COMMON PROBLEMS
  • Head

  • Neck

    • Stingers and burners: very common injury in football and any other contact sports, caused by nerve compression from impact to the neck and shoulder area. This is accompanied by transient upper extremity pain, pins and needles and a burning sensation down the arm towards the hand on the affected side.
    • Nerve root compression: most patients report moderate to severe arm pain which may or may not be accompanied by neck pain. It is usually a cause of a prolapsed or herniated disc in the neck applying pressure on the nerve, as it exists which causes the pain. It can be found in the older population and may even be of an insidious onset.
    • Whiplash: Most common injury with motor vehicle accidents or sporting injuries usually a cause of hyper-extension of the upper neck due to the sudden acceleration to deceleration. The pain may take up to 48 hours to become evident and may refer down the shoulders and arms with headaches.
    • Cervical postural syndromes: The most common poor posture alignment with the pocked chin, hunched back, rounded shoulders which are seen in the older population but unfortunately in the younger generation which slouch whilst sitting in a chair at school. This is due to tight muscles, stiff upper back, restricted shoulder movement, and adopted prolonged poor posture.
    • Acute Wry neck: very common neck pain usually due to quick and sudden movements or when upon waking from sleep. It presents with extreme pain on movement and limitation of movement due to muscle spasms. The neck stiffness and moves away from the side that has been injured.
    • Thoracic Outlet syndrome: this is when the nerves and/or blood vessels are compressed between the anterior and middle scalene muscles in the neck. This may occur due to the abnormal compression of the clavicle (collar bone) with the shoulder girdle on arm movement.
  • Shoulders

    • Frozen shoulder (adhesive capsulitis): This affects the movement of the shoulder which usually deteriorates over time. This is due to the inflamed capsule of the shoulder. Research can’t tell us why this occurs but is common in the mid to old aged population. This condition will resolve over a prolonged period of up to 18-24 months.  
    • Rotator cuff injury/ tendinopathy: is an injury to any of the four rotator cuff muscles. Tears or inflammation are usually due to sudden and powerful movements, or gradually over time due to wear and tear. Common injuries are falling out on an outstretched arm, or making a powerful and sudden thrust movement in a sporting activity. The symptoms that people may experience are a sudden tearing feeling in the shoulder with pain, limited movement of the shoulder with pain, specific tenderness on shoulder, and pain which is worse at night and affecting sleep
    • Dislocated shoulder: is the common injury on a sporting field. Usually the shoulder dislocates forward or backwards. It needs immediate attention and relocated by a trained medical professional. You will need to obtain an x-ray to eliminate the risk of a fracture. If you have had recurrent dislocations then you should seek advice from your medical advisor. 
    • Fractured Clavicle: usually caused by falling on an outstretched arm, on the point of the shoulder. The clavicle (collar bone) usually fractures in the middle third
    • Winged Scapula/ scapular instability: usually a cause due to another injury or problem underlying within the shoulder complex, it’s when the shoulder blade protrudes out on the back, rather than laying flat on the back of the chest wall. You may need an assessment of your shoulder girdle
    • Subacromial bursitis: Have similar symptoms to supraspinatus tendinitis with shoulder pain over a 60o arc when lifting your arm sideways. It may restrict your range, but it may not be that painful when testing resistance (this is how to distinguish between this and a shoulder tendon that may be injured)
    • Shoulder Impingement syndrome: usually known as throwers shoulder or swimmer shoulder, it is caused by the tendons of the rotator cuff muscles been impinged by the shoulder joint with movements above the head.
    • AC joint injury:  injury can be caused when the ligaments that connect the two bones that make up the joint (acromion and clavicle) are damaged, usually from a fall onto an outstretched arm. Symptoms include localised pain at the end of the clavicle, and swelling
    • Gleniod Labrum tear: A tear may occur when there is repetitive throwing, lifting heavy objects below shoulder height, catching heavy objects or falling onto an outstretched arm. Pain which cannot be localised to one spot and when lifting overhead, weakness and tenderness are some of the symptoms
    • Shoulder sublaxation: sublaxation is a partial dislocation of the shoulder joint. It can be caused by instability of the shoulder and can be associated with pain and/or dead arm sensation
    • Fracture of the neck of the humerus: a break at the top of the humerus. It is caused by either falling onto an outstretched hand or a direct impact to the shoulder. Often seen in young adults, adolescents and the elderly.
    • Long head of bicep/ Pec major tears: symptoms include a sudden sharp pain at the front of the upper arm, pain and swelling over the front of the shoulder joint, and increased swelling through the bicep or pectoral region
    • Scapula fracture:  a break in the shoulder blade bone at the back of the shoulder. It includes sudden pain in the back of the shoulder, pain when trying to move the shoulder or upper back. Difficulty raising arm above head, tenderness over the shoulder blade, swelling and creaking or clicking when moving the arm. It can be caused by a direct impact to the scapula from a blunt object or from a fall onto the arm or shoulder. Car crashes are amongst the most common causes of this type of injury
  • Elbow/Forearm

    • Tennis elbow/lateral epicondylitis: a common injury that causes pain on the outside of the elbow. Weakness in the wrist can also occur when doing everyday tasks.  It can be caused by overuse or repetitive strain caused by repeated extension of the wrist against resistance or using a screwdriver, typing or painting a lot. It can also be caused by poor technique in tennis as well as the racquet grip being too tight, strings being too tight or playing with wet heavy balls
    • Golfers Elbow: is very similar injury to tennis elbow only it occurs on the inside of the elbow. It is most common in throwers and golfers. Weakness of the wrist can also occur and is caused by repeated wrist flexion such as carpentry. The muscles on the palm side of the forearm become painful and inflamed at their attachment point on the inner side of the elbow
    • Students elbow: also known as olecranon bursitis. It is an inflammation and swelling of the bursa that protects the bone at the back of the elbow. It can be caused by traumatic or repetitive impacts to this area
    • Broken arm: is a break in one of the bones that form the elbow joint (either the humerus, ulna or radius). It can be caused from a fall directly onto the joint or a hard impact to the forearm. It can also be caused from falling on an outstretched hand or from a strong muscular force.
    • Elbow hyperextension injury: occurs when the elbow is over-straightened or bent the wrong way. Occurs mostly in contact sports such as rugby league and martial arts. Because of the over-straightening, it can cause damage to the ligaments and structures of the elbow
    • Radial nerve entrapment: entrapment of the radial nerve can occur in people who pronate and supinate their arm repetitively. Symptoms include pins and needles or tingling in the hand and outer forearm, tenderness in the muscles in the upper forearm, aching in the wrist and pain radiating into the upper arm sometimes
    • Cubital tunnel syndrome (a.k.a Funny Bone): the cubital tunnel is an area on the inner side of the elbow in which the ulnar nerve passes through. If there is a problem, the nerve gets compressed and is a form of neuropathy. Tingling or numbness on the outer border of the hand, into the little finger and the side of the ring finger can occur. Also weakness in gripping and difficulty with tasks requiring fine motor control can occur along with pain at the elbow
  • Wrist/Hand

    • Carpel Tunnel syndrome: caused by the median nerve being compressed in the wrist.  These includes traumatic wrist injuries like sprains and broken wrists, repetitive use of the wrist, pregnancy (caused by fluid retention in the wrist), vibrating machinery use, congenital (as some people have a smaller narrower carpal tunnel and arthritis
    • Repetitive strain Injury – RSI: caused by repetitive movements of the wrists or fingers.  For example, typing, racket sports, musicians and manual and production line workers. Symptoms include pain, dull ache, throbbing, tingling, numbness and tightness
    • Colles fracture of the wrist: is a break at the wrist end of the radius.  Symptoms include instant pain at the wrist, deformity of the wrist called a dinner fork deformity, swelling, bruising, and pain when moving the wrist. It is caused by a fall onto an outstretched hand
    • Scaphoid fracture:  the scaphoid is one of the small bones in the wrist known as the carpal bones. It is the most common carpal bone to be fractured and is often caused by falling onto an outstretched hand
    • Mallet finger: in an injury which results in the inability to maintain a straight position of the end joint of one of the fingers.  This can be caused by a ball striking the fingertip. Pain in the end of the finger, tenderness when touching the back of the finger and the inability to straighten the end joint in the finger without help are some of the symptoms of this condition
    • Broken Finger:  is a break or fracture in any of the 3 phalange bones which makes up each finger.  This can be caused when the finger is crushed between two hard objects or when a ball for example jars the finger. Immediate pain, swelling and bruising are some of the symptoms
    • Wrist ganglion: is a small often painless lump. The cause is unknown but it has been suggested that damage to the joint, a joint capsule problem or problems with the tendon sheath causes the joint tissues to bulge out
    • Wrist strain/sprain:  in an injury to any of the ligaments of the wrist.  It is a very common injury and is usually caused by falling onto an outstretched hand. Pain when moving the wrist, and tenderness on palpation are some of the symptoms associated with this condition
    • Wrist bursitis: a bursa is a small sack of fluid that aids in lubricating the joints where the tendons lie. If the bursa is repetitively subjected to trauma or friction it can become inflamed and swollen causing wrist pain. This often is caused in people who put weight on their hands a lot, such as cyclists or weight lifters
    • De Quervains Tenosynovitis: is inflammation of the synovium of the tendons of the thumb as they pass through the wrist. It occurs mostly in racket sports like tennis or squash along with canoeing and ten pin bowling. It can also occur in golfers. Symptoms include tenderness and swelling on the thumb side of the wrist, and creaking of the tendon when it moves
    • Fracture of the hook of hamate: the hamate bone is one of the bones that make up the carpal bones of the wrist; it is situated on the outside of the wrist. A fracture can be caused on the hook of the hamate (the protruding part of the bone) when swinging a golf club, tennis racket or baseball bat especially when it suddenly hits an immoveable object such as the floor.  A stress fracture that goes unnoticed and progresses to a full fracture is the other cause. Symptoms include wrist pain, reduced grip strength and tenderness on touch on the palm side of the wrist 
    • Bennett fracture: is a fracture-dislocation of the 1st carpo-metatarsal joint. It involves a fracture of the base of the metatarsal along with a subluxation of the joint. Causes include a punch with a clenched fist or among football goal keepers and rugby players. Immediate severe pain at the thumb side of the wrist, rapid swelling and deformity of the thumb can occur
    • Handlebar palsy: is a condition in which cyclists often suffer. This is because of the ulnar nerve at the wrist being compressed against the handlebar.  This can cause tingling, numbness and weakness in the hand
    • TFCC tear: is an injury to the triangular fibrocartilage complex which is found in the wrist between the ulnar bone and the carpals bones.  This can be caused either by a trauma from an injury such as a fall on an outstretched hand or degenerative. Pain in the wrist on the little finger side especially when moving the wrist to the little finger side, tenderness over the back of the wrist, swelling, clicking of movements of the wrist and reduced grip strength are some of the symptoms associated with this condition
    • Trigger finger:  is when a finger becomes bent in towards the palm of the hand. This is because the tendon becomes inflamed and thickened and so it cannot slide through the tunnel created by the overlying tissues as smoothly as it usually does. Hence the finger gets stuck in a bent position and may click or lock.  Symptoms include pain at the base and palm side of the finger, tenderness with palpation, a lump at the base of the finger  and difficulty straightening the finger are some of the symptoms associated with the injury
  • Abdominal

    • Bruised ribs (rib contusion): it is caused following a direct impact to the chest. This may be from a fall or a direct impact from a hard object. However, the most common cause is from a car accident. Symptoms include sudden pain on impact, pain on breathing, bruising, and tenderness of the ribs on palpation
    • Rib fracture: is very common in contact sports and occurs when there is a hard impact toe the chest such as an elbow.  Pain and swelling  at a particular point in the ribs,  and pain when breathing in deeply or when coughing or sneezing are some of the symptoms
    • Collapsed lung or pneumothorax: occurs when there is a build up of air in the space between the lungs and the rib cage (called the pleural space).  This results in pressure on the lungs so it can not expand as much it usually does. It only occurs on one side at a time. A bulla, which is an air sac on the surface of the lungs, bursts when doing heavy exercise, or scuba diving, flying or hiking at altitude. Other risks for this type include asthma and COPD
    • Abdominal muscle strain or inflammation: is a tear or rupture of part of the abdominal muscles. It is when a person has to do fast whole body movements and changes of directions. This include athletes involved in weightlifting, throwing, gymnastics, rowers, wrestling and pole vaulting
    • Costochondral separation: usually occurs after a direct impact such as a fall onto the side of the body or being hit by something. Violent twisting movements or coughing violent can also result in a costochondral separation
    • Sternum fracture: is a break to the breast bone. Often caused by a direct impact to the bone especially from road traffic accidents. It may also occur during chest compressions when performing CPR.  These types of fractures can also occur with less force, these include golfers and weightlifters. Older people with osteoporosis are also at risk
    • Referred chest pain: pain in the chest can sometimes be referred from the back.  Symptoms include pain in the chest without any traumatic injury to the chest area, pain when taking deep breaths, coughing or sneezing, stiff upper back and tenderness
    • Stress fracture of the ribs: caused by excessive contraction of the muscles that attach to the ribs such as the serratus anterior. Gradual onset of chest or back pain, when taking deep breaths or sneezing tenderness of the ribs and pain on one side but unable to pin point exact location are some of the symptoms
    • Pectoral strain: occurs mostly in weight lifters especially when they perform a bench press.  A sudden sharp pain at the front of the arm or shoulder especially when bringing arm towards the chest against resistance and rotating the arm, and swelling are some of the symptoms that occur with this injury
  • Hip and groin

    • Groin strain (adductor muscle tear): is a tear or rupture to any one of the five adductor muscles. It usually occurs when sprinting, changing direction or in rapid movements of the leg against resistance such as when kicking a ball
    • Piriformis syndrome: causes pain in the buttock which radiates down the leg to due to the sciatic nerve being impinged by the piriformis muscle.  One of the causes of this is having tight adductor muscles. This means that the abductors on the outside of the leg cannot work properly and so put more strain on the piriformis
    • Inguinal hernia: occurs when part of the internal tissue bulge through a weakness in the overlying abdominal wall. It can cause pain, discomfort and other complications such as pinching which can cause intestinal blockages and may cut off the blood supply which requires immediate treatment
    • Perthes’ disease: affects children ranging from 4 to 8 years’ old. However, it can also occur in young children and teenagers.  It is a condition that affects the hip joint where the top of the femur meets the socket of the pelvis. The blood supply to the head of the femur is disrupted resulting in necrosis. Once the blood supply returns to normal, the bone tissue is laid down and the femoral head reforms and hardens. This will occur over a period of 1 to 3 years.  Symptoms include tiredness and pain in the groin and sometimes in the knee, stiffness and decreased range of movement of the hip joint, walking with a limp and the affected leg may appear shorter than the other leg
    • Hip bursitis: it is when the bursa becomes inflamed causing pain in the hip. This can be caused by a direct impact to the bursa like a fall onto the hip or from repetitive friction from the overlying muscles and tendons usually during running. As the repeated friction causes the bursa to become inflamed, every time the tendon runs over the bursa, pain results
    • Osteitis pubis (inflammation of the pubic bone): results in groin pain that originates from the pubic bones at the front of the pelvis.  It can occur from overuse or from a direct impact. It is not common and can be seen in soccer and hockey players as well as pregnant woman. Symptoms include groin or pelvic pain when running, doing sit ups or squatting
    • Labral tear of the hip joint: occurs from trauma like traffic accidents, collisions and bad falls, falling onto the outside of the hip, twisting on a hip that has a lot of weight on it, repetitive strain on the hip or impingement of the labrum in activities like cycling, horse riding and martial arts.  Symptoms include pain in the hip or groin, a clicking or locking of the hip joint and  stiffness and decreased range of motion
    • Snapping hip: often seen in dancers in which a snapping noise and feeling around the hip joint results.  It is when the muscle flicks across the bone
    • Synovitis of the hip: often affects young children between 2 and 9 years of age which causes pain and inflammation around the hip joint.  The cause is unknown but is often linked to a virus. Pain on movement of the hip, difficulty walking, fever and radiating pain to the knee are some of the symptoms
    • Obturator nerve impingement: is exercise related groin pain, which starts off at the proximal groin and with increasing exercise radiates towards the distal medial thigh. Symptoms include weakness or lack of propulsion of the limb during running
    • Iliopsoas strain: when overuse occurs like doing too many sit ups or doing lots of hill running, the muscle or tendon becomes inflamed.  Symptoms include groin pain when you lift your knee up to your chest especially against resistance and a sensation of tightness and swelling in the groin
    • Osteoarthritis of the hip: a degenerative condition resulting from wear and tear in the hip. Pain in the joint with weight bearing, stiffness and clicking or cracking when moving are some of the symptoms associated with this condition
    • Hip dislocation: occurs when the head of the femur moves out of the socket on the pelvis. It usually occurs from a traumatic force such as falls and road traffic accidents.  Symptoms include instant pain in the hip on impact, instability to move the hip joint, the leg appearing in an awkward angle and the greater trochanter can be felt easily
    • Slipped capital femoral epiphysis: occurs when there is a fracture at the neck of the femur. It usually occurs over a period of time and the two parts of the bone then ‘slip’ apart with the head of the femur moving backwards.  It can cause problems with decrease in blood flow to the head of the femur resulting in bone growth and so needs to be addressed as soon as possible. Hip and groin pain which can radiate down to the knee, walking with a limp and limitation when rotating hip out, and moving leg to the side are some of the symptoms
    • Hip tendonitis: Is degeneration, pain and inflammation of any of the tendons in the hip area.  It is caused when the tendon is put under a lot of strain, either doing something that it is not used to, repeatly doing an activity more than what is normal or from biomechanical problems.  Symptoms include pain, tenderness, stiffness and uncomfortable feeling with contracting the muscle
    • Illium apophysitis: is an overuse injury which occurs in children and adolescents at the front of the pelvis.  People with tight hip muscles and repetitive pulling of these muscles on the growth plate can cause irritation and inflammation of the area. Symptoms include a dull pain at the front of the hip tenderness when feeling the area, mild swelling can occur and pain getting worse with activity
    • Iliopsoas bursistis: causes inflammation of the bursa which sits under the iliopsoas muscle at the front of the hip. It is an overuse injury which is due to repetitive rubbing of the iliopsoas tendon on the bursa. Hence it usually occurs in runners and swimmers. Pain at the front of the hip, pain radiating forwards the knee, tenderness at the front of the hip and stiffness are some of the symptoms
    • Avulsion fractures: is a break in the pelvic bone caused by a strong muscular contraction pulling a chunk of bone away from its attachment point. Symptoms include sudden pain during powerful movements, pain at the back  or at the front of the pelvis, tenderness, weakness and bruising and swelling
    • Ischiogluteal bursitis: is inflammation of the bursa that lies between the ischial tuberosity and the tendon of the hamstring muscle.  Symptoms include the pain and tenderness at the ischial tuberosity, pain when stretching the hamstrings, pain when flexing the knee against resistance and pain may be aggravated by sitting 
  • Lower Back

    • Sciatica: is back pain which radiates down into the back of the legs. It is caused by pressure on the sciatic nerve through a variety of factors. These include prolapsed or slipped disc. Symptoms include muscle tenderness, muscle spasms, pain worse by sitting, coughing or sneezing and the pain may be sharp and with pins and needles and/or numbness
    • Coccyx injury: is a type of tailbone pain. It is caused by an unstable coccyx which causes chronic inflammation. It is also caused by a fall or direct trauma to the base of the spine, repetitive strain or overuse (particularly in cycling or rowing), muscle spasms or tightness in the pelvic floor muscles, glutes and adductor muscles, problems with surgery and childbirth. However, with sitting it often eases
    • Broken tailbone: occurs after a fall where the person lands directly on the tailbone.  Symptoms include pain in the tailbone especially when sitting or with bowel movements
    • Compression fracture of the spine: is a break in one of the vertebrae bones due to a compression force, often occur in the lower back due to additional weight on the vertebrae above.  Often caused from a fall from a height landing on the feet or buttocks. Another cause is the weakening of the bones in which the vertebrae is squashed under the weight of those above it. Nerve involvement is common
    • Spondylitis: is a form of chronic, degenerative arthritis that affects the spine and sacroiliac joints and other joints of the body. The cause is unknown but there is a hereditary factor.  Inflammation within the spine and sacroiliac joints develops which also triggers the development of bony growths which often fuses the vertebrae causing pain and stiffness
    • Spondylolisthesis:  is when one of the vertebrae slips forwards over another one. It is commonly seen in children between the ages of 9 and 14.  It is also common in sports that have a lot of strain on the back such as throwing, wrestling, weightlifting and gymnastics
    • Spondyloysis:  this is a stress fracture of the pars inter-articularis in the spine. It is an overuse injury and is more common in young athletes involved in  sports requiring lots of bending backwards and rotation of the spine, common with cricket bowlers, soccer players and gymnasts.
    • Lumbosacral sprain: is a ligament injury to the lower back. It occurs when a forceful or rapid movement (usually twisting or side bending) takes place which overstretches and maybe tears the ligament. Symptoms include pain in the lower back often to one side of the spine and when twisting or bending, stiffness, muscle spasms, tenderness and swelling
    • Sacroiliac joint pain: is a dysfunction that refers to either hypo or hyper mobility of the sacroiliac joint. This causes problem with surrounding structures such as the ligaments and the muscles. This results in pain on either side of the lower back and can radiate to the buttocks and the groin, stiffness, causing difficulty rolling in bed, putting on shoes and getting in and out of the car and an ache to the side of the ache if driving too long
    • Muscle strains in lower back: occurs when a sudden movement or lifting something too heavy takes place. The muscles go into spasm and do not get enough blood through them resulting in weakness. Symptoms include sudden sharp pain in the back, possible swelling or bruising over the area of the rupture and difficulty in moving especially bending forwards, sideways or straightening
    • Scoliosis: is an S or C shaped curve of the spine. It can either be congenital in which you are born with it, or it can develop over time. It can range from being very mild to severe cases in which deformity can be seen. Symptoms include one shoulder being higher than the other, a more prominent shoulder blade on one side leaning to one side and back pain sometimes
    • Lordosis/hyperlordosis: is an exaggerated lumbar curve of the spine. This can be caused by muscles around the hip and spine becoming tight and some others becoming weak and stretched which causes an imbalance. If the curve becomes too great than more stress is placed on other parts of the spine  that causes pain
    • Spinal canal stenosis: is when the spinal canal narrows causing pressure on the nerves resulting in pain and numbness. Causes include thickening of bone and tissue or wear and tear of the bones and joints over time. Arthritic trauma such as falls or an accident is another cause. Other symptoms include low back pain, leg pain, and weakness or tiredness in the legs
    • Spondylosis: are bony overgrowths of the vertebrae which form the spinal column. It is a degenerative condition and is often more common in the lower back. Symptoms include stiffness and pain first thing in the morning, pain radiating down into the buttocks or back of thighs and pain worse when leaning backwards or to the side due to the location of the osteophytes
    • Bruised tailbone: can result from a fall onto the backside. This type of impact compresses the soft tissue in between the coccyx and the surface which it landed on. Pain at the base of the spine, pain when sitting, walking becoming uncomfortable and pain with bowel movements are some of the symptoms that can take place with this injury
    • Iliolumbar ligament sprain: when the iliolumbar ligament is injured between the pelvis and the 5th lumbar vertebrae. This can occur from a sudden movement or repeated bending and lifting. Symptoms include pain in the lower back, pain on one side of the back, pain on bending forwards or sideways, muscle spasms, tenderness and reduced range of motion
    • Herniated disc:  also known as a slipped disc or prolapsed disc.  It can put pressure on the spinal column which passes behind the discs and vertebral bodies. It is this pressure on the spinal cord which refers pain and other symptoms to the leg
  • Thighs

    • Hamstring strain (pulled hamstring): involves a tear on one or more of the hamstring muscles.  It is most common in sprinters, hurdles jumpers, football players and rugby players. Symptoms include sharp sudden pain at the back of the leg during exercise, pain when stretching the muscle, pain when contracting the muscle with resistance, swelling and bruising and if it's severe, then a gap in the muscle can be felt
    • Quadriceps strain: is a tear in one of the quadriceps muscles at the front of the thigh. It can range from a mild discomfort to a major tear of most of the muscle.  It occurs usually with sprinting, jumping or kicking especially if a good warm up doesn’t take place
    • Myositis ossificans (heterotopic bone formation): is a painful calcification or bone growth resulting from severe or poorly treated contusion.  Causes include an impact that results in damage to the sheath that surrounds bone and the muscle. Symptoms include decreased range of movement, pain in the muscle when using it and a hard lump in the muscle
    • Dead leg (quadriceps contusion):  is a bruise or contusion caused by a sharp impact with a muscle which is usually crushed against the thigh bone. Symptoms include swelling, bruising or restricted movement
    • Rupture of the rectus femoris tendon:  is a tear at the top of the muscle near the hip and can result from overuse or explosive loads on the muscle.  This can be from overuse through kicking or sprint starts. A sudden sharp pain at the front of the hip/groin, swelling, bruising, pain when lifting the knee up against resistance, and pain with palpation are some of the symptoms that can occur with this condition
    • Rectus femoris tendon inflammation: is caused from overuse through kicking or explosive movement as in sprint starts. Symptoms include pain developing gradually with no sudden point of injury, pain at the front of the hip during and after exercise, pain on palpation on the muscle, pain when lifting knee or straightening knee against resistance, and stiffness at the front of the hip
    • Hamstring muscle contusion: involves a direct blow to the back of the thigh causing the muscle to be crushed against the bone. Usually occurs with contact sports and symptoms include pain at the site of injury, swelling, bruising and decreased range of motion
    • Referred hamstring pain: this type of pain can originate from the lower back, sacroiliac joints of the buttock muscles.  Symptoms include pain which may be sudden or gradual and significant reduction in flexibly usually doesn’t occur
    • Hamstring origin tendonitis/tendionopathy: is inflammation of the hamstring tendon as it attaches to the ischial tuberosity at the top of the back of the thigh.  It can be caused after a tear of the hamstring tendon which is poorly treated or from an overuse injury. Generalised pain and tenderness, pain when stretching the hamstring muscles and a gradual onset of pain following a sprint session are some of the symptoms
    • Stress fracture of the femur: caused by prolonged overuse or from one sudden force. Symptoms include a dull deep ache, pain when a bending force is applied to the femur, pain referred to the knee and pain becoming worse when the patient allows the thigh to hang over the edge of the bench or chair especially if a weight is applied downwards onto the thigh
    • Femur fracture: is a broken thigh bone. It can either be a stress fracture (when the femur undergoes repetitive stresses and pain gets worse over time) or a traumatic fracture (from a specific force such as road traffic accidents and falls from a great height). Symptoms include severe pain in the thigh, a deformity may occur, swelling and inability to move the leg 
  • Knees

    • Iliotibial band syndrome/runners knee: causes include tight or wide IT band, weak hip muscles, trigger points within the IT band and gluteal muscles, over pronation, overuse, excessive hill running and leg length difference. Symptoms include knee pain on the outside of the knee, tightness of the iliotibial band, pain aggravated by running especially downhill, pain during flexion or extension of the knee, weakness in hip abduction and tender trigger points in the gluteal area
    • Chondromalacia patella: This can either be acute (from an impact like falling directly on it or hit from the front) or overuse (from repetitive rubbing of part of the cartilage against the underlying bone). Symptoms include grinding or clicking feeling when straightening the knee, pain at the front of the knee, pain worse when walking downstairs, pain when pressing down on the knee cap when the knee is straight, pain when sitting down for too long and minor swelling
    • Patellofemoral pain syndrome: describes pain at the front of the knee from the patella. It often occurs when the patella doesn’t move or track in a correct function when the knee is being bent and straightened. This can lead to damage to the surrounding tissue such as the cartilage which can lead to pain. Symptoms include aching pain in the knee joint particularly at the front around and under the patella especially when walking down hills or stairs, tenderness along the inside border of the kneecap, swelling, clicking or cracking when bending knee, uncomfortable feeling when sitting down for too long
    • Bakers cyst (popliteal cyst): is when there is swelling at the back of the knee. It is usually caused by another condition in the knee joint causing the swelling. There is usually a very obvious round golf ball sized swelling at the back of the knee. A sensation of pressure in the back of the joint which can go down to the calf muscle, decrease range of motion, and aching and  tenderness after exercise
    • Housemaid knee (pre-patella bursitis): is swelling of the bursa at the front of the knee. It can be caused by pressure (kneeling over a long time) or a direct blow to the knee (fall).  Symptoms include pain and tenderness on the kneecap and just below it, swollen and warm to the touch, difficulty kneeling and fluid filled lump may be visible
    • Jumpers knee (patella bursitis): is pain at the base of the patella. It is often caused by overuse especially in sports that require direction changing and jumping movements.  Symptoms include pain at the bottom and front of the knee cap especially with palpation, aching and stiffness, and calf weakness
    • Infra-patellar bursitis: is caused from friction between the skin and the bursa. Symptoms include pain at the front of the knee and swelling in the area of the bursa
    • Osgood-Schlatters disease:  is a very common cause of knee pain in young athletes and children between ages of 10 and 15 years. This is because there is a period of rapid growth combined with a high level of sporting activity which results in a pulling force from the patella tendon on the tibial tuberosity. This area then becomes inflamed, painful and swollen.  Symptoms include pain at the tibial tuberosity and tenderness (top part of the shin bone below the knee cap)
    • Sinding-Larsen-Johansson Lesion: usually affects young boys to their early teens, it is caused by a number of factors such as an excessive traction of the patella from the patella tendon and usually with a period of rapid growth. Symptoms include pain at the front of the knee and gets worse during or after exercise and tender to touch
    • Tibial plateau fracture: it is often fractured during high speed accidents like skiing, horse riding and certain water sports. It can be associated with injuries to the anterior cruciate ligament, collateral ligaments, meniscus and articular cartilage. With this type of fracture, it can result in early onset of osteoarthritis. Symptoms include swelling and pain, stiffness and unable to weight bear on the injured side
    • Patella dislocation: usually dislocates round the side of the knee. Occurs from an acute blow/twisting action of the knee. In most cases the patella will relocate when straightening the knee. However, it can be extremely painful. Symptoms include swelling in the knee joint, pain around the patella, impaired mobility in the knee and obvious displacement of the knee joint
    • Anterior cruciate ligament injury (ACL sprain): in a tear to the anterior cruciate ligament when a twisting force is applied to the knee while the foot is in a fixed position on the ground or upon landing. It can also occur when there is a direct blow to the knee from the outside like in a football or a rugby tackle.  Symptoms include an audible pop or crack at the time of the injury, a feeling of initial instability, swelling, lots of pain, decreased range of motion and tenderness
    • MCL sprain/MCL tear (medial collateral ligament sprain): is damage to the inside of the knee. It is often caused by twisting or an impact to the outside of the knee when the knee is slightly bent. Symptoms include pain and tenderness
    • Meniscus tear:  usually injured when there is a direct impact in contact sports or twisting. Pain on the inner surface of the knee joint, swelling of the knee, inability to bend the knee fully and inability to weight bear on the affected side are some of the symptoms
    • Lateral collateral ligament (LCL) sprain: occurs when there is a direct blow to the inside of the knee.  It mostly occurs in sports such as rugby and football tackles. Symptoms include tenderness and pain
    • Posterior cruciate ligament (PCL) sprain: occurs when there is a direct impact to the front of the tibia usually when the knee is bent. This can be from a front on tackle or collision or when falling with a bent knee. Symptoms include pain, swelling and instability of the joint
    • Osteochondral fractures in the knee: is a tear of the cartilage which covers the end of a bone within a joint. Usually occurs in children and adolescents as their bones are softer and so are more likely to fracture this way. It usually occurs during a violent twist to the knee especially when weight bearing. This can be caused from a direct trauma such as a tackle or other impact or from a fall. Symptoms include immediate pain, rapid swelling, pain becoming worse with weight bearing and locking or instability of the knee
    • Lateral cartilage tear: occurs when twisting or contact occurs. It can also be caused due to degeneration of the cartilage in the older population. Symptoms include tenderness or pain around the lateral surface of the knee joint, swelling, pain when bending rotating and pressing down on the knee. Sometimes an audible pop, crack or clicking sound can be heard
    • Osteochondritis dissecans: is it caused by separation of a fragment of cartilage from the joint space. This occurs due to the disruption to the blood flow. Other causes include traumatic injury, overuse, growth disturbances, ligament weakness, cartilage injuries and genetics.  Symptoms include aching joint pain, swelling, knee locking or catching, unstable knee and decreased range of motion
    • Knee contusions (bruised knee): caused by a direct fall onto the knee or getting hit by something such as a club or ball.  Instant pain, bruising, tender to touch and swelling sometimes are the symptoms associated with this condition
    • Knee synovitis: occurs when the synovial membrane which lines and lubricates the knee joint becomes inflamed.  It can also be caused by rheumatoid arthritis or gout. Symptoms include pain, swelling, stiffness and increased skin temperature/redness
    • Pes anerine tendinopathy/bursitis: occurs when the bursa on the medial side of the knee becomes inflamed due to the repetitive friction in sports like cycling, running and swimming. Symptoms include pain over the inner lower leg, pain on climbing stairs, localised swelling, pain on contracting the hamstrings, pain on stretching the hamstrings and tightness in the three associated muscles (Sartorius, gracilis, semitendinosus)
    • Popliteal injury: symptoms include pain at the back of the knee joint, tenderness on palpation, pain or discomfort with resisted knee flexion when the tibia is externally rotated, and tight hamstrings
    • Fat pad impingement: occurs when a force is directed at the patella and it becomes impinged between the femoral condyle and the patella.  Tenderness, swelling and a long history of knee hyperextension are some of the symptoms that occur with this condition
    • Patellar tendon rupture: occurs when an explosive load or when jumping takes place.  Symptoms include pain, an audible pop, swelling, an inability to weight bear and straighten the knee or hold it in a straightened position
    • Acute patellar injury:  an injury to the kneecap from a direct blow (from a hard object like a hockey stick or football boot) or a fall onto the knee. A fractured patella can also occur
    • Patellofemoral instability:  is when there is a feeling that the knee cap ‘slips away’ or feeling loose on movement of the knee. This can be caused by lax or over-flexible ligaments around the knee, the knee cap being too high within the knee joint or the tibial tuberosity lies towards the outside surface of the tibia. Another cause can be from a dislocation of the knee
    • Quadriceps tendinopathy: is when there is pain and inflammation of the quadriceps tendon as it inserts into the top of the knee cap. Over time in can lead to degeneration of the tendon. Weight lifters often get this condition due to the deep squats they have to do. Symptoms include pain during and after exercise, pain when contracting the muscle, pain with palpation, stiffness and pain when standing from a crouched position
    • Quadriceps tendon rupture: usually occurs from landing from a jump as this places excessive landing on the quadriceps tendon causing a tear. Another cause is from degenerative changes to the tendon from ageing. Symptoms include inability to weight bear,  the knee giving way during movement, lack of muscle strength, swelling, pain, bruising, an audible pop and the patella may be seen to move downwards
    • Osteoarthritis of the knee: is wear and tear on the knee joint. This results in pain and decreased movement in the joint. Causes include prolonged and excessive use of the knee joint, previous fracture at the site of the knee, obesity and genetic factors. Symptoms include a deep aching pain, stiffness, swelling and clicking or cracking noises when the knee is moving
    • Biceps femoris tendinopathy:  is when there is inflammation of the muscle that causes a partial rupture that doesn’t heal properly or when there is an overuse. Tenderness, swelling, pain, stiffness and tight hamstring muscles are some of the symptoms that occur
    • Biceps femoris tendon avulsion: is when the tendon pulls away from the bone. This can occur in sports that use explosive bending of the knee such as sprinting. Symptoms include pain, swelling, loss of hamstring strength and a bone fragment can be palpated through the skin
    • Hamstring tendon rupture:  occurs when there is explosive or kicking movement takes place. A sudden sharp pain in the back of the knee, swelling, tenderness and pain when you bend the knee against resistance are some of the symptoms that take place with this condition
    • Articular cartilage injury:  is when there is damage to the tough cartilage that lines the ends of the bones. This results in inflammation and pain in the knee joint and in the long term it can quicken the onset of osteoarthritis. Locking of the knee and audible clinks or clicks can also take place
    • Peroneal nerve injury:  results from a blow to the outside of the knee causing numbness and tingling down the shin. Other causes include fibula fracture, knee dislocation and injury during surgery. Other symptoms include weakness in lifting their foot upwards, a foot drop in severe cases and a slapping gait (the foot slaps on the ground when walking)
    • Synovial plica irritation: synovial plica is a synovial fold found along the inside border of the kneecap. This may become inflamed causing variable sharp pain located front, medially or back of the patella, sharp pain with squatting and a thickened band under the inside of the patella are some of the symptoms that are associated with this condition
  • Shin/Calves

    • Shin splints: is shin pain at the front of the lower leg.  This can be caused by inflammation of the periosteum of the tibia, over pronation of the feet, over supination of the feet, inadequate footwear, increasing training too quickly, running on hard surfaces and decreased flexibility at the ankle joint. Symptoms include shin pain over the inside lower half of the leg, pain at the start and end of activity, swelling, lumps and bumps with palpation,  pain when foot is pointed and redness over the inside of the shin
    • Calf strain: is a tear to either the gastrocnemius or soleus muscle, often more likely at the point they join the Achilles tendon.  Symptoms include sudden sharp pain at the back of the calf muscle, inability to walk  and bruising
    • Achilles tendonitis: causes include overusing it, increase in activity, less recovery time between activities, changes of footwear or training surface, weak calf muscles, decreased range of motion at the ankle joint, tight calves, running up hills, over- pronation of feet and wearing high heels. Symptoms include gradual onset of Achilles pain and tenderness
    • Ankle sprain: a stretching and or tearing of the ligaments. The most common type of sprain is when you ankle turns over so the sole of foot faces inwards damaging the ligaments on the outside of the ankle. Symptoms include pain, swelling, and bruising
    • Sinus tarsi syndrome: can be caused from over- pronation or poor foot biomechanics or from an inversion ankle sprain. Symptoms include poorly localised pain just in front of the lateral malleolus and tenderness at the opening of the sinus tarsi
    • Peroneal tendonitis: is when the peroneal tendons become inflamed causing pain and swelling on the outer ankle because of overuse. Pain and swelling on the outside of the ankle or heel, pain with palpation and tight calves are some of the symptoms that occur with this condition
    • Total rupture of the Achilles tendon: occurs following a history of inflammation or degeneration of the tendon but also results from a sudden even such as pushing off hard on the toes or suddenly bending the foot upwards. Symptoms include a sudden sharp pain, a snap or bang noise, gap felt in the tendon and lots of swelling
    • Achilles bursitis: occurs when repeated trauma occurs and the bursa becomes inflamed.  Symptoms include pain at the back of the heels, tenderness and swelling
    • Personal tendon dislocation: if the tissue that holds the tendons is torn by turning the ankle over, the tendons can slip forward over the malleolus.  If repeated dislocation occurs, the tendon rubs against the bone causing inflammation. Symptoms include pain when you turn your soles of the feet outwards and upwards, pain and tenderness behind the lateral malleolus and swelling and bruising
    • Tibialis posterior syndrome (PTTD): is a dysfunction of the muscle, resulting in a fallen arch or flat feet.  Symptoms include pain and history of injury to the tibialis posterior muscle
    • Eversion ankle sprain:  is rare and occurs when the ankle rolls too far inwards, it’s often accompanied by a fracture of the fibula bone. Symptoms include immediate pain, rapid swelling, bruising, difficulty weight bearing and limited mobility
    • Medial malleolus stress fracture:  the medial malleolus is a bony bit inside of the ankle. Stress fractures can occur here but it is very rare. Symptoms include pain in the inner ankle which is worse when running and jumping, tenderness over the medial malleolus and swelling
    • Tibialis posterior tendinopathy: injury or degeneration of the tendon may cause pain on the inside of the foot that my radiate along the line of the tendon. Creaking on the tendon when it moves can also occur
    • Posterior deep compartment syndrome: occurs when a muscle becomes too big for the sheath that surrounds it. This can be through an impact which causes bleeding within the compartment and therefore swelling, a muscle tear which causes bleeding and an overuse injury that causes swelling. Symptoms include chronic calf pain, pain in the shin when you  kick, jump or go up onto your toes, pain when pulling the toes and foot downwards and weakness in this movement which may cause a foot drop
    • Anterior compartment syndrome: occurs when the muscle on the outside of the shin becomes too big for the sheath that surrounds it which then causes pain.  Symptoms include a sharp pain in the muscle on the outside of the lower leg usually from a direct blow, weakness when trying to pull the foot upwards against a resistance which may result in a foot drop or a slapping gait, swelling and tenderness over the tibialis anterior muscle and pain when the foot and toes are bent downwards
    • Lateral compartment syndrome: occurs when the muscles on the side of the leg swell too big for the surrounding sheath which causes pain. Symptoms include pain when walking or running and swelling or tenderness
    • Broken ankle: is often associated with a sprained ankle. It can be caused by rolling the ankle over to the side, extreme flexing or extending of the joint and landing from a height. Symptoms include sudden, intense pain at the ankle, pain on weight bearing, maximal tenderness located on the bone and considerable swelling and bruising develop quickly
    • Tibialis anterior tendon sheath inflammation: inflammation of the tendon or the protective sheath that surrounds the tendon can cause through overuse particularly through running on hard surfaces or in racket sports where you have to change directions frequently. Pain when you bend your foot and toes up, swelling and redness over the front of the ankle where the tendon is, a creaking feeling when you press your fingers into the tendon and weakness lifting foot upwards which can result in foot drop or slapping gait are some of the symptoms that can occur with this condition
    • Partial rupture of the Achilles tendon: can occur in athletes from all sports but particularly in running, jumping, throwing and racket sports.  It is when the tendon tears but not completely. Scar tissue will form which is likely to lead to inflammation of the tendon. Symptoms include a sudden sharp pain in the Achilles tendon, stiffness in the Achilles tendon first thing in the morning and a small swelling in the tendon
    • Retrocalcaneus bursitis: is when there is inflammation between the Achilles tendon and the posterior border of the calcaneus. Causes include biomechanical abnormalities, joint stiffness and proximal soft tissue tightness
    • Ankle impingement: is a bony growth at either the front or back of the ankle bone where it meets the shin bone.  Anterior ankle impingements can be caused from repeated or bad ankle sprains as the ligaments thicken and get pinched between the bones. Posterior impingements usually occur in ballet dancers and can be due to bony protrusions at the back of the ankle
    • Osteochondral lesions of the talus:  usually occurs with an ankle sprain.  This occurs because landing onto the ankle. Symptoms include ankle pain, swelling catching or locking and stiffness
    • Footballers ankle: occurs when there is a bony growth at the front of the ankle where the joint capsule attaches. It usually follows from an injury where the ankle has been stretched or over bent. Symptoms include pain and tenderness when pressing in with your fingers over the front of the ankle joint, pain when you bend your foot up and down, a band of pain across the front of the ankle joint when kicking a ball and bony lump at the front of the ankle
    • Tibia osteochondral fracture: is an injury to the cartilage which lines the end of the tibia bone where it meets the talus to form the ankle joint. Symptoms include loss of normal ankle function and movement, pain on weight bearing, tenderness around the ankle, pain on moving the ankle, rapid swelling, possible deformity and clicking and creaking in the ankle
  • Foot/Heel