins the base of the spine (the sacrum) to the pelvis (hip bone), can become stiff and painful. The pelvis can rotate forwards or backwards and shift up or down, reducing the movement available and creating pain. This is often associated with tightness and or weakness in hip muscles such as the piriformis, hip adductors, psoas/iliacus, gluteus maximus. Weak core muscles may also be involved. An unbalanced pelvis can cause pain all the way up the spine and into the shoulders. Muscle energy techniques performed by a physiotherapist are useful for making the pelvis level again and reducing pain

McKenzie is a New Zealand physiotherapist who is known for a particular approach to lower back pain. McKenzie extension exercises are the most commonly used treatment. These exercises can be particularly helpful for lumbar disc problems, but if done with the wrong type of back pain can make pain worse, so only do these exercises if you have been assessed by a physiotherapist first

Nerve tissue is quite elastic, lengthening and shortening as your body moves. Nerves can become trapped or stuck to surrounding tissue, especially in the lower back and neck. This limits the nerve’s ability to stretch normally creating pain in the area of entrapment and into the arm or leg. To treat this, techniques are used to remove the pressure from the nerve and allow normal movement. Home exercises involve repeated movements that facilitate nerve gliding without stretching the nerve. If nerves are over stretched they can become extremely irritated. The Ridgway method uses very gentle osculations of the neck or lumbar spine muscles and vertebrae to improve movement of the nerve root. Manual therapy techniques by a physiotherapist are also used to release the nerve from the surrounding tissue that may be restricting its movement. Exercises can be performed at home to maintain normal movement

Maitland is an Australian physiotherapist who developed a method of moving joints in an oscillatory manner to improve their movement. His techniques are one of the most commonly used by physiotherapists to increase joint movement in stiff joints. Mulligan is a New Zealand physiotherapist who developed another method of loosening joints by combining normal movements with overpressure on the joints to facilitate more movement in the joint. Mobilizations with movement, NAGs and SNAGs are what he called these techniques. They are generally less painful than other mobilization techniques but very effective

For spinal pain, spinal mobilization and manipulation are almost always used at some point during a treatment programme. Mobilizations are more gentle movements of each vertebra in relation to the ones next to it. A spinal manipulation involves a greater force but very small amount of movement when the spinal joints are positioned in their tightest position. These techniques can give great relief of pain very quickly

Proprioception is the ability to tell where one part of your body is positioned in relation to another without using your vision. If you have good proprioception and muscle control you should be able to balance well and avoid your joints and muscles being strained. Poor proprioception may lead to injury during everyday activities and sports. Proprioceptive training with a physiotherapist aims to improve your body position awareness through a series of exercise progressions

If a bicycle is set up incorrectly it can lead to knee, hip and back injuries. I have specific training and experience is setting up your bicycle to fit your body. It is very difficult to do this for yourself and the bike shop you buy from may not set it up perfectly

Using a semi-rigid tape or flexible K Tape to support joints during activity can help prevent injury or help to overcome an injury by protecting the damaged ligament or muscle tissue. The most common use of taping is for sprained ankles but it can also be used to reduce pain around the knee cap, improve your upper body posture, lower back posture, and help correct shoulder movement.

Occasionally it is not obvious why you have a recurrent injury. Using video in slow motion can help to identify problems with your movement patterns that may be causing your repeated injuries. Analysis of the video footage by a physiotherapist can be used to tailor an exercise programme to your needs

Singers and non-singers can get problems with their voice, such as losing vocal range or developing hoarseness. This can be due to tension in muscles above or below (suprahyoid and infrahyoid muscles respectively) the larynx (voice box). Physiotherapy to release these muscles and muscles of the temporomandibular joint (TMJ/jaw) along with altering head and neck posture can help restore your vocal ability and range. There can be other causes of vocal problems, so in most cases you should see a Speech and Language Therapist or Ear Nose and Throat surgeon for investigations to exclude other causes of your symptoms

After surgery, many conditions will need physiotherapy to help get your body moving again. Due to the trauma of surgery and the pain you experience after surgery, your muscles become weak and loose bulk, joints may stiffen and scarring may restrict your normal movement. A combination of strengthening exercises, stretching and manual therapy with a physiotherapist will help to improve this

Myo refers to muscle tissue and fascia is the connective tissue throughout your body. Myofascial release is a technique that gently improves the mobility of the myofascial system. By applying pressure to soft tissues and holding for a sustained period of time, the tissue begins to stretch. This particular treatment also increases the local blood flow and facilitates healing in the area

Deep tissue massage is a vigorous massage technique that aims to reduce tension in your muscles and other soft tissues. This treatment can be a bit painful but leaves you feeling much more flexible afterwards. Many athletes and dancers have regular deep tissue massage to help prevent injury or to keep them performing

Sports Physiotherapy is a general term to describe a variety of manual therapy techniques, muscle control, strengthening and stretching exercises with a physiotherapist that help the body recover from sports related injury

In western acupuncture and dry needling, acupuncture needles are inserted into areas of muscle that have increased tension and are painful to touch. This reduces the muscle tension almost immediately and relieves pain. This western version of acupuncture does not use meridian lines like traditional acupuncture and the needles are not left in for more than a few seconds. Dry needling can sometimes be a bit painful but research has shown the treatment to be very effective for treating trigger point pain

Home visits can be arranged within a couple of miles of the Edinburgh physiotherapy clinic if you are unable to come to the clinic for assessment or treatment. Please phone to arrange a visit. Home visits are charged at the same rate as a one hour appointment, but you will only receive around 40 minutes of treatment due to the travel time involved. Please keep in mind it is always better to attend the clinic if you are able to