Spinal Pain? We've Got Your Back!

Source: Lyman, K.J., Gange, K.N., Hanson, T.A. and Mellinger, C.D., 2017. Effects of 3 different elastic therapeutic taping methods on the subacromial joint space. Journal of manipulative and physiological therapeutics , 40 (7), pp.494-500 Kinesiology tape (K-Tape) is a form of therapeutic elastic tape which has been commonly used by various healthcare professions. The developers hypothesise that the tape has similar thickness and elasticity similar to human skin can be used to help offload, stabilise and increase or inhibit muscle contraction based on the way it is applied. However, results of clinical trials have often been either inconclusive or conflicting, highlighting the need for further research. Shoulder Impingement Syndrome is a common shoulder condition which is theorised to be a narrowing of the subacromial space ultimately affecting the subacromial bursa, supraspinatus tendon or both. However, research is now highlighting that such mechanisms may not be present and the term ' subacromial pain syndrome' is now used more widely. K-Tape has often been used to help treat people which such shoulder complaints, and previous studies has looked an patient reported outcomes such as pain and disability - however very studies look to examine the physiological change at the shoulder change following the application of tape. A study by Lyman et al (2017) looked to 'evaluate the underlying physiological effects of the elastic therapeutic taping methods on the subacromial joint space in healthy individuals by using musculoskeletal diagnostic ultrasound' Study Design 48 people were recruited for this study, 24 males and 24 females, with ages ranging from 18-59 years with NO history of shoulder pain in their dominant arm. An ultrasound machine was used on each participant to establish their baseline acromialhumeral distance. The shoulder was then taped in 1 or 3 ways: 1) Taping of supraspinatus from origin to insertion 2) Taping of anterior and posterior deltoid from origin to insertion 3) A combination of both Following the application of the tape, the participant was instructed to rest for 5 minutes before the acromihumeral distance was measured to note any difference. Outcome These more granular results demonstrate that taping of the anterior and posterior deltoids has a statistically significant effect. In contrast, neither taping of the supraspinatus alone nor taping with both techniques increased the measured distance at a statistically significant level. In every case, the measured space increased after taping. The measured effect was larger in women than in men. My View This study highlights that taping the deltoid muscle can improve the subacromial space when examined under ultrasound and could be a useful form of adjunctive treatment when helping people with shoulder pain and alongside a comprehensive rehabilitation programme. However, this study was performed in healthy subjects and further research translating this research to those with shoulder pain to examine whether there are similar outcomes and whether pain and disability improves as a result

Source: Akshay Date & Luthfur Rahman (2020) Frozen Shoulder: Overview of Clinical Presentation and Review of the Current Evidence Base for Management Strategies, Future Science OA, 6:10, FSO647, DOI: 10.2144/fsoa-2020-0145 Frozen shoulder is a common condition which occurs in approximately 2-5% of the population with a peak incidence between 40-70 years of age. It is characterised by varying levels of pain and limitation in range which is more common in women and can occur in both shoulders in roughly 20-30% of cases. While frozen shoulders are normally self limiting, symptoms can continue for a number of years with varying levels of pain and functional limitation and in some instances may never fully resolve. There are 2 reasons why people can go on to develop frozen shoulder: · Primary : The most common presentation where pain and limitation are noted however without an underlying cause · Secondary : Frozen shoulder can occur following trauma, shoulder surgery, prolonged immobilisation, diabetes, thyroid disease or other autoimmune disorders Pathophysiology and presentation The reason as to why people develop primary frozen shoulder is still not full understood, however research has shown that the joint capsule that surround the shoulder becomes thickened and tight with evidence of inflammatory cell within the capsule with some suggestion of an autoimmune cause for primary shoulder pain. It is proposed that there are 4 stages of frozen shoulder that is demonstrated in the table below. Ther onset of symptoms however can be gradual over a period of months with symptoms being poorly locaused and reported as a deep ache, with night pain being an common feature. On examination people usually demonstrate good rotator cuff strength and no specific tenderness on palpation however a marked loss of range of movement, partiucuarly into rotation. As frozen shoulder affects the joint capsule, any form imaging such as an x-ray is normal but can helpful to rull out any other types of pathology.

Lower back pain is incredibly common, and is the leading cause of disability globally. While painful, symptoms are seldom anything to be concerned about and in fact the prognosis for recovery is good - typically 8-12 weeks. For some, people with lower back pain report symptoms that can be felt into the leg. More often than not, people who experience such symptoms have either been told or report that they have 'sciatica'. However, over the years sciatica has been used as an umbrella terminology to describe ANY pain felt in the leg when actually there are several reasons this may occur, two of these causes are: Neuropathic Pain: Defined as 'pain caused by a lesion or a disease of the somatosensory nervous system'. In other words, back pain associated with a disc herniation, which causes compression of the nerve leading to symptoms down into the leg Nociceptive Pain: Defined as ' pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors. Nociceptors are triggered by mechanical, chemical, or thermal stimuli arising from all innervated structures’. In other words, pain that arises from another structure around the lower back but not associated with nerves. It's important to attempt to identify whether the pain is associated with the nerve of another structure as ultimately the treatment moving forward will vary. So, are there different symptoms that people experience that could help differentiate between neuropathic (nerve) and noiceiptive (other structure) pain? Fourre et al have identified common signs and symptoms which can help (see below)

Recently. the UK Government announced changes to their guidance and laws on how to manage the COVID-19 Pandemic. According to the recently published 'Living with COVID-19', regular asymptomatic testing and required self isolation should you test positive has been removed. However, the UK government still recommend: Wearing a face covering in crowded and enclosed spaces Testing if you do develop symptoms (the NHS still suggest that a temperature, loss of sense of taste or smell and a new continuous cough are the most common signs) Stay at home if you are unwell Regular hand washing The current recommendations the Public Health England Infection Protection and Control Teams is that PPE shall continue within a healthcare setting until advised otherwise. Therefore Matt Ross Physiotherapy shall continue with: The wearing of full PPE Strict cleaning procedures both before, after and inbetween patient appointment times Sufficent gaps in between patients to ensure adequate social distancing While facemasks have not been mandatory for a while now, the clinic has a broad range of clients from different ages and diffent medical conditions and I have a duty to ensure everyones safety during this time. I therefore kindly request that all clients continue to wear a face covering whilst on the premises (unless medically exempt or for any other valid reason). If you feel unwell, please do not attend your appointment and notify me so we can arrange at your earlies convenience This guidance will be reviewed on the 1st April 2022. Many thanks for your continued support.

Matt Ross Physiotherapy has been established for almost 3 years and throughout this time I have had the pleasure of helping hundreds of clients with various conditions. Since the very start I have always aimed to provide professional, evidence based physiotherapy ensuring people receive interventions based on the recent scientific evidence and I am delighted to receive positive feedback as well as recent awards from Global Health and Pharma. As a result of increased demand I am delighted that the clinic has changed it's opening times to enable more people to receive the very best physiotherapy in Chelmsford. The clinic times are as follows: Monday to Wednesday: Closed Thursday to Saturday: 8.30am to 6pm Sunday: 10am to 4pm. Emergency appointments may be available at request - please contact directly. Booking appointments has never been easier and can be done by clicking the 'instant booking' located at the footer of the webpage. This is the very first step in developing the services and availability of the clinic and I am looking forward to many more exciting developments in the next to distance future! Kind regards Matt Ross 

From Monday 19th July 2021, Boris Johnson and the UK government announced plans to lift all remaining COVID restrictions which includes social distancing the the use of face masks. While this a great step in our return to normality based on the amazing efforts of the UK public and the vaccine rollout, it's clear that the number of UK infections are continuing to rise sharply. Your health, safety, and well being are of huge importance to me at the clinic and I will continue with: The wearing of full PPE Thorough cleaning between customers Gaps between appointment times to ensure that you do not come into contact with other customers. Personal lateral flow testing 2 times per week. While during our consultation I try to maintain social distancing as much as possible, the nature of our profession means that in order to perform an objective assessment may require close contact. In light of this, and for the safety of both you and I, I would be grateful of you would continue wearing a face covering throughout your time in the clinic. If you are mask exempt then please let me know prior or at the start of your consultation. If you require physiotherapy and are still concerned about attending a face to face clinic then don't forget that I still offer home visits and virtual consultations. Thank you for your continued support and understanding and please stay safe. Kind regards Matt

I am absolutely delighted to announce that Matt Ross Physiotherapy has won the 'Best Emerging Physiotherapy Clinic in Essex' accolade following nomination in the 2021 GHP Private Healthcare Awards. These annual Healthcare & Pharmaceutical Awards, organised by Global Health and Pharma, recognises the tireless work undertaken by companies, individuals and initiatives that contribute towards promoting the physical and mental welfare of those in need of support and I am delighted to be acknowledge by the GHP judging panel. Since the opening of the clinic back in 2018, I have always ensured that those who required physiotherapy treatment received the very best, evidence based and holistic interventions, making sure that people fully understand their condition and how to work together to aid their rehabilitation and I'm confident that over the coming years the clinic will continue to go from strength to strength. Lastly, thanks to all my friends and family for your continued support throughout this journey and to all my clients, old and new, for your kinds words and trust over these last few years. Matt

Dear all, On Monday 4th January 2021, Boris Johnson and his government announced a new national lockdown in an attempt to reduce the high rates of transmission and infection that is circulating throughout the UK. This new lockdown is similar to that of March 2020, however I am delighted that the government has decided that Physiotherapy services are 'essential' and in accordance with advice from the Chartered Society of Physiotherapy, services will remain open. Matt Ross Physiotherapy will continue to follow strict and thorough cleaning protocols to ensure the health and safety of everyone. This includes: Temperature check and hand sanitiser on arrival With one clinic room this ensures that you will not come into contact with anyone else other than the clinician Full PPE worn throughout the consultation Following the 1 meter+ rule where able Lengthened time between appointments to enable through cleaning of the clinic  I understand that some people may require physiotherapy services and are unable to attend as they are concerned about the current situation or currently shielding. You'll be pleased to know that there are a number of different options available: Telephone and Video consultations Ask the Expert Q&A section FREE lockdown exercises These next few months will no doubt be difficult for everyone but with the current vaccine programme accelerating there appears to be light at the tunnel. However should you have any physiotherapy needs during this time or have any questions please feel free to let me know. Stay safe. Matt

Dear all, As you are no doubt aware, Boris Johnson and the government announced further restrictions and implemented tier 4 in an attempt to reduce the rate of transmission of the virus. This sadly means the closure of non-essential retail and services. After further investigation and consultations with our governing body I have been informed that physiotherapy are deemed an essential service and therefore, according to government guidelines, face to face appointments are available as usual. Your health and safety during this time has always been of high importance and I will continue to maintain the high standards of cleanliness that I have done throughout the whole year which includes significant gaps between appointments to allow thorough cleaning, full PPE and temperature check on arrival. I understand in light of current circumstances you may have concerns about attending a face to face appointment and in this instance I am pleased to be able to offer telephone / video consultations. Please let me know if you would prefer this type of appointment. Also, please take a look at the FREE lockdown exercises that I have created that will help keep you fit and healthy during this time. Many thanks for your continued support. And while it will certainly be different this year, I want to wish you a very Merry Christmas, no matter how you celebrate it, and a happy and healthy New Year. Matt