Sports Injury Treatment

In 2010 Kevin Kelly opened Plymouth Sports Injury Clinic, which is located in his Peverell Chiropractic Clinic.  With his background in Sports Science and Chiropractic and his specialist field of interest, the treatment of Myofascial injuries he is uniquely qualified too treat sports injuries  as these tend to be specifically soft tissue injuries.

Kevin’s wife Elena Long PhD is a Sports Massage Therapist who deals with the management, manipulation and rehabilitation of primarily the muscular soft tissues of the body.  She is also proficient in using Kinesio-taping for Sports injuries and spinal problems.

 It is important to listen to your body so that you can have injuries treated before they develop fully, having regular treatment.  Preventative treatment / Sports Massage can be very helpful for this, and Proprioceptive Muscle Testing – a technique which is very useful for determining areas of weakness in atheletes before these areas develop into injuries is a superb technique to use.  Kevin Kelly has trained in this technique and it produces impressive results.

Some of the Sports injuries treated in our central Plymouth chiropractic and sports injury clinic.

Runners Knee

Runner’s Knee or Patellofemoral Pain Syndrome is a cartilage irritation to the underside of the kneecap (Patella) it can cause a generalised pain under, in, and around the knee cap. You still can run, but please drastically reduce your

runners knee treatment at our Plymouth chiropractic clinic

Runners Knee is very common

mileage.  Do not run every day, and only as far as you can go without pain.  Uphill running might be less painful than downhill running which aggravates this injury.

To help speed up your treatment, apply ice to the knee (try a bag of frozen peas wrapped in a damp tea towel) for around 20 minutes a few times a day.  Never put ice directly on your skin!

During your treatment when exercising mildly, shorten your gait length and land with the knee slightly bent, which can take up to thirty percent load off the joint.

Keep your knee moving correctly by strengthening your knee’s support muscles the quads and gluts with exercises like lateral side steps and squats. It’s also important to stretch your hip flexors.

Important! Stop training if you have pain on the inside or outside of the knee immediately upon waking, which doesn’t go away as the day progresses and if running starts to aggravate your injury.

 

Achilles Tendonitis/Tendonosis

Achilles Tendonitis is a chronic common injury which is often an overuse injury, the Achilles tendon is the largest

image showing the achilles tendon

The Achilles tendon is the thickest in the body

tendon in the body and can become damaged if you step up their training too quickly, this may damage the tendon or cause a tightening of the calves which causes undue tension in the achilles tendon.  The Achilles tendon connects the two major calf muscles to the back of the heel, this tendon may tighten and becomes irritated (tendinitis).  If you have any pain during or after running you need to stop.  Do not attempt to train through this injury.  If you keep training as usual, you may increase your risk of Achilles tendon rupture.

For the rehabilitation apply ice up to five times a day (never put ice on bare skin) for 20 minutes.   Strengthen the calves with eccentric heel drops: stand with the balls of your feet on a step; rise up on your strong foot, once up, take your stronger foot off the step and lower down on your injured foot, dropping your heel below the step. Rise back up, return your other foot to the step. Do 20 times. Pool-run, use a cross-trainer, and swim (not Breast stroke), but avoid cycling unless it’s not painful.

Important! Avoid too many calf stretches, It can also occur if a different type of footwear is used altering the normal lower leg biomechanics such as wearing flip-flops and high heels, all of which can irritate the Achilles. Stop, if you have severe pain and swelling above your heel, even when not running, or standing up on your toes causes pain. If the injury does not heal it can form a tendonosis of the achilles tendon, this is more serious but can be treated in our clinic with IASTM (Instrument assisted soft tissue mobilisation), myofascial release and specialised exercises.

Shoulder Injuries

Shoulder injuries. These may be overuse injuries or, as is more common strains to the muscles and tendons of the shoulder.  Impingement Syndrome is a term often thrown around to describe a lot of shoulder conditions, 90% of these are incorrectly diagnosed and are normally easily treated  with the techniques mentioned below.  The rotator cuff (consisting of four muscles in total) is also the primary support structure for the shoulder as the shoulder is an atypical ball and socket joint, having a very shallow socket which offers little support or protection. Therefore even minor strains to these muscles can cause dysfunction creating significant pain and disability including shoulder pain, arm weakness, and decreased sports performance.

Treatment normally consists of Myofascial release, Instrument Assisted Soft Tissue Mobilisation (IASTM), muscle balancing, shoulder mobilisation (see video below) and Kinesio-taping.

Hamstring Injuries

image showing a sportsman with a hamstring injury

Hamstring injuries are often caused by tight fascia and not tight muscles

Hamstring injuries are common amongst both athletes and sports men and women and can range from minor strains to more serious ruptures of the muscle that run down the back of our thighs. Hamstring issues usually take place because these muscles are weak – often from being too long or too short. Tight, short muscles are under greater tension.  Another factor is muscle imbalance: many runners’ quadriceps overpower their hamstrings, which sets them up for injury. Manual Muscle Testing can determine if these weaknesses are present.

If the pain comes on suddenly and strong and the area bruises you need to stop running completely. Recovery time may be days, weeks or months, depending on the severity of the tear and how rapidly you have it treated. If it’s a less severe, chronic overuse injury (which is very common), you can usually run gently, but it will take time to heal fully. Running a slow, easy pace is ideal. Pool running, bicycling and swimming are good substitute activities.

 Important! Stop, if you get a sharp sudden pain when exercising stop immediately to prevent further injury.

Tennis and Golfers Elbow

peverell chiropractic clinic image of an elbow examination

Tennis and golfers elbow occur at work more than in sports.

Tennis and golfers elbow are very common injuries both treated here in our clinic, most of these injuries respond

well to treatment.  Kevin Kelly says the chronicity and severity of the problem are very important, if the injury has just developed in the last 6 weeks it tends to be much easier to treat as their is reduced pathology to the tendons – less severe tendonitis (inflamation) to the tendon and less tendonosis (damage to the structure and hence functional integrity of the tendon).

The treatment we provide is Myofascial Correction©, this is the technique developed by Mr Kelly which consists of a combination of joint manipulation/mobilisation, myofascial release, soft tissue therapy, IASTM, kinesio-taping and exercise therapy

If the problem is moderately to very severe or the patient has had the problem for more than two months cortisone injection(s) maybe necessary.  In the case of tennis and golfers elbow: if after 3 or 4 treatments and the injury is not responding we recommend patients for cortisone injection(s) which will normally help the problem.

Mr Kelly says that “It is very important if you are either a sports person or the injury is because of a specific task at work that you initially endeavor to try and sort it out with conservative treatment”.  The reason for this is because if you are, for example a sportsman  (a tennis player) with a tennis elbow, if you decide not to have any conservative treatment and to have a cortisone injection initially and it only partially helps you may have another injection and your problem improves, and the following year you have a similar problem and another 2 injections, that is really your limit as too many cortisone injections are contraindicated as they can further weaken your injured tendon.  You could end up with arm pain, a weakened tendon that does not respond to conventional conservative treatment and an end to your tennis.

Iliotibial Band Syndrome

Iliotibial Band Syndrome causes knee pain that is usualy felt on the outside (lateral) aspect of the knee. The iliotibial (IT) band lies along the outside of the thigh from the hip to the knee. When you run, your knee flexes and extends, which causes the IT band to rub on the lateral condyle of the femur. Runners who develop ITBS may suffer from hip abductor and/or gluteal muscle weakness, they may overpronate or have a leg-length difference. ITBS can be stubborn, nagging injury and need to be treated ASAP. They are commonly treated in our clinic. As with any injury if you ignore the first symptoms and continue training you can aggravate it.

image showing the anatomy of iliotibial band syndrome

iliotibial band syndrome is often incorrectly called runners knee

Exercises to strengthen the hip abductors are helpful. We have over 1500 exercises and stretches available for our patients Use a foam roller before and after you run: rest the outside of your thigh on top of the roller, and roll your IT band from your knee to your hip. Hiking and bicycling can aggravate ITBS. Instead, swim, pool-run, and use a cross-trainer. IT band issues often get better if you can learn to shorten your gait, so that your weight centres on the front of the heel or the mid foot as you land.

Important! Do not run, if you have a pain on the outside of the knee that radiates up and down your leg when just walking down a hill or stairs.

 

 Plantar Fasciitis

image showing the anatomy of plantar fascitis

plantar fasciitis is very common

Plantar Fasciitis presents with dull ache along foot arch or on the bottom of your heel that tends to be worse on arising in the morning. Plantar fasciitis is the small tears and inflammation to the tendons and ligaments that run from your heel to your toes. People with very high or very low arches are at risk, as both foot types alter biomechanics putting stress on the plantar fascia causing it to be stretched away from the heel bone. Other causes are extreme pronation or supination (foot rolls inward or outward excessively) and increasing your running distances too quickly. Long periods of standing, especially on hard floors without supportive footwear, may intensify the problem. Tight hip flexors, weak core muscles, and a history of lower back pain can also contribute.

Plantar fasciitis is one of the most stubborn injuries, and running through it can delay healing. Recovery time can range from three months to a year, but in average six months is quite typical. In chronic cases, a complete break from running is usually best. Pool running and swimming which keeps pressure off your feet, might help to maintain your fitness, as the cycling and cross-training, but only if you can do those activities without pain.

Important! Stop running, if you develop ongoing, constant arch pain and tenderness that doesn’t seem to fade even once you’ve warmed up on a run.

Shin Splints

Shin Splints refers to medial tibial stress syndrome, an achy pain that takes place when small tears occur in the muscles around the tibia (shin bone). Shin splints are common among new runners and those returning after a long brake from running. They’re a sign that you’ve done too much. Shin splints affect runners wearing the wrong or old running shoes, and those with high arches or flat feet. If you have high arches, you may need a cushioned shoe or if you have flat feet, a firm shoe might be the solution.

image of man with shin splints

Shin splints oftyour en occurs if you increase training intensity too quickly.

When the first twinges of pain start, reduce your running for a few days to a week, and then slowly increase your mileage. The easiest and best way to avoid shin splints is to increase distance gradually, make sure you are wearing appropriate shoes. Beginners, especially, can benefit from the professional help at a specialty running shop.  Rest, ice, and ibuprofen can help to ease the pain. Taping the shin with Kinesio tape can relieve pain and speed healing.

Important! Stop, if you develop tenderness down the leg, especially if you hop on it. If walking (not just running) hurts, it could be a stress fracture.

Stress Fractures in the leg are often the result of overuse or repeated impact on a hard surface. Unlike an acute fracture that happens as the result of a slip or fall, stress fractures develop as a result of cumulative strain on the bone. Runners most often have stress fractures in their tibias (shin), metatarsals (feet), or calcaneus (heels). Runners, who over train are most at rick. Bones need time off to rebuild after a workout. If you increase the duration, intensity, or frequency of your running too soon, your bones can’t repair themselves fast enough to keep up.  Stress fractures are more common in women than men, usually due to nutritional deficits, low estrogen levels, and inadequate calorie intake.

The amount of rest you will need depends on the severity of the fracture and its location.  If you ran through the pain, your recovery could take longer.  Avoid all impact exercise, instead, pool-run and swim.  Once you can walk without any pain, you can try a bit of jogging, but you have to stop if there is persistent pain. It’s crucial that you build your distance slowly—start with just a few minutes.  Improve bone density with weight training, and make sure you’re getting enough calories and nutrients.

image: showng some of the instruments designed and used by Kevin Kelly