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INTRODUCTION TO MUSCULOSKELETAL DISORDERS TREATED WITH PHYSIOTHERAPY - HEREFORD

In this page I describe what musculoskeletal disorders (MSKD's) are and how they can cause pain and dysfunction.

 

I then describe in more detail the most common musculoskeletal  disorders that are treated with physiotherapy here in Hereford within each subcategory.

 

It is very important to get these assessed and treated as soon as possible.  ​Early assessment and treatment speeds up recovery and reduces the risk of future injuries or  complications. 

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Who benefit

WHO BENEFITS FROM TREATMENT?

Physiotherapy, sports therapy & sports massage are very beneficial for anyone who is suffering from  a musculoskeletal disorder  (MSKD) , participating in exercise or who competes in sport here in Hererford. Depending on what is required, a progressive exercise plan can be utilised along with manual therapy to improve your strength, flexibility, mobility, balance and stability. This will aid with either pain relief,   injury rehabilitation, injury prevention or both. 

 

For anyone who participates in regular exercise, manual therapy techniques, especially massage can be very useful to use before, straight after and also in-between exercise to assist with recovery and injury prevention. 

Sports - Cycling
MSKD's
msk&pain

​WHAT ARE â€‹MUSCULOSKELETAL DISORDERS (MSKD's)

​Musculoskeletal disorders (MSKD's) are a range of injuries, disorders, or abnormalities that can develop within the soft tissues and/or the skeletal system. The soft tissues encompass nerves, spinal discs, muscles, tendons, ligaments, and cartilage. Injuries or abnormalities in any of these areas can lead to dysfunctions and pain.​

 

Common MSKD's that can be treated are:

  • INJURIES

    • ACUTE/CHRONIC

      • Muscular & tendon injuries

      • Joint/ligament injuries 

      • Overuse injures 

      • Recurrent/Repetitive injuries

  • MUSCLE IMBALANCES ​

  • COMPENSATORY MOVEMENT PATTERNS

  • SPINAL PAIN

    • LOW BACK & NECK PAIN - Disc damage, disc bulge, spondylosis (arthritis in the spine), muscular and ligament injuries

  • POSTURAL DYSFUNCTION ​

  • ARTHRITIS

  • POST SURGICAL REHABILITATION

  • REDUCED BALANCE AND STABILITY (PROPRIOCEPTION)

  • REDUCED STRENGTH/ ENDURANCE / FLEXILBITIY

  • INCREASED MUSCULAR TENSION

    • TENSION HEADACHES

    • GENERAL MUSCULAR TENSION

    • TRIGGER POINTS

 

.................................AND MANY MORE

Exercise rehabilitation wih crutches

 

​​​​​​​​​​​​​​​Pain is a natural response to damage or abnormal stress placed on the soft tissues (muscles, tendons, ligaments, nerves) or bony structures in the body. Swelling and inflammation is often present along with pain.

 

When inflammation and swelling occurs, chemicals are released as part of the normal healing process. Some of chemicals can cause irritation and increase the activation of the nerves involved with producing pain.  This serves as a warning system to try and prevent any further damage to the area. It does this by causing you to try and avoid straining or stressing the area any further (e.g. if the knee has been injured, pain causes you to take weight off the knee by limping or resting more). This then helps to  reduce the load passing through the damaged area, allowing for healing.  

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Examples of situations that can trigger pain are:

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  • Injuries.

    • Acute injuries - causes immediate damage to the local area. e.g.  a ligament sprain.

    • Chronic injuries  develop over a prolonged period of time as abnormal loads/stress are applied to an area  that results in inflammatory reactions and pain ( e.g.Overuse injuries).

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  • Increased tension within muscles

    • This can lead to adhesions/trigger points within  the muscles. These can cause both localised and/or referred pain as well as other symptoms such as pins and needles and changes to sensation.

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  • Nerve root compressions  such as a disc bulge c

    • Causes pain either directly from the disc squashing the nerve,  or after the build up of inflammation that can occur after the spinal disc, ligaments or tendons etc have been damaged.  

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MSKD'S - PAIN AND SWELLING

PAIN DURING HEALING

Pain is an essential part of healing and sometimes it is better to allow pain to be present rather than to mask it with medication. As pain is a warning sign to avoid damaging the area further, if pain is masked by medications, you may end up overloading the area and causing more damage. As the stages of healing progress we will then want to reduce the pain and encourage movement to promote normal healing. 

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Showing areas of pain in muscltiple joints
Swelling in knee

SWELLING DURING HEALING

Swelling is also an important part of healing. It brings nutrients and removes any damaged waste material, so it is important to initially allow swelling. Reducing the swelling too much too soon may in fact delay healing. 

​​​​Although pain and swelling are important for the initial stages of healing there may be occasions when they may linger for too ling. At times an area may also become over sensitive in which there is more  pain than what you would expect for the amount of damage. In these situations we want to encourage a reduction in pain and swelling to promote healing.

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Experiencing pain during exercise is also something that we need to consider. We all know the saying 'No pain, no gain'. This is generally meant for the burning pain felt from lactic acid in the muscles. A certain level of pain is acceptable, but It is  not always appropriate to continue with an exercise.

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SEEK MEDICAL ADVICE AND TRY TO AVOID AGGRAVATING PAIN IF IT IS:

  • Present after an Injury

  • Deeper joint pain (spine and limbs)

  • Sharp & shooting pain

  • Severe pain

  • Pain that progressively gets worse during an activity (exercise, walking, cleaning etc)

  • Pain that lingers for a prolonged time after finishing an activity

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Although rare, there will be times when pain can be something more serious that would require urgent or even emergency treatments. Questions during the initial assessment will ask about  RED FLAGS which will help to rule these out.

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If you are experiencing pain seek advice from a medical health professional before attempting any exercises or self treatment techniques that you may have come across. It is essential that certain things are ruled out first and that a diagnosis can be made in order to provide the most suitable treatment plan. 

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I have had patients who though they had strained their calf muscles but it was in fact  deep vein thrombosis. This is an emergency situation that requires immediate referral to A&E. I have had many patients over the years who I sent to A&E or for urgent assessment by their GP. Most turned out to be ok, but their have been  a some who ended up having Cancer, a DVT, Cauda Equina Syndrome (a serious lower back problem that requires emergency surgery).

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When serious pathology has been ruled out I will guide you through the appropriate treatment plan specific or your needs. 

Football players falling
PainHealing
Swelling
Risk factors MSK
RiskMSK

RISK FACTORS FOR MSKD'S?

There are many individual differences that can increase the likelihood of suffering from an MSK disorder, such as:​

  • Overweight

  • Sedentary

  • Poor posture

  • Movements causing repetitive stress (work or leisure)

  • Sport or general exercise

  • Overexertion

  • Prior injuries​

  • Poor overall health 

  • Older individuals

 

 

Excess weight can exert a greater force on the joints, thereby increasing the load and stress that passes through them, especially when walking or running. This, in turn, can elevate the amount of strain placed on the structures responsible for maintaining joint stability, including the ligaments and muscles and may cause an acute injury.​

OVERWEIGHT

Infographic: injuries more common now because we are generally more sedentary
infographic: Higher BMI increases the risk of injury

 

​In modern  times, the general population leads a more sedentary lifestyle, resulting in the underutilization of certain muscles, such as the gluteal (buttock) muscles. These muscles play a pivotal role in maintaining correct movement patterns. Prolonged sitting can lead to weakening of these muscles, thereby disrupting their ability to help control movements and causing chronic injuries. The body will try to continue functional movements and uses  compensatory movements  and uses other muscles.

SEDENTARY

It is imperative to maintain a moderate level of physical activity to maintain the strength and stabilising effects of these muscles. Compensatory mechanisms may impose excessive stress and strain on other body parts, thereby increasing the likelihood of pain and injury. 

 

Prolonged poor posture can lead to an increased risk of MSKD's.

 

These postures may be attributed to occupational demands or habitual postural inadequacies.

 

Certain occupations, particularly those involving manual labour, may entail risk factors that heighten the likelihood of pain and injury. E.g. repetitive bending with rotation of the spine or heavy lifting can lead to sudden acute injuries. Prolonged, poor habitual postures can lead to  chronic injuries that gradually develop over time.​

POOR POSTURE

epetative strain from typing
Poor posture from Manual work digging causing injury, hereford

REPETITIVE STRESS

​Repetitive movements have been identified as a significant risk factor for developing MSK disorders. Individuals who engage in jobs that require performing the same movements over extended periods of time, such as typing or repeatedly bending forward, are at an increased risk of developing carpal tunnel syndrome or a disc injury respectively.

 

This can result in a heightened strain on the muscles and joints involved, leading to potential long-term health implications.

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MUSCLE IMBALANCES

Can occur throughout the body can increase the risk of injury. If a muscle is too tight, too weak or if compensatory movement patterns have occurred then injuries are more likely. 

 

PARTICIPATING IN SPORTS

This can elevate the likelihood of sustaining injuries due to external forces or dysfunctional movements, such as twisting a knee while turning to kick a ball.

 

OVEREXERTION

Overexertion can result in fatigue and weakness, leading to decreased stability, and balance 

and the increased risk of injury. 

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PRIOR INJURIES

If not effectively rehabilitated exoeriencng prior injuries may cause weakness, resulting in reduced strength, stability, and balance.

 

POOR OVERALL HEALTH

If a patients health is poor, they may experience general weakness and reduced endurance, increasing the risk of fatigue and falls.

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OLDER INDIVIDUALS

Gradually develop weaker muscles, less stability and balance, and deteriorating joints with reduced effectiveness of the structures surrounding the joints.

COMMON MSKD'S THAT CAN BE TREATED WITH PHYSIOTHERAPY IN  HEREFORD

There are many common MSKD'S throughout the body that cause pain and can be treated with exercises and/or manual therapy. The following is a list of common disorders that will benefit with treatment.​

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  • NECK -  whiplash, disc injury/prolapse, arthritis, increased muscular tension/trigger points, myofascial pain

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  • SHOULDER -  impingement syndreome, rotator cuff tears, labral tears, increased muscular tension, trigger points, myofascial pain, scapula dyskinesis, acromioclavicular joint  injuries, dislocation, tendinopathy, bursitis, frozen shoulder, arthritis, calcific tendonitis

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  • ELBOW - tennis elbow, golfers elbow, tendinopathy, bursitis, fractures, ligament injuries, increased muscular tension/trigger points, myofascial pain

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  • HAND & WRIST - Post fracture rehabilitation, DeQuervain's, dislocations, arthritis, impingement syndromes, ligament tears, tendinopathy, carpal tunnel syndrome, nerve compression, post surgical. repetItive strain injuries, increased muscular tension/trigger potins, myofascial pain

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  • FINGERS & THUMB - fractures, dislocations, ligament injuries, tendinopathy, mallet finger, swan neck deformity, Boutonniere deformity,  repetitive strain injuries, increased muscular tension/trigger potins, myofascial pain

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  • LOW BACK - arthritis, disc bulge/prolapse, disc injury, degenerative disc disease, joint dysfunctions/injuries, spondylolisthesis, spondylolysis, fracture, non-specific low back pain, increased muscular tension/trigger points, myofascial pain

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  • HIP/PELVIS - arthritis, femoroacetabular impingement, labral tears, ligament tears, synovitis, tendinopathy, bursitis, muscle strain/tear, stress fracture, increased muscular tension, myofascial pain, sacroiliac joint pain, piriformis syndrome, deep gluteal pain syndrome, hamstring tendon injury.

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  • KNEE - arthritis, meniscal injury, ligament injury, bursitis, tendinopathy, fat pad impingement, knee cap dislocation, cartilage damage, patellofemoral pain, increased muscular tension/trigger potins, myofascial pain.

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  • CALF - strain, tear, increased muscular tension/trigger potins, myofascial pain

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  • Foot and Ankle - arthritis, ligament injury, tendinopathy, fracture,  plantar fasciitis, increased muscular tension/trigger potins, myofascial pain

THE MOST COMMON TYPES OF MSKD'S TREATED

As  shown above, there are many different types of musculoskeletal disorders. These are described in more detail in the following pages.   Click on the links below to read more information on the most common musculoskeletal disorders that are treated here at Dynamic Movement Physiotherapy, Hereford. ​

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  1. Injuries

  2. Muscle Imbalances

  3. Neck Pain

  4. Low Back Pain

  5. Reduced ROM, Flexibility

  6. Increased Stiffness

  7. Arthritis

  8. Post Operative

  9. Reduced Balance, Proprioception and Stability

  10. Increased Muscle Tension & Trigger Points​​

Common MSK's
MOre information
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