Paediatric musculoskeletal (MSK) problems can cause symptoms such as pain, weakness or reduced function and can affect a child’s bones, joints and muscles. Musculoskeletal problems are quite common in children especially as their bodies are still growing and developing. These problems can affect children in a number of ways and prevent them from participating in normal activities.
Musculoskeletal problems can be caused in a number different ways. Children can injure themselves just as easily as adults and can be especially common in very active or sporty children. Some children may have a congenital problem which means they are born with a musculoskeletal condition. Another major common factor is often the growth and development of the child which can cause pain as the body changes in size and shape.
At ICE we are very fortunate to have Nicola Shaw, an experienced Paediatric Musculoskeletal Physiotherapist, who specialises in the management and treatment of these of these conditions.
Choose a Clinician
Over the last 20 years we have been very fortunate to work with some excellent doctors and specialist consultants. There are cases where your problem may require some more in-depth investigation or a more medical/surgical approach to resolve your complaint. At ICE we are able to make the following onwards referrals: –
Diagnostics
In addition to our in-house ultrasound diagnostic service we are also to refer you for further diagnostic Imaging such as X-Rays or MRI scanning to a local hospital or scanning centre.
Injection Therapies
We are able to refer you to specialist consultants for treatments such as Platelet Rich Plasma (PRP) Injections and Corticosteroid injections in the case of soft tissue complaints and a variety of injection treatments for degenerative joint symptoms.
Surgical Procedures
There are some situations where a surgical approach gives you the only realistic possibility of recovering your physical function whether it be a shoulder, lower limb or spinal condition. If having surgery is a prospect for you then at these concerning times you’ll want to know you’re in good hands. At ICE we are able to refer you to a number of excellent and experienced consultants that we have worked closely with and are able to recommend on previous results rather than who might just look suitable on an internet search engine.
In the case of Private Medical Insurance these onward referrals will usually be made via your General Practitioner and in the case of self-paying patients these referrals can usually be made directly.
Physiotherapy that concentrates specifically on treating Women’s and Men’s Health; conditions associated with the pelvis (Also referred to as Pelvic Health). Treatment involves a detailed and skilled assessment of the musculoskeletal system as well as the muscles inside the body known as the pelvic floor.
Many Women and Men suffer in silence when it comes to pelvic health, maybe, unaware that a solution is out there, or assume it’s a normal part of ageing or having a child. This is not the case.
Often people feel too embarrassed to seek help, on average its takes women and men 4-7 years of suffering before going to visit a health practitioner.
Physiotherapists in this area are very experienced and a large part of their job is to understand the taboo and embarrassment people feel when managing these highly sensitive conditions. It is one of the reasons our specialist, Teja, feels so passionate about helping this client group.
Clinical evidence supporting this type work is very strong, as a result the NICE guidelines for urinary incontinence recommend that physiotherapy should be first line management.
What does it treat?
Pregnancy related back and pelvic health conditions – antenatal and postnatal:
Pelvic girdle pain
Symphysis pubis dysfunction
Coccyx pain
Back pain
Thoracic Pain
Wrist and Shoulder Pain (associated with pregnancy)
Diastasis Rectus Abdominis (Separation of the abdominal muscles)
In pregnancy the body starts to change from as early as conception, involving the pelvis and the pelvic floor muscles. Statistics show that up to 80% of women can develop some form of back or pelvic girdle pain and in a smaller percentage, this can become severe. Specialists work to restore function and reduce pain throughout pregnancy and the postnatal period using a variety of techniques including manual therapy techniques, myofascial release, advice and exercise.
The Mummy MOT
The Mummy MOT is a postnatal detailed physiotherapy assessment of the abdominal and pelvic area that specifically checks:
Tummy gap
Pelvic Floor
Posture
Breathing
You will receive a report of the findings and an appropriate safe exercise programme will be prescribed.
The Mummy MOT identifies muscle imbalances through the assessment and the restorative exercise programme corrects them, regaining stability and allowing optimal function.
The Mummy MOT is performed by a Specialist Women’s Health Physiotherapist and is designed for all women who have had a baby so whether you are 6 weeks or 6 years postnatal the Mummy MOT is for you.
Teja works closely with local postnatal Pilates and fitness specialists in order to progress your fitness effectively and safely.
Here is a short video by Maria Elliott, the founder of the Mummy MOT, explaining more – here
Pelvic Floor related conditions
Bladder
Stress urinary incontinence
Urge urinary incontinence, urgency and frequency
Nocturia (waking during the night to empty bladder)
Giggle incontinence
Bowel
Faecal incontinence
Defecation disorders
Constipation
Vaginal prolapse
The feeling of something coming down, bulging sensation
Pelvic pain
Pain in and around the pelvis
Pain in the genitalia
Sexual pain
Erectile dysfunction
The pelvic floor is a complex group of muscle that forms a bowl shape in the base of the pelvis. These muscles are fundamental in supporting the bladder, bowel and womb. If the pelvic floor muscles are not working properly this can result in a number of symptoms, for example leaking, urgency and vaginal prolapse. The pelvic floor undergoes significant change during pregnancy and delivery, and can cause dysfunction in up to 1 in 3 women. The pelvic floor muscles change throughout life, meaning that menopause is another time when women can start to experience symptoms. Specialist physiotherapists, are able to, assess and treat these muscles, which may be underactive, overactive or both! Overactive pelvic floor muscles can cause pain in and around the pelvis and genitalia, or painful intercourse. In these circumstances detailed assessment may reveal the need to release these muscles, allowing the pelvic floor to relax and be re-taught to work correctly again.
Men’s Health
Men also have a pelvic floor and sometimes this can become weak causing urinary incontinence (urge or stress) or erectile problems. Overactive pelvic floor muscles can cause pain in and around the pelvis, prostatitis or perineal pain.
Benefits:
Restore function
Reduce Pain
Restore quality of life
Training & Experience:
A Women’s and Men’s Health Physiotherapist must undergo the same training as a Physiotherapist, gaining an approved degree and practicing for 2-3 years in a hospital or practice. They then need to undertake further training to specialise in the pelvic area and gain full membership with the POGP (Pelvic Obstetric and Gynaecological Physiotherapy), achieved by completing MSc modules in Pelvic Health.
FAQ’s
Will I need Internal examination? Your physiotherapist will talk through your symptoms and medical history and carry out an assessment, this may involve an internal assessment with your consent and after discussion.
Can I bring or request a chaperone? Yes absolutely, if that makes you feel more comfortable. Some people feel happier to attend alone and this is fine too, the most important thing is you don’t delay and see someone about your problem.
Can I still come if I am on my period or bleeding? Yes you can, as you may not require an internal assessment on every visit.
How many sessions will I need? This depends on your diagnosis; your physiotherapist will be able to discuss recovery time and put a plan in place with you after the initial assessment. Between the two of you, you can keep reviewing your progress and amend your treatment plan if necessary.
What should I wear? It is recommended that you wear loose, comfortable clothing to your appointment, so your clinician can easily access the area that needs treating.
Will it be painful? You shouldn’t experience any pain you cannot tolerate, some people may find parts of their treatment uncomfortable, depending on the problem, but your clinicians should tell you what to expect. If anything is getting too uncomfortable it’s important you tell your clinician immediately.
Do I need to see a Doctor or Consultant first? Not at all, you can just call up and book an appointment.
Is it safe to have treatment when pregnant? Physiotherapy is safe throughout your pregnancy and after, but it is important you let your physiotherapist know you are pregnant and any relevant details. Your Physio will take a full obstetric history and will adapt treatment as necessary
I feel embarrassed about discussing my problem and being examined? Many people feel this way, but please be assured you will be treated with complete discretion and compassion and we will have seen the problem many times before – they are more common than you may think. But if you are feeling anxious just let your clinician know and they will do their best to ease this anxiety and answer any questions you may have.
Do I need to bring anything else with me? In most cases the answer to this question is no, come as you are. However, if you have a diagnosis from a doctor it would be useful to have this information with you.
Choose a Clinician
Shockwave therapy is a safe, non-invasive treatment for soft tissue injuries. Shock waves are directed to the site of the injury through a special treatment probe.
During Shockwave therapy, high energy sound waves are applied to the injured area to break down any scar tissue and calcifications which your body may not be able to repair itself. As the tissue is broken down by the shock waves the body starts building up a new tissue to replicate the body’s own self -healing process.
The first medical treatment with shockwaves was lithotripsy. This allowed focused shockwaves to essentially dissolve kidney stones without surgical intervention. Today, over 98% of all kidney stones are treated with this technology. The use of shockwaves to treat tendon related pain began in the early 1990s.
Benefits:
Pain relief
Non surgical
Non Invasive
No medication
Fast Treatment
Minimal Complications
Succeeds where other treatments have failed
70-90% significant or total resolution in difficult chronic cases
What does it treat?
Heel pain/ Plantar fasciitis
Achilles tendon pain
Shin pain/Shin splints
Knee pain (patellar tendonitis)
Hip pain (tendinopathy)
Tennis elbow
Golfers elbow
Shoulder pain
High Hamstring pain
Training required:
You must undergo training in the use of Shockwave treatment for chronic tendon problems
FAQs
How long do treatments sessions last?
The actual shockwave treatment is quick and non-invasive it usually takes between 4-8 minutes to deliver, sessions usually last up to 45 minutes and would include:
Education about managing chronic tendon pain
Manual therapy
Specific exercise programme
Shockwave treatment
Post Shockwave advice
The most common shockwave treatment process is 4 to 6 sessions, with 5-10 day interval between treatments.
How long before I see a difference or am fully recovered?
Some patients see immediate results others see improvements over time, it really depends on the person and the problem. On average treatments are required once a week for approximately four weeks. In 20-30% of patients there is a chance that they will see no or little improvement as this treatment isn’t for everyone.
Will it hurt?
Treatment can be uncomfortable, but you should not experience pain at a level that cannot be tolerated. Don’t be concerned if discomfort increases again 2-3 weeks after – this is the repair process. Do not take NSAID’s (Non-steroidal anti-inflammatory drugs) or ice for 48 hours after the treatment and make sure you take things a little easier.
Are there any side effects?
Generally, patients do not experience any side effects.
Some potential side effects are:
Brusing
Swelling
Redness
Localised discomfort or numbness
These side effects should only last from a few hours to a few days.
There is a very small risk of tendon or ligament rupture in some cases
Will I be able to go back to work/drive immediately after treatment?
Yes, in the majority of cases there should be no reason you cannot carry on with your day to day activity as normal, however as with any treatment we would recommend you take things a little easier after treatment.
Are there any conditions that would prevent me having Shockwave Therapy?
Yes, you are unable to receive Shockwave therapy if you have any of the following and must inform your physiotherapist immediately:
Under 18 years of age
Hemophilia
Anticoagulant Medication
Active blood clots (DVT)
Pregnancy or trying to conceive
Active Cancer disease
Corticosteroid Injection in the last 6 weeks
What should I wear for treatment?
As with a physiotherapy session we recommend loose, comfortable clothing that allows access to the problem area.
Do I need to bring anything else with me?
No, just bring yourself.
How do I know if this treatment is right for me?
Your Clinician will be able to advise if this treatment is for you. The treatment isn’t for everybody, its generally used when a patient hasn’t responded to traditional therapies and the have been struggling with their condition for at least 6 months.
Is it expensive?
Shockwave Therapy is £60 a session, £165 for 3 sessions or £300 for 6 sessions. Although shockwave therapy is more expensive than traditional physiotherapy, it does require investment in the latest technologies and maintaining these and we are confident it will provide a fuller and faster recovery to most patients with chronic pain. If you have Private Medical cover your insurer may cover the cost of Shockwave Therapy, please contact them to check your level of cover.
Chartered Physiotherapists combine their knowledge and skills to treat a broad range of disorders of the musculoskeletal system. The term musculoskeletal refers to:
Muscles & Tendons
Bones & Joints
Nerves
Ligaments & Cartilage
Spinal Discs
Physiotherapy management consists of a range of approaches including manual assessment and treatment techniques, specific therapeutic exercise, manipulation, acupuncture, electrotherapy and advice on posture and movement disorders.
Benefits:
Pain relief
Long term improvements in joint mobility
Better coordination and improved strength
What does it treat?
Physiotherapy offers a variety of specialised services of benefit to patients with:
Traumatic & non-traumatic work related injuries
Sports injuries
Joint & Nerve Injuries
Neck Pain & Headaches
Arthritis
Back Pain & Sciatica
Fractures & Dislocations
Muscle and ligament injuries
Post-operative rehabilitation and recovery
Training required:
Becoming a physiotherapist takes a minimum of 3-4 years of degree training. To practice as a physiotherapist, you must be registered with the Health and Care Professions Council (HCPC). In order to register with the HCPC, you first need to successfully complete an approved degree (BSc) in physiotherapy. Courses can differ but all involve a lot of practical therapy.
Once qualified most physiotherapists ‘rotate’ around different specialists within an NHS hospital, a process that lasts 2-3 years. Successful completion of these rotations usually leads to a more senior role within a certain specialty. Some senior physiotherapists choose to center with the NHS while others might move into private practice.
Once registered as a practitioner, you’ll be required to retain your name on the register by keeping your knowledge and skills up to date.
It is really important to ensure that your physiotherapist or anybody treating you has the right qualifications and training.
Take a look at our Physiotherapy team, you can read about their training and experience as well and look at each of the specialisms to help you decide the Clinician most suited to you and your injury. Or if you’d prefer, our reception team will be more than happy to advice the best clinician for you when you call to make an enquiry or book an appointment.
FAQs
How long do treatments sessions last?
An initial consultation can take up to 45 minutes depending on problems any follow up treatments take upto 30 minutes.
How long before I see a difference or am fully recovered?
Recovery time can vary, some patients see immediate improvements whilst others take a few sessions before they start to notice a difference. Likewise some patients will achieve complete recovery, whilst others achieve improvements and some pain relief. We can usually give a more accurate recovery time and diagnosis after the initial consultation
Will it hurt?
You shouldn’t experience any pain you cannot tolerate, some people may find parts of their treatment uncomfortable, depending on the problem, but your clinicians should tell you what to expect. If anything is getting too uncomfortable it’s important you tell your clinician immediately.
Will I be able to go back to work/drive immediately after treatment?
Yes, in the majority of cases there is no reason you cannot continue with the day to day activities you were doing before your appointments. Although it may be advisable to take things a little bit easier after treatment but it’s very unlikely you will experience any serious side effects.
What should I wear for treatment?
This depends on the area that needs treating, generally its recommended you bring a pair of shorts and wear comfortable, loose clothing so the Clinician can easily access the area that is causing you a problem. i.e Shorts for a knee problem
Do I need to bring anything else with me?
In most cases the answer to this question is no, come as you are. However if you have had an MRI scan or a diagnosis from a doctor it would be useful to have this information with you.
Osteopathy explores the link between the structure of the human body and the way it functions.
Osteopaths develop a highly sensitive sense of touch and use this to identify problem areas of the body.
Using gentle stretching and mobilising techniques, as well as manipulating joints, an osteopath works with the body to create the perfect conditions to facilitate the healing process.
Treatment usually consists of:
soft-tissue releasing techniques
specific adjustments, affecting joints and muscles, tendons and ligaments.
helping to restore normal joint stability and function
Advice can also be given on self-help treatments.
Osteopaths usually start any treatment by releasing and relaxing muscles and stretching stiff joints, using gentle massage techniques, rhythmic joint movements and muscle release techniques.
The osteopath may also carry out manipulation using short, quick movements to spinal joints.
Chiropodists specialise in providing professional advice on proper foot care to patients of all ages and walks of life.
Typical work activities and services provided by Chiropodists include (but are not limited to):
Treatment of corns, callouses, verrucas, in-growing toenails, and fungal infections.
Long-term management of chronic disorders with therapeutic techniques, such as minor surgery using local anaesthesia
Monitoring and managing foot problems and deformities caused by diseases such as rheumatoid arthritis and advising and treating patients at high risk of foot problems and amputations such as sufferers of diabetes.
Analysing a person’s way of walking or running, correcting any problems by prescribing, producing and fitting orthotics and other aids and appliances.
Delivering foot healthcare education, in particularly to vulnerable groups in society such as the elderly and children
Working closely with other medical practitioners, for example, orthopaedic specialists, GPs and health visitors in providing health care.
Cranial Osteopathy involves subtle and gentle realignment of the skull, spine and pelvic bones and the tissue that surrounds those bones in order to improve their mobility and the circulation of fluid surrounding the central nervous system to improve its function.
Cranial Osteopathy can be used on almost anyone from new born babies to the elderly.
Cranial Osteopathy for Babies may help with:
Colic
Crying
Feeding Difficulties
Sleep Disturbances
Cranial Osteopathy for Adults may help with:
Neck/ Back pain
Headaches
Digestive Problems
Arthritic & Joint Pain
Many people choose Cranial Treatment as they prefer it to stronger techniques or manipulations used in general Osteopathy. Others may not be able to have stronger techniques applied to them for medical reasons (i.e. Osteoporosis).
Cranial Osteopathy can be used by itself, or in conjunction with other treatments.
Acupuncture is the insertion of needles into the skin and underlying tissues in key trigger points.
Stimulation of these points is thought to induce rhythmic discharges which cause a release of endorphins, the body’s natural painkillers and certain hormones into the system.
All physiotherapists may use acupuncture as an adjunct to their conventional treatment if required
Podiatry is concerned with the diagnosis and the treatment of foot and leg conditions and the podiatrist is well placed to liaise with other health professionals to support the patient and their family.
With foot, ankle and lower limb problems being so widespread, the need for podiatric care is increasing, and the ways in which these problems are treated is always progressing.