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Lateral hip pain / gluteal tendinopathy rehab

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Lateral hip pain / gluteal tendinopathy rehab

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Rehab Exercises for Gluteal Tendinopathy (trochanteric bursitis/lateral hip pain)

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Ten Footsteps programme - Live Well with Pain

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A quick guide about hypermobility for health and social care practitioners - helping you to help your patients.

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Persistent pain affects 30-50% of us

Its impact is significant, negatively affecting our physical and mental health, our social and home lives and our ability to stay in work.

There are a lot of misconceptions about persistent pain

Common public understanding is significantly out of step with current scientific thinking.

Understanding pain is important

How you think about your pain can change the way it feels and how you respond to it.

Healthcare design and delivery doesn't always reflect the best scientific understanding

It often fails to fully embrace the complicated biological, psychological and social nature of pain.

Change is needed

Where better place to start than raising awareness, facilitating a better understanding and empowering people to take back control?

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Its impact is significant, negatively affecting our physical and mental health, our social and home lives and our ability to stay in work. Common public understanding is significantly out of step with current scientific thinking. How you think about your pain can change the way it feels and how you respond to it.

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South Tees Hospitals NHS Foundation Trust

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Back facts booklet PDF

1. Low back pain can be scary but it's rarely dangerous

Low back pain can be distressing and disabling but it's rarely life threatening and you are very unlikely to end up in a wheelchair.

2. Getting older is not a cause of low back pain

Although it is a widespread belief and concern that getting older causes or worsens low back pain, research does not support this, and evidence-based treatments can help at any age.

3. Long-lasting back pain is rarely associated with serious tissue damage

Backs are strong, if you have had an injury, tissue healing occurs within 3 months. So, if pain persists beyond this time it usually means there are other contributing factors.

A lot of low back pain begins with no injury or with simple every day movements. These occasions may be linked with stress, tension, fatigue, inactivity or unaccustomed activity which makes the back more sensitive to movement and loading.

4. Scans rarely show the cause of low back pain

Scans are only helpful in a minority of people. Lots of scary sounding things can be reported on scans such as disc bulges, degeneration, protrusions, arthritis, etc.

Unfortunately, the reports don't say that these findings are very common in people without low back pain and that they don't predict how much pain you feel or how disabled you are. Scans can also change, and most disc prolapses shrink over time.

5. Pain with exercise and movement doesn't mean you are doing harm

When pain persists, it is common that the spine and surrounding muscles become really sensitive to touch and movement. The pain you feel during movement and activities reflects how sensitive your structures are - not how damaged you are. So, it's safe and normal to feel some pain when you start to move and exercise. This usually settles down with time as you get more active. In fact, exercise and movement are one of the most effective ways to help treat low back pain. See our BACKTracks or NHS fitness studio for some self-managed exercise ideas.

6. Low back pain is not caused by poor posture

How we sit, stand and bend does not cause low back pain even though these activities may be painful.

A variety of postures are healthy for the back. It is safe to relax during everyday tasks such as sitting, bending and lifting with a round back - in fact its more efficient.

7. Low back pain is not caused by a 'weak core'

Weak 'core' muscles do not cause low back pain, in fact people with low back pain often tense their 'core' muscles as a protective response. This is like clenching your fist after you've sprained your wrist. Being strong is important when you need the muscles to switch on, but being tense all the time isn't helpful.

Learning to relax the 'core' muscles during everyday tasks can be helpful.

8. Backs do not wear out with everyday loading and bending

The same way lifting weights makes muscles stronger, moving and loading make the back stronger and healthier. So, activities, like running, twisting, bending and lifting are safe if you start gradually and practice regularly.

9. Pain flare-ups do not mean you are damaging yourself

Whilst pain flare-ups can be very painful and scary, they are not usually related to tissue damage. The common triggers are things like sleep, stress, tension, worries, low mood, inactivity or unaccustomed activity.

Controlling these factors can help prevent exacerbations and if you have a pain flare-up, instead of treating it like an injury, try to stay calm, relax and keep moving.

10. Injections, surgery and strong opioids usually aren't a cure

Spine injections, surgery and strong drugs like opioids aren't very effective for long-lasting low back pain in the long term. They come with risks and can have unhelpful side effects.

Finding low-risk ways to put you in control of your pain is the key.

Adapted from the paper Back to basics: 10 Facts about low back pain. BJSM 2019 O'Sullivan P, Canerio JP, Osullivan K, Lin J, Bunzil S, Wernill K.

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact the patient experience department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the patient experience department of any special requirements, for example; braille or large print by emailing: [email protected]
The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850

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10 Back Facts - South Tees Hospitals NHS Foundation Trust

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These videos are available directly from Youtube as a playlist. You can also download the instructions as a PDF.
Introduction
Your shoulder should start to feel better within 6 to 12 weeks if you do the simple exercises on the following pages. These have been recommended by the UK's leading shoulder physiotherapists and proven to reduce pain and improve your shoulder.This booklet will show you how to do them within the comfort of your home. You can also watch videos of how to do these daily exercises on the following website. (www.bess.org.uk). You may only be able to move your arm a small amount at the start but this will improve over time. A small increase in pain while exercising is ok as long as it goes away within 30 minutes and is not worse the next day. If this happens, don't worry, do less repetitions the next time and then gradually build up again. It may take 6 weeks before you start to see improvement. If your shoulder does not improve over 6-12 weeks, or gets worse despite the exercises, you will need to visit your doctor again.
Getting the most out of your exercises
The key to success and getting the most from your exercises are: -Build the exercises into your daily routine so you can do them regularly. -Find time when you are not under pressure and can give the exercises your full attention. -Try to do the exercises on six days each week with one day off. If you want to get better, you will need to do them on at least four days of the week. -You don't have to do all three exercises straight away - you can start with two and build in the third when you get confident. -It helps to keep an exercise diary to record how many repetitions you have done and see how you are progressing. -If one particular movement causes more pain, then use it each week to test if you are improving and getting better.
Exercise One: Wall slides
Find a smooth wall or wall mirror and a cloth that will slide easily on the wall (or put clean socks on your hands). Stand facing the wall. Place the edges of your hands against the wall with your thumbs facing you. Now step forward as you gently push into the wall and slide your hands up as far as you can. Relax and return to start position. * Repeat 8 times * Rest for a minute * Repeat 8 times * Rest for a minute * Repeat 8 times. When you can do this exercise easily you can progress by doing it without the support of the wall and adding a light weight.
Exercise Two: Push-ups against a wall
Now put your hands on the wall as if you are going to do a push-up. Make sure your hands are placed a little wider than the width of your shoulders, your hands are turned out slightly and your elbows are below your shoulders. Now lower your body towards the wall keeping your body nice and tall. * Repeat this 8 times * Rest for a minute * Repeat 8 times * Rest for a minute * Repeat 8 times. When you can do this exercise easily you can progress and increase load by moving your feet further from the wall.
Exercise Three: Shoulder rotation
Sit next to a table with your elbow supported just below shoulder height on a rolled up towel. Now make a gentle fist, keep your elbow bent and then rotate your forearm to point upwards. Return to the start position and relax. Make sure you sit up tall whilst you do this. When it is easy for you to do this you can add a light weight - start with half kilo or a small 500ml water bottle. As the exercise gets easier you can increase the weight.

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These videos are available directly from Youtube as a playlist. You can also download the instructions as a PDF. Introduction Your shoulder should start to feel better within 6 to 12 weeks if you do the simple exercises on the following pages.

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The information and exercise videos below have been developed by BESS physiotherapists and are designed for people who have been diagnosed with frozen shoulder.  Frozen shoulder is a common condition that affects the shoulder causing significant pain and reduced movement.  The majority of people who experience frozen shoulder will eventually get better with or without treatment.

By following the advice and exercises within the video your symptoms should improve. Remember that the course of frozen shoulder is a long one, but if you feel that you are not making progress within 6-12 weeks or your shoulder pain is getting worse, please contact your health care provider.

Acknowledgements: BESS Expert Patient Group (BESS EPG) members, Shoulder Research Users Group (SHRUG), UK FROST Trial (NIHR HTA: 13/26/01) & South Tees Hospitals NHS Foundation Trust.

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The information and exercise videos below have been developed by BESS physiotherapists and are designed for people who have been diagnosed with frozen shoulder. Frozen shoulder is a comm…

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The information and exercise videos below have been developed by BESS physiotherapists and are designed for people who have been diagnosed with tennis elbow. Tennis elbow is a common cause of elbow pain. Pain is located on the outside of the elbow and is usually associated with gripping activities.

By following the advice and exercises within the video your symptoms should improve. The longer your symptoms have been present the longer this may take. If your symptoms fail to improve within 6-12 weeks or your elbow pain is getting worse, please contact your health care provider.
Acknowledgements: BESS Expert Patient Group (BESS EPG) members, Shoulder Research Users Group (SHRUG) & South Tees Hospitals NHS Foundation Trust.

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The information and exercise videos below have been developed by BESS physiotherapists and are designed for people who have been diagnosed with tennis elbow. Tennis elbow is a common cause of elbow pain. Pain is located on the outside of the elbow and is usually associated with gripping activities.

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Patellofemoral pain / knee pain exercises

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Patellofemoral pain / knee pain exercises

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Neck & Upper Back Strength & Mobility // 15 minutes // Mat Based

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Neck Class MSK Physiotherapy Loughborough Hospital

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Chronic Pain - acceptance and commitment

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Chronic Pain - acceptance and commitment

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Pain and Me: Tamar Pincus talks about chronic pain, acceptance and commitment

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Homerton Healthcare NHS Foundation Trust

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Homerton Healthcare NHS Foundation Trust

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Advanced rehabilitation for low back pain

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Due to social-distancing restrictions we are not currently able to provide in-person groups. We have recorded our exercise classes & provide live online classes to help you continue your physiotherapy independently.

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Dolphins Disabled Swimming Club happens at the King Alfred Leisure Centre

Physiotherapist led pool-based exercise and swimming sessions

07761 099 590 (Contact: Membership Secretary )

Times: Tuesday and Thursday 09:30 - 10:30am

Costs £5 per class. Annual membership £20 for one year

https://www.facebook.com/DolphinsDisabled/?locale=en_GB

https://dolphinsdisabledswim.wixsite.com/ddsc

Exercise / Weight Management

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Link to PDF for Leicester exercises.

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Once you have enough movement in your wrist, and your pain has reduced, you need to improve the stability (strength) of your wrist.

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Plantar Fasciitis (MSK Patient Portal) – NHS Ayrshire & Arran

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What is Plantar Fasciitis?

Plantar Fasciitis, also known as heel pain, is one of the most common conditions affecting the foot. Your plantar fascia is a strong band of tissue that stretches from your heel to your toes. It supports the arch of your foot and also acts as a shock-absorber in your foot when you walk.

Plantar Fasciitis often occurs in people between the ages of 40-60, however can affect any age. The condition is usually diagnosed by clinical findings alone. Classic signs and symptoms of Plantar Fasciitis are:

A gradual onset of pain affecting the base of the heel

Pain during the first steps out of bed in the morning

Pain after a period of inactivity or rest

Lessening pain with moderate foot activity

Worsening pain later on during the day or after long periods of standing or walking

What Causes Plantar Fasciitis?

There is usually a combination of factors that can lead to the development of Plantar Fasciitis such as:

Wearing unsupportive footwear

Tight or weak muscles around the foot and ankle

Being overweight

Occupations that involve extended periods of standing or walking on hard surfaces

Sudden increase in physical activity levels - for example, recently started running

What Can I Do for my Plantar Fasciitis?

Changes in lifestyle and modifying the known causes as previously mentioned can reduce the symptoms getting worse. The one professional who can help you manage your symptoms is you!

Footwear -

Avoid wearing flat unsupportive shoes.

Shoes that have flexible soles generally offer the foot less support and can place strain on tissues such as your plantar fascia. If you have shoelaces makes sure they are tied appropriately.

Strengthening and stretching exercises  -

Targeted strengthening and stretching exercises for the muscle in and around your foot and ankle can help to improve your heel pain.

Local NHS Ayrshire & Arran podiatrists have devised exercise clips to help with your symptoms.

Before undertaking the suggested exercises please review our disclaimer below.

Painkillers-

A range of different medications may be available to help reduce your pain to allow you to move more comfortably. Do not exceed the daily allowance of these medicines even if your pain is high and always consult a health professional prior to taking any new medication. If you are unsure of what medication you can take, speak with your local pharmacist, practice nurse or GP for guidance.

It is important that if you are prescribed medication that you take them regularly and at the recommended dose (see medication packet for details). All medicines can cause side-effects, particularly if they are not used as prescribed. Side-effects range from common to uncommon and vary from person to person. Information on possible side-effects are available on the leaflet inside the packaging of your medication. It is important to speak to your local pharmacist, practice nurse or GP who may be able to change the dose or the medication itself to something that is more suitable.

You should try and use the prescribed medication regularly at the recommend dose as prescribed. Some medicines can take a number of weeks to have significant effect, however this is dependent on the person. It is best to speak again with your GP or pharmacist about what other options are available if you don't feel your medicines are helping.

Weight management  -

Additional weight can place extra strain on the joints and tissues in your feet. Losing even a small amount of weight can make a big difference to the strain on your joints when walking, running, or going up and downstairs.

If you need help with weight-control, access our weight management section where you can find information, advice and groups you can join to help you manage your weight better. Follow this link to an  NHS BMI Calculator  to guide you on whether you should consider weight management

Modifying activity levels  -

If you are in pain don't tackle all your activities of daily living, such as housework, at once. Break the harder jobs down into smaller time frames and do something gentler in between. Extensive walking or standing should be avoided if it aggravates your heel pain. It is recommended to modify activities rather than to fully stop all forms of movement or exercise so try swimming or cycling instead of walking or running.

Plantar Fasciitis Exercises

The exercises in the videos below have been provided to help with your heel pain. If there is any doubt about your fitness to do these exercises then please discuss this with your GP.

You may find that these exercises may slightly increase your symptoms initially. However you should find that the exercises themselves will become easier to do. These exercises can take up around 12 weeks for you to notice a great improvement.

If the exercises do cause some discomfort then taking prescribed medication from your GP or pharmacist may help you to continue to exercise.

If these exercises cause a large increase in your pain or after 12 weeks there are no noticeable changes in your day to day symptoms then please contact your GP or  NHS Inform  for more advice.

Disclaimer

Please note: These exercises should not be used without prior consultation with a medical professional as the use of the wrong exercise may cause additional health related issues and discomfort. NHS Ayrshire & Arran and MSK NHS Ayrshire & Arran are not liable or responsible for any harm, losses or damages whatsoever resulting from the use or misuse of the information contained in or implied by the provided information in each video. These are provided for information only.

If you have any concerns about your ability to perform exercise then please discuss your concerns with your doctor or healthcare provider prior to participating in any advice that is on the MSK NHS Ayrshire & Arran website.

It is recommended to use your ice pack (cryocuff) or cool pack after your exercises to reduce the pain and discomfort this may cause.

Please choose the most relevant exercise section for you.

The guide below will help ensure you are working at the right level:

Pain during exercise

Aim to stay in the green or amber boxes. If you are in the red area then you can modify the exercises by trying reducing the amount of movement during an exercise, the number of repetition, reducing the weights, reducing your speed or increasing rest time between sets.

Pain After Exercise

Your pain or other symptoms should return to your pre exercise baseline within 30 minutes of exercising. You should not feel an increase in pain or stiffness that last longer than 60minutes the next morning after your exercises.

Before undertaking the suggested exercises please review our disclaimer. Please click  HERE

This exercise is aimed at stretching the plantar fascia. To begin place a towel around the ball of the affected foot, keep your heel in contact with the ground and avoid bending your knee. Pull the towel toward you until you feel the stretch in the bottom of your foot and back of your calf muscle. Hold the stretch for 20 seconds and repeat 3 times with a small rest period between stretches.

It is particularly useful to perform the stretch first thing in the morning or after a period of rest.

If you feel this stretching exercise is making your condition worse the please focus on performing the exercises which are marked as strengthening

This exercise is aimed at stretching the plantar fascia as well as the calf muscle. Place your hands on a wall for support then wedge the toes of the affected foot against the wall with the foot angled at around 45 degrees. Keep the heel of the affected foot against the ground at all times. Now begin to bend the front knee whilst moving your body towards the wall until you feel a stretch in the back of your calf and bottom of your foot. Hold the stretch for 20 seconds and repeat 3 times with a small rest period between stretches. This stretch can be done with or without shoes on.

If you feel this stretching exercise is making your condition worse the please focus on performing the exercises which are marked as strengthening

Exercise 3: Standing Calf Stretch (Gastrocnemius and Soleus muscles)
Plantar Fascia Standing Calf Stretch (gastrocnemius and soleus muscles) - YouTube

(Part 1) Place you hands on a wall for support and take a step back with the affected foot. It is important that the heel of the affected foot remains on the ground throughout this stretch, additionally try to keep the toes of both feet pointing straight towards the wall rather than rotating the foot so that the toes are pointing outwards. Now begin to bend the knee of your front leg whilst moving your chest towards the wall until you feel a stretch in the back of you calf muscle, hold for 20 seconds and repeat 3 times with a small rest period between stretches.

(Part 2)

The second part of this exercise is aimed at stretching the soleus muscle. Adopt the same starting position as you did for the previous exercise. Slide the affected foot towards the front foot as demonstrated. This time when bending the front knee also bend the knee of the back leg until you feel a stretch deeper in the calf muscle. Hold this for 20 seconds and repeat 3 times. As before be sure to keep your heels in ground contact throughout the stretch.

If you feel this stretching exercise is making your condition worse the please focus on performing the exercises which are marked as strengthening

This exercise is aimed at strengthening the muscle in your calf and foot. To perform this exercise stand close to a wall, placing your hands against the wall for balance. Raise up slowly onto your tip toes lifting both heels off the ground, when you have raised the heels up up as far as you are comfortable with begin to slowly lower the heels back down to the ground. Strengthening exercises should be built up gradually over a period of weeks, so to begin with do as many repetitions as you can manage.

The aim is to do 3 sets of around 10 -15 repetitions but remember it may take you several weeks before you are able to reach close to this target.

This exercise is aimed at strengthening the muscles in the foot. Place a folded up towel on the floor as is seen in the video. Place the toes of the affected foot against the folded edge of the towel in a flexed position. Try to have your toes flexed up as far as you can comfortably manage. Now begin to raise up onto your tip toes lifting your heel off the ground. Try to raise up onto the tip toes for a count of around 3 seconds, pause at the top for 2 seconds then slowly lower the heel back down to the ground for a count of 3 seconds.

Perform this exercise every second day.

Strengthening exercises should be built up gradually over a period of weeks, so to begin with do as many repetitions as you can manage. The aim is to do 3 sets of around 12 repetitions but remember it make take you several weeks before you are able to reach close to this target.

This exercises is aimed at strengthening the small intrinsic muscles in the foot. Place a small towel flat on the ground. This exercises is performed in a seated position make sure your back is straight and leg bent comfortably at 90 degrees with your affected foot placed flat on the towel. Use your toes to begin crunching the towel up with the aim of pulling the towel in towards you, do this in a slow controlled manner. When you have pulled the towel in as far as possible straighten it back out again and repeat the process between 3-5 times. Make sure your heel stays in ground contact throughout the exercise.

This exercise is aimed at strengthening the small intrinsic muscle in the foot. This exercises is performed in a seated position make sure your back is straight and leg bent comfortably at 90 degrees with your affected foot placed flat on a strip of thera-band. Pull the end of the band over your knee towards you which in turn will pull your toes up into a flexed position. Anchor the band on your thigh maintaining a good level of tension on the band throughout the exercise. Hold the band tight and begin to slowly push your toes down towards the ground against the resistance of the band, when your toes reach the ground allow them to slowly raise back up to their starting position.

Aim to do 3 sets of around 20 repetitions. You can adjust the difficulty of the exercise by creating more or less tension on the band. Make sure your heel stays in ground contact throughout the exercise.

This exercise is an effective way of massaging your plantar fascia. Fill a small bottle with water until it is around ¾ of the way full and place in the freezer until the water is frozen. Place the bottle of water on the ground then place your affected foot on top of the bottle. Begin slowly rolling your foot over the bottle from your heel to your toes and back again. Apply as much pressure as you are comfortable with and continue rolling back and forth for around 5 minutes.

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Plantar Fasciitis, also known as heel pain, is one of the most common conditions affecting the foot. Your plantar fascia is a strong band of tissue that stretches from your heel to your toes. It supports the arch of your foot and also acts as a shock-absorber in your foot when you walk.   Plantar Fasciitis often occurs in people between the ages of 40-60, however can affect any age.

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Lateral ankle sprain? Learn the best exercises for a sprained ankle from the time of injury to return to sport!

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Patellofemoral pain? Check out this blog for myths, exercise progressions, and management strategies for rehab.

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https://fpm.ac.uk/sites/fpm/files/documents/2023-08/sacroiliac%20joint%20injection.pdf