In 2003,following 3 years of study, she gained a jazz-dance teaching certificate at 'Maxime d'Harroche Dance School', Barcelona.

After moving to London she studied at 'WAC' (Performing Arts and=2 0Media College), graduating in 2005 with a Degree in Performing Arts (Dance and Drama).

She danced in the afro-cuban dance company “ Siete Poderes” (7 Powers)for two years, as well as going to Cuba for three months to train and dance with the company 'DANZA LIBRE'

Having entered the world of pilates in 2007, training at 'Pilates International' London, she is now a Level 3 Pilates Teacher.

“My aim is to make the most of the one to one training experience, tailoring the session to meet the clients specific needs, within a trusting environment”.

Dee Jemil
Massage, Reflexology Therapist,
8 years experience.

Pilates is a non-passive therapy which utilizes specialized equipment that offers resistance for muscle strengthening while balancing muscular force at the joint. It is highly effective anytime during the recovery/healing process and can cut rehabilitation time significantly.

How Does Pilates Assist in Rehabilitation?
Pilates addresses specific site injury while rehabilitating the entire body to support the healing process. Breath work is integral during the sessions, as oxygenation and circulation combine to accelerate the healing process. Pilates guides the body in its recovery process a variety of ways:
•           Pilates decompresses the neck and back while addressing the deterioration of joint range of motion and muscular flexibility that most clients experience from trauma.
•           Pilates stimulates circulation while facilitating muscular flexibility, joint range of motion and proper musculoskeletal alignment.
•           Pilates promotes new neuromuscular patterns, heightened body awareness and more precise coordination and endurance – assisting in decreasing pain levels.
•           Pilates exercises assist in the reconnection of the brain and body, promoting faster healing.

Pilates pre- and post-surgery
Pilates sessions prepare clients before needed surgery, and are powerfully effective in shortening rehabilitation time after surgery as well. Pilates increases the body-mind connection allowing the body to be in a healthier state before surgery, and assists injured clients in releasing the trauma held in their body from their accident.

A Long Term Solution
Pilates is often the most effective tool for injury rehabilitation because it addresses and strengthens the body as a cohesive unit. As clients become stronger, they also become aware of their bracing patterns and imbalances. This leads clients to understand how to deal with incorrect movement and bracing in their every day lives.

Many clients state that Pilates helps their pain consistently diminish, and they feel a steady return to their pre-injury status. At this point, Pilates helps prevent re-injury and becomes a fitness routine to maintain their progress.

“Pilates is a wonderful complement to or after physical therapy”

Instructors

The Pilates Method
The Pilates method is a system of movement and therapeutic exercise developed over a span of 60 years by German born athlete and physical therapy pioneer, Joseph H. Pilates. Utilizing the specialized equipment he designed, the method works by toning muscles as well as balancing muscular force at the joint level. It stimulates circulation through facilitating muscular flexibility, joint range of motion and proper musculoskeletal alignment. In addition, it promotes new neuromuscular patterns, heightened body awareness, and more precise coordination. All these things combine to help prevent future re-injury and reduce - even in some cases alleviate - chronic pain altogether.

Mary Boyarski
Pilates and Alexander Technique Instructor
Mary Boyarski was born and raised in the Philippines, where she began dancing at the age of seven. She received a dance degree from the College-Conservatory of Music in Cincinnati, Ohio, where she performed with the Cincinnati Ballet Company and Contemporary Dance Theatre for five years. Two daughters later, she became involved in the fitness industry, training with the YMCA and teaching three different types of fitness classes. She started running and participated in numerous 5 and 10-kilometer races and half marathons. At this time she also received a masters degree in education, specialising in Montessori primary education.

In 1994 she moved to London to study to be an Alexander Technique teacher. She was qualified at the end of the 3-year training by STAT, ATI, and The Centre for Training. She received her Pilates mat work training at The Pilates Institute and qualified with an NVQ 2 in August 2003. She immediately started teaching group mat classes at David Lloyd North Finchley and played a role in the expansion of their Pilates programme. She received her initial studio training from Polestar Pilates, and is now completing a second studio training course with Alvin Quek at The Pilates Clinic. In addition, she has done workshops focusing on osteoporosis and the elderly, pregnancy, back problems and a new approach to human structure and functioning.

Mary blends her dance, Alexander Technique and fitness experience into her Pilates teaching; she focuses on helping each student learn how to move and work as a unified and flowing system, and to discover the grace and power of their own body.

Mariah Thomas
Instructor

Mariah Thomas was born in Asheville, North Carolina, USA. The path towards Pilates began with her training in Classical Ballet. Mariah danced for various American ballet companies including Ballet Austin, The Pennsylvania Ballet and Augusta Ballet. Pilates was always part of the cross training for dance throughout her days as a student and professional and she turned to it to keep fit and rehabilitate from dance related injuries. Mariah first studied to be a Pilates Instructor with Dolly Kilpezic of D.K. Body Balancing in Las Vegas, Nevada and received her first qualification in 2003 which is recognized by the Pilates Method Alliance, USA. She has taught for the Pilates Studio of Ballet Austin, the Ballet Austin Academy, Pure Austin Fitness, Premiere Lady Fitness and various other studios and gyms throughout the United States. Upon moving to the U.K. Mariah has studied with Pilates International to further her Pilates knowledge and has received Level 3 Pilates Instructor Status through Pilates International and the Register of Exercise Professionals for the U.K. Mariah has been teaching at the IGo Pilates Studio since March of 2008 and enjoys the intimate atmosphere of teaching one to one and small group classes that the studio allows.

Blanca Torras Roda
Instructor
Blanca was born in Barcelona Spain, 1979. Having always danced and being very sporty, she first entered the professional fitness industry in 1998, teaching aerobics, steps, and exercise to music.

In 2003,following 3 years of study, she gained a jazz-dance teaching certificate at 'Maxime d'Harroche Dance School', Barcelona.

After moving to London she studied at 'WAC' (Performing Arts and=2 0Media College), graduating in 2005 with a Degree in Performing Arts (Dance and Drama).

She danced in the afro-cuban dance company “ Siete Poderes” (7 Powers)for two years, as well as going to Cuba for three months to train and dance with the company 'DANZA LIBRE'
Having entered the world of pilates in 2007, training at 'Pilates International' London, she is now a Level 3 Pilates Teacher.

“My aim is to make the most of the one to one training experience, tailoring the session to meet the clients specific needs, within a trusting environment”.

Alison Jessica Mills
Physiotherapist

Ali has been practicing as a chartered physiotherapist for the last 10 years, whilst treating patients with complex problems in the NHS as well as in the private sector.

She has vast experience in treating a wide range of acute and chronic conditions including sports injuries and has a special interest in posture related pain, joint hyper-mobility and rehabilitating lower limb injuries.

At iGoPhysio Ali uses her proficient knowledge in manual therapy, such as mobilisations, soft tissue release, acupuncture and electrotherapy, and combines this with traditional Pilates techniques, to treat specific medical problems.
Shirmilla Julka
Physiotherapist
Studio Hours

iGoPilates offers private lessons and group classes with certified instructors for individuals of all ability levels.

Studio Hours

Monday - Thursday       7:00 am – 7:30 pm
Friday                             7:00 am – 4:00 pm
Saturday                        7:00 am – 1:00 pm
Sundays                       10:00am – 2:00pm

Call iGoPilates front desk at 020 8455 7809 to schedule a lesson today!

Pilates Testimonials

Treatments
Our staff are skilled in using physical approaches to improve, maintain and restore physical, psychological and social well-being tailored to meet the needs of each patient as an individual

Each specialisation and how it could benefit you is outlined in individual sections with information which you might find useful.

Physiotherapy
Physiotherapy is an established and dynamic profession that uses a range of treatment techniques to restore movement and function to the body. We treat people of all ages for a large range of physical problems resulting from injury, illness, disability or ageing. We devise and review treatment programmes to assist the rehabilitation process enabling patients to improve their movement and function and reduce levels of pain. We also offer advice on injury prevention to achieve healthy and active lifesytles.

CONDITIONS WE TREAT

•           Muscular Skeletal Arthritis, Muscular aches and pains, Neck and Back pain, Ankle pain, Achilles Tendonitis, Golfers / Tennis elbow, Groin pain, Carpal Tunnel Syndrome, Patellafemoral pain syndrome, Shoulder impingement injury, soft tissue bruises, spinal injuries / fractures, Slipped Disc, Sciatica, Repetitive Strain Injury (RSI), Headaches, Posture dysfunction.
•           Neurological Strokes, Multiple sclerosis, Parkinsons
•           Orthopaedics Post surgery e.g knee replacement, hip replacement, arthroscopy, ACL reconstruction.
•           Respiratory Shortness of breath, asthma, chest infections
•           Sports Injuries
•           Womens Health Incontinence, Pregnancy Related Problems

HOW CAN WE HELP?

We assess, diagnose and treat all injuries. Physiotherapy treatment can include one or a combination of the following:

•           Joint and spinal mobilisation and manipulation
•           Soft tissue massage and fascial release techniques
•           Personalised exercise therapy and rehabilitation
•           Taping
•           Acupuncture
•           Electrotherapy
•           Advice and education – because self management is so important
•           Pilates.
For more information please contact us.

Sports Injuries
Sports Injuries? Everyday millions of people participate in sports activities. From soccer fields to snow covered slopes, sport improves physical function, co-ordination and self discipline. Unfortunately injuries are an everyday part of sport. Therefore, with prompt physiotherapy assessment, diagnosis and appropriattreatment full recovery can be achievable and maintainable.

CONDITIONS WE TREAT
•           Achilles tendonitis
•           ACL rupture
•           Ankle sprains
•           Golfers elbow
•           Groin strain
•           Hamstring strains
•           Ligament ruptures
•           Ligament strains and sprains
•           Osteoarthritis of the knee
•           Carpal Tunnel Syndrome
•           Patellofemoral pain syndrome
•           Runners knee
•           Shin splints
•           Shoulder impingement injury
•           Sinus tarsi syndrome
•           Soft tissue bruises e.g. dead leg
•           Soft tissue inflammation
•           Spinal injuries/fractures
•           Sporting back
•           Sprained ankle
•           Tendon strains and sprains
•           Tennis elbow
and many more...
Please call for advice and further information.

HOW CAN WE HELP?

We assess, diagnose and treat all injuries. Physiotherapy treatment can include one or a combination of the following:

•           Joint and spinal mobilisation and manipulation
•           Soft tissue massage and fascial release techniques
•           Personalised exercise therapy and rehabilitation
•           Taping
•           Acupuncture
•           Electrotherapy
•           Advice and education – because self management is so important
•           Pilates.

Acupuncture
Acupuncture is the time tested therapy that has been practised in the Far East for thousands of years. The philosophy behind the treatment is that energy lines or meridians circulate around the body. These meridians contain our energy flow or “qi”. It is when this qi is impaired through the body that imbalance and illness occurs. With the insertion of fine needles at various points on the meridian, the energy can be moved or redirected to where it is needed most. In this way the body's balance can be restored and the illness resolved.
CONDITIONS WE TREAT
•           Arthritis
•           Musculo-skeletal Conditions
•           Dizziness
•           Facial paralysis
•           Fatigue/Tiredness
•           Hay fever and Sinusitis
•           Pre-menstrual symptoms
•           Migraines & headaches
•           Pregnancy care
•           Respiratory disorders
•           Stress related illness
•           Well-Being
•           Pain Management

PRINCIPLES

The principal aim of acupuncture is treating the whole person to recover the equilibrium between the physical, emotional and spiritual aspects of the individual.
HOW WILL I BENEFIT?

Our health is dependent on the body's motivating energy - known as Qi - moving in a smooth and balanced way through a series of channels beneath the skin Qi consists of equal and opposite qualities - Yin and Yang - and when these become unbalanced, illness may result. By inserting fine needles into the channels of energy, an acupuncturist can stimulate the body's own healing response and restore its natural balance.

Clinical Pilates
Pilates is a series of flowing movements designed to strengthen and stretch the muscles of the body. It considers the body as a whole and restores and teaches correct posture and movement of the body which is often out of balance through modern life styles and habitual movement. It focuses on the core muscles of the trunk to provide a solid base for movement to originate from, and also the smaller stabilizing muscles that ensure the larger global muscles of the body can execute precise movement.

BENEFITS
•           Flattens, tones and strengthens abdominal muscles
•           Develops longer, leaner muscles
•           Improves posture and prevents injury
•           Balances strength with flexibility
•           Relieves stress and tension
•           Enhances body awareness
•           Heightens concentration
•           Enhances athletic performance and movement quality
•           Increases circulation and improves digestion
•           Boosts self image

PRINCIPLES

These principles are applied to every exercise and ensure quality of movement, therefore improving body awareness:
•           Relaxation
•           Breathing
•           Concentration
•           Flowing Movements
•           Alignment
•           Co-ordination
•           Centering
•           Stamina

APPLICATION

Clinical Pilates is very popular amongst performing artists and sports people looking to enhance performance and decrease the risk of injury through the correction of faulty movements. Deep postural muscle strengthening is effectively achieved through the Clinical Pilates programme. Latest research has highlighted the role of postural muscle control in the treatment and prevention of a wide range of musculoskeletal injuries. Thus, its application is unlimited.

Rehabilitation
What Is The Rehabilitation Centre ? The rehabilitation Centre features a spacious, naturally lit treatment area. The gym is designed to allow therapists to progress individualized treatment programs in an environment that supports a natural flow between the use of state-of-the-art equipment. Therapists at the clinic treat a variety of conditions and specialize in the treatment of orthopedic and sports injury problems.

CONDITIONS WE TREAT

•           Achilles tendonitis
•           ACL rupture
•           Ankle sprains
•           Golfers elbow
•           Groin strain
•           Hamstring strains
•           Ligament ruptures
•           Ligament strains and sprains
•           Osteoarthritis of the knee
•           Carpal tunnel syndrome
•           Parpal tunnel syndrome
•           Patellofemoral pain syndrome
•           Runners knee
•           Shin splints
•           Shoulder impingement injury
•           Sinus tarsi syndrome
•           Soft tissue bruises e.g. dead leg
•           Soft tissue inflammation
•           Spinal injuries/fractures
•           Sporting back
•           Sprained ankle
•           Tendon strains and sprains
•           Tennis elbow

Exercise
Physical activity can prevent many major illnesses. Evidence shows that regular exercise can:
•           promote healthy blood sugar levels to prevent or control diabetes
•           promote bone density to protect against osteoporosis
•           reduce the overall risk of cancer
•           increase levels of HDL or “good” cholesterol -reducing the risk of developing heart disease
•           lower high blood pressure-reducing the risk of developing heart disease
•           boost the immune system
•           boost self-confidence and help prevent depression
•           in combination with a balanced diet, help to maintain a healthy weight
Igophysio use established clinical exercise pathways to ensure that injury is short lived and normal body function is restored. Home exercise combined with clinical pathways ensures that

If you require further information or would like to make an appointment please call 020 8455 7809 or email at info@igophysio.co.uk

Massage
What is Massage?
iGo Physio is delighted to introduce a Remedial massage and complementary health service to its North London Clinic. Remedial massage used independently or in conjunction with physio therapy is there to support and assist the rehabilitation and recovery of those illnesses or injuries as a result of stress, strain and chronic conditions or as a tool to assist those in training for sporting events or practices. Remedial massage focuses on the manipulation of soft and deep tissue release, with special focus on lengthening and strengthening the muscles fibres to increase elasticity in the muscle groups, remove the build up of lactic acid and other toxins and to overall increase the range of movement and flexibility not only in the muscle but also in the supporting ligaments, tendons and joints. Treatment after an initial consultation would include a variety of techniques, including trigger pointing, passive stretching, with special focus on realigning the skeletal system.
For those who may be interested in something a little more gentle or relaxing, treatment can be tailored to work primarily on soft tissue release to induce a state of relaxation this can be combined with the use of Aromatherapy oils to treat a series of stress related ailments or illnesses.

Reflexology is now also featured within our service, this is the manipulation of certain pressure points on the feet which increase and regulate the function of the central nervous system and the endocrine system and has been proved helpful in treating a number of stress related conditions especially where the immune system has been affected.

Aromatherapy
Aromatherapy Massage
Aromatherapy massage and the use of Aromatherapy is one of the most popular and well known treatments available today for treating various conditions brought on by stress and illness. Aromatic oils and their usage have ancient roots with associations to the Greek, Chinese and Persian civilisations. However it was the ancient Egyptians that are regarded as the true founders of Aromatherapy. Their Methods of distillation and extraction of essential oils from plant and flower extracts for their medicinal and cosmetic uses still hold true today. It wasn't until 1937 that the word 'Aromatherapy' was first used by the French Cosmetic Scientist Rene-Maurice Gattefosse, whose work and research revealed that the volatile extracts distilled from certain aromatic plants had a profound effect on the skin. By the 1950's the Austrian born Marguerite Maury opened the first Aromatherapy clinic in London and introduced the idea of combining essential oils with Massage.
The use of Aromatherapy oils combined with massage is now reputed for its therapeutic and healing qualities on the mind, body and soul. It can assist in many different ways, in balancing and regulating the endocrine system, stimulating the central nervous system, relaxing the muscular system, revitalising and toning the skin, aiding the functions of the immune, respitarory and digestive systems, and as a mood enhancer, calming and relaxing the mind.

Essential oils which are originally derived from plant and flower extracts inherit the chemical compositions from which they are derived from to give them their therapeutic properties, for example Peppermint is well known for aiding the functions of the digestive systems, Camomile is known for its ability to promote sleep and relaxation, grapefruit for its diurectic properties and so on. By combining essential oils with massage, the oil is absorbed through the skin diffused into the bloodstream, or taken up by the lymph or interstitial fluid and then carried to various parts of the body where it then starts to take effect.

Treatment usually consists of a consultation process between the Client and therapist to establish what the issues are and which blend of oils are best suited to the treatment. It would be usual for a blend of up to five essential oils mixed in a carrier oil of Grapeseed or sweet almond to be prepared for treatment. The recommended minimum treatment time would be an hour and it is also advised that the oils remain on the body for a further couple of hours after treatment to allow for full absorption of the oils through the skin to various parts of the body so as the full effects and benefits of the treatment can be realised.

As a practioner of Aromatherapy for the past seven years I use essential oils on a daily basis not just for the purpose of massage but also for various physical, psychological, emotional and spiritual pursuits and can truly say I could never be without my oils!

Abbreviated version
Aromatherapy massage and the use of Aromatherapy is one of the most popular and well known treatments available today for treating various conditions brought on by stress and illness. The use of Aromatherapy oils combined with massage is now reputed for its therapeutic and healing qualities on the mind, body and soul. It can assist in many different ways. Essential oils which are originally derived from plant and flower extracts inherit the chemical compositions from which they are derived from to give them their therapeutic properties, for example Peppermint is well known for aiding the functions of the digestive systems, Camomile is known for its ability to promote sleep and relaxation, grapefruit for its diurectic properties and so on. By combining essential oils with massage, the oil is absorbed through the skin diffused into the bloodstream, or taken up by the lymph or interstitial fluid and then carried to various parts of the body where it then starts to take effect. After a thorough consultation between client and practioner to establish the clients needs it would be usual for a blend of up to five essential oils to be mixed into a carrier oil such as Grapeseed or Sweet Almond to then be used in treatment.

Recommended length of treatment: minimum 1 hour

Benefits of Aromatherapy massage include:
•           balancing and regulating the endocrine system
•           stimulating the central nervous system
•           relaxing the muscular system
•           revitalising and toning the skin
•           aiding the functions of the immune
•           respitarory and digestive systems and as a mood enhancer
•           calming and relaxing the mind.

Reflexology
Reflexology is a therapeutic treatment to restore health and well being more popularly carried out on the feet, (but can also be done on the hands). The theory is based on using skilled techniques to apply pressure and manipulate certain points on the feet to help clear subtle energetic blockages which may be the cause of or may if left untreated create physical imbalances in the body which can lead to bad health.

Reflexology is devised on two popular theories, the first is zone therapy and the second is based on applying direct pressure to what is known as a reflex point. Zone therapy is based on the assumption that there are ten imaginary zones running from the top of the head down to the base of each toe (front and back) with an additional 5 zones in each big toe. Each Zone represents a channel of life force energy referred to as “Chi” The second theory is based on applying direct pressure to what is known as a reflex point. Each Reflex point represents an organ or part of the body. The feet represent a perfect microcosm or mini map of the whole body. All the organs, glands and body parts are represented in the feet laid out in the same arrangement as in the body (even the inside of the curve of the foot corresponds to the natural curve of the spine). Working within the zone or applying direct pressure on a reflex point releases subtle energy blockages to restore health.

In particular reflexology is thought to assist the function of the central nervous system which is responsible for healthy brain activity. The feet are vibrant in nerve endings relaying messages back to brain which produce certain neurochemical responses such as the release of endorphins (the body's own natural painkillers). In combination with the other systems in the body in particular the endocrine system which is responsible for the chemical balances in our body by way of secretion of hormones known as chemical messengers. Stress is a major factor in altering the neurological and chemical responses in the body which eventually lead to distress, and ultimately ill health. When the body is under stress the brain relays messages to the endocrine system to release certain hormones to create a number of physical responses to allow us to cope with any given situation. If the body has to continuously respond in this way, ill health will eventually set in. Therefore reflexology is useful in helping to restore these altered neurological and chemical responses back to their original state, thus restoring health.

A further important biological and anatomical reason for working the feet is stimulate circulation and remove and breakdown the accumulation of uric acid and calcium deposits.
In particular, reflexology is helpful in the treatment of headaches, migraines, menstrual disorders, stress related infertility, insomnia, fatigue, digestive disorders, Chohns disease, constipation, irritable bowel syndrome, depression, skin disorders, drug addiction, sinuses, , hayfever, cold and flu symptoms. It is also thought to be effective in certain disorders and diseases where neurological pathways have been damaged such as strokes, MS, ME, Parkinson's Disease, Celebral Palsy and Bells Palsy.

The recommended treatment time is one hour, and I would suggest a course of six sessions at no more than two week intervals to treat any given disorder.

Baby
Baby Massage
The IAIM (International Institute of Infant Massage) is the only internationally recognised body for infant massage with over 47 countries embracing the work undertaken by this institute. Their mission statement acknowledges the needs of babies and their caregivers to be loved, respected and valued through nurturing touch, promoting their work through education and research throughout the world.

Fundamental to the development of any infant is the need and desire for touch. Within the first 3 years of any infant’s life touch is vital, laying the imprints to the foundations or your child’s emotional, psychological and physical development. Many cultures and their generations have embraced and acknowledged infant massage understanding the host of benefits to mother, baby and the community at large.

This 5 week course allows caregivers who ever they may be, mothers, fathers, siblings and grandparents to engage and understand how your baby communicates through a combination of touch, song and rhyme and facilitated discussion. Don’t forget that Infant massage also strengthens the attachments and bonds of friendships and communities in bringing babies and their caregivers together, whilst opening our hearts to communicating with our babies in allowing us, hopefully to open our hearts to each other!
- Dee Jemil (IAIM instructor) BA Hons, ITEC, MAR

IAIM Mission Statement
“ The purpose of the International Association of Infant Massage is to promote nurturing touch and communication through training, education and research; so parents, caregivers and children are loved, valued and respected throughout the world community. ”

Baby Massage Course

What Are The Benefits of Baby Massage?
Fundamental to the development of any infant is the need and desire for touch. Within the first 3 years of any infants life touch is vital laying the imprints to the foundations of your child’s emotional, psychological and physical development. Many cultures and their generations have embraced and acknowledged infant massage understanding the host of benefits to mother, baby and the community at large.

Baby massage:
•           Strengthens your baby’s immune system and may help regulate sleep patterns, by lowering levels of cortisol and norepinephrin that aid in reducing stress and relaxing your baby.
•           Stimulates touch receptors and sensory organs, thus aiding the neurobiological development of your infant to include improved motor, language and social skills.
•           Increases the emotional bonds between parent and child in stimulating the release of certain hormones, namely Oxytocin – referred to as the ‘love’ hormone.
•           Stimulates the digestive system, and may help relieve symptoms of gas, colic, constipation and gastrointestinal cramps
•           Allows one-to-one communication with your baby that allows parents a better understanding of their baby in reading and respecting cues, improved parenting skills, decrease in postnatal depression .

What to expect from the course?
The course is run over 5 consecutive weeks, and covers a full body massage routine to include, feet, legs, tummy, chest, hands, arms, face and back. The routine is combined with songs and rhymes, facilitated group discussion to include, the benefits of baby massage, behavioural states, how to include siblings, partners and grandparents, why babies cry, and bonding. We will also learn a specific routine for Colic/Wind. It also allows an opportunity for mums and babies, to make friends and share experiences.

How old should my baby be?
The course is suitable for infants from 6 weeks to crawling

What do i need to bring?
A changing mat, a towel and blanket. (massage oil and handouts are provided)

How much does the course cost?
£55

How long does the course last?
5 weeks

What are the course dates?
TBC

Who is the Course Instructor?
My name is Dee Jemil and I am a CHAIM Centre Therapist. I have been a practising therapist for the past 8 years and specialise in a number of massages, these include, Remedial Massage/Deep tissue, Swedish Massage, Aromatherapy massage, Pregnancy Massage, Manual Lymphatic Massage, Indian Head Massage, Onsite massage, Reflexology, Reiki, Crystal Healing, i am a full member of the Association of Reflexologists and also belong to the Holistic Healers Association. I have a particular interest in Mums, Babies and fertility.

How to make contact if you have any enquiries or questions?
The Course instructor can be reached on Tel: 0208 455 7809 or Email dee@igophysio.co.uk

NB: There is limited availability for buggies and push chairs, where possible please leave at home.

Testimonials
I can highly recommend massages provided by Dee. She is professional and friendly and right from the start I was confident in her expertise. I particularly appreciated the time she devoted to assessing factors that could affect and influence the therapy including life-style, health and fitness questions that I haven't often been asked but which I can see have a direct impact.
The massage itself is exactly what I want in a massage, a thorough and comprehensive deep tissue massage which focused on a long term back condition. Dee's vast experience in this field means she explained the muscle structure and treatment and draws my attention to underlying issues that could be contributing to my condition. Since having regular massages I feel on top of the world, I feel taller and it makes me feel better within myself. I can stand up straighter with no back problems. Any aches and pains I may have disappear. I feels more supple, so much more relaxed and have a fantastic nights sleep following these massages. Dee is absolutely fantastic and has such a great manner that makes you feel at ease right from the first massage. I also book a month in advance as she is always booked out each weekend.
Bella P.

We've been fortunate enough to have visited some of the best spa's in the world, taken full advantage of the 'spa experience' and had treatments from some great therapists, but it's without exaggeration that I can truly say that Dee gives the best massage.

Both my husband and I have had a series of back ailments, for a number of years. Mine is a result of 2 pregnancies very close together and my husbands an old sports injury, nothing has really helped.

Dee has been visiting our home for about 3 years, mostly we ask her to visit on a sunday evening, which in itself is deliciously decadent. She arrives, always smiling, armed with her tools, her very comfy bed, a heap of towels and her box of alchemy, from which she mixes up a concoction of oils which perfectly compliment your mood for the day.

Dee has a great technique, she knows exactly which muscles to work and she works them with just the right amount of pressure for you to feel a significant difference. She's hugely knowledgeable about alternative therapies and will advice you what else you could be doing to further improve your situation. Her reflexology, something I always like to end my session with, is amazing!

Long after Dee leaves, I'm still feeling light and fantastic. I couldn't recommend Dee and her magic hands highly enough.
Muniza & Haroon

I have a persistent shoulder problem caused by spending the last 15 years in a desk job. Dee's energy in finding the offending knots and massaging deep into the muscle tissue is invaluable in keeping me going and enabling me to carry on an active lifestyle. Keep up the good work Dee!
Anne B.

Dee has been treating me regularly for a number of years. I would not return to her if I did not find the effects of her treatments beneficial and long lasting. She is constantly updating her skills and knowledge with travel and training, and seems to have very little ‘personal baggage.’ She keeps herself refreshed and up to date, and is a lovely practitioner, both competent and confident. She shows great understanding and support beyond physical therapy, and brings empathy and calm to every massage session. She has my full support, and I have no hesitation in recommending Dee as a practitioner.

Only that she might become world renowned, and become too busy to treat one of her most devoted clients= me.
Thanks, Dee.
Jean Beith

I never expected to associate a sense of physical and spiritual well- being with the north-west London district of Cricklewood, but since starting to visit Dee there on a regular basis I find I now do.

Dee is an extremely accomplished masseur who is genuinely passionate about her craft. Over a period of many years she has become expert in a wide variety of massage techniques, and is continually seeking to extend them and to apply them individually to those who come to see her.

She works with rhythm and feeling, combining experience and innovation, from the soothing rubbing in of aromatic oils to (if requested) firmer deep-pressure strokes on targeted areas. She is happy to talk (and more importantly to listen). She is also happy to respect a need for silence.

Dee is one of life’s healers. That’s why I keep going back.
Adrian

I searched long and hard to find a masseuse who had the two-fold quality of being able to provide the right pressure and ensure a deep tissue massage. I was delighted to find Dee who is very professional and extraordinarily talented; being able to manipulate the muscle groups and break down the knots. The results of a massage from Dee ensures movement and posture are restored and I am relaxed and able to continue with sports and busy daily life.

The fact that I have returned to her on a regular basis for over three years speaks for itself! I cannot recommend her highly enough and am happy to give a verbal reference should it be required.
Leslie A – Hertfordshire.

After a pretty healthy life I was suddenly at 62 struck down with Fibromyalgia and my mobility was reduced by 50%. Nothing that the N.H.S had to offer seemed to help and then I met Dee. She used her training and intuition to identify particular muscle groups that were in constant spasm and worked to stretch and relax them. Slowly over a year later my mobility is 80% back to normal. Dee stuck with it when everyone else was telling me to “live with it” and I’m sure in time my mobility will be back to normal.

Thank you Dee for your perseverance!
Kathy M.

Dee is a skilful and experienced masseuse with a natural gift for healing. When my energy levels are low, she can lift them. When my muscles are sore she soothes them, when I feel stressed she helps me to relax and unwind. Whatever my state of body and mind, Dee has the ability and sensitivity to give me the boost I need to go back into the world, happier, stronger and calmer than when I arrived.
Debbie B.

Dee has been a wonderful reflexologist for me for many years, I can truly recommend her. Over the years I have been to many, but never to someone as in-tune with my body as her. Her attention to detail and her help with every lump and bump has certainly ensured that I feel fitter and healthier and able to cope with a fairly stressful life.

She has also worked in my company Theme Traders as an on-site masseur at events and we have always had excellent reports back about her amiable character and excellent massages.
Kim E.

I have known Dee for couple of years as my massage therapist. Dee has helped me in my well being through her massage techniques.

Dee does a first class job. Dee is organized, efficient, extremely competent and has an excellent rapport with me. Her communication skills are excellent.

In summary, I highly recommend Dee as a massage therapist. A life healer.
Raj S

Ergonomics
At igophysio we recognise the importance of correct ergonomics in today's workplace.

With the rapid development of computers an increasing number of people are working in offices for long hours in relatively fixed positions, performing repetitive movements while working hard to meet deadlines. This type of work is associated with health problems such as pain and discomfort in the neck, arms, elbows, wrists and hands.

A physiotherapist with a specialist knowledge in ergonomics and work related conditions can perform an individual work station assessment. Recommendations will be given such as the correct seating and workspace layout to prevent such conditions happening. Risks will be identified and advice given on correct posture, height of the desk and chair, position of screen, mouse and keyboard.

Igophysio run on-site physiotherapy and ergonomic clinics for corporate clients. Such services are tailor made to the individual business in order to satisfy their needs and demands.

Posture Management
Its not rocket science, we all know that posture is important, but it is too often neglected when treating a problem.

Igophysio realise that re-training muscle function is largely a waste of time if you don’t start by first correcting a patient’s postural alignment.

Adverse postures leads to sustained loading of joints, ligaments, muscles, and other musculoskeletal tissues which overtime causes these tissues to become overloaded, irritated, and painful.

Our tissues also deform (‘stretch out’) significantly when we sustain loads on them, so prolonged adverse postures can lead to irreversible loss of tissue stiffness. Stiffness is often thought of as a bad thing, which if excessive it certainly is, but our tissues do need some amount of ‘stiffness’ to hold our body parts together and to stop joints from moving too far.

Posture needs to be assessed both statically (sitting, standing…), but also dynamically, for example when walking and running. Often people walk / run with a postural alignment that inhibits muscles around the low back / pelvis region from working efficiently, resulting in abnormal pelvis mechanics and associated low back, pelvis, hip, and knee problems.

Correction of posture involves learning the specific movement(s) to correct alignment of the body, and persistence! Further rehabilitation is then carried out from this corrected alignment.

Ergonomic Assessment may also be required to identify and correct any barriers to sitting correctly that may exist, e.g. seating, workstation setup. It is much easier to sit with good posture when the workstation and chair setup encourage it.

To find out more or to book an appointment call 020 8455 7809 or email at info@igophysio.co.uk

Manual Handling & Lifting
The lifting and moving of objects is a common cause of pain and injury to your body. The low back is most often put at risk, but the neck and shoulders can also be injured. You can protect yourself against injury both at home and work by trying to eliminate the need for lifting and bending in the first place.

Principles of manual handling

Plan the task: is there a better way?
•           Does the lift need to occur?
•           Modify the lift by using equipment whenever possible.
•           Ask another person to help.
THINK before you lift and try to reduce the:
•           Need to lift below knee height or above shoulder height.
•           Distance the load away from your body.
•           Weight, shape, and size of the load.
•           Number of times you are going to lift.
•           Distance you are going to carry.
•           Speed of your lift.

Back injuries are most likely to occur if you move objects when the spine is bent forward and twisted at the same time. Store heavy items or those used frequently at waist height. You should:
•           Prepare your body by warming up and then doing some stretches before you lift and carry.
•           Keep feet wide apart.
•           Lower and lift using hips and knees not back.
•           Maintain natural curve of back.
Do not:
•           Twist your body while lifting.
•           Lift with a bent back.
•           Lift with a jerking or awkward action.
Make your work easier
•           Keep objects that you move regularly between shoulder and mid-thigh height, so you don’t have to bend down or lift above your shoulders.
•           Always check the weight and stability of the load before you lift.
•           Get help if necessary!
•           Do not lift and carry heavy items! Use a trolley, hoist, crane, or forklift.
•           Make sure the pathway is clear.
•           Wear loose comfortable clothing and flat non-slip shoes.

How can physiotherapy help?

Physiotherapists are experts in human movement. They understand how your muscles, bones, joints, and ligaments work and how injuries occur. Our research helps physiotherapists to give you good preventive programs and treatment. They can:
•           Assess your muscle strength and fitness to design an appropriate fitness program.
•           Teach you how to better handle loads.
•           Show you how to prevent injury in your home or workplace.
•           Treat muscle, joint, and ligament injuries to assist with a speedy recovery.

Why fitness helps

Your physical condition is important. For example, stiff joints and muscles can reduce your ability to keep your back in a safe position as you lift. If your leg muscles are not very strong, you may find it harder to lift effectively. Poor fitness will cause your muscles to tire, placing more stress on the spine and other joints. A Physiotherapist can advise you on the best way to improve your fitness.

To find out more or to make an appointment call 020 8455 7809 or email at info@igophysio.co.uk

Work-Related Injury Prevention & Management
iGoPhysio is keen to establish partnerships with local businesses to help them manage one of the biggest causes of absence from work.

Injuries at work can often cause severe and debilitating symptoms such as pain, numbness and tingling. These often lead to reduced productivity of staff, increased sickness absence, and temporary or permanent disability. Common causes include;

•           Repetitive or forceful movements
•           Heavy lifting or the moving of heavy objects
•           Poor ergonomics (workstation or equipment set up)
•           Poor posture
•           Exposure to vibration
•           Generally unsafe work environments

Evidence shows the longer a person is off work the less likely they are to return, therefore, iGoPhysio aim to:-

•           Prevent and minimise the incidence of musculo-skeletal disorders in the work place
•           Provide early access to physiotherapy assessment and treatment
•           Work with employers and employees to help patient’s stay at work or return as soon as possible
•           Encourage physical activity, good posture and self-management strategies at work and at home

Return To Work Rehabilitation Programmes
iGoPhysio have helped many people successfully return to and maintain a normal working life, despite previously being absent from work for long periods of time. Our treatment, management and rehabilitation of patient’s work-related injuries are cost effective when compared with the business costs of absenteeism.

iGoPhysio’s ‘Return-to-Work Rehabilitation Programme’ involves simultaneously decreasing pain and restoring function with carefully planned active treatment and self-management. Our Return-to-Work Rehabilitation Programme is specifically designed to help people return to all their normal daily activities after an accident or injury.

This holistic programme of individual treatment sessions is designed to overcome both the physical problems associated with an injury and the psychosocial impacts.

Initial Assessment

The programme begins with a Functional Capacity Assessment (FCA) of the patient’s current ability and limitations. An initial FCA score will be calculated. At all future treatment sessions FCA scores are generated. This easy to use system allows our Physiotherapists, along with the patient, the patient’s Rehabilitation Case Manager and the patient’s employer, to monitor the patient’s progress (subject to patient consent).

At the end of the initial assessment short and long term SMART goals are discussed, agreed and set between the Physiotherapist and the patient.

Following this initial assessment iGoPhysio can provide a comprehensive medico-legal reporting service

Treatment

iGoPhysio is able to see patients in a variety of settings;

•           Home Visits
•           Clinic Appointments
•           Gym Sessions

The location of the initial assessment and treatment sessions is largely dependent on patient preference, the nature and severity of the injury and the type of job / previous activity levels of the patient.

The Return-to-Work Programme typically lasts for 8-12 weeks using evidence-based treatment protocols. The detailed initial assessment and goal setting allow our Physiotherapists to formulate tailor-made treatment programmes specific to the patient’s needs. Our aim throughout treatment is to motivate and connect patients with an attitude of independence, and responsibility to their own future health and wellbeing.

Treatment regularly comprises of;

•           Education - provided regarding the patient’s condition, the effects and importance of treatments, injury prevention and self-management.
•           Electrotherapy
•           Manipulation and Mobilisation
•           Acupuncture
•           Graduated personal exercise programme - to counteract post-injury muscle weaknesses and imbalances. It is imperative, to reduce the risk of re-injury, that muscle strength is nearing full strength prior to return to work.
•           Specific work conditioning - performed with most patients to improve strength, endurance, and postural tolerances prior to return to work.
•           Cognitive-Behavioural Therapy (CBT) - acknowledging and overcoming unhelpful thoughts & beliefs, and fear-avoidance behaviour.
•           Manual Handling and Postural / Ergonomic Advice – if relevant, common types and mechanisms of manual handling injuries can be discussed in relation to the identification and reduction of risks during work practices and the demonstration and practice of basic handling techniques. Workstation ergonomics and the principles of postural awareness can also be discussed if appropriate.

Final Assessment

Following the assessment a final report (with the informed consent of the patient) will provide a summary of the treatments, goals, patient progression and FCA outcome measures. An analysis of these functional measures, along with the return to work decisions of the assessing Physiotherapist will be sent to all Doctors, Rehabilitation Case Managers and Employers concerned. The final report will outline whether any further medical or therapeutic intervention will be required, the scale on which the patient can return to work (if not full duties) and any equipment required (along with recommended suppliers and price guide) to allow the patient to return to work.

Medical Insurance
Private Medical Insurance

iGoPhysio are registered as physiotherapy providers with all major private medical insurers. iGoPhysio will aim to invoice your insurers directly for payment.

If you have private medical insurance please let us know when booking your treatment. Please have your policy details to hand, as we will require the name of the company you are insured with and your policy number. We will then liaise with your insurers so we can invoice them directly. Where this not possible, iGoPhysio will take payment directly from you and provide you with a receipt that you can use to claim the money back from your insurers.

Healthcare Cash Plans

iGoPhysio are registered as physiotherapy providers with all Healthcare Cash Plans. With Cash Plans a referral to physiotherapy from a Doctor is not usually required; you can make the referral yourself. The usual process of payment is for you to pay for your treatment directly, and we will provide receipts for you to claim back costs.

If you are interested in taking out a Healthcare Cash Plan for yourself or family, please contact us and we can recommend the most suitable products for your needs.

Personal Injury Cases

iGoPhysio frequently works with solicitors and case managers to provide physiotherapy treatment to injured individuals. If there is a current claim regarding your personal injury your solicitor / case manager will be able to refer you to iGoPhysiotherapy directly.

iGoPhysio will invoice and liaise with the solicitor, case manager, or insurance company directly, leaving you to concentrate on your rehabilitation without worrying about any cost incurred.

AC Joint Pain
Dislocation / subluxation of the acromio-clavicular joint.
This injury can be caused by falling on your shoulder, elbow or outstretched arm.

What are the symptoms of the separation of the acromio-clavicular joint?
Symptoms include pain at the end of the collar bone or when you move your shoulder joint, especially with the arms above your shoulders. Dependent on how severe the injury is, you may also feel a little bony lump where the collar bone sticks up.

What treatment can you have for dislocation / subluxation of the acromio-clavicular joint?

Things you can do yourself

•           Rest – a sling may be used initially after the injury.
•           Cold therapy: Put a cold pack (typically applied for 20 minutes wrapped in a tea towel) directly on the injury
•           As it becomes less painful, your Physiotherapist will work on mobility and strengthening exercises for the shoulder.

If necessary, professionals may tape your collar bone into place to allow it to heal in an acceptable position. Your collar bone will remain strapped for around two to three weeks. If this injury is neglected and allowed to heal out of place, the result could be increased wear and tear on your joint causing future problems.

After your shoulder has been immobilised for a few weeks you will be advised to get further treatment such as physiotherapy.

Achillies Pain
Achilles Tendon Injury
Pain in the region of the Achilles tendon is an extremely common injury especially among distance runners. Injury to the Achilles tendon occurs when the load applied to the tendon, either in a single episode or, more often, over a period of time exceeds the ability of the tendon to endure that load. This is called Achilles tendinopathy. Factors that may predispose to Achilles tendon injury include:

•           Years of running
•           Increase in activity (mileage, speed, gradient)
•           Decrease in recovery time between training sessions
•           Change of surface
•           Change of footwear
•           Flat footedness
•           Calf weakness
•           Reduced muscle length (tight calves)
•           Reduced range of movement at the ankle joints and joints of the foot

The keys to successful treatment of Achilles tendinopathy are early diagnosis and RICE (rest, ice, compression and elevation). iGoPhysio provide specific strengthening programmes and correction of predisposing factors such as muscle tightness and abnormal biomechanics. These are all required together with appropriate progression to functional activities and sport-specific rehabilitation programmes.

Achilles teninopathy responds best if treatment is implemented at an early stage with the aim being to settle pain and inflammation through the use of heel raises in shoes, soft tissue massage and mobilization of the Achilles tendon. Your physiotherapist will implement intensive self stretching programmes which are important to maintain muscle and tendon length.

Sever's Disease
Tendon attachments are cartilaginous plates that provide a relatively weak cartilaginous attachment from tendon to bone. In adolescents, during rapid growth phases, bone lengthens before muscles and tendons are able to stretch correspondingly. This can lead to traction of the Achilles tendon causing inflammation at the attachment of this tendon.

Posterior Impingement Syndrome
This is where the rear aspect of one of the bones of the ankle joint becomes pinched by the adjacent aspect of the shin bone when fully pointing the toes or during activities involving jumping and pushing off the toes such as ballet, gymnastics and football. This condition causes pain and tenderness at the back of the ankle. Treatment involves relative rest and manual mobilization of the joints of the foot and ankle. Occasionally surgical intervention is required.

Achillies Tendonitis
Although it is believed to be the thickest and most robust tendon in the body, damage does sometimes occurs to the Achilles Tendon causing an extremely painful injury. Achilles Tendonitis is the irritation and inflammation of the Achilles tendon.

What Causes Achilles Tendonitis?
Achilles tendonitis is an over-use or repetitive strain injury and therefore sports associated with running or jumping can aggravate the Achilles tendon.

Achilles Tendonitis is commonly caused by a lack of flexibility or flat footedness. Rigidity of the tendons comes with age and therefore as we get older we become more susceptible to injury.

Achilles Tendonitis is commonly caused by a lack of flexibility or flat footedness. Rigidity of the tendons comes with age and therefore as we get older we become more susceptible to injury.

What are the Symptoms of Achilles Tendonitis?
The main symptom of Achilles Tendonitis is pain at the back of the heel, usually at its most acute after long periods of inaction such as first thing in the morning or after sitting down for while. Aggravating activities like running and jumping are usually painful.

What Treatment can you have for Achilles Tendonitis?
Treatment for Achilles Tendonitis should be swift as the inflammation associated with Achilles Tendonitis can lead to degeneration of the tissue, increasing the chances of developing the more serious disorder of Achilles tendon rupture.

Acute Low Back Pain
Acute low back pain is usually of sudden onset and is often triggered by a relatively minor movement such as bending to pick up an object. This minor incident may be more indicative of fatigue or lack of control, rather than tissue overload. The pain may develop over a period of hours due to the development of inflammation. Patients with chronic low back pain may also have acute episodes that may become more frequent and require less initiation over time. The pain is usually in the lower lumbar area and may be central, to both sides, or to one side. It may radiate to the buttocks, hamstrings or lower leg. Sharp, stabbing pain in a narrow band down the leg is radicular pain and is associated with nerve root irritation, sometimes as a result of a ‘slipped disc’. More commonly, the pain the patient feels in the buttock and hamstring is referred from the lumbar spine - with the patient complaining of a deep seated ache.

Management of Severe/Acute Low Back Pain
Initially the patient should always adopt the most comfortable position. Movements that cause unbearable pain should be avoided, while movements that are uncomfortable, have no effect or reduce the pain are encouraged. We advise our patients to remain as mobile as possible as we have found this results in more rapid resolution of symptoms. Pain killers and anti-inflammatories should be taken to control pain and, therefore, reduce associated muscle spasm. Prolonged postures (such as sitting) should be avoided.

Your Physiotherapist can provide you with individual advice regarding the best management of your acute lower back pain. As your symptoms resolve, your Physiotherapist can teach you progressive stretching, strengthening and core stability exercises to minimise the risk of a reoccurrence.

Ankle Injury
Ankle sprains are the most commonly diagnosed ankle problems with thousands occurring each day. The term 'sprained ankle' seems to imply a rather insignificant injury, but this is not always the case. Inadequate rehabilitation can lead to prolonged symptoms, decreased sporting performance and increased risk of recurrence.

The ligaments of the ankle joint are known as the lateral ligament complex and the medial (or deltoid) ligament complex. Injuries to the lateral ligament complex (through inversion injuries) are far more common than injuries to the medial ligament This is due to the relative instability of the lateral joint and weakness of the lateral ligaments compared with the medial ligament. Occasionally in severe injuries, both medial and lateral ligaments are damaged. The amount of swelling and bruising is usually, but not always, an indication of severity.

Common ankle injures seen by iGoPhysio are:

•           Lateral & Medial Ligament Injuries
•           Persistent Pain after Ankle Sprains
•           Persistent Pain after Ankle Strains
•           Other Causes of Ankle Pain

Lateral Ligament Injuries
These can occur in activities requiring rapid changes in direction especially if these take place on uneven surfaces (e.g. grass fields). An ankle sprain may be accompanied by an audible snap, crack or tear, which, although often of great concern to the patient, is not directly related to the significance of the injury. The management of lateral ligament injuries, initially is to reduce pain and swelling through specific compression strapping by the therapist and regular icing and elevation. Following this, range of motion is restored as quickly as possible through ankle mobilisations, the prescription of specific exercises and then the aim is to build muscle strength, balance and to look to prescribing a progressive sport-specific exercise programme. Equipment such as wobble boards, wobble cushions and trampets can be used during rehabilitation.

Arthritis Pain
Osteoarthritis causes joints to become inflamed and painful. This pain often leads to secondary weakness in the muscles surrounding a joint. Inflammation, pain and weakness can be helped by physiotherapy whether they are acute or chronic stages.

What is Osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis. OA is caused by general ‘wear and tear’ on joint cartilage, causing pain and joint inflammation. OA most commonly affects people who are middle-aged or older. OA can range from very mild to severe. It generally affects the hands and the large weight bearing joints such as the knees, hips, feet and the back. To have a certain degree of OA can almost be considered a normal part of ageing. A common misunderstanding is that OA is always a progressive and serious disease.

What are the symptoms of osteoarthritis?
The severity of symptoms varies. Typical symptoms are pain, stiffness, and reduced range of movement at the joint. The stiffness tends to be worse first thing in the morning but usually eases as the days goes on. Swelling and inflammation of an affected joint can sometimes occur.

Other factors that indicate osteoarthritis are:

•           Other factors that indicate osteoarthritis are:
•           An affected joint tends to look a little larger than normal. This is due to overgrowth of the bone next to damaged cartilage and sometimes swelling.
•           You may have reduced mobility if a knee or hip is badly affected.
•           No symptoms may occur. Quite a number of people have X-ray changes that indicate some degree of OA but have no symptoms. The opposite can also be true. That is, you may have quite severe symptoms but with only minor changes seen on the X-ray.

Physiotherapy measures to help treat osteoarthritis
Pain and inflammation can be relieved through electrotherapy and gentle mobilisation. iGoPhysio will prescribe a personal exercise programme to help protect the inflamed joints against further damage and strengthen the appropriate muscles around them whilst maintaining range of movement.

Back Pain
How does back pain occur?
Back pain can be caused by injury or bad postural habits. Back pain is something that many people experience at some stage during their life. It brings with it stress and interruption to our work and social life.

Fortunately, serious or permanent damage is relatively uncommon. Your spine is an extremely strong structure made up of small bones (vertebrae) which are connected by discs and ligaments which make it strong, flexible and shock absorbent. It is reinforced by strong supportive muscles. All these structures have numerous nerve endings. If they are under stress or injured they will let you know!

Most back injuries do not cause any lasting damage. The pain experienced is your body telling you to do something about it!

How can Physiotherapy help?
iGoPhysio will carry out a full assessment to determine the cause and develop an individually tailored rehabilitation programme.

We offer comprehensive treatment of acute and chronic conditions using both a hands-on approach and core-stability retraining. We will offer advice to enable you to manage your back in the long term and therefore reduce the risk of recurrence of pain and time off work. The better you are informed the more likely you will recover and be able to prevent re- occurrence of your injury.

To bring relief of pain iGoPhysio may utilise some of the following;

Buttock pain is commonly seen in athletes involved in kicking or sprinting sports. It can occur on its own or it may be present with low back or leg pain. Pain in this region may arise from a number areas or be referred from the lower back.

Refered Lumber Pain
Referred pain is often described as a deep, aching, diffuse pain, variable in site. Pain referred from the lumbar spine may be a result of abnormalities of the intervertebral disks and some of the small joints in the spine. Spondylolysis and Spondylolisthesis may also cause buttock pain.

Sacroiliac Joint Dysfunction
Sacroiliac joint dysfunction may also refer pain to the buttock. The sacroiliac joint is the articulation of the sacrum (at the base of the spine) with the pelvis. The most common presentation seen by iGoPhysio is pain in one buttock (although it can be in both). Clinically the patient has deep buttock pain, difficulty in ascending and descending stairs and difficulty rolling over in bed. With this condition there is often a rotation of the sacroiliac joint with one side of the pelvis being higher than the other resulting in a possible difference in leg length. This is often associated with instability of the low back and pelvis.

Teninopathy
Localised, constant pain is more likely to be caused the buttock itself. The hamstring muscles have an attachment from the buttock region. The tendons at this attachment commonly become inflamed as a result of overuse.

Calf Pain
Calf pain is a common presenting complaint and if not managed properly it can persist for months or recur. Common causes of calf pain are:

•           Muscle Strains
•           Cramps
•           Biomechanics
•           DVT
•           Reffered Pain

Muscle Strains
Muscle strains are the most common causes of calf pain. An explosive acceleration such as stretching to play a ball at squash or tennis may cause injury. The calf region is also a common site of contusion (local damage to the muscle which results in bleeding) caused through a direct blow to the muscle. Some people experience episodes of cramping pain in the calf that may be due to recurrent minor calf muscle strains, which are as a result of poorly rehabilitated scar tissue. Calf pain can also be referred pain from neural structures or from the lumbar spine.

Cramps
The calf is the most common site of muscle cramps in the body. These can be treated with regular muscle stretching, correction of muscle balance and posture, and adequate conditioning for the activity. Other strategies implemented at iGoPhysio include incorporating plyometrics and eccentric muscle strengthening into training programmes, educating regarding maintaining adequate carbohydrate reserves during competition and the treatment of myofascial trigger points. We can advise on adequate fluid, carbohydrate and electrolyte intake with the recommendation of appropriate supplement drinks.

Biomechanics
Biomechanical factors may be the underlying cause of calf pain. Excessive flat footedness (over pronation) can overload the calf muscles causing muscle tightness and soreness. This can predispose to the development of compartment syndrome. iGoPhysio can arrange for you too see one of our accredited podiatrists if we believe that your symptoms are caused by a biomechanical problem.

DVT
Conditions often missed include deep venous thrombosis (DVT) which occurs occasionally in calf injuries. Signs and symptoms include constant calf pain, tenderness, increased temperature and swelling within the calf. Hospital treatment is required for a confirmed DVT.

Reffered Pain
Calf pain can also be referred from the lumbar spine, usually in the form of a ‘slipped disk’. These pains are usually deep and aching all the time but can sometimes be exercise-induced. The knee joint may also occasionally refer pain to the calf.

Calf Strain
Calf strain ranges from the tearing of a few muscles fibres to completely rupturing the muscles itself causing a person pain in the calf area.

What causes calf strain?
The calf muscle is usually strained whilst running or walking as the calf muscle's function is to control the heel bone and they are therefore most active during the push-off phase of walking and running.

What are the Symptoms of calf strain?
The pain of a calf strain injury can range from a still cramping and tightness during the stretching or contraction of the muscles at the back of the lower leg, to immediate pain and even soreness when touched. In the worse cases, there can be acute stabbing pain and the person will be unable to walk meaning the muscle may have completely torn. Often bruising and swelling occurs.

Disc Prolapse
What is a slipped disc?
A disk prolapse, or ‘slipped disk’, occurs when the thick paste-like disk nucleus is pushed out through a tiny defect in the fibrous disk wall. This bulge of nucleus can irritate the nerve root. Disk prolapses are commonly seen in patients between the ages of 20 and 50 and is more common in males than females.

How Does a Disk Prolapse Occur?
A prolapse usually occurs in disks that have been previously damaged. This explains why frequently a minor movement, such as bending over to pick an object off the floor, may cause such a painful and seemingly severe injury.

Symptoms
The patient with a disk prolapse typically presents with acute low back pain and/or leg pain following a relatively trivial movement usually involving bending forward. Pain is often aggravated by sitting, bending, lifting, coughing and sneezing. Pain is usually eased by lying down, particularly on the non-painful side, and is often less in the morning after a nights rest.

Treatment
Treatment in the acute phase consists of painkillers and should start extension / side glide exercises as soon as possible. As the acute episode settles, it is important to restore normal pain-free movement to the area with localised mobilisation, stretching and stabilisation exercises.

Elbow & Forearm Pain
To use the upper limb, whether in sport or everyday activities demands a well functioning elbow. Common conditions we see, and the treatment we use are:

•           Tennis Elbow
•           Golfers Elbow

Tennis Elbow
Sports people and manual workers commonly complain of pain on the outside aspect of the elbow, commonly due to repetitive wrist extension activities. This condition is traditionally labelled ‘tennis elbow’. Pain is caused by the scarring, thickening and tightening of one of the wrist extensor tendons that attaches just below the outside aspect of the elbow joint.

Other potential causes of pain on the outer aspect of the elbow are synovitis, bursitis, or a trapped nerve. All of these can exist on their own or in conjunction with tennis elbow.

Golfers Elbow
A similar condition may also affect the inside aspect of the elbow and is commonly labelled as "golfers elbow". This condition is also of an overuse nature as with tennis elbow but affects the wrist flexor tendons.

Treatment
iGoPhysio uses a combination of treatments to resolve these frustrating and often debilitating injuries. These include massage, stretching of muscles, mobilisation of nerves, mobilisation and manipulation to the neck and upper spine, strapping and a detailed functional rehabilitation program that addresses strengthening, the correction of predisposing factors and a graduated return to activity.

Most patients with chronic elbow pain have some form of referred pain from the neck. Treatment for this referred pain is covered under Neck Pain.

Facet Joint Pain
Facet Joint Syndrome
Facet Joint Syndrome is pain arising directly from the facet joint. The facet joints are at either side of the intervertebral joints that are the joints between the disk and vertebra in your back. Their role is to prevent excessive movement, and provide stability for the spine. When the facet joints are functioning correctly they move freely to control the movement of the spine.

What Causes Facet Joint Syndrome?
A fall and blow to the body sustained playing sport or as a result of a car-crash, for example, can put excessive pressure on the facet joints bringing about acute pain. Extending the spine or bending towards the affected side will exacerbate the pain in the facet joint.

Pain in the facet joints can be caused by several things like sudden excessive movements that can have a great impact on the joint itself, or degeneration within the joint, resulting in the pain lasting longer than a few days. In the event of some kind of trauma there in an inflammatory reaction causing swelling in these joints which is a component factor in the joint pain. Pain can also be caused due to an impingement on a nerve within the joint.

What are the Symptoms of Facet Joint Syndrome?
Typically there is pain just to one side of the spine and the spine will generally feel very stiff in the mornings. Often the muscles in the area of pain go into spasm.

Foot Pain
iGoPhysio consider foot pain in three regions during assessment:

•           Heel Pain
•           Midfoot Pain
•           Forefoot Pain

Heel Pain
Heel pain is most commonly caused by:
•           Plantar fasciitis
•           Fat pad contusion
•           Calcaneal (heel bone) fractures – traumatic and stress fractures
•           Nerve entrapment
•           Tarsal tunnel syndrome
•           Talar stress fracture
•           Retrocalcaneal bursitis
•           Heel spurs

Midfoot Pain
Pain in the midfoot is commonly caused by:

•           Stress fracture of the navicular / cuboid / cuneiforms
•           Extensor tendinopathy
•           Joint sprains
•           Lisfrancs joint fracture dislocation
•           First tarsometatarsal joint pain
•           Tibialis posterior tendinopathy
•           Peroneal tendinopathy
•           Cuboid syndrome
•           Plantar fascia strains
•           Abductor hallucis strains

Forefoot Pain
Forefoot pain is commonly caused by:

•           Stress fracture of the metacarpals
•           Metatarsophalangeal joint synovitis
•           First metatarsophalangeal joint sprain (‘turf toe’)
•           Halllux limitus
•           Hallux valgus
•           Sesamoid fractures
•           Morton’s neuroma
•           Claw toe

Footballers Ankle
Footballer's ankle is the name given to the dislocation of the peroneal tendons that are located behind the bony point on the inner side of your ankle (malleolus).

What Causes Footballer's Ankle?
An ankle sprain can be the cause of Footballer's Ankle as long as the dislocation of the peroneal tendons occurs as a result of the sprain. A direct kick to the tendon can trigger the injury and this is the cause of its name, Footballer's Ankle.

The tissue stabilising the peroneal tendons can sometimes be torn when an ankle is turned over and the tendons can relocate themselves on the wrong side of the malleolus. When this occurs repeatedly, it causes great damage to the tissue, resulting in inflammation.

What are the Symptoms of Footballers Ankle?
Footballer's ankle causes great pain on movement of the foot. Other symptoms are swelling, bruising and tenderness and pain behind and around the malleolus.

Fractured Clavicle
Fractured Collar Bone
A fractured collar bone is a crack or splintering of the collar bone (the bone that runs along the front of the shoulder to the breast bone, located just below your neck). It is the most commonly fractured bone in the body.

What causes a fractured Collar Bone?
You can fracture your collar bone if you fall badly onto an outstretched arm or fall on the shoulder. A collision when doing contact sports such as rugby can also cause a fracture. Collar bone fractures are usually as a result of a physical injury and the bone most often fractures in its middle third.

What are the symptoms of a fractured Collar Bone?
There are various symptoms of a fractured collar bone, but if a fracture occurs you will usually know about it as it's very painful.

Apart from the pain, other symptoms include swelling and bruising around the broken bone, a bony deformity may be seen or felt and once the swelling has gone down it is often easy to feel the fracture through the skin

What treatment is there for a fractured Collar Bone?
If you suspect you may have broken your collar bone you should see your GP immediately. There are few things you can do yourself to ease the pain or heal the fracture so you must seek medical help. Treatment mainly involves resting the affected area in a sling. There are various types of slings available, most common been what is referred to as a 'figure of eight' splint. This is a brace that wraps around the shoulders to keep them back. It is very unusual for a collar bone fracture to require surgery, unless the fracture has broken the skin or the fracture is severely displaced.

A medical professional will also be able to provide interventions to help ease the pain.

A fractured collar bone will take between four to eight weeks to heal. During the healing process no sports activity should be undertaken. Recovery is usually complete with a full return to normal. You may notice a bump where the fracture was for a few months after, or longer, but this shouldn't cause any problems or pain.

Fractured Ribs
There are 12 pairs of ribs, which are attached to the vertebrae (backbone), in the back and of which 10 are attached in the front to the sternum (breastbone) by cartilage. The ribs function as protection for the vital organs in the chest cavity such as the heart, lungs, liver, and spleen.

Between the ribs are small muscles for support, which are called the intercostals. The ribs attach to the sternum with cartilage at locations called the costochondral junctions.

What causes a fracture of the ribs?
A direct blow to the ribs normally causes a fracture. Because the ribs are close to the skin surface and don't have as much protection as other bones, they are vulnerable. Simple rib fractures are the most common form of significant chest injury. Costochondral separations can also occur where a rib separates from the sternum. These result in pain similar to a rib fracture and if the dislocation is complete, there may be a palpable defect.

A severe blow to the chest may also result in a fractured sternum or breastbone. Again signs and symptoms resemble a rib fracture with pain along the sternum.

What are the symptoms of a fractured rib?

•           Pain (particularly on deep breaths and coughing)
•           Bruising to the rib area
•           Muscle spasms over the ribs
•           Possibly some crunching-type sounds when the rib is touched at the point of injury.

What treatments are available for fractured ribs?
Although chest x-ray remains the most effective means of diagnosing rib fractures, approximately 25% do not show up on x-ray and are diagnosed by physical exam. Rib fractures are difficult because simple breathing causes pain.

Treatment involves relieving the pain while the fracture heals. Because of breathing, the ribs cannot be splinted like other bones. Most rib fractures heal in a few weeks (about six).

There is little you can do yourself, apart from rest and allow the ribs time to heal. Medical treatment in the first instance should be sought.

Frozen Shoulder
Frozen shoulders affect around 3% of the population and are slightly more common in women. It restricts the movement in the shoulder joint. This is believed by some to be as a result of hormonal imbalances, with many women suffering from a frozen shoulder around the time of menopause. It also affects athletes.

What causes a frozen shoulder?
Frozen shoulder often occurs with no explanation. Some people may develop a frozen shoulder after a traumatic injury, but this is not always the case.

There are some factors that make suffering from a frozen shoulder more common. These include:

•           Shoulder trauma or surgery - if you have a shoulder injury frozen shoulder may occur, but not always. Surgery also increases the risk, especially if it is followed by a sustained period of joint immobilisation
•           Age and gender - You are most likely to suffer from a frozen shoulder between the ages of 40 and 60, and as previously mentioned, women are more prone to suffering from a frozen shoulder than men
•           Endocrine disorders - people who have diabetics or thyroid problems are particularly at risk from suffering from a frozen shoulder
•           Other systemic conditions - heart disease and Parkinson's diseases have been associated with an increased risk of developing a frozen shoulder.
What are the symptoms of a frozen shoulder?
Pain and stiffness in the shoulder joint, pain at night when lying on the affected side and limited range of motion.

A frozen shoulder tends to have three 'stages' to it:

1.         You will suffer some bad pain but will notice that you still have limited movement
2.         The pain will ease off, but movement will become very limited
3.         Finally the shoulder loosens up and returns to normal with full movement.

Physiotherapy Treatment
A frozen shoulder can be diagnosed on examination by a physiotherapist. An X-Ray is occasionally taken to confirm that there are no other problems or possible causes for the shoulder pain.

•           Exercises and stretching helps increase the motion in the joint and to minimise the loss of muscle. Exercise and stretching the affected shoulder is integral to ensure your shoulder returns to its normal functionality.
•           Ultrasound
•           Thermotherapy
•           Use of non-steroidal anti-inflammatory drugs such as ibuprofen (always seek the advice of a medical professional)
•           ortisone injections (used to decrease the inflammation in the frozen shoulder joint and help reduce pain. They also help allow more agility when stretching and exercising. Cortisone is only effective when used in conjunction with physiotherapy).

Golfers Elbow
A very similar condition to tennis elbow may also afflict the inside aspect of the elbow and is commonly referred to as "golfers elbow". This condition is also of an overuse nature relating to a strength deficit.

The correct medical term for Golfer's Elbow is Medial Epicondylitis and it is characterized by pain which affects the inside of elbow and it is associated with work-related activities.

What causes Golfer's Elbow?
There are many other activities that can result in Golfer's Elbow such as working out at the gym or simply working in front of a computer for prolonged periods. Each of these activities use the same muscles (wrist flexors and forearm pronators) repetitively and can result in the inflammation of common flexor tendon of the wrist where it attaches at the inside of the elbow (medial epicondyle). The causes of Golfer's Elbow are similar to tennis elbow but pain and tenderness are felt on the inside (medial) of the elbow, on or around the joint's bony prominence.

What are the symptoms of Golfer's Elbow?
Symptoms include tenderness and pain at the medial epicondyle, made worse by resisted flexing of the wrist and forearm pronation . The pain may spread down the forearm. Activities that use the flexor muscles like bending the wrist or grasping can make matters worse. Sufferers find they have difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments) and the pain typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several years.

What treatments are there for Golfer's Elbow?

Exercise programmes including;

•           Neural and flexor muscle stretches, and progressive conditioning exercises to strengthen the area and prevent re-injury.
•           Massage to relieve stress and tension in the muscles
•           Myofascial release of the forearm flexors and pronator teres
•           Cross frictions to the tendon
•           Acupuncture
•           Electrotherapy

For stubborn cases of Epicondylitis your doctor may advise corticosteroid injections, which dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects.

If rest, anti-inflammatory medications, and a stretching routine fail to cure your elbow pain, you may have to consider surgery. However, physiotherapy should always be the first treatment option, before both steroid injections and surgery. If injections or surgery are performed they should always be followed with a program of physiotherapy or the problem with undoubtedly reoccur.

Groin Pain
Acute groin pain is usually relatively simple diagnose. Chronic groin pain, however, can be caused by a numerous factors.

In patients with groin pain it is important to localise the area of abnormality. There are many reasons for groin pain arising from:

•           Adductor (inner thigh) muscles - chronic muscle strain or tendinopathy occur.
•           Hip joint - labral tear, synovitis, trochanteric bursitis or a stress fracture of the neck of femur.
•           Pubic bones - osteitis pubis or stress fracture of the pubic ramus.
•           Abdominal muscles - strain of the hip flexors, appendicitis, or an inguinal hernia.
•           Burstis - there are a number of bursae contained within the groin and many of these are susceptible to overuse and inflammatory change.
•           Refered pain - lower thoracic spine, the lumbar spine or the sacroiliac (SI) joint.

Headaches
Who gets headaches?
Headaches affect approximately two-thirds of the population. Headaches are often seen in those with poor posture, office workers and people under stress. This kind of headache is called a ‘cervical headache’.

Typical Presentaion
A person working for long periods at a desk with a poor posture is most at risk of developing a cervical headache. Maintaining a poor posture for long periods can lead to tight muscles and joints in the neck, shoulders and upper back which in turn manifest themselves as a headache.

What causes Headaches?
Cervical headaches are caused by the stiffness and tightness of the joints, muscles, fascia and nerves in the neck, presenting as a constant, steady, dull ache, often on the forehead, temples or the back of the head. There is often a history of trauma, such as a ‘whiplash’ injury or repetitive trauma at work or during sporting activities. The onset is usually gradual and may be present for days, weeks or months and is often associated with neck pain and stiffness.

Treatment
Treatment includes:
•           Mobilisation and manipulation of the joints in the neck
•           Stretching and strengthening of the muscles in the neck
•           Massage to tight muscles in the neck and shoulders
•           ostural retraining.

Heel Pain
Plantar Fasciitis
The most common cause of heel or rear foot pain is plantar fasciitis or as it is sometimes referred, 'heel spurs'. This condition occurs mainly in runners and is often associated with a biomechanical abnormality, such as excessive pronation or supination of the foot. Pain is worse in the morning and improves during the day. There is a point of tenderness on the inside border of the heel bone that often extends along the inside border of the foot. Treatment involves avoidance of aggravating activity, ice, stretching, inserts for the shoes and wearing footwear with adequate support.

Fat Pad Syndrome
Another common cause of heel pain is the fat pad syndrome or contusion. This is also known as a 'bruised heel'. This may develop acutely from a fall onto the heels or chronically from excessive heel strike with poor heel cushioning. Treatment involves rest, the use of a heel cup, good footwear and taping.

Calcaneal Stress Fractures
Calcaneal stress fractures result from overuse. They require X-ray and treatment as the fracture heals.

Knee Trauma and Surgery
Some clients require orthopaedic surgery following a knee injury. Rehabilitation must commence from the time of injury, not surgery, as this may be months later. Pre-operative physiotherapy starts with acute injury management and progresses to improving strength and range of movement to allow accelerated post operative recovery.

Knee Pain
There are many different conditions affecting the knee joint including:

•           Arthritis
•           Weakness
•           Anterior knee pain
•           Posterior knee pain
•           Lateral Knee Pain
•           Medial Knee Pain
•           Swollen knee
•           Clicking / locking knee
•           ‘Giving way’
•           Traumatic Knee Injury
•           Dash board injury
•           Knee surgery

Arthritis
There are numerous types of arthritis. Osteoarthritis is by far the most common, often described as general ‘wear and tear’ of a joint.

•           Osteoarthritis (OA)
•           Rheumatoid arthritis (RA)
•           Reactive arthritis
•           Septic arthritis

Weakness
Knee weakness is commonly seen in patients with arthritic and post operative knees. Many arthritic patients with weakness have difficulty standing from a chair or sofa and struggle whilst negotiating the stairs. An individual graduated strengthening programme is required and written for each individual patient.

Anterior Knee Pain
Anterior knee pain presents over the front of the knee. There are many causes of anterior knee pain:

•           Patellofemoral instability
•           Fat pad irritation / impingement
•           Patellar tendinopathy
•           Synovial plica
•           Osgood-Schlatter lesion
•           Sinding-Larsen-Johansson lesion
•           Quadriceps tendinopathy
•           Bursitis

Posterior Knee Pain
Posterior knee pain presents at the back of the knee. This seen less commonly than anterior knee pain but also has a number of potential causes:

•           Hamstring tendinopathy
•           Knee joint effusion
•           Referred pain from patellofemoral instability, the lumbar spine or neural tension
•           Polpiteus tendinopathy
•           Baker’s cyst
•           Gastrocnemius (calf muscle) tendinopathy
•           Deep venous thrombosis (DVT)
•           Claudication
•           Posterior cruciate ligament sprain

Lateral Knee Pain
Lateral knee pain presents on the outside surface of the knee joint. It can be caused by:

•           Lateral meniscus abnormality
•           Osteoarthritis of the lateral compartment of the knee
•           Excessive lateral pressure syndrome
•           Hamstring tendinopathy
•           Superior tibiofibular joint injury
•           Referred pain from the lumbar spine

Medial Knee Pain
Medial knee pain presents on the inside surface of the knee and can be caused by:

•           Patellofemoral syndrome
•           Medial meniscus abnormality
•           Osteoarthritis of the medial compartment of the knee
•           Pes anserinus tendinopathy / bursitis
•           Pellegrini-Stieda syndrome
•           'Breaststroker’s knee'

Swollen Knee
The degree and onset of swelling is an important clue used in diagnosing a knee injury.

Clicking / Locking Knee
This is often seen in meniscal injuries or if a loose body is present within the knee joint. If the knee locks in a bent position the injury is likely to be of meniscal origin. A knee that locks in a straight position is more likely to be caused by patellofemoral pain and injury.

'Giving Way'
‘Giving way’ can occur in unstable knees such as those with anterior cruciate ligament ruptures. It can also occur in conjunction with meniscal (cartilage) tears, patellofemoral pain or severe knee pain. Patients with recurrent patellar dislocations or loose bodies within the joint may also get sensations of the knee giving way. Knees that only give way on stairs / steps usually points to quadriceps weakness.

Traumatic Knee Injury
Acute knee injuries can cause considerable discomfort and potentially long periods off work / sporting activities. Injury can be caused by direct trauma or twisting movements. Common traumatic injuries seen by iGoPhysio are:

•           Patellofemoral syndrome
•           Meniscal (cartilage) injury
•           Anterior cruciate ligament (ACL) tears
•           Posterior cruciate ligament (PCL) tears
•           Medial collateral ligament injury
•           Lateral collateral ligament injury
•           Patellar fracture
•           Patellar dislocation
•           Patellar tendon rupture
•           Bursal haemotoma
•           Fat pad impingement
•           Tibial plateau fracture
•           Superior tibiofibular joint injury
•           Ruptured hamstring tendon
•           Coronary ligament sprain

Dash board injury
Knee injuries are common in road traffic accidents. Ligamentous injury and / or bone bruising can occur, especially with front seat passengers, if the knee/s impacts into the dash board.

Knee surgery
Some clients require orthopaedic surgery following a knee injury. Rehabilitation must commence from the time of injury, not surgery, as this may be months later. Pre-operative physiotherapy starts with acute injury management and progresses to improving strength and range of movement to allow accelerated post operative recovery.

Ligament Injuries
Ligaments are made of very strong fibres. Their function is to hold a joint in its correct position particularly during movement and exercise. Ligaments have limited flexibility and as a consequence some or all of their fibres can tear if they are subjected to an excessive force. This injury is often referred to as a ligament 'sprain'.

Symptoms
A torn ligament can be very painful. It usually causes localised swelling, heat and ultimately bruising. It may be too painful to weight bear through the affected joint and additionally the joint may feel quite unstable. The sooner this injury is diagnosed and treated the more quickly and completely it will heal.

How does Physiotherapt treatment help?
Treatment can be divided into three stages:

1. Initial Treatment
Swelling can initially restrict joint movement. This needs to be resolved as quickly and completely as possible if a stiff joint is to be avoided.

Because there is often a reflex inhibitory reaction that affects the muscles that control an injured joint, it is common for these muscles to lose strength and tone. If overlooked such weaknesses can put the injured joint under additional strain. Long term this can cause further muscle imbalances and injuries. These muscles are tested on the initial assessment and if any muscle imbalances are noted we teach you how to correct them.

Sometimes pain can cause adjacent muscle groups to lock in spasm. Altered mechanical dynamics due pain can also result in muscle spasm. An injured joint may also need a special support or strapping. We will either provide this for you or arrange for its delivery.

2. Secondary Treatment
Once the initial acute stage is resolved any thickened residual swelling needs to be softened to prevent it from impeding the joint's natural movement. Ultrasound, gentle massage and careful stretches are very effective at this stage.
Any restriction in joint movement is returned with gentle passive movement, carefully graded joint mobilisations and specific exercises. It is important that the joint is returned to its full range of movement.
If an exercise programme was previously implemented it is constantly reviewed to ensure that affected muscles return to their optimal strength. iGoPhysio take particular care to ensure that these muscles regain strength throughout their full range of movement and that they are well controlled during exercise.

3. Final Treatment
Healthy muscle, tendon or ligament fibres lie relatively parallel to one another. This allows the fibres to glide freely over each other as the area contracts or stretches. Traumatised tissue tends to heal with fine fibres laid in a haphazard formation that does not have the same flexibility of healthy tissue. It is important to soften and gently stretch this tissue as it forms.
iGoPhysio takes injury prevention very seriously. All too often the final stage of rehabilitation, proprioception training, is left untreated. This is a common cause of recurring injuries in the same area. iGoPhysio will put in place the proprioceptive exercises required to facilitate you achieving maximal rehabilitation, and a reduced risk of injury reoccurrence.

Low Back Pain
What is Lower Back Pain?
Lower back pain can be either an acute (sudden and short term) or chronic (long-term and often getting progressively worse) disabling condition that affects many people at some stage in their life. Lower back pain can also be described as a symptom of many other conditions.

What Causes Lower Back Pain?
It can be caused by an injury or a form of trauma, like a sports injury, a car accident or a fall, which although seemingly unlinked, can be the cause of many problems or abnormalities in the lower back that result in pain.

Poor posture can be another cause, as can emotional stress, obesity, age and poor body mechanics such as lifting without bending the knees.

Lower back pain can be the result of damage to the soft tissue like muscles, ligaments and tendons due to an accident of some sort. Other causes can be particular conditions such as osteoarthritis, rheumatoid arthritis, and degeneration of the discs between the vertebrae or cancer.

In summary, the possible causes of lower back pain can be categorised as mechanical, inflammatory, due to tumours, metabolic, referred pain from elsewhere, or can even be caused by depression.

Physiotherapy treatments
•           Postural advice and adaptations
•           Exercise programmes
•           Mobilisations & Manipulations
•           Trigger point therapy
•           Acupuncture
•           Massage
•           Ultrasoun

Lumbago
Lumbago is a term describing general mid to lower back pain.

What Causes lumbago?
The exact causes of lumbago are unknown or rather its cause could be put down to a variety of things such as lifting objects that are too heavy and not lifting them in a proper way, overuse of the back, or as a result of some other condition you may be suffering from.

A common cause of backache is weak stomach muscles, which increases the stress on the back muscles.

Several factors can contribute to back pain, like a sprain or spasm in a muscle or ligament, compression of the spine, or bulging or ruptured discs, all of which can put pressure on the nerves in the area. Back pain can also result from more serious disorders ranging from a trapped nerve to diabetes and cancer, and although it is often very difficult to determine the exact cause of back pain, some people may develop it for no apparent reason.

What are the Symptoms of Lumbago?
•           Pain in the lower back that doesn't radiate down through the legs
•           Stiffness of the back especially in the morning
•           Poor posture or an "S" shape in the spine.

Lumbago may be accompanied by other symptoms such as:

•           Loss of sensation in the soles of the feet or in the calf region
•           Loss of plantar flexion (pointing) of the foot
•           Back stiffness in other areas of the spine.

Physiotherapy treatment
•           advise on your posture and exercises to improve it
•           advice on what you should be avoiding
•           Thermotherapy
•           Ultrasound
•           Massages
•           Strengthening program; weak stomach muscles are often a cause, regular gentle stomach muscle exercise may make a big difference
•           Traction or joint manipulation/mobilisation technique

Neck Pain
Neck pain is an extremely common condition and there are many recognisable symptoms associated with it. Neck pain is often associated with headaches and can also refer pain to the shoulder and arm. iGoPhysio will give you a thorough assessment and ask you about headaches and any referred pain.

Following are some of the most common neck conditions we treat at iGoPhysio.

•           Cervical postural syndrome
•           Acute wry neck pain
•           Whiplash
•           Nerve root pain

Cervical postural syndrome
The most common neck pathology seen by iGoPhysio is "cervical postural syndrome". This condition is characterised by a protruding chin and rounded shoulders. A common complaint is that of burning or aching across the neck and shoulders. Pain is aggravated by maintaining one position for long periods. Office workers who work at a computer are most likely to suffer from this condition.

While benefiting from physiotherapy treatment to address the various abnormalities associated with this condition. Patients also benefit from an ergonomic workstation assessment from one of our therapists.

Acute wry neck pain
Acute wry neck pain is a common and very painful injury characterised by a sudden onset of sharp neck pain with limitation of movement. It commonly occurs during a sudden quick movement or on waking.

Whiplash
Whiplash is a common injury following road traffic accidents but can also occur in sport. The patient rarely complains of pain at the time of injury. The pain gradually increases over the following few days. Early mobilisation of the neck is essential in the management of whiplash. In the majority of cases the neck should not be immobilised in a soft collar.

Nerve Root Pain
Acute nerve root pain is a condition characterised by arm pain, often in combination with numbness and/or pins and needles. The patient may or may not experience pain in the neck itself.

Treatment
All of iGoPhysio’s treatment and rehabilitation programmes are tailored to your own specific condition to correct the current problem and prevent recurrence.

Treatment Includes:
•           Mobilisation and manipulation of the neck
•           Stretching and strengthening of the neck musculature
•           Massage to tight muscles in the neck and shoulders
•           Postural retraining

Broken Neck
A broken neck is a fracture or dislocation of one or more of the seven bones (vertebrae) of the neck. A fracture to one or more vertebrae is very serious injury and if you suspect someone may have fractured their neck they should not be moved without professional advice. Following X rays and CT scans specialist medics will decide whether the fracture is stable or unstable. An unstable fracture is immobilised in a hard neck brace for at least six weeks, as the position of the fragments of broken vertebrae could dislodge with movement. A stable fracture would mean the patient could move the neck gently, as pain allows.

A broken neck does not necessarily mean that there is spinal cord damage or injury. However this can only be determined by a medical professional.

What causes a Broken Neck?
A neck fracture is normally caused by severe trauma to the neck. Examples include:
•           Falls, such as from a horse or bike
•           Collisions, such as motorcycle or automobile
•           Diving into shallow water
•           Severe and sudden twist to the neck
•           Severe blows to the head or neck area

What are the symptoms of a Broken Neck?
A broken neck is usually caused by an accident or injury. The symptoms include:
•           Neck pain, which may or may not be severe
•           Difficulty breathing
•           Swelling and bruising
•           Tenderness
•           Decreased feeling in the arms or legs
•           Muscle weakness or paralysis of the arms or legs

What treatments are there for a Broken Neck?
If you suspect someone has a broken neck do NOT move them as this may cause more harm. Ring the emergency services on 999. Broken necks are delicate and need to be treated in the right way by a medical professional only.

After a patient is diagnosed with a broken neck, the doctor will have to determine the best treatment depending on the type of break. Surgery is often considered to treat a fractured neck. The surgeon chooses the treatment method based on the severity of the fracture. For example, the fractured bones (vertebrae) may be fused to the healthy vertebrae next to it, or may be removed and replaced with a bone graft that is fused to the vertebrae on either side. Traction techniques may be used to help align the bones as they heal. Neck surgery is often complicated and the recovery process can be slow. After full recovery, further rehabilitation and Physiotherapy treatment should be sought.

Stiff Neck
What is a Stiff Neck?
A stiff neck is a condition that causes stiffness, immobility and pain to the neck that may originate from any of the structures in the neck. These include muscles and nerves as well as spinal vertebrae and the cushioning discs in between. Neck pain may also come from regions near the neck, like the shoulder, jaw, head, and upper arms.

What causes a Stiff Neck?
A common cause of a stiff neck is muscle strain or tension. Usually, everyday activities are to blame. Such activities include bending over a desk for hours, having poor posture while watching TV or reading, placing your computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning the neck in a jarring manner while exercising. Traumatic accidents or falls can cause severe neck injuries like vertebral fractures, whiplash, blood vessel injury, and even paralysis.

What are the symptoms of a Stiff Neck?
When your neck is stiff, you may have difficulty moving it, especially to one side. If neck pain involves nerves (for example, significant muscle spasm pinching on a nerve or a slipped disc pressing on a nerve), you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere.

Physiotherapy treatment Stiff Neck?

•           Cold therapy: Put a cold pack (typically an ice pack applied for 20 minutes) directly on the injury
•           Thermotherapy: Apply heat (typically in the form of heated pads, warms packs or lamps) to the areas of the body causing pain. NB. Often Cold therapy and Thermotherapy area alternated, with the cold application happening first
•           Exercise programmes and stretches
•           Gently massage the sore or painful areas
•           Trigger point therapy
•           Acupuncture
•           Postural and sleeping advice and adaptations.

Pre & Post Op Rehab
Success of surgery depends a lot on what happens in the postoperative stages. It is important to maximise the surgery by doing exercises that help to stabilise, mobilise and protect the area. Your consultant may also recommend you have some sort of pre-operative intervention, if this is the case iGoPhysio will be happy to design and carry it out.

iGoPhysio will be able to guide you through these stages of rehabilitation. We can assist in monitoring your progress, setting your goals, and providing appropriate treatment to maximise your recovery potential. iGoPhysio can also inform you of how you can help your own recovery, and what should be avoided. You will be provided a specific rehabilitation program, and we aim to back to your full levels of activity and/or sport as quickly as possible.

Typical conditions treated by iGoPhysio:
Knee
•           Anterior & Posterior Cruciate Ligament reconstructions
•           Patella realignment
•           Post Arthroscopy - cartilage tears

Shoulder
•           Rotator cuff repairs
•           Stabilisations following reoccurring dislocations
•           Fractures

Spinal Injuries
•           Discectomy
•           Laminectomy
•           Spinal Fusions

Joint Replacements
•           Knee
•           Hip

Groins
•           Repairs

Ankle
•           Achilles tendon repairs
•           Lateral ligament repairs
•           Foot surgery
•           Ankle Arthroscopy

Quad Pain
Quadriceps injuries
The front of the thigh is the site of common sporting injuries such as ‘dead leg’ or quadriceps muscle contusion. This is usually caused by a direct blow to the muscle causing local damage resulting in bleeding into the tissues. Contusions can occur anywhere in the quadriceps muscle. Physiotherapy treatment can result in reduced pain, promoted healing and faster return to full activity.

Muscular strains of the quadriceps muscles are also relatively common. The site of pain is usually well localised in cases of muscle strain. Muscle strains occur in the mid belly of the muscle. A muscle strain usually occurs with an increase in running speed or extra distance kicking. A sudden pain is felt in the front of the thigh. There is local pain and tenderness and, with a severe strain, swelling and bruising occur.

If the pain is variable, not clearly localised and if certain aggravating factors are lacking, it may be referred pain. Referred pain may arise from the hip joint, the sacroiliac joint, the lumbar spine or nerve structures.

Treatment
Muscle strains and contusions are treated in much the same way. Management includes minimisation of bleeding and swelling. Treatment is aimed at the restoration of full range of movement and strength through massage therapy, electrotherapy, stretching and a progressive muscle strengthening programme with the result in return to all activities.

Hamstring Injuries
Hamstring muscle strains are common injuries among sprinters, hurdlers and long jumpers. They also occur in other sports involving sprinting.

Treatment
The effective management of pain in the hamstring area is dependent upon correct diagnosis. Initially the therapist must diagnose whether the injury to the posterior thigh is a muscle strain or pain referred from elsewhere so that appropriate treatment can be carried out. Over the first 48 hours regular ice and compression should be applied. Treatment is aimed at the restoration of full range of movement and strength through massage therapy, electrotherapy, stretching and a progressive muscle strengthening programme with the result in return to all activities.

Rotator Cuff
The rotator cuff is a structure composed of tendons that with other muscles hold the ball of the shoulder in place and provides mobility and strength.

A great deal of pressure and strain is put on these muscles if you play racket sports or partake in throwing events where your arm is above your head a lot.

The rotator cuff muscles are a series of tendons and these can become torn leading to pain and restricted movement of the arm. A torn rotator cuff can happen following a trauma to the shoulder or just through 'wear and tear'. Many athletes, like pitchers in baseball and javelin throwers, suffer of such injuries due to the repetitive movement of their shoulders.

What causes a Rotator Cuff injury
A Rotator Cuff Injury can be caused by repetitive throwing and strain of the muscles or general degeneration which normally affects older people, smokers, or those having had cortisone injections

What are the Symptoms of Rotator Cuff
Symptoms of Rotator Cuff include difficulty in lifting the arm and pain on the outside of the shoulder possibly travelling down into the arm. Pain in the shoulder can get worse at night and there is often stiffness in the shoulder joint

What Treatment can you have for Rotator Cuff?
Things you can do yourself

•           Rest
•           Cold therapy: Put a cold pack (typically an ice pack applied for 20 minutes) directly on the injury
•           Thermotherapy: Apply heat (typically in the form of heated pads, warms packs or lamps) to the areas of the body causing pain. NB. Often Cold therapy and Thermotherapy are alternated, with the cold application happening first
•           Visit your chemist and purchase deep heat spray that can help muscle pain
•           Use of non-steroidal anti-inflammatory drugs such as ibuprofen (Always seek the advice of a medical professional).

Rehabilitation treatment

•           Muscle imbalance exercises
•           Ultrasound
•           Trigger point treatment
•           Soft-tissue massage
•           Strengthening and stretching exercises of the relevant muscle groups

Repetitive Strain Injuries
What is RSI?
Repetitive Stress Injuries generally occur in those over the age of 30. The incidence of this type of injury is becoming more widespread as many jobs now require people to make repetitive actions such as typing, or clicking a computer mouse. It can also occur frequently in sports; some examples include Achilles Tendinitis in basketball or Tennis Elbow in tennis.

How do they occur?
These injuries often result when stress is placed on a joint due to the same action being performed over and over. The two most common types of repetitive stress injuries are Tendonitis (inflammation of the tendon) and Bursitis (inflammation of a structure called the bursa which is a sac-like structure within a joint).

Treatment
iGoPhysio can help you resolve your pain and get back to full function. Treatment can consist of exercises, stretches, and electrotherapy.

Road Traffic Accidents
Road traffic accidents are a common cause of musculoskeletal injury. These injuries are caused by both direct trauma and, in the case of ‘whiplash’, the acceleration / deceleration associated with a road traffic accident. These injuries are often very debilitating and require early assessment and treatment by a physiotherapist. Any area of the body can be injured and the severity is often dependent on the size and direction of the impact received. Common conditions caused by road traffic accidents are:

•           Whiplash
•           Back pain
•           Thoracic (chest) pain
•           Shoulder pain
•           Knee pain
•           TMJ (jaw) pain

Shin Pain
Common reasons for shin pain are:

•           Shin Splints
•           Stress Fracture of the Tibia
•           Stress Fractures of the Fibula
•           Chronic Compartment Syndrome

Shin Splints
The term 'shin splints' has been used to describe pain along the inside border of the shin commonly experienced by runners.

Shin pain generally involves one or more of three pathological processes:

1. Bone Stress - a continuum of increased bone damage exists. Ranging from bone strain to stress reaction to stress fracture.

2. Inflammation - inflammation develops at the insertion of muscles and fascia to the inside border of the shin bone.

3. Raised Intracompartment Pressure - the lower leg has a number of muscle compartments each enveloped by fascia. These muscle compartments may become swollen and painful as a result of overuse or inflammation.

One of the major causes of all three injuries is abnormal biomechanics.

Stress Fracture of the Tibia
Stress fracture of the tibia presents as a gradual onset of shin pain aggravated by exercise. Pain may occur with walking, at rest and even at night. The patient with 'shin splints' (now referred to as inflammatory shin pain or traction periostitis) complains of various symptoms. Pain is felt along the inside border of the shin and usually reduces with warming up. The patient can often complete a training session but pain gradually recurs after exercise and is worse the following morning. Initial treatment is to reduce inflammation. Podiatric assessment and physiotherapy advice regarding stretching and training are also important components of the management of this condition. The most effective definitive treatment involves a deep physiotherapeutic massage therapy.

Stress Fractures of the Fibula
Stress fractures of the fibula can cause shin pain. These can be caused by muscular stress and forces placed through the bone. This injury is often caused by biomechanical abnormality. It is treated with rest from activity until the tenderness settles and then with a graduated exercise programme. Soft tissue abnormalities should also be corrected.

Chronic Compartment Syndrome
Chronic compartment syndromes are a common cause of shin pain. The exact cause of this condition remains unclear. An inflammatory process occurs and leads to fibrosis and reduced elasticity of the fascia surrounding the muscle compartments. As a result, when the patient exercises, the muscles attempt to expand but are unable to do so. This results in increased pressure and, therefore, pain. Treatment consists initially of a conservative regimen of relative rest and deep massage therapy and assessment and correction of any biomechanical abnormalities. Surgery can be indicated if conservative treatment fails.

Shin Splints
What are shin splints?
Shin Splints is the name referring to a pain in the shin region below the knees and above the ankle in the lower leg.

What Causes shin splints?
Shin Splints can be caused by overusing certain muscles usually during long-distance running, especially if running on a hard surface. However, other factors are often involved such as posture and body alignment when running. Having flat feet or low arches can also be a common cause of shin splints and one factor commonly implicated in causing shin splints is overpronation (over-flattening) of the foot.

Shin Splints are caused through the overuse of muscles that could be due to a sudden injury or a delayed condition. The most common cause is the irritation and inflammation of the tendons and tissue surrounding the tibia and this condition is called medial tibial stress syndrome. Other common causes are a compartment syndrome or a stress factor.

What are the Symptoms of shin splints?
Most people feel pain on the inner side of the tibia during and after exercise. Often a contraction in the shin leads to muscle soreness. Sometimes there is swelling and even lumps on the bone. In some cases it is painful to bend the foot or toes downwards and the inside of the shin appears to be red.

Physiotherapy Treatment

•           Cold therapy: Put a cold pack (typically an ice pack applied for 20 minutes) directly on the injury
•           Thermotherapy: Apply heat (typically in the form of heated pads, warms packs or lamps) to the areas of the body causing pain. NB. Often Cold therapy and Thermotherapy are alternated, with the cold application happening first
•           Advice regarding the use of non-steroidal anti-inflammatory drugs such as ibuprofen (always seek the advice of a medical professional)
•           Strengthening and stretching exercises
•           Low-impact exercises such as swimming
•           In the long-term you may need to change your running style in order to correct the way that the foot hits the ground, as well as making sure that good footwear is worn
•           Orthotic advice to help raise fallen arches.

Shoulder Dislocation
Dislocating your shoulder is where the ball of the shoulder joint pops out of the shoulder socket. It is one of the most common sporting injuries sustained in contact sports such as rugby. The dislocation can either be an anterior or posterior dislocation where the arm appears out of position either pointing forwards or backwards.

What causes shoulder dislocation?
Contact sports and hitting your shoulder hard against a solid object can dislocate the shoulder. Usually when the shoulder dislocates, the top of the humerus shifts and sits in front of the shoulder blade, called an anterior dislocation.

What are the symptoms?
If the arm does not appear to be out of place and the dislocation is obvious, then other symptoms include the sudden onset of acute shoulder pain, a loss of sensation or feeling on the outside of the shoulder (this symptom could indicate possible damage to the auxiliary nerve), swelling, numbness, weakness and bruising.

What treatment can be done for shoulder dislocation?
Medical treatment must be sought immediately for dislocations. Do not attempt to do anything yourself as if the shoulder is put back into the socket incorrectly then this may result in severe damage to the shoulder and possible permanent nerve damage.

Doctors treat dislocated shoulders by manipulating the shoulder back into place. This is usually followed up with an x-ray to ensure the shoulder has been put back into place properly, and no other bones were fractured around the shoulder as a result of the manipulation.

The arm should then be put in a sling and you should not use your arm for several weeks while it recovers.

A rehabilitation programme to exercise and restore the range of motion to the shoulder and strengthen the muscles is integral. They will also help to prevent future dislocations.

It is important to keep the range of movements in the elbow wrist and hand therefore gentle mobilisation of these areas should happen, progressing to small extension, flexion and rotation of the shoulder, depending on how painful the shoulder is.

After the shoulder has been rested you can enhance mobilisation and strength in that area through physiotherapy.

Shoulder Impingement
Impingement Syndrome
Impingement syndrome happens when the rotator cuff tendons get trapped in the shoulder joint.

What causes impingement syndrome?
Overuse can cause this injury to occur. A trauma such as an accident or a fall can also cause this injury. This is a common injury in swimmers and throwers as well as racket players and sports people who make repetitive movements with their arms above their shoulders.

What are the symptoms?
Symptoms are pain in the shoulders when the arm is lifted above the shoulder, pain when you lift your arm forwards and upwards quickly and possible inflammation in the shoulder area.

Shoulder Pain
Normal function of the shoulder is vital for completing activities of daily living and popular sports. A reduction in shoulder function can lead to a lowered quality of life. iGoPhysio has extensive experience in designing specific rehabilitation programs for the shoulder complex. Common causes of shoulder pain, treatment and prevention:

•           Rotator Cuff
•           Shoulder Instability
•           AC Joint
•           Referred Pain
•           Shoulder Injury Treatment
•           Shoulder Injury Prevention

Rotator Cuff
The rotator cuff is a group of four muscles that balance the forces of larger, global muscles and control the head of the humerus (arm bone) during movement of the arm. The rotator cuff muscles can be affected in a variety of ways such as tendinosis, tears, and impingements. Rotator cuff tendinopathy is a commonly seen in athletes. In this condition the rotator cuff tendons become swollen as a result of overuse, faulty biomechanics or as a result of excessive load due to altered shoulder mechanics. Pain associated with rotator cuff conditions is often felt during overhead activities such as throwing, swimming and racquet sports. Pain is increased when the arm is taken out from the side of the body between 70º and 120º.

Treatment given at iGoPhysio includes strengthening, reducing aggravating actions, taping, electrotherapy, acupuncture and hands-on manipulations by a physiotherapist. The initial aims of treatment are to reduce swelling and pain within the rotator cuff tendons. Potentially causative abnormalities are also eliminated. As pain and swelling reduce, strengthening exercises are prescribed for the scapula (shoulder blade) stabilising muscles and the rotator cuff muscles themselves.

Shoulder Instability
Shoulder instability may be forwards (anterior), backwards (posterior), downwards (inferior) or multidirectional. Anterior instability may be caused by either trauma, causing a dislocation, or atraumatic with a gradual onset. Surgery is sometimes required to repair the damage caused by a traumatic dislocation. Following surgery it is essential that a personalised rehabilitation programme following recommended guidelines is followed. Atraumatic instability is treated with an intensive rehabilitation program focussing on the strengthening of the rotator cuff muscles and scapular stabilising muscles.

Posterior instability is most commonly seen in athletes. It is treated with strengthening and control exercises for the posterior stabilising muscles.

Multidirectional instability is a combination of instabilities and is usually atraumatic. Multidirectional instability is often associated with joint hypermobility syndrome but can also be caused by repetitive trauma. Treatment involves strengthening of the shoulder stabilising muscles.

iGoPhysio integrates a global approach to rehabilitation incorporating the patient’s whole body. Our rehabilitation focuses on the strengthening of scapula stabilising muscles and shoulder stability muscles. This is achieved with closed chain rehabilitation, rotator cuff strengthening, plyometrics and proprioceptive exercises.

iGoPhysio’s rehabilitation programmes are functional and specific to the individual patient's lifestyle. Treatment modalities used include swiss ball exercises, medicine ball work, electrotherapy and rubber resistance band exercises.

AC Joint
AC joint subluxation is a common injury seen in athletes who fall onto an outstretched hand or onto the point of the shoulder. iGoPhysio may strap AC joint injuries in the initially before prescribing structured mobilising and strengthening programmes.

Referred Pain
Pain is commonly referred to the shoulder and upper arm form other areas of he body. Dysfunction within the neck frequently causes referred pain to the shoulder region. Treatment involves mobilisation and manipulation of the affected joints causing the referred pain, massage to spasmodic muscles groups and stretching and strengthening exercises.

Sacro Iliac Joint Pain
Sacroiliac joint Dysfunction
At the bottom of the back, more precisely at the back of the pelvis, are the SI joints or Sacroiliac joints and there are several dysfunctions that can exist in this area causing pain. The sacroiliac joints sit between the sacrum and the ilia.

What is Sacroiliac joint Dysfunction?
Sacroiliac Joint Dysfunction is an abnormality in the mechanics of the joint, which puts abnormal pressures on the joint surfaces, ligaments and surrounding muscles, causing pain to the individual. There are many different possible causes of the dysfunction due to the many different twisting forces applied to that area when the lower limbs are moved.

What Causes Sacroiliac joint Dysfunction?
Sacroiliac joint Dysfunction can be caused by suffering a trauma such as a fall or a car crash. However, often it is caused by a mechanical imbalance, or there may be other medical inflammatory conditions present.

An alteration in alignment due to a trauma like someone falling on one buttock or mechanical imbalances like a discrepancy in leg length, can all lead to Sacroiliac joint Dysfunction. The repeated stress on the joint during various activities can lead to pain. Inflammatory disorders also can have an effect, such as Ankylosing Spondylitis.

What are the Symptoms of Sacroiliac joint Dysfunction?
Sacroiliac joint Dysfunction typically causes a dull aching pain at the base of the spine. The pain can vary from an ache to being sharp in nature with certain movements such as bending, lifting or rolling over in bed. Sometimes there is referred pain in the groin, buttock or the back of the thigh, but this referred pain will rarely go below the knee. Occasionally Sacroiliac joint Dysfunction can be responsible for pain in the testicles amongst males.

Physiotherapy Treatment for Sacroiliac joint Dysfunction

•           It is especially advisable not to do any actions that may exacerbate the pain such as lifting and bending. However, staying as active as possible is important to overall wellbeing
•           Orthotics can be used if a discrepancy in leg length is the cause of the dysfunction
•           Use anti-inflammatory medicine (always seek advice from a medical professional)
•           Hot and cold therapy
•           Sports massage
•           Physiotherapy

Sciatica
Sciatica is a specific pain that originates from the sciatic nerves which each run from one side of the pelvis through the hip and buttocks and down the leg. The Sciatic nerve forms what is effectively an electrical cable to and from the brain. Sciatica is a condition where pain, weakness or altered sensation can be experienced in the buttock, hamstring, calf or foot but stem from the spine, via the Sciatic nerve.

What Causes Sciatica?
Although the cause of Sciatica lies in the spine, not all sufferers will experience back pain and symptoms can be variable. The problem can manifest as back pain with leg pain, or leg pain only. The major cause of Sciatica is a Prolapsed Inter Vertebral Disc (more commonly known as a 'slipped disc') at the bottom of the back.

Sciatic can be triggered by very small, normal movements like bending over to one side at a bad angle to pick something up, as well from suffering a trauma like falling off a ladder and landing on your back. What happens in all cases is that the sciatic nerve is compressed and consequentially causes you pain. Scaitica can also be caused by stretch type injury as well as gradual onset.

Sciatica is generally caused by compression of nerve roots in the lumbar spine causing pain to the lower back, buttocks and legs, and far less commonly by compression to the sciatic nerve itself, which is the "true" meaning of the term sciatica. One of the primary causes of sciatica is a slipped disc. Other factors however that can cause sciatica include: injury to the buttocks, prolonged external pressure on the nerve, pressure from a tight muscle or nearby structure.

What are the symptoms of Sciatica?
The pain that accompanies sciatica can range from mild to debilitating.
Normal symptoms include:

•           A sensation of pain.
•           Weakness, numbness or tingling that generally begins in the lower spine and radiates down through the hips and buttocks and down the leg.

Additional more serious symptoms may include:

•           Impaired circulation.
•           Numbness of muscles, or a feeling of weakness, along the nerve pathway in the leg or foot.
•           Loss of bladder or bowel control.
•           Difficulty in moving and controlling the leg

Physiotherapy Treatment for Sciatica
Physiotherapy is very effective in the treatment of disc related problems such as Sciatica. Treatment by iGoPhysio can relieve nerve root compression caused by fibrous scar tissue following a disc prolapse, or the build up of gas. iGoPhysio also aim to prevent further episodes of sciatic pain through teaching correct postural techniques, and exercises to correct any muscle imbalance in the spine.

Most cases of Sciatica tend to settle down with physiotherapy treatment, but severe cases of Sciatica may require steroid injections or even surgery. Common treatments iGoPhysio use to treat Sciatica are:

•           Hot and Cold Treatment
•           Stretching
•           Regular exercise
•           Postural advice
•           Massage therapy including trigger point techniques
•           Acupuncture
•           Steroid injections
•           Spinal mobilisation and manipulatio

Slip Disc
The spine is made up of the vertebrae that have cartilage discs between them. The discs consist of a circle of connective tissue with a central gel-like core. This makes the spine flexible and at the same time acts as a protective buffer.

In the centre of this column of vertebrae and discs is the spinal canal, which contains the spinal cord stretching from the brain stem down to the first or second lumbar vertebra. It continues as a bundle of nerve fibers. Between each vertebra, the spinal cord has nerve root connections to other parts of the body.

The spine is connected to the ribs at the chest and is divided into three parts:

•           Neck (cervical vertebrae)
•           Chest (thoracic vertebrae)
•           The lower back (lumbar vertebrae)

What is a slipped disc?
A slipped disc is the name given to prolapsed intervertebral discs that put pressure on the spinal cord and nerve root causing pain. The term is in fact misleading because an intervertebral disk is unable to slip or slide. Slipped discs most commonly occur in the lumbar spine, at the bottom of the back, between the fourth and fifth vertebra (L4/ L5).

What causes a slipped disk?
Repeated overuse of certain tasks, during bending, lifting, and sporting activities can cause a slipped disk. Usually there is one offending movement that will be the catalyst for a prolapse to occur. Overuse of certain spinal disks in the back can lead to degeneration of the outer layer of the intervertebral disc and, if this degeneration is sufficient, the gel-like nucleus material is liable to prolapse out of the disc. If the prolapse is pressing on the nerve root this will cause you pain. Other causes include stress fractures and also genetics may also play a part in the probability of a slipped disk occurring.

What are the Symptoms of a slipped disk?
Onset of sudden and severe pain in the back made worse by flexed positions such as sitting. Often the prolapse direction means that pressure is put on the sciatic nerve which produces pain in the buttock, hamstrings, the back of the knees, the calf or the heel.

Sometimes symptoms may include numbness and loss of motor control over the leg.

Sports Injuries
We treat all types of sports injuries, ranging from ACL tears in the knee to simple sprains of the ankle or joint separations of the shoulder. Whether you have an ongoing problem from an old injury or you have just hurt yourself, we can help. Our experienced staff will accurately assess your problem and provide you with the rehabilitation that you need in order to return to your sport as soon as possible. Early recovery and active rehabilitation are important goals in the treatment of sports injuries; our clinic is equipped with a large gym and the appropriate tools to help you achieve these goals.

How can physiotherapy help?
Whether you are an elite athlete or simply enjoy recreational sport and activity, we will fully assess your problem. From there we will devise a treatment programme to allow you to maximise your potential and facilitate your return to sport

Early diagnosis and treatment of any sports related injury, from strains to sprains, will help to minimise damage and achieve the best results.

A full biomechanical assessment is required to not only diagnose the problems but also to source the cause of the problem. This is important for the full return to sports. Often only the symptoms are treated and as a result the problem is not identified leading to a recurrence later on. Preventing further injuries is as important as treating the pain.

Once the acute stage of the injury has been treated, a rehabilitation programme is essential to ensure the quickest recovery and return to sporting activity. iGoPhysio's rehabilitation will enable you to retrain the specific skills required for your sport or activity, as well as ensuring you condition yourself to reduce the chance of the same injury in the future.

Injury Prevention
iGoPhysio has experience in treating all levels of athletes from recreational to elite levels. Our physiotherapists can offer advise on fitness and training if you are planning to embark on a strenuous sporting activity (e.g. Skiing). This can help to improve the body's condition and reduce the risk of injury. Please keep the following prevention tips in mind as they will help you reduce your injury risk:

•           Participate in a conditioning program to build muscle strength
•           Do stretching exercises daily
•           Always wear properly fitting shoes
•           Nourish your muscles by eating a well-balanced diet
•           Warm up before any sports activity, including practice
•           Use or wear protective equipment appropriate for that sport

Whether your sport is soccer, hockey, basketball or golf, after you have properly healed, we ensure that you receive the appropriate exercises and drills to prevent a re-occurrence and enhance your performance so that you can return to your sport in top notch shape.

Running injuries
Running injuries are assessed using a combination of:

•           Full gait analysis
•           Full biomechanical assessment
•           Assessment of core stability and muscle imbalance
The aim is to find the cause of the problem and not just treat the injury itself. This will give you a positive long term outcome and help prevent further injuries.

Common problems seen in runners which can be effectively treated with Physiotherapy are;

•           Achilles Tendonitis
•           Runner knee
•           Lower back pain
•           Ankle problems

We also have close links with Podiatrists and Orthotics and will refer you when appropriate.

Ski Injuries
It is important that all injuries are rehabilitated back to full sports and not left once the client has become pain free. Often when this happens joints are not fully mobile and muscles are not strengthened enough to deal with demands of skiing and as a result reoccurrence of injury can be high. In order to prevent this we take our client back to a level when they are safe to return to the peaks.

Our chartered physiotherapists are able to assess and treat all skiing injuries. Treatment and Assessment includes the following:

•           Post injury or surgery - e.g. knee, ankle, hip and spinal injuries
•           Injury risk assessment
•           Full muscle imbalance assessments to identify are areas of weakness and instability
•           Knee brace fitting - our physiotherapists are trained to fit braces when required.
•           Return to sport exercise programme

Strokes
Role of Physiotherapy
Stroke affects everyone in different ways, so your therapist will first assess your condition and help you and your family to understand any problems or impairments you might have after the stroke. iGoPhysio will then work with you on specific problem areas; these will depend on the severity of your stroke, and previous abilities, and the life you hope to lead in the future.

Stroke rehabilitation
Stroke rehabilitation is carried out both inside and outside hospital.

Inside hospital
In hospital, physiotherapists will work with people who have had strokes to teach them the necessary skills to return to their home environment. They will also work closely with occupational therapists to make sure that the person will be able to move safely around their home.
While people who have suffered a stroke will have had neuro-physiotherapy in hospital, it's often not the best time to get the most out of physiotherapy. People are often too shell-shocked or ill to make sense of what has happened or to be motivated. Because having a stroke is a a life-changing event, they will need to grieve for the lifestyle left behind and begin to adjust to a set of new and challenging circumstances.

Outside hospital
Physiotherapy after discharge from hospital is very important but the provision of services is often lacking. People who have had a stroke may have had a physiotherapist and/or occupational therapist visit to assess their homes, and to help them and their relatives to prepare the home environment for them to come home to. Sometimes there will be a very long waiting list for physiotherapy, and people may be frustrated by this and eager to carry on with the work done in hospital. They may also want more treatment than the NHS physiotherapy team can offer or want ongoing treatment when NHS input is being curtailed.

No waiting lists
iGoPhysio have no waiting lists and are experienced at treating stroke patients at their home. iGoPhysio are able to continue the work done by physiotherapists in hospital providing a much smoother rehabilitation experience and maximising the potential for improvement.

Not everybody who has a stroke will be admitted into hospital, or be seen by a physiotherapist whilst in hospital. In this case physiotherapy can be arranged through the patient's GP. However, what is provided is often defined, not by clinical need, but by the availability of resources, long waiting lists are common. iGoPhysio can provide immediate appointments. This allows you to receive rapid access to treatment, and a better rehabilitation experience.

How physiotherapy works
Having a stroke can have a serious impact on movement, sensation, balance and co-ordination and the aim of physiotherapy is to help regain as many of these abilities as possible. The severity of the stroke will dictate how much recovery is possible, but physiotherapy works to maximise potential recovery.

Normally a stroke affects one side of the body and the affected side will often feel weak and heavy, which makes it more difficult for the person to move. In order to compensate for the weaker side, the stronger side becomes dominant and overactive to compensate for the weaker side. This means that a person who has had a stroke will tend to rely heavily on the stronger side of their body.

A physiotherapist will assess the alignment and activity of various body parts, and the physiotherapy treatment will focus on getting the side affected by the stroke to move more effectively.

Every person who has had a stroke has different degrees of difficulty in the activities of daily living. Physiotherapy will address the particular problems at the time of treatment. Generally the aim will be to help with mobility and balance. If the stroke is severe, this could mean helping with getting from bed to chair or on and off the toilet. If the stroke is mild and the person young and previo

usly fit, this could mean help with running and jumping, and returning to sport The recovery of movement is most marked in the first 3 months following a stroke, but progress can still be made many years after a stroke. The degree of recovery depends on many factors, the most important being the severity of damage caused to the brain by the stroke.

Individual assessment and treatment is the best way to plan physiotherapy to help with specific problems.

Tennis Elbow
Tennis Elbow is the inflammation and degeneration of the common extensor tendon of the forearm that attaches to the outside part (lateral epicondyle) of the humerus bone at the elbow. Tennis elbow is common amongst sports people and manual workers. Tennis elbow is not a diagnostic term, it is no more specific than back pain as a diagnosis. In fact this condition is more common in non tennis players then tennis players.

What causes Tennis Elbow?
Tennis Elbow is the most common injury in patients seeking medical attention with the complaint of elbow pain. The inflammation in the extensor tendon of the forearm muscles is caused by prolonged gripping such as driving, racket sports or even using a hammer. The inflammation and pain associated with tennis elbow is due to tiny tears in a part of the tendon and in muscle coverings. After the initial injury heals, these areas often tear again, which leads to haemorrhaging and the formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Collagen, a protein, leaks out from around the injured areas, causing inflammation. The resulting pressure can cut off the blood flow and pinch the radial nerve, one of the major nerves controlling muscles in the arm and hand.

Symptoms Of Tennis Elbow
Generally the symptoms arise from a degenerative process relating to a strength deficit in one of the extensor tendons of the forearm just below where it originates from the elbow. This is most commonly a result of an overuse syndrome related to excessive use of the wrist.

Symptoms include pain associated with wrist and gripping activities on the outside of the upper forearm just below the bend of the elbow and occasionally this pain radiates down the arm toward the wrist. There is difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments). Pain typically lasts for 6 to 12 weeks and the discomfort can continue for as little as 3 weeks or as long as several years.

If you feel pain directly on the back of your elbow joint, rather than down the outside of your arm, you may have bursitis, which is caused when lubricating sacs in the joint become inflamed. If you see swelling, which is almost never a symptom of tennis elbow, you may want to investigate other possible conditions, such as arthritis, infection, gout or a tumour.

Physiotherapy treatment
Tennis elbow is the most common elbow condition iGoPhysio treat. Treatments commonly used involve:

•           Massage to relieve stress and tension in the muscles
•           Exercise programmes including; neural and extensor muscle stretches, and progressive conditioning exercises to strengthen the area and prevent re-injury.
•           Tapping a band around your forearm to take pressure off the extensor tendons.
•           Myofascial release of the forearm extensors (especially extensor carpi radialus brevis)
•           Cross frictions to the tendon
•           Acupuncture
•           Electrotherapy
•           Advise on Corticosteroid injections for stubborn cases of tennis elbow. These dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects

If rest, anti-inflammatory medications, and a stretching routine fail to cure your tennis elbow, you may have to consider surgery, though this form of treatment is rare (fewer than 3 percent of patients). Physiotherapy should always be the first treatment option, before both steroid injections and surgery. If injections or surgery are performed they should always be followed with a program of physiotherapy or the problem with undoubtedly reoccur.

Thoracic & Chest Pain
Thoracic Intervertebral Joints
There are relatively few disorders of the thoracic spine (upper back). Disorders may involve damage to the disks or joints between vertebrae. The small joints between the spine and the ribs can also be a cause of pain in this region.

Sternoclavicular Joint
The sternoclavicular joint is where the collar bone (clavicle) joins with your sternum. A disorder with this joint can cause chest pain and is often injured in conjunction with the acromioclavicular (AC) joint of the shoulder. This joint can be sprained, subluxed and dislocated. Treatment varies dependent upon the severity of the injury.

Referred Pain
The most common cause of chest pain in those under 35 is referred pain from the thoracic spine. Referred pain may or may not be associated with thoracic pain. A thorough examination is required in these cases to diagnose the cause of the pain.

Blunt Trauma
The ribs may be fractured or bruised as a result of a direct blow. X-rays will confirm a fracture. These injuries will be tender for at least three weeks. Recovery from these injuries can be speeded up by physiotherapists.

Scheuermann's Disease
The most common cause of thoracic pain in adolescents is Scheuermann's Disease, a disorder of the growth plates of the thoracic vertebra. Pain is often felt between or around the shoulder blades. The pain may have commenced suddenly as a result of a sudden movement or may have been of a more gradual onset.

Treatment
Treatment aims to restore full mobility by mobilisation and manipulation of the joints and massage to the spinal muscles. It is important to follow this up with a rehabilitation programme involving stretching and strengthening exercises. Chest pain occurs frequently in athletes, usually due to musculoskeletal causes.

Non-Musculoskeletal Chest Pain
There is usually no obvious method of injury or trauma with non-musculoskeletal chest pain.

Chest pain (often described as central and crushing) associated with symptoms such as arm pain, palpitations, shortness of breath and sweating may indicate that the pain is cardiac in nature i.e. heart or angina attack. An ambulance should be called as urgent hospital treatment is required in the case of a heart attack.

A history of chest pain combined with a productive cough may point more in the way of a respiratory origin.

Symptoms that show relief with antacid medication are most likely gastrointestinal
i.e. stomach ulcer or gastrointestinal reflux.

TMJ
The temporomandibular joint (TMJ) is one of the most complex joints in the body, and can be affected by a range of problems. Patients with a TMJ disorder often suffer from recurring headaches or chronic pain. iGoPhysio focus on functional restoration of the biomechanics of the head, neck and jaw.

What are the symptoms of TMJ dysfunction?

•           Pain in the ears, temples or neck
•           Clicking, locking or popping of the jaw
•           Severe recurring headaches
•           Occasional hearing loss
•           Neck pain or stiffness
•           Sensitive teeth
•           Restricted opening of the jaw
•           Dizziness or ringing of the Ears

What Causes TMJ Dysfunction?

TMJ dysfunction can occur for no particular reason or be apart of a more complex problem. There is usually more that one factor involved.
•           Trauma such as a motor accident
•           Cross bite
•           Stress / nervous habits
•           Clenching and grinding of teeth
•           Muscle imbalances
•           Inflammation of the joint
•           Rheumatoid arthritis
•           Osteoarthritis
•           Posture

What is the treatment?

Treatment varies from simple advice to extensive therapy. iGoPhysio can help by:
•           Giving advice
•           Prescribing exercises
•           Using electrotherapy modalities such as ultrasound, TENS, muscle stimulation and heat
•           Advising on ergonomic changes at work and at home
•           Acupuncture
•           Manipulations
•           Stress management

Whiplash
What is Whiplash?
"Whiplash syndrome" is the name given to a group of neck pain syndromes most commonly resulting from rear-end vehicle impacts. Permanent damage is uncommon and your long-term outlook is good. Whiplash injuries are not usually serious and do not involve damage to the bones, discs or nerves in the neck.

The cause of pain in the acute (recent) stage after whiplash may be acute muscle injury, but there can be other significant injuries depending on the force of the injury. These can include spinal fracture, haematomas (bleeding into the tissues) and nerve damage.

Signs & Symptoms
Most people report pain in the back of the neck, worse on movement. Pain may radiate up to the head, across to the shoulders, arms or between the shoulder blades. Headaches are typically at the back of the head and spread forwards over the head.
Other, less common symptoms can be:

•           Disturbances of eyesight
•           Problems with balance and dizziness
•           Weakness and heaviness in the arms
•           Pins and needles on the inner sides of the hands
•           Hoarseness and difficulty swallowing and eating
•           Disturbances of hearing

Additionally, some bruising may occur in the seatbelt area. If rotation or turning of the neck is involved, then other structures in the neck may be affected, such as the nerves which pass between the vertebrae and out to the arm. The symptoms of whiplash may resemble other conditions and medical problems. Always consult your physician for a diagnosis. For mild to moderate severity of injury, early physiotherapy helps to ensure a full and quicker recovery. However, for severe injuries, physiotherapy for the neck may not be practical until a period of one to two weeks has passed as the patient is in too much pain during the initial period.

How physiotherapy Helps
iGoPhysio is experienced in dealing with whiplash and can use a variety of techniques to alleviate your pain and return you to full levels of activity. It is important to start treatment early as whiplash can develop into chronic back pain. iGoPhysio can:

•           Use sports massage techniques to speed up recovery (very important).
•           Apply joint manipulation techniques.
•           Use ultrasound and electrical stimulation.
•           Prescribe a rehabilitation programme and monitor it.

Initial treatment immediately after the incident will often involve the following and really depends on the findings and your physician's recommendation. Treatment may include:

ice applications for the first 24 hours - applying a cold pack, or even a small bag of frozen vegetables, such as peas or corn, placed in a light towel to the sore area for 10-15 minutes every few hours can be helpful. This will decrease the inflammation and cramping.

after 24 hours, use of both heat and cold can give you relief. Alternating between these can be helpful.

cervical (soft) collar - rest your neck by wearing a soft supportive collar or small towel roll pinned under the chin as needed for fatigue. Take care to preserve the normal curve of the neck when wearing a support. This should generally be worn for only two days as relying on a collar for a longer period can potentially be harmful; the muscles supporting your neck can become weak.

gentle active movement after 24 hours- movement is important for healing. Move the head frequently and gently in all directions, as long as the movement is comfortable and not forced.

nonsteroidal anti-inflammatory medications- take these as directed and approved by your doctor. Inflammation is inevitable after whiplash so these medications can prove to be of significant importance during the first week post injury.

muscle relaxing medications - If you are in a car accident, it is very important to follow your doctor's directions and physiotherapist's instructions as best as you can in order to quicken your recovery. This is a serious injury which should be dealt with accordingly.

Components of the Rehabilitation Program - The program is usually between 4 and 8 weeks in length and includes the following:

•           A detailed initial assessment
•           A detailed initial report (for your insurance company and physician)
•           Completion of a treatment plan (for your insurance company)
•           A combination of the following treatments:
- Education
- Progressive Exercises (including stretches, strengthening and conditioning)
- Postural Alignment Training
- Ultrasound
- Heat/Ice
- Lumbar Support (low back support for sitting)
- Massage Therapy
- Joint Mobilization (hands-on treatment)
- Manual & Mechanical Traction
- Transcutaneous Electrical Nerve Stimulation (TENS)
- Interferential Current
- Supportive Pillow
- Home-Based Exercise Program
- Taping
- Laser

Wrist & Hand Pain
iGoPhysio see patients with wrist pain from an acute injury (such as a fall on an outstretched hand), or pain that has developed gradually as a result of overuse. Wrist and hand pain may also be referred from the neck or upper spine. Treatment for this referred pain is covered under Neck Pain.

Wrist Pain Acute
Injuries to the wrist often occur as a result of a fall on to the outstretched hand. These injuries may include fractures of the wrist bones (radius, ulna, scaphoid) and subluxation or dislocation of the hand bones. It is also possible to fracture a bone in the hand (the hamate) swinging a golf club or tennis racquet. These injuries usually require physiotherapy to restore strength and movement as the fracture or dislocation heals.

Wrist Pain Chronic
Wrist pain can also be of gradual onset. This type of pain is often a result of overuse and associated with the tendons around the wrist. Treatment for wrist injuries includes mobilisation, graduated strengthening, nerve stretches and strapping.

Hand Injuries
Hand and finger injuries are very common in sport and although the majority require minimal treatment, some are potentially serious and require immobilisation, precise splinting or surgery. Many hand and finger injuries require specific rehabilitation and appropriate protection upon return to activity. Treatment and rehabilitation of hand injuries is complex and involves splinting, compression, specific strengthening exercises and taping.

Treatment Options

Testimonials
I came across the clinic by chance, and couldn't believe that the physiotherapist suggested reducing my treatment sessions, after two weeks I was amazed that I was feeling so much better, I couldn't believe that I had been so compulsive about being treated for so long. I am so grateful for the physiotherapist being so honest and firm with me, I am now great and my wife and kids sees me more.

I got selected for my football squad and hadto go for 1st team trials, I wasn't ready, the physiotherapist got me working, training and kept a careful eye on me, I got selected for the first team to play in Holland. I was so grateful that the team of physios kept up my treatment, Ihave never felt so fit!

I have been a professional body builder all my life, won titles and been British Champion, tried some Pilates after a groin strain, couldn't believe that I wasso tested, I always thoughtI was fit, I've got a lot to learn. The physio was so great and I was amazed at how fit she was compared to me and I train twice a day everyday!

Whenever I need an appointment, they always accomodate me at my time of need.

My GP recommended the clinic and spoke very highly of their care, I was not disappointed.

After my road traffic accident, I needed home visit treatment, this was no problem, the therapist was so nice, that i felt releived and comforted, I was back to my old self not very long after.

My mum was taken ill and had to be admitted to a care home, my GP arranged some physiotherapy through the clinic and I could not wish for better care and attention.

I had to have surgery following a football injury, my insurance company recognised the clinic and my treatment was brilliant, I am now back to my sport and feel great.

All the physiotherapists are Chartered and recognised by my health insurance company, claiming was very easy, I didn't need to be involved whatsoever, the clinic were very good.

I just love the pilates studio, after my treatment was completed, I carried on with my pilates and I am a completely converted women.

I got a groin injury during my training for the New York marathon and need urgent treatment, I got seen on the same day, caught my flight 2 days later and came in with 4.5 hours, a personal best time for me.

Referrals
iGoPhysio accept referrals from GP's, Consultants, Solicitors, Insurance Companies, Businesses and all medical legal packagers.

Patients claiming from any medical health insurance company may need to obtain the authorisation of their insurers before booking an appointment.

Self paying patients can self refer.

We suggest obtaining a letter of referral, surgical notes or any supporting X-rays when attending for the initial assessment, as this will enable us to have all the medical history at hand and enable treatment planning to be easier.

Our Chartered Physiotherapists are Chartered registered, HPC registered and we are recognised on most medical legal panels as experts in our field.

For further information contact Mr. Sunil Kapoor, Business Manager.

I-Shop

Sit Back Plus
Product Code: 402-

For the larger framed person who needs a wider back support. Core Products now offers the Sitback Plus. Sitback Plus offers all the comfort and quality of our standard Sitback Rest, but with a wider back panel to accommodate larger-framed people.

Hot / Cold Packs
Product Code: COL81

››   Fast & Effective
››   Versatile
››   Inexpensive
››   Reusable
››   Non Toxic Biodegradeable Gel
››   Pack Will Not Leak

Theraflex Elastic Gel Hot/Cold Packs
Re-usable hot/cold packs manufactured from a new elastic gel that stays very supple for both hot and cold therapy. The elastic gel is non-toxic and biodegradable.

Hip Supports
Product Code: NK309

Tubular aid in neoprene 4mm. thick with nylon internal linen.

Waist velcro fastening with wide adjustment. Advisable for lower limb (thigh) prosthesis carrier.

Knee Supports
Product Code: 37-109

Powerform Functional Hinged Knee Brace

A versatile knee brace for medial and lateral coligament instabilities and tears and hyperextension or chronic knee instability problems. The polycentric hinges allow for full range of motion and include a built-in “Stop” to prevent hyperextension of the knee. The brace will provide effective compression and stability following surgery. Also indicated for use on sprains, strains, medial or lateral instability.

Ankle Support
Product Code: POB027

Fitting
The Aequi is easily fitted by the user. The orthosis is fitted by following a logical sequence of numbers shown on the tapes (symbolised by dice).

Hygiene
The materials used in the orthosis ensure that it is easily washable, so it is easy to clean and hygienic. Machine (delicates) wash or hand wash at max. 40ºC.
Important
The stiffening must always be fitted to the inner side of the foot. The Aequi is worn over the sock, and optimal stabilisation can only be achieved if it is worn with a lace-up shoe.

Size
The Aequi is available in several sizes with a separate version for right and left. Use the table below to look up the required size.

Sports Orthotics
Product Code: 14170-

provides immediate relief from Metatarsal (ball-of-foot) pain. It supports the longitudinal arch and offers unmatched comfort and shock absorption.
£ 28.20 inc VAT (15%)

Additional Product Info
Please note that Lynco® are American products, therefore when placing your order please specify men`s or women`s and your chosen UK size. This will then be converted to an American size which you will receive.

Exercise Balls
Product Code: 400850-

For all traditional kinds of treatment using large balls in physiotherapy, ergotherapy and psychomotor activity.

Additional Product Info
Large Balls with Greatest Possible Safety

Gymnastic Balls
Product Code: 400460-

A general purpose A.B.S. exercise ball which can be for all traditional kinds of treatments and exercise.

Load bearing capacity 1000kg

Wobble Boards
Product Code: WB20

Wobble and Rocker Boards - for better balance, better sports and faster rehabilitation

Additional Product Info
Regular use of wobble boards will give you:
›› Improved balance and coordination
›› Better propioceptive awareness for injury prevention
›› Increased leg strength and ankle range of motion (R.O.M.)
Instantly Adjustable Tri-Level Design Adjusts in seconds with a simple spin of our patented sphere to three different degrees of angulation. As your balance improves you simply spin the sphere to a steeper angle. Also features a non-slip surface, great for bare feet or sports shoes.

50cm Wobble Board - Intermediate Tri-Level
›› 50cm Birch disc with 3 different angles: 10, 12 & 15 degrees
›› Intended for beginners, seniors and intermediate level users
›› Larger size board allows for wider, more stable stance 40cm Wobble Board - Advanced Tri-Level
›› 40cm Birch disc with 3 different angles: 15, 17 & 20 degrees
›› For more advanced level users and athletes. For use on one leg or two
›› Our most popular size board for daily balance maintenance

Weights
Product Code: XET200
Velcro Strap on Wrist and Ankle Weights A versatile range of Wrist and Ankle Weights made from a hardwearing, soft touch vinyl, which fit easily and snugly around the wrist, arm and leg. Available in 10 sizes.

Theraband Assist
Product Code: XET82

The flexible double loop for fastening and fixation of the Thera-band for exercises

Additional Product Info
CAUTION
The use of goggles is required for certain exercises when using exercise banding. Please refer to instruction booklet provided with the product.

Training Mats
Product Code: EXE511
›› Anti-slip base with neat radiused corners and weld - sealed edges
›› 100% durable closed-cell ergonomic nitrile rubber/pvc foam, double laminated
›› Hard wearing in a choice of mid blue, red or green
›› Anti-bacterial, anti-fungicidal treated for maximum hygiene
›› Does not contain allergy inducing latex. Non-toxic - CFC`s free
›› Fully complies to RoHS (Restriction of Hazardous Substances)
›› Superb resilience. Resists common chemicals and solvents
›› Lightweight, easy to roll-up, clean and store
›› Far outlasts cheap standard foam mats

Contacts Us

Appointments

Appointments are available Monday to Friday 7:00am to 8:30pm.

Weekend and home visit appointments are available upon request. To make an appointment telephone 020 8455 7809.

How to Find Us
At iGoPhysio we have private patient car parking on all sites.

iGoPhysio
Golders Hill House,
592 Finchley Road,
London,
NW11 7RX