Whalley Physiotherapy

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  1. Are you laughing comfortably?

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    Are you laughing comfortably?

    You may not want to answer that question – you are not alone.

    Did you know that one in three women suffer from leakages (of urine) at some point during their life?

    And it can be at any age.

    This can be due to weakness of the pelvic floor muscles, linked to pregnancy, childbirth or the menopause; so it is easy to understand how widespread the problem is yet because of embarrassment it’s hidden away – a taboo subject.

    It is common to have urinary leakage with coughing, sneezing or during exercise and sport.

    Urgency or the need to rush to the loo to get there in time can also happen.  Also, it is easy to see how sex life may be affected by weakness of these important muscles – another subject difficult to discuss.

    The good news is that there is good evidence that exercise for the pelvic floor muscles provides a more safe and effective treatment, though complex conditions may require other avenues.

    Many women try but feel they don’t know if they are doing the exercises correctly and soon give up.

    The pelvic floor muscles need to work in the right way and the exercises need to be precisely done to be effective so it is best to be taught on an individual basis, and then follow an exercise plan.

    As with most things in life worth achieving, time and effort is needed to make a difference.

    P.S.  Men – you are not entirely exempt from developing problems, although it is less common.

    But you also do have a pelvic floor, so would benefit from exercises too.

    If you want some more information or assistance please contact Hilary, our pelvic floor specialist on 01254 82313

  2. Feedback from Mrs S

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    Wow, what a lovely testimonial we have received from one of our wonderful patients Mrs S
    “I suffered a head injury and whiplash in February 2017 with bruising to the spine and back. In March I came for help but was scared to let anyone touch me in case of further damage to my body. Jane appreciated this and understood the need to negotiate my way back to fitness. Her concern instilled confidence in me and she made an assessment.
    The weekly care was a lifeline. I was housebound and isolated with slight memory loss, word confusion and disorientation. She allowed me to talk as she worked ‘hands on’.
    The chats were a therapeutic bonus and I found myself laughing again. Each week she reminded me of how far I’d come, how I was doing, and where I would be the next week.
    Simple exercises to do at home helped too, its been a long journey back to fitness.
    Its been worth every penny and I’m grateful to everyone for their care and attention.


    Plantar fasciitis is an extremely painful condition, but it can be alleviated with a variety of treatments and exercises, says physiotherapist Jane Connolly HPC CSP

    Anyone who has had plantar fasciitis will tell you how painful it can be. It’s often felt as a sharp pain under the heel, sometimes radiating into the arch, that is worse first thing in the morning as you put weight through your foot or after prolonged periods of sitting. In the early stages it eases within a few minutes of walking but often there’s a tender spot under the heel or arch and it hurts pulling the toes towards the shin.

    The plantar fascia is a broad band that attaches from the heel bone, calcaneus, to the toes. It serves to stabilise the arch of the foot during walking and acts as a shock absorber as the foot hits the ground. Repetitive over stretching results in an overuse injury to the ligament as it attaches to the calcaneus. Initially it may be inflammatory but with time becomes more degenerative in nature. There may also be some involvement of muscles located immediately deep to the plantar fascia.

    Causative factors for plantar fasciitis include increasing the amount of running or walking you’re doing, wearing flat shoes with no cushioning, being overweight, having tight calf muscles or even flat feet can all result in more strain or effort being put throughout the ligament.

    Most people who have plantar fasciitis recover with conservative treatments within several months. In the first instance rest and avoid aggravating activities. Don’t walk barefoot on hard surfaces and choose shoes with cushioned heels and a good arch support.

    Ice the painful area for 15 to 20 minutes and take the appropriate medication in the early stages.

    Gait analysis may identify biomechancial foot problems and orthotics prescribed.

    A physiotherapist can make an accurate diagnosis and may use electrotherapy such as ultrasound to relieve symptoms, manual techniques such as massage or apply tape to support under the foot. Mostly they will advise you on exercises to stretch the plantar fascia and calf muscles which takes priority initially over strengthening. Calf muscle stretches with the leg straight (to target the larger gastrocnemius muscle) and with the knee bent (targeting the lower soleus muscles) are done three to five times per day, holding the stretches for up to 30 seconds at a time.

    The plantar fascia stretch is done by pulling the foot and toes upwards aiming to feel a stretch in the arch of the foot. Rolling the foot over a ball can also help stretch underneath the foot.

    A corticosteroid injection may give temporary pain relief but multiple injections aren’t recommended and in more chronic cases extracorporeal shock wave therapy is sometimes used.

    For such a seemingly small problem the repercussions of walking badly can have a knock on effect higher up in the body causing problems in the knee, hip or back. Consequently, as ever, early diagnosis and treatment can be essential.

  4. Shoulder Issues: Early diagnosis and treatment.

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    The shoulder joint is a relatively unstable ball and socket joint that is moved and controlled by a small group of four muscles known as the rotator cuff. These muscles and their tendons surround the shoulder joint and are responsible for stabilising the head of the humerus firmly within the shallow socket of the shoulder and shoulder rotation.

    The tendons run under a bony protective arch over the top of the shoulder (acromion which is part of the scapula) in between which sits the subacromial bursa (a lubricating sack) which helps protect the tendons from rubbing against the bone. It’s under this arch that the tendons are vulnerable to being damaged by being intermittently trapped and compressed during shoulder movements. Repetitive overhead activities like decorating, overhead sports like netball, heavy prolonged lifting and the development of bone spurs in the bones around the shoulder may irritate or damage the tendon resulting in a Rotator cuff impingement syndrome. This is when the damaged tendon catches under the boney acromion resulting in, amongst other things, a painful arc when lifting the arm out to the side and up.

    A tear in the rotator cuff  can also be caused by a single traumatic event such as falling onto an outstretched arm or due to age related degenerative wearing of the tendon itself. The damage is common in people over 40.

    A tear in the rotator cuff can severely restrict movement of the arm. The pain is described as a dull ache deep in the shoulder, sometimes radiating down the top of the arm and is common at night especially lying on the affected side. It’s  particularly painful reaching behind your back or activities like combing your hair or reaching for your seatbelt.

    Your physiotherapist will suspect a rotator cuff injury based on your clinical history and the findings from a series of clinical tests. It is important to get the pain under control and promote healing of the tendon, say with ultrasound, whilst doing guided exercises to strengthen and improve the flexibility of the shoulder without aggravating the injured tendon.  Postural correction is an important part of rehabilitation especially working on the muscles that control the scapula position to help minimise the impingement of the tendon under the acromion.

    Atraumatic, degenerate tears generally don’t do well with  surgical repair but shoulder movement can be recovered with specific exercises lead by your physiotherapist. On the other hand an injury causing a traumatic tear can be repaired surgically and should be considered as soon as possible for the best outcome. A diagnostic ultrasound scan is the most accurate method to diagnose the specific rotator cuff injury pathology. MRI’s may show a rotator cuff injury but sometimes they’re missed whereas X-rays are of little diagnostic value.

    So, the key to recovery is . Immobility of the shoulder due to pain or weakness can cause secondary problems like a frozen shoulder so advice and the right exercises are paramount.

  5. Tennis Elbow: Early Treatment is Vital

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    RV88 Whalley Physio Tennis Elbow

    There are plenty of things you can do to alleviate the pain caused by tennis elbow, says physiotherapist Jane Connolly HPC CSP

    Tennis elbow – or lateral epicondylitis – is a common injury affecting the muscles or tendons of the forearm where they attach to the epicondyle of the humerus. It is classed as a tendinopathy which is aggravated by repetitive wrist extension or by gripping strongly whilst twisting your wrist.
    Despite being called ‘tennis elbow’ it isn’t only racquet sports that causes the problems. Any job that involves a repetitious overuse of the wrist results in micro trauma within the tendons and may explain why, apart from the very early stages, the problem has been shown to be due to degenerative changes rather than an inflammatory process. Poor working positions on a computer over an extended period of time can also cause pain.

    The most common symptom is pain and tenderness on the outside of the elbow or in the muscles of your forearm which comes on gradually over time or even a few days after the initial injury. The pain can vary from mild discomfort to severe pain that gets worse when trying to stabilise the wrist whilst gripping, like holding a cup, opening a jar, using a screw driver or shaking someone’s hand firmly. It’s also aggravated when you bend your wrist backwards against a force, for example when doing backhand in tennis.

    Mild symptoms of tennis elbow ease with rest and most importantly by avoiding aggravating activities. There are some things you can do to help yourself. Lifting objects with your palm facing up, not down, will put less strain on your damaged muscles or using ice on your elbow can ease your pain for a while. For some wearing a strap, splint or brace around your forearm may help relieve the strain on your tendon meaning that you can continue with activities once the pain has settled down.

    Physiotherapy is usually very effective in reducing pain and maintaining and improving movement and mobility. There are various techniques to reduce pain including deep tissue massage, ultrasound and laser therapy and most importantly exercises which are graded within the limits of pain to slowly increase muscle strength and length without causing damage.

    Early treatment before the condition becomes chronic is most beneficial. Waiting too long can mean that the treatment choices become more invasive such as steroid joint injections, but often these ease pain initially but have limited success in the long term. As with every procedure, there are some risks linked with steroid joint injections. Other procedures offered are autologous blood injections which involve a sample of your blood being taken and injected back into your elbow or platelet-rich plasma injections which involves the plasma and platelets being injected.

    Tennis elbow usually gets better using the treatments listed above. Early treatment intervention and rest, avoiding things that make it worse, is essential due to the degenerative nature of the condition. As a last resort you may be recommended to have surgery but often by this time the damage is done.

  6. Sprained Ankle: A Full Recovery

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    RV89 Whalley Physio Ankle

    You don’t have to play sports to sprain your ankle. A sprain is an overstretch or tear of the ligaments which attach bone to bone. Sometimes other soft tissues are involved but most often it is the three ligaments that lie on the outside of the ankle attaching the fibula to the foot. The cause of injury doesn’t have to be excessive. Simply rolling inwards on your ankle, usually when you have your toes on the ground and heel up, can result in pain and then swelling and bruising on the outside of the ankle which migrates down to the toes.

    For diagnosis sprains are classified from Grade l to 3.

    Grade 1 – a mild sprain which settles in two to three weeks but needs to be rehabilitated properly to prevent joint stiffness, ligament laxity, muscle weakness or tightness plus reduced proprioception.
    Grade 2 – the ligament is excessively stretched or partially torn causing extensive swelling and bruising. Recovery takes four to six weeks and rehabilitation becomes more complex and extensive.
    Grade 3 – the ligament is completely ruptured resulting in instability and needs immobilising. It may be the bone is fractured which is difficult to differentiate without an x-ray. If you are unable to bear weight or if there is significant swelling or deformity, you should seek medical treatment.

    Treatment in the first instance is usually to follow the RICE regime. Initially it involves resting, protecting and reducing swelling of your injured ankle. Physiotherapy helps with pain relieving techniques, massage and strapping to assist you during this painful phase and advises on pain-free exercises.

    As the pain settles the focus changes to restoring your ankle’s flexibility, range of motion and strength. Scar formation takes at least six weeks and the aim in this time is to achieve a normal functional length of the ligament and muscles with specific lengthening and strengthening exercises. One important aspect of rehabilitation that is often overlooked is proprioception ie our sense and awareness of the position of our body parts. It is closely linked to balance and helps to reduce the risk of re-injury. Located within the muscles, tendons and ligaments are tiny sensors which relay information about joint position, pressure and muscle stretch to the brain. If you’ve ever automatically recovered as you’re about to twist your ankle then this is the proprioceptors working automatically to prevent further injury.

    Proprioception is improved through exercises which begins as soon as possible after an injury. Generally in lower limb injuries, this is as soon as full weight bearing is possible. This kind of exercise can start very simply, without the need for equipment using single leg balance exercises, closing your eyes and then progression to a wobble board.

    All in all, with correct treatment, recovery from a lateral ankle sprain should be full and not recurring so you have confidence to return to everyday activities or chosen sport.

  7. Job Vacancies: MSK Physios: Days, Evenings & Weekends

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    Due to expansion, we are looking for experienced Full or Part Time Physios who are friendly, keen and professional! This is an exciting opportunity for enthusiastic Physiotherapists join our vibrant team and to work in a busy, welcoming, well-established Private Practice which is easily accessible from within the heart of the Ribble Valley, Preston, Bolton, Burnley, Chorley, Skipton and Blackburn.

    Opportunities for Days, Evenings and Weekend sessions are available. Whalley Physiotherapy has an excellent reputation; we absolutely pride ourselves on the quality of what we do for our patients!

    Applicants need to have at least 3 years post qualified specialising in MSK work, strong manual therapy skills, and the ability to work as a team. We are strong advocates of good, sound clinical reasoning, simple treatment and highly effective outcomes – we have all the facilities you need and a great team around you.

    These are both part time positions and full time, seeing mainly private clients with some insurance work. Our patients include those who self-refer, private healthcare clients, medico-legal as well as professional and amateur athletes.
    We offer a dynamic, modern and friendly working environment with support provided from experienced clinicians. CPD opportunities and in-house training will be provided. The clinic is spacious and has a gym for rehabilitation of the patients and classes.

    • CSP membership.
    • HCPC Registration.
    • Minimum 3 years post graduate experience.

    Interested candidates should send their CV and covering letter to rebecca@whalleyphysiotherapy.co.uk



    RV86 Whalley Physio ski

    If you suffer a knee injury when skiing, there are remedies to ensure effective rehabilitation, advises physiotherapist Jane Connolly HPC CSP

    Injuries to the knee joint account for around one third of all skiing injuries.  One of the most common is the ACL, a short ligament in the middle of the knee which provides stability and limits rotational movements. It is easily damaged especially during a slow, backwards fall where there isn’t enough sudden force to spring the bindings open so pushing the back of the boot forwards into the calf or by trying to stop a fall by standing up putting all the weight on the outside ski and twisting the arms and trunk towards the mountain. The result is that the ligament is strained, partially torn, or fully ruptured, often in association with other structures within the knee-joint.

    A photo by Nathalie Gouzée. unsplash.com/photos/hSeq6sn2HeE

    At the time of injury you might hear a loud pop and develop intense pain in the knee which makes walking or weight-bearing very difficult. You may get swelling within a few hours because of bleeding within the joint, making it difficult to straighten the knee. In some instances, after physiotherapy treatment you can ski without an ACL. If you ski once a year, a rehabilitation programme
    including strength, proprioception and balance exercises and a knee brace may be an option. However if you’re more active and your knee ‘buckles’ giving way regularly and there is a lack of strength then this instability can lead to arthritic issues and more permanent pain.

    One option is reconstruction. It’s nearly always a day case using keyhole techniques, often grafting a small part of the hamstring to take the place of the ligament. Although the rehab period will be around six to nine months, the success rate of the ACL reconstruction is very high. If you do have an ACL reconstruction, working with your physiotherapist throughout rehabilitation is essential to ensure your knee is as strong as possible and thus less susceptible to re-injury.

    Preparation is essential to reduce risks. Skiing uses specific muscles and weak, tired muscles give less protection to the joints making them more injury prone. Ideally you should start a specific conditioning programme at least six weeks before you go involving aerobic training, such as walking or biking, so you can ski a full day.
    Strengthening and plyometric exercises help build power, strength, speed and balance in your core and legs which along with agility drills will minimise the risk of injury.

    At Whalley Physiotherapy we tailor and manage specific exercise programmes so you can make the most of your skiing holiday.

  9. LEAN & KEEN IN ‘17

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    The Latest top tips and advice from Jane:


    Physiotherapist Jane Connolly HPC CSP advises on how we can start to improve our health and wellbeing as we go into 2017 after some well-deserved time off over Christmas

    It’s that time of year again where we make New Year’s resolutions to keep fit and healthy.


    We all know exercise is good for health and well-being. It not only improves muscle tone and general fitness, it also increases energy levels, stabilises sleep patterns and boosts selfesteem and mood.

    It has also been proven that regular activity lowers the chance of developing heart disease and Type 2 diabetes.


    To help you get started, here is a list of top tips:

    * Make exercise enjoyable – Finding an activity that you enjoy doing, increases the likelihood that you will stick at it. Hours on a treadmill may not be your thing so take your dog for a long walk instead. Any activity that gets your heart rate up is good and if you make a regular commitment to exercise with a friend then you will be more likely continue.


    * Don’t overdo it, be realistic – It may be tempting, while you have the fitness buzz, to go from 0 to 60 straight away. Resist this urge and ease yourself in gently to begin with. Doing too much too soon, can lead to injuries or burnout, resulting in you giving up exercise altogether.


    * Try something new and set a goal – If you’re already exercising regularly, set yourself a challenge to try something new. This is a good way to ensure you don’t get bored, and often you’ll find that embarking on a new activity uses different parts of your body that you aren’t used to, increasing your overall mobility. Setting realistic, attainable goals is key to maintaining a healthy lifestyle.


    * Eating and drinking well – Studies have shown around 80 per cent of any fitness goal depends on your diet. This applies whether you are trying to lose weight or train for an event. Food is fuel for your body and it is important that you put the right things in it to maximise results. Also keep hydrated! For everyone, a healthy and well-balanced diet should be part of our lifestyle.


    * Warm up, cool down and stretch – You are less likely to get an injury if you do a warm up and stretch before and after exercising. It may only be for about 10 minutes or so but is essential in preparing your body mentally and physically for your exercise session. Don’t forget about rest – when you relax, the body is able to repair itself post exercise.

    A photo by Julia Caesar. unsplash.com/photos/asct7UP3YDE

    * Preventative physiotherapy – Regular visits to an expert physiotherapist will enable you to avoid unnecessary aches and pains. It make sense to start off from a pain-free, injury-free status or get professional advice to ensure you don’t exacerbate any existing injuries or acquire new ones due to inappropriate exercising. Try some of these tips and see how they can help you to keep those New Year’s resolutions!


  10. Merry Christmas from Whalley Physio 2016

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    Sending you the very best wishes for a joyful holiday season.

    We just wanted to say a huge thank you for your custom and support over the last year.

    2016 has been another busy year and we are sure that 2017 holds lots of positive changes and additions to the clinic.

    We will be open throughout the holiday season with the exception of Christmas Eve, Christmas Day, Boxing Day and the Bank Holidays, if you need us just call on 01254 823183.


    All our best wishes,

    Jane, Hilary, Mary, Gemma, Sarah, Ciaron, Becca, Anne, Sue, Peggy & Timba