Brian and his staff use some of the best modern equipment available in order to achieve effective and fast results for the treatment of fractures and all other soft tissue injuries.
Extracorporeal Shockwave Therapy (ESWT)
What is Shockwave Therapy?
It is a cutting edge treatment that was first used medically to essentially dissolve kidney stones (called lithotripsy) without the requirement for surgery. The use of Shockwave Therapy has been used to treat chronic muscle and tendon pain since the 1990’s. Shockwave refers to high intensity pressure waves that directly penetrate the affected tissue. These pressure waves are repeatedly applied to the area with an applicator for around 5-10 minutes, depending upon the condition. It basically helps to stimulate the body’s own self-healing processes.
What conditions can be treated?
Your physiotherapist will give a full consultation prior to treatment, which will enable us to assess whether your condition is likely to respond to the treatment. Most tendon and muscle problems can be treated with Shockwave Therapy, including:
- Tennis elbow
- Golfer’s elbow
- Plantar fasciitis (policeman’s heel, heel spur)
- Patellar tendinopathy
- Shoulder tendinopathy
- Trochanteric bursitis (hip pain)
- Achilles tendinopathy
- Ilio-tibial band syndrome
How does it work
- Research suggests that Shockwave Therapy is 70% effective in eliminating chronic pain
- The main aims of Shockwave Therapy are to break down scar tissue and calcification within tendons and to create an inflammatory reaction in order to attract the cells that are required to reduce pain and encourage healing
- Shockwave also creates new blood vessels in order to aid healing and lay down new body tissues and it increases the metabolic activity around the affected area
- It helps to overstimulate nerve fibres, and actually helps to block pain signals and therefore intensifies the analgesic effect (Gate Control Theory)
What are the benefits?
- No anaesthesia required
- Effective pain relief
- Minimal number of treatments required
- May help to avoid the need for surgery
What will I feel during treatment?
- The Shockwave treatment can be uncomfortable- we gradually increase the intensity of the shocks, but you are in control and we will stop when you tell us
- We use a gel/cream in order to get good contact between the treatment head and the skin
Are there any side effects following treatment?
- In a small number of cases there may be bruising over the area treated. It is normal to have some localised reddening
- There may be some discomfort during and immediately following treatment as we are looking to promote an inflammatory reaction, but this will reduce and you may take Paracetamol if required. However, in most cases pain and discomfort immediately decreases after treatment. Do not take anti-inflammatories (such as Ibuprofen) as this will interfere with the mechanism of action of the Shockwave
How many treatments am I likely to need?
- Research suggests that 3-5 sessions are sufficient in order to significantly reduce pain and results are often felt after the first session
- Research suggests 1-2 sessions per week
- The healing process continues even after the last treatment as the tissues continue to repair
Pulsed Magnetic Field Therapy (PMFT)
The use of Pulsed Magnetic Fields to aid the healing of bones has long been practised with good results, particularly when applied to delayed or non-union fractures. The American FDA approved the use of PMFT in the treatment of recent and non-union fractures in 1979.
The treatment is non-invasive and involves inducing low frequency electric currents in bone by using a pulsed magnetic field. It is defined in the treatment of fractures as ‘the use of time varying magnetic fields that induce voltage wave-form patterns in bone similar to those resulting from weight-bearing’.
Magnetic fields will penetrate most things, so a POP is no obstacle for treatment using this modality. The physiotherapist will mark the appropriate area using any x-rays available as a guide. Please be assured that even without x-rays, we will tend to know where your fracture will be by the way that you have been managed. For example, by what surgery you have had or by what type of POP you are in. The presence of metal work is also no obstacle for this treatment.
Please see the following literature review, written by Brian Simpson MCSP, which will give you a much more thorough understanding of treatment using Pulsed Magnetic Fields.
“Laser” stands for Light Amplification by Stimulated Emission of Radiation. Some lasers are used in direct contact with the skin as they produce a divergent beam. Our lasers emit a non-divergent beam which means that they do not need to be in contact with the skin to achieve the same effect as there is no loss of power to the surrounding area. The lasers used in our clinic are 3 W and 5W lasers and so are extremely powerful.
Research shows that the use of these lasers causes those cells which lay down bone (osteoblasts) to work more efficiently and those cells that eat away at bone (osteoclasts) to work less. We know this because osteoblast activity will produce a chemical called Alkaline Phosphatase (ALP) and we can see an increase in the levels of ALP when using the laser. Also, we see a reduction in the levels of Tartrate Resistant Acid Phosphatase (TRAP) which is expressed when there is osteoclastic activity. Therefore, you have more bone forming cells than bone ‘eating’ cells.
You will be required to wear protective goggles whilst the laser is working as the radiation can potentially cause eye damage if you stare at the beam without your goggles.
Low Intensity Pulsed Ultrasound (LIPUS)
Low-intensity pulsed ultrasound aims to speed up fracture healing by stimulating bone cells to grow and repair. This involves a short daily treatment (normally 20 minutes) using an ultrasound probe that is placed on the skin at the site of the fracture, so it is non-invasive and you do not feel anything during treatment.
Current evidence on the efficacy of low-intensity pulsed ultrasound for promotion of fracture healing is adequate to show that this procedure can reduce fracture healing time, particularly in circumstances of delayed healing. It is also useful in cases of recent fractures.
The LIPUS cannot be used through a POP unless a small window is cut into it so we have access to the skin over the fracture.
LIPUS can also be used to treat soft tissues, such as Achilles tendonitis.
There are no major safety concerns with regards to this treatment.
DEEP OSCILLATION® is a patented electromechanical therapeutic procedure using resonant vibration of the tissue with DEEP OSCILLATION® equipment from Physiomed, Germany. A special design makes it possible, using electrostatic attraction and friction, “to produce mechanical vibrations in treated tissues of the body, not only at the skin on the surface but also in deeper tissues” (Brenke and Siems 1996). Schönfelder and Berg (1991) refer to a “penetrating vibration and pumping effect deep into the tissue”. The frequency can be varied in the range from 5-250 Hz.
The treatment applicator/therapists vinyl gloved
hands and the patient are connected to the equipment (voltage source). A vinyl film between the applicator, and/or vinyl gloves and the patient functions as a dielectric. This results in a weakly conducting capacitative layer between the contact surfaces. In action, pulsed electrostatic attractions draw the tissue to the applicator/gloved hand and release it at the rhythm of the chosen frequency. The therapist sets the pressure gradient, speed and direction of the movements. The patient can treat himself if appropriate. The treatment procedure is characterised by minimal external mechanical effects, which allows it to be used in cases of acute pain, fresh injuries and in the treatment of wounds. Numerous pilot studies have demonstrated pain reduction, minimisation of oedema and anti-fibrotic effects. It is commonly used for the treatment of Lymphoedema (Jahr, S., Schoppe, B. and Reißhauer A. (2008) Effect
of treatment with low intensity and extremely low frequency electrostatic fields (Deep Oscillation®) on breast tissue and pain in patients with secondary breast lymphoedema. J. Rehabil. Med. 40, 645-650).
The DEEP OSCILLATION® system, above all, has effects on the micro-circulation of the interstitial connective tissue. Treatment results in a normalisation of the steady state, i.e. of the permanent fluid flow
between the tissue surrounding the cells and the lymph and blood vessels. In this manner, pain can be diminished and the circulus sanus be restarted or else accelerated.
Clinically proven effects
• Strong pain-alleviating potential. This applies to acute traumatic as well as to chronic pain
• Anti-inflammatory effect
• Prevention and reduction of secondary and primary lymphoedema
• Prevention of fibrotic remodelling processes, reduction of fibrosis
• Muscle relaxation, promotion of physical activity, mobilisation
• Support of wound healing processes
• Normalisation of haemodynamic parameters of the skin, correction of aesthetic-neurotic problems
and influence on biological ageing through preventive effects on premature ageing
Fields of Application
Acute Trauma & Chronic Conditions, softening scar tissue
Wound healing, Diabetic Foot, Burns and Ulcers
Primary and Secondary Lymphoedema, Chronic Oedema
Lipoedema and Lipo-Lymphoedema,
Training Aftercare & Performance Stabilisation in Sport, Damage from Overstraining
Pre and Day One Post Operative: Orthopedic, General & Aesthetic Surgery
Pain Syndromes (FMS, Sudeck’s Dystrophy etc.)
Common conditions: Arthritis, Back Pain, Tennis & Golfers Elbow, Whiplash
What is acupuncture?
Acupuncture is a form of therapy in which fine needles are inserted into specific points on the body. Your practitioner will discuss with you if they feel that acupuncture is appropriate and will be of benefit to you.
How does acupuncture work?
Acupuncture helps reduce pain by causing changes in pain pathways in the brain and spinal cord as well as releasing natural painkillers such as endorphins. Acupuncture is used to help relieve the pain and discomfort associated with various conditions, such as arthritis and back pain.
Is acupuncture safe?
Acupuncture is very safe. Serious side effects are very rare – less than one per 10,000 treatments.
Is acupuncture painful?
When the needles are inserted you may feel a sharp sensation and then a dull ache. Please inform your practitioner if you experience significant pain. The needles used are much finer than those used in injections and blood tests, and so are less painful to insert. Single-use, sterile, disposable needles are used in this clinic.
Does acupuncture have any side effects?
You need to be aware that:
- drowsiness occurs after treatment in a small number of patients, and, if affected, you are advised not to drive;
- minor bleeding or bruising occurs after acupuncture in small number of treatments;
- pain during treatment occurs in about 1% of treatments;
- existing symptoms can get worse after treatment (less than 3% of patients). You should tell your acupuncturist about this, but it is usually a good sign;
- fainting can occur in certain patients, particularly at the first treatment. Please ensure that you have eaten prior to treatment;
If there are particular risks that apply in your case, your practitioner will discuss these with you.
Is there anything your practitioner needs to know?
Apart from the usual medical details, it is important that you let your practitioner know:
- if you have ever experienced a fit, faint or funny turn or are epileptic;
- if you have any allergies to metal;
- if you are pregnant or actively trying for a baby;
- if you have a pacemaker or any other electrical implants;
- if you have a bleeding disorder;
- if you are taking anti-coagulants e.g., Warfarin, or any other medication;
- if you have damaged heart valves or have any other particular risk of infection.
Soft Tissue Treatments
These treatments will often involve a variety of modalities in order to reduce pain and inflammation and to get you back to your activity more quickly. Each condition is initially assessed and then treated accordingly. You will be informed of what treatment options there are available after your initial assessment before any treatment is carried out.
Treatments may include:
- Electrotherapy, e.g., ultrasound