Upper Limb Injury Clinic
Prevention, Diagnosis, Treatment & Rehabilitation for conditions such as Tennis Elbow & Frozen Shoulder
Upper limb injuries are very common among athletes and non-athletes alike. Ranging from injuries and pain in the hands through to elbow and shoulder issues, these injuries can be very debilitating. At Hub we are highly experienced in dealing with acute and chronic injuries such as ‘frozen shoulder’, tennis elbow, carpal tunnel syndrome, muscle strains and joint complaints. (There is more information below on some of the common conditions that we treat.)
At Hub our specialist team consists of osteopaths, massage therapists and rehabilitation specialists and is fully equipped to take you through your journey, from assessment and diagnosis to treatment, rehabilitation and the long term management of your injury to prevent it recurring.
Our team is dedicated to helping you to get rid of your pain and debilitation and to return you to your usual activities as quickly as possible and have an excellent record when it comes to the prevention of injury recurrence.
We are registered with ALL healthcare insurance providers. Please let the team know if you are using health insurance when you make your appointment.
Some common conditions we work with:
Frozen shoulder or ‘adhesive capsulitis’ is a common cause of shoulder pain. It refers to inflammation and scarring of the capsule which surrounds the shoulder joint. It tends to affect people aged between 40 and 60, with women affected more than men.
The two main symtpoms of frozen shoulder are pain and a gradual loss of range of movement in most directions. The reasons for this injury are largely unknown but ‘adhesion’ (scar tissue) begins forming in the joint capsule.
The most important thing to do with a frozen shoulder is not to ingnore it. The injury can last for over 12 months in some circumstances and the sooner treatment and rehabilitation exercises are started, the quicker the recovery time.
Tennis / Golfer's Elbow
Tennis elbow (lateral epicondylitis) is inflammation of the tendons around the bony bump on the outside of the elbow. The inflammation is typically caused by prolonged, excessive or repeated use of the forearm muscles. Tennis elbow affects men and women equally, peaking in incidence between the ages of 30-50.
The injury occurs not only in sporting actvities such as tennis, squash and badminton but also in day to day activities such as carpentry, sewing, screwdriving, gardening and typing.
Typical symptoms include aching, throbbing or tenderness on the outer elbow that can be made worse by seemingly trivial movements such as carrying bags, chopping food and even turning door knobs.
The treatment of tennis elbow revolves around ceasing or limiting the activity that is aggravating the pain, icing the area and then addressing the muscle imbalance in the forearms. Deep soft tissue massage and trigger point therapy can help alleviate the tension in the forearm and rehabilitation exercises can return strength to the area.
Further consideration in tennis players is to take lessons to improve the backhand technique, increase the grip size to reduce grip tightness and avoiding playing with wet, heavy balls.
Golfer’s Elbow (also known as Medial Epicondylitis) refers to inflammation and degeneration of the tendons on the inside of the elbow. It is characterised by pain felt along the inside of the elbow and forearm. There is also elbow pain if the elbow is straight and the hand is moved forward and back at the wrist. Golfer’s Elbow tends to be caused by prolonged gripping activities, throwing and racquet sports.
Management of Golfer’s Elbow usually involves activity modification, soft tissue treatment such as massage and stretching and supervised strengthening exercises. Ice, anti-inflammatoy medication and a compression strap can also be very effective at reducing localised strain of this area.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome, a common cause of wrist and hand pain, is caused by wrist swelling in an anatomical area known as the Carpal Tunnel. The Carpal Tunnel is a gap in the carpal (wrist) bones through which muscles, blood vessels and nerves pass on their way to the hand from the forearm. Compression of the Median nerve causes altered sensation in the wrist and the fingers nearest the thumb, as well as the thumb itself.
Research studies have shown that the pressure within the Carpal Tunnel is increased if the wrist is held in a position of extension (such as typing at a keyboard) or flexion (when gripping tightly). These positions can make the symptoms of Carpal Tunnel Syndrome worse, so a wrist support is often recommended. In severe cases of Carpal Tunnel Syndrome surgery may be required.
Repetitive Strain Syndrome (RSS)
Repetitive strain injury (RSI) is a general term used to describe the pain felt in muscles, nerves and tendons caused by repetitive movement and overuse.
The condition mostly affects the forearm, elbow, wrist, hands, neck and shoulders. The symptoms can vary, but often include:
- pain or tenderness
- tingling or numbness
RSI is usually associated with doing a particular activity repeatedly or for a long period of time. It often occurs in people who work with computers or carry out repetitive manual work.
Certain things are thought to increase the risk of RSI, including:
- doing a high-intensity activity for a long time without rest
- poor posture or activities that require you to work in an awkward position
- cold temperatures
If you think you may be suffering from RSI, seek expert advice immediately as early intervention can limit the likelihood of chronic issues.
Shoulder Impingements / Painful Arc
Shoulder impingements often occur due to rotator cuff injury and tendonitis. This condition is sometimes called painful arc syndrome syndrome, due to the pain that is felt during a certain part of the shoulder’s range of motion. It can be caused by the subacromial bursa being squashed or ‘impinged’ between the rotator cuff muscles and the bone, during repeated overhead shoulder movements.
Treatment will often require rehabilitation to improve postural and functional issues while resting from resistance-based activities.
We have appointments available with our specialists:
8am – 8pm Monday to Friday
8am – 4pm on Saturdays.
Call us now or use the contact form below
0845 116 2102
0207 720 9644
Make an Enquiry
How many sessions will I need?
Getting you pain free and functioning properly is a process, not an event. With this in mind, most people do require a course of treatment but the length varies greatly depending on the severity of your condition and previous injuries etc. As your condition improves visits become less frequent. At Hub we emphasise the importance of thorough rehabilitation to prevent injuries from recurring and on some occasions we do recommend that patients return from time to time in the long term to maintain the improvements and to check that there are no further issues building up.
What is involved?
When deaing with pain and injuries of the upper extremity, we use a very thorough process of:
We will carry out a full case history and physical assessment to take in all the possible contributing factors to your current symptoms. Our movement assessment is very thorough as we hope to be able to identify any areas of weakness, tightness and imbalance, even in areas of the body away from your symptoms as these can commonly be significant.
Following the assessment, we will be able to identify what structure is causing your pain and symptoms as well as the underlying cause of why it has happened. This information will guide the nature of the treatment and rehabilitation plan going forwards. At this stage we may be able to give a prognosis of how long your recovery will take.
Treatment plans will vary greatly depending on the cause of your issue but will definitely include work to alleviate your symptoms, such as soft tissue work and spinal manipulation as well as techniques to address any mechanical issues which may be causing the strain to the tissues which are in pain.
Following the treatment and rehabilitation of your injury, you will be given a management plan that may consist of continued rehabilitation exercises, lifestyle/postural changes and possibly future check ups to ensure the problem does not recur.
What's the next step?
Once you are fully recuperated, our team are perfectly placed to help you remain injury-free through:
- ongoing treatments to maintain physical health
- exercise programmes to improve fitness / weight levels
- nutritional plans to optimise health levels
To find health should be the role of the doctor. Anyone can find disease.