Archview Physiotherapy Blogs

Frozen Shoulder Treatment

Written by Siofra Fogarty

About your shoulder

The shoulder is a ball and socket joint. The shoulder capsule is tissue that surrounds the shoulder joint, supported by ligaments and muscles. The capsule supplies the joint with nutrients and lubricating fluid. It also helps to stabilise the shoulder.

What is frozen shoulder

Frozen shoulder is the painful and gradual stiffening of the shoulder capsule. This painful stiffening over time leads to sleep disturbance and limits your ability to use your arm in day- to-day activities.

How common is it?

It is most common in women than men and people aged 40-70 years.

Causes

The exact cause of frozen shoulder is unknown. For some reason your body has an over reactive response to a minor injury and tries to heal your shoulder capsule with scar tissue. This leads to pain and stiffness. People with diabetes or history of recent shoulder surgery or recent injury have an increased chance of developing this condition.

There is 3 distinct Phases of true frozen shoulder

  • Painful phase
  • Stiffness Phase
  • Thawing Phase

What happens during each Phase?

Painful phase

This can last from 2-9 months. The pain often starts gradually and builds up. It may be felt on the outside of the upper arm and can extend down to the elbow and even into the forearm.

It can be present at rest and is worse on movements of the arm. Sleeping is often affected, as lying on it is painful or impossible. During this time movements of the shoulder begin to be reduced.

Stiffness Phase

It can last from 4-12 months. Scar tissue forms around the shoulder joint making movement difficult. At this stage, pain can be more manageable and you are able to sleep better at night.

Thawing Phase

It can last from 5-26 months. The pain and stiffness starts to resolve during this phase, and movements become easier. This happens because your body starts to break down the scar tissue around your shoulder capsule.

Different treatment options

Physiotherapy treatment ca help to improve and maintain shoulder range of motion.

Along with prescribing an individualised exercise program consisting of stretches, strengthening and flexibility.

Heat pack x 15-20 minutes to help relieve pain and stiffness.

Avoid overhead movements.

Maintain correct posture.

Frozen shoulder anatomy

Patellofemoral Pain Syndrome (PFPS)

Patellofemoral Pain Syndrome (PFPS)

By Amanda Olsen, MISCP, ATC

Knee pain is a common reason for people to seek out physiotherapy. Our knees are an important joint in the body which helps keep us upright and moving so it’s understandable that when painful, it can be debilitating, and worrying. If you have knee pain your first thought may be that it is something sinister – i.e. torn meniscus (cartilage) or a ligament injury. However, often, it is simply Patellofemoral Pain Syndrome (PFPS).

To understand Patellofemoral Pain Syndrome (PFPS) it is important to know what the knee joint consists of – two joints: the tibial-femoral joint and the patellofemoral joint. The tibial-femoral joint is where the femur (thigh bone) and the tibia (shin bone) articulate and work together. The other joint, the patellofemoral joint, is where the patella (kneecap) articulates with the femur via a space called the trochlear groove at the distal end of the femur. While it is a small piece of bone, the patella is vital to a properly functioning knee. It acts as an attachment site for the quadriceps so it can work efficiently during movement. The quadriceps is a group of muscles that distally converge into the quadriceps tendon which attaches on the top of the patella. At the bottom of the patella, there is the patellar tendon, which attaches the patella to the tibia. It is also important to note that on the surface behind the patella, there is a layer of cartilage which enables smooth movement.

In a healthy knee, the patella should track upwards smoothly and shift a little laterally (in the outwards direction) along the trochlear groove during flexion and extension of the knee. In someone who has Patellofemoral Pain Syndrome (PFPS), there may be a patellar mal-tracking present – most commonly an excessive gliding laterally when the knee is fully straight.

When this happens, you may experience some of, but not limited to, the following signs and symptoms:

  • A general diffuse-type pain all around the knee/kneecap
  • Pain or stiffness when sitting for long periods of time
  • Pain during exercise or activity à this can be as simple as when walking, but most noticeably with explosive or high impact movements such as squatting or jumping
  • Pain with stairs à ascending will hurt, but descending may be particularly worse
  • Crepitus may be heard à this is that awful crackling or popping sound your knee makes when bending and straightening it and is due to the cartilage behind the kneecap becoming rough from the mal-tracking

The key thing to note is that Patellofemoral Pain Syndrome (PFPS) is not an acute, trauma-related problem. Rather, it is a gradual onset of muscle imbalances that if not picked up on, leads to pain and dysfunction.

Some common causes include, but again are not limited to:

  • Really tight hamstrings (back of the thigh): the hamstrings are responsible for bending the knee. If they are tight, there is a constant flexion force that the patella is counteracting even when the knee is straight.
  • Imbalance of VMO:VL firing ratio: the VMO (vastus medialis oblique) is a collection of muscle fibers of your quads on the inner part of your thigh and attaches onto the inner part of the patella. The VL (vastus lateralis) is the outer part of your quads and attaches onto the outer part of the patella. Ideally, the firing ratio when squeezing your quad, is equal, if not the VMO firing just before the VL does. If there is excessive firing of one over the other, that signifies an imbalance, and thus influences the patella to move more to that direction. Most commonly, it is the VL that takes over excessively, and the VMO is too weak to counteract the strength of those fibers.
  • Tight iliotibial band (IT Band): this is that thick band that runs down the outer part of your thigh, starting from the hip and inserting into the outer edge of the knee. This is most commonly tight in runners and cyclists. Some of the distal fibers of the IT Band converge with the distal fibers of the VL and thus can also influence patellar tracking and cause that excessive lateral shift.
  • Tight and weak quads overall: yes… they can be both at the same time! Tightness stems from trigger points (or knots) in the muscle fibers which doesn’t allow the muscle to stretch properly and thus cannot appropriately fire, which inhibits its ability to work and strengthen efficiently.
  • Weak gluteus muscles (buttocks muscles): if these are weak, then the thigh is prone to internally rotating more than it should during movement, and this causes an increased pressure on the knee
  • Fallen arches or overpronation: sometimes you are born with this. Fallen arches causes an increased pressure on the inner aspect of the knee and inhibiting proper patellar tracking.

As you can see, there are numerous causes that can contribute to Patellofemoral Pain Syndrome (PFPS) and knee pain in general, and the list above isn’t exhaustive. Your physiotherapist will check these aspects in your initial assessment and treat accordingly through the use of hands-on myofascial release of tight muscles, dry needling, joint mobilizations to the patella and stretching and strengthening of what muscles are found to be tight and weak. You may be advised initially to modify your activity levels or stop altogether until symptoms settle. Once the imbalance is taken care of, and your pain has drastically reduced or ceased completely, return to the desired sport/activity levels will be commenced safely as per your physiotherapist’s guidance.

Anatomy of Patellofemoral Joint
Muscles of the upper leg

Physiotherapy Home Visit

Physiotherapy Home Visits – If you are unable to come to us we can come to you

Here at Archview Physiotherapy we provide Chartered Physiotherapy both in one of our clinics and in your home as part of our home visit service. We are available to call out to you or your family member if you are unable to get to the clinic.

There are many reasons why someone may not be able to come and see us in the clinic. Here is a short list of some of those: hip/knee replacements, recent surgery or fractures, severe back/neck/leg pain, decreased mobility, stroke, cerebral palsy, degenerative neurological conditions such as multiple sclerosis and motor neuron disease.

Prior to the home visit the physiotherapist would arrange a time that suits you and any family members that you may wish to be present. The physiotherapist would bring all the equipment they feel they might need. The treatment would last approximately 45minutes.

On the day the physiotherapist would arrive at your home and you would show them to the most appropriate area for them to discuss your issue, assess and treat your pain and see what yours needs are, then together we would set targets to achieve your goals. The physiotherapist will also examine you around your home to establish any possible issues i.e. trip hazards and they can advise you on how to adapt your home to ensure your safety.

After the consultation and treatment the physiotherapist will tailor an exercise programme for you which you would be required to do between physiotherapy treatments. This will enable you to get the best results from your treatment.

If you feel a home visit is a service you or one of your family members is in need of please do not hesitate to give us a call on 01-4913228 or email us on info@archviewclinic.ie for more information and to book an appointment for one of our Chartered Physiotherapists to come to your home.

Home visit physiotherapy

Cervical Dystonia

Written by Carol Hopkins

What is it?

Cervical dystonia (spasmodic torticollis) is a condition which causes the muscles of the neck to contract involuntarily. This can cause abnormal movement and awkward neck and head postures. There are two types of movements: sustained/tonic or jerking/clonic. These movements can also be combined. Muscle spasms and pinched nerves in the neck can in turn cause great amounts of pain. The severity can vary greatly from person to person and from mild to severe.

What are the symptoms?

  • Neck muscles contracting involuntarily

  • Sustained muscle contractions = abnormal head and neck posture

  • Muscle spasms = jerking head movements

What are the causes?

The cause of cervical dystonia can either be primary or secondary in nature. If it is a primary cause this means it is the only apparent neurological condition with or without family history. A secondary cause is where the issue is brought on by something such as a physical trauma.

There is currently no physical test to diagnose cervical dystonia. Therefore, it is vital you see a fully trained neurological specialist and/or physiotherapist to be assessed correctly to avoid any misdiagnosis.

There is currently no cure for cervical dystonia but there are treatment options available to help ease your symptoms i.e spasms, pain and altered posture. Working with the correct health care professionals can help you to come up with the best treatment plan for you.

How can Physiotherapy help?

Seeing a physiotherapist with experience of neurological disorders and cervical dystonia is essential. The physiotherapist will perform and initial assessment in order to determine, if not already done so, if it is in fact cervical dystonia or another condition of the neck muscles. Once an examination is done the physiotherapist can perform techniques to help improve the range of movement and decrease the spasms/pain in your head and neck. The physiotherapist can then determine the best appropriate home exercise plan for you. Physiotherapy along with the correct medication intervention (botox injection and oral medications) should help to ease your pain and increase range of movement, flexibility, correct the muscle imbalances, improve posture and coordination and to enhance general functional abilities for in your home and workplace.

If you are currently suffering from cervical dystonia and haven’t tried physiotherapy yet, please get in touch and our physiotherapist Carol would be delighted to see you and help you on your road to recovery.

cervical dystonia neck pain

Pelvic Malalignment

Written by Amanda Olsen

Did you know that your pelvis can go out of alignment? It occurs more often than you’d think, and can be a cause of certain ailments/pain OR can be the result of other issues occurring in your body.

A general overview of the anatomy of the pelvis…
– The pelvis, or “the pelvic girdle” is made up of three components: the two hip bones (the ilia), the sacrum, and the coccyx (your tail bone).
– The area where the sacrum meets the hip bone (ilia) is called the sacroiliac joint (dimples at low back).
o This is the most common place for dysfunction to occur in the pelvis – this joint can also refer pain into the low back
– These three components are held together by many ligaments and muscles

What happens?
– Whether due to a sudden traumatic experience (i.e. car crash, landing forcefully on one leg) or a prolonged onset from muscle imbalances, the pelvis can become mal-aligned
– The different types of mal-alignment are:
o Upslip: one hip is higher than the other
o Forward/backward rotation: one side of pelvis is either more forwards or more backwards than the other side
o Inflare/Outflare: one side of pelvis either flares out from mid-line more or more towards mid-line more than the other side
o Leg Length Discrepancy: one leg may be longer than the other because of a forward rotation of the pelvis on the side of the longer leg
o Sacral torsion: the sacrum is tilted or rotated more to one side

Signs & Symptoms:
– Pain at site of sacroiliac joint (dimples of low back)
– Low back pain
– Buttock pain
– Feeling “off kilter” or “out of balance”

How physiotherapy can help:
– Your physiotherapist will carry out several tests and measures to determine if you have a pelvic mal-alignment that could be causing your current symptoms
– If a mal-alignment is confirmed, the following things can be done for it:
o Muscle Energy Techniques: there are a few, but the one specific to your findings is the one that will be used – this helps get the pelvis back into alignment
o Dry Needling: if muscle tightness is causing the mal-alignment then dry needling will help loosen it out and its hold on the pelvis will be released
o Trigger point/myofascial release: alternative to dry needling where the therapist’s hands are loosening out the muscle and connective tissue around it
o Exercises: specific exercises will be given to you based on what the findings are, and are tailored to keep the pelvis in its corrected alignment

Having a pelvic mal-alignment can create a knock-on effect to the back, hips, knees, and feet. So if you are experiencing any of these, it’s possible that your pelvis needs to be corrected!

Pelvic bones
Pelvic mal-alignment
Skeleton mal-aligned

Importance of warm up and cool down

Written by Alison Yeung

Importance of Warm Up and Cool Down

As winter draws near and temperatures drop, the importance of a warm up before exercise and a cool down after exercise cannot be understated.  Although most people know that warming up is a normal practice before beginning a workout, it is tempting to skip a warmup or cooldown if time is limited.   However, this article explains why warming up and cooling down the body is essential for preventing injuries and optimizing performance.

Why Do We Need to Warm Up?

The purpose of a warm up is to literally warm the muscles of the body so that they are prepared to stretch during exercise movements.  If the muscles are not warm, then rigorous exercise can cause muscle strains or ligament/ tendon tears.  In addition, performance in your workout or sport can be hindered without a proper warmup, since the muscles would be less able to move through certain ranges of motion.

How Do I Warm Up?

Although your warmup will depend on what kind of workout or sport you are doing, there should always be a cardio aspect to gradually increase the heart rate and increase the core temperature.  5-10 minutes of light cardio is sufficient.  Some examples of cardio warmups include:

  • Skipping rope
  • Jumping jacks
  • Jogging (can be in place)
  • Speed walking
  • Light elliptical
  • Cycling

In addition to increasing your heart rate, it is beneficial to warm up any specific movements you may be doing in your workout or sport.  This will help prevent injury because the ranges of motion you go through during exercise might be different than the ranges of motion you use for activities of daily living.  For example, if you are about to squat heavy weights, doing squats with no weights first will help your body attune to the movement and focus on form before you lift a heavier load.  If you are about to play football, warming up with agility and speed drills will help your fast twitch muscles “wake up” and be ready for quick movements during the game.

Lastly, you can do warmup exercises for specific muscles that you want to activate during your workout.  For instance, if you are doing squats, you might want to do some glute-firing exercises beforehand, so that those muscles are more likely to be activated as you squat during your workout.

Why Do We Need to Cool Down?

After an intense workout, your heart rate is elevated and your core temperature is high.  Even after a low-intensity workout or sport, certain muscles that are used repetitively during the activity are tight by the end.  Thus, it is important to cool down to bring the body temperature back to normal and counteract any tension on the muscles.

How Do I Cool Down?

Immediately after an intense cardio workout, a cool down should start with some light movements such as walking or side stepping back and forth.  This gradually decreases the heart rate, prevents dizziness, and prevents blood from pooling in the veins.[1]

Stretching is also imperative after exercising. Static stretches (stretches that are held in one position) are good for counteracting the shortening of muscles after repetitive use in a workout.  For example, runners should take care to stretch their quadriceps, calves, hamstrings, hip flexors, IT bands, and glutes after running.  Lying spine twists are also helpful in stretching the lower back.  Golfers may want to stretch their lower backs because of the constant rotational motion of the sport, as well as their hip flexors and calves from all the bent over stances and walking.  Ultimately, you want to be doing stretches for the muscles that you used the most in your exercise.  This will assure that those muscles do not shorten or build up tension that could limit your range of motion or cause injury.  Make sure to hold each stretch for at least thirty seconds, and be careful to not overstretch; you should feel a gentle pull on the muscle but never pain.

Moreover, although it can seem time-consuming and boring to warm up and cool down, both practices significantly improve your body’s movement and protect your body from injury.  It is worth it to take those extra 5-10 minutes before and after your workout.  Your body will thank you in the long run!

group doing stretches to warm up and cool down

Fibromyalgia and Reflexology

HOW DO YOU SURVIVE WITH FIBROMYALGIA IN WINTER?

REFLEXOLOGY CAN HELP YOU!

Written by Susana Palazzotti

Fibromyalgia refers to a group of non-articular rheumatic common disorders characterised by pain and stiffness of varying intensity of the muscles, tendons and surrounding soft tissue. Although the outcome of the general physical examination is usually normal people look healthy, a careful examination of the muscles of people with fibromyalgia, reveals the touch sensitive areas in specific places called tender points.
Winter is probably the most feared season by people with painful chronic conditions like fibromyalgia, since climate change can increase the pain and, in turn, impact the mood.
There are several theories about why  winter increases the pain, for example:
–  Change in the sleep cycle and internal clock (circadian rhythm)
-The body creates more pro-inflammatory cytokines (proteins consider the bosses of immune system)
-During the winter many people experience seasonal affective disorder, a type of depression that could also increase the pain.
-The muscles are tightened more in the cold.
– People avoid going outside, so that you have less physical activity and worsens the condition.

In a small study of 10 fibromyalgia patients who were treated with reflexology twice a week for five weeks , the researchers found definite improvement in the symptoms of the ten patients , no side effects. Patients undergoing regular treatments reflexology report an improvement in : -Myofascial pain, headaches, tenderness and tightness in my muscles.-Mental Clarity-Irritable bowel syndrome-Fatigue-Sleep disorders-Depression

If you have fibromyalgia and suffer a lot of pain in this time, Here are some  practical tips to help you survive the winter:
1. Keep yourself warm. There are some items that you can use in your daily life and allow you to control the pain by cold winter. e.g electric blanket.
2. Keep moving. Exercise is one of the best ways to keep controlled the symptoms of fibromyalgia, and quitting can make them worse. Look for a plan of exercises you can do, such as yoga or Pilates .
3. Use wool. Wearing woolen clothes, woolen bedding can significantly reduce the pain of fibromyalgia. Make sure you are dressed warmly in winter.
4. Try to have a shower at night.  Just before you get to bed so that you stay warm.
5. Keep your home well lit. If you are a person who suffers from seasonal affective disorder, this can help you a lot.

Reflexology can be done as part of a full body massage, or as an independent treatment. Treatments usually last about 60 minutes. Make an appointment with our expert reflexologists.

reflexology for fibromyalgia
fibromyalgia

Physiotherapy for headaches

Written by Carol Hopkins

There are a couple of different classifications of headaches. This blog hopes outline each type and how physiotherapy may be able to help you. It is very important to see your GP if you regularly suffer from headaches, if this is your first headache, or if this is your worst headache yet.

Tension Type Headaches (TTH)

This type of headache can be either episodic which means you have less than 15 days a month or they can be chronic meaning you experience more than 15 days a month. These headaches can last anywhere from 30 minutes to 7 days. People often describe them as a bilateral pressing or tightening head pain with no significant associated symptoms. Along with this people often have tenderness in their neck and shoulders.

Cervicogenic Headaches

This type of headache is often secondary pain felt in the head from a source in the neck. This pain is often felt on one side of the head. There is often no pattern of frequency, severity, duration or any associated features. There may also be a history of neck trauma or poor posture.

Migraine

This type of head pain is different as it is a disorder of the central nervous system resulting in pain & neurological symptoms. There can be a genetic predisposition to migraine. Attacks normally last 4-72 hours. This pain is also often felt on one side of the head and described as a pulsating, moderate to severe pain. Sufferers can also experience associated symptoms such as, nausea or photophobia.

Physiotherapists commonly see TTH and cervicogenic headaches. There are 20 muscles that refer pain to the head. Your physiotherapist will use techniques such as soft tissue and trigger point release, dry needling, exercise rehabilitation and massage along with others to treat the headaches.

If you are experiencing any of the above please contact us on 01-4913228 for an appointment with one of our Chartered Physiotherapists. If you would like more information on types of headaches and the treatments available you can also contact Migraine Association of Ireland.

lady with neck pain
woman with headache

Parkinson’s Disease

Written by Titus Selvaraj

Role of physiotherapy in Parkinson’s disease

 Parkinson’s disease (paralysis agitans / shaking palsy) is a slowly progressive neurologic disease that is characterized by a fixed inexpressive face, tremor at rest, slowing of voluntary movements, gait with short accelerating steps, peculiar posture and muscle weakness (caused by degeneration of an area of the brain called the basal ganglia), and low production of the neurotransmitter dopamine.

Approximately 9,000 people are with Parkinson’s in the Republic of Ireland. The WHO estimate that in the next thirty years the incidence of Parkinson’s will double. It is commonly seen in population over 50, but at least 10 percent are under 40.

Main symptoms of Parkinson’s disease are:

  • tremor, shaking, or trembling
  • slowed movement
  • stiff or rigid arms, legs, and trunk
  • balance trouble that can lead to falls

Other symptoms that are common in Parkinson’s (not everybody will have all of them) include:

  • abnormal walking
  • decreased arm swing
  • excessive salivation
  • feelings of depression or anxiety
  • increase in dandruff or oily skin
  • lack of facial expression (hypomimia)
  • less frequent blinking and swallowing
  • lowered voice volume (hypophonia)
  • slight foot drag
  • small cramped handwriting (micrographia)
  • stooped posture
  • trouble sleeping
  • constipation
  • generalised body pain
  • decreased sense of smell
  • tiredness

Depression is common in people with Parkinson’s. Psychotic symptoms, such as visual or auditory hallucinations, may occur in up to 50% of cases.

 

Physiotherapy Goals

  • Maintain and improve levels of function and independence, that helps to improve a person’s quality of life
  • Use exercise and movement strategies to improve mobility
  • Correct and improve abnormal movement patterns where possible
  • Maximise muscle strength and joint flexibility
  • Correct and improve posture and balance to minimise risk of falls
  • Maintain good breathing pattern and effective cough
  • Educate the person with Parkinson’s and their carer or family members
  • Enhance the effects of drug therapy

Our physiotherapists play a vital role in supporting people with Parkinson’s to choose management strategies, prioritise and address the challenges they face over the course of the condition.

During the earlier stages of diagnosis, greater emphasis is placed on education and self-management. The individual should be encouraged to continue being active and participate in physical exercise for as long as possible. Significant respiratory complications develop in many people as Parkinson’s progresses, so attention is paid to monitor and manage encroaching weakness of respiratory muscles and rigidity of the thoracic cage.

Physiotherapy Management includes:

 Visual cueing

  • Auditory cueing
  • Proprioceptive cueing
  • Dual task training
  • Intensive sports training
  • Treadmill training with body weight support
  • Resistance training
  • Aerobic exercise

Benefits of exercise in PD?

Exercise can benefit in two ways:

Symptom management.  Research has shown that exercise can improve gait, balance, tremor, flexibility, grip strength and motor coordination.  Exercise such as treadmill training and biking have all been shown to be beneficial.

Possibly slowing disease progression.  Improved mobility decreases the risk of falls and other motor complications of Parkinson’s.

How can you benefit from exercise?

The best way to achieve these benefits is to exercise on a consistent basis. People with Parkinson’s enrolled in exercise programs with durations longer than six months, regardless of exercise intensity, have shown significant gains in functional balance and mobility as compared to programs of only two-week or ten-week durations. Furthermore, when it comes to exercise and PD, greater intensity equals greater benefits. Intense exercise is exercise that raises your heart rate and makes you breathe heavily.

 Should exercise be done well before major motor symptoms of PD occur?

In PD, a special kind of neuron—brain cells—that produces the chemical transmitter dopamine gets damaged and lost. There is a lag between the time when the loss of neurons begins and the time when Parkinson’s motor symptoms start to show. By the time most people are diagnosed, as much as 40-60 percent of their dopamine neurons are already gone.

The reason that people with Parkinson’s don’t experience symptoms until they reach this point is that the brain can compensate for the loss of dopamine neurons by gradually changing to adapt to the situation.

In fact, the brain reshapes itself throughout life in response to experience. Scientists call this ability to change and compensate experience-dependent neuroplasticity.

 How does exercise change the brain?

Researcher found that the ones that had exercised, the brain cells were using dopamine more efficiently. They also found that exercise improves that efficiency by modifying the areas of the brain where dopamine signals are received — the substantia nigra and basal ganglia.

group doing stretches to warm up and cool down

Calf Pain

Written by Alison Stickel

In the midst of the summer, many become more involved in the outdoors with cycling, hiking and more. Patients often present us with really sore and tight calf pain as a result. The calf can easily be injured due to overexertion and improper stretching before exercise.

The calf anatomy is made up of two muscles. The gastrocnemius is the largest muscle and bulge you see as your calf. The smaller and more intrinsic muscle deep below the gastrocnemius is the soleus muscle.  Acute muscle strains can occur in both muscles. The larger gastrocnemius muscle is more commonly affected or injured.

Symptoms of calf muscle strains can include:

  • Pain with calf stretching
  • Tenderness at the muscle
  • Tightness of the muscle
  • Pain with exertion of the calf
  • Pain with the raising the heel (especially on steps)

Treatment is necessary because overuse of the calf muscle can lead to thickening of the tissue and predisposing the calf to further injury. Overuse can also cause muscle imbalances and compensatory movement and walking patterns that can lead to other biomechanical issues.

Treatment from a physiotherapist will help reduce pain, tightness and prevent re-injury. Treatment techniques include:

  • Deep and soft tissue work to release tension In the muscle
  • Dry needling
  • Hot and Cold Therapy
  • Massage Therapy
  • Tailored stretches and exercises for muscle re-strengthening
calf pain