A common issue we see at Physiofusion is confused and frustrated patients that have had replacements (like hips and knees) but that have never seemed to recover to the point they expected. They are still in pain or still can’t return to the sport they loved (and was the reason for their operation in the 1^st place) or still feel weak or ‘malaligned’ on that side…and the list goes on.

Why Your Joint Replacement Has Stalled?

Most people expect a straightforward recovery after their joint replacement. Surgery done, new joint in, back to normal. But for a lot of people, (somewhere between 3 and 6 months) things plateau. Progress slows, confidence drops, and life still feels restricted. The surgery worked. The surgeon has confirmed the joint is ‘perfect’ so why doesn’t it feel like it?

The answer is usually one (or more) of these things:

1. Soft tissues around the joint (they didn’t replace those!) are irritated
2. The mechanics of the leg have not normalised, e.g; the motion is incorrect
3. There is tightness in some structures and weakness in others
4. There are underlying issues with balance or stability around the joint

Things To Consider Post Joint Replacement

Modern joint replacements are built to be loaded, so weight bearing is important. The implant needs progressive stress through it to integrate properly and the muscles around it need to be challenged to rebuild strength. Gentle walking and basic exercises get you started, but they won’t get you to where you want to be long-term. You will be fit to ‘basic level’ and likely not the level of fitness required for all of your lifes challenges.

At the 3 month point, most people should be working on single leg strength, progressive loading, return to perfect movement patterns, balance and stability training. If you’re still doing the same exercises you were given initially, it’s catch up time. Or something hasn’t got to plan.

Pain is not necessarily anything to worry about. Recovery stalling is not a sign anything has gone wrong either. It’s usually a sign the rehab hasn’t kept pace with where the tissue actually is.

Common Questions on Joint Replacement Answered:

Q: I’ve been to my surgeon and they said everything looks perfect on my X-ray but I’m still in pain 4 months down the line. Is that normal?

This is a very common event. And yes it’s very normal. Your body is still healing from the operation even at this time. It’s still structurally ‘bedding in. The scar is still changing and hopefully slowly ‘loosening off’. The muscles and ligaments have been surgically accessed to put the prosthetic in and are still developing strength. Remember also that the old habits of how you had to move with your worn and torn joint will also need retraining out to normalise movement and some structures may be tighter now than before your original worn joint. What matters is the overall direction of travel. If things are gradually improving week on week, you’re on track. If pain is not improving or worse still increasing, that’s worth discussing with your physio

Q: I was told to avoid certain movements because the joint could pop out?

Hips are the most prone joint replacements to dislocate and so you will be advised to not flex them beyond 90 degrees or take the hip into adduction (across your body central line). This is especially important in the 1^st 12 weeks and probabilities of dislocation reduce over the following months. Your physio will be able to advise when your personal joint is able to move into the directions and angles that previously you should have been cautious of.

Knee replacements don’t have these seem cautions. The joint is much less likely to dislocate and, quite the opposite to the hip, movement is very much encouraged to the fullest extent pain allows.

Q: How do I know if the pain I feel during exercise is safe to push through or a sign to stop?

A useful rule of thumb is the 24 hour rule. Pain or soreness during or after exercise that settles back to your baseline within 24 hours is generally fine to work through. It is a normal response to tissue stretch or load. If pain spikes significantly during an exercise, does not settle overnight, or leaves you worse than you started the next day, it is a signal to modify the exercise rather than push on. The goal is to find the edge of your capacity and build from there, not to avoid discomfort entirely, but to make sure the response of your tissues is optimal.

Q: I don’t feel things are as good as they should be and don’t feel confident to go alone with my home rehab….

That’s ok. Help is at hand. We can assess the new joint. Let you know how its getting on in our professional experience. Answer any questions. Provide any post-op treatment the joint would benefit from (for example soft tissue release). Review your home rehab program and try to get it back on track and appropriate for the time scale following the operation. Provide you with personalised reassurance based on your body, its assessment findings and not ‘Google’ averages!

As always, if you have any questions or queries. for us regarding your joint replacement, you can reach out to us for free using our Ask A Physio service, here. Our experienced therapists aim to get back to you within 24 hours.

Low Vitamin D levels have been linked to a wide range of health issues, including:

• Cardiovascular disease
• Type 2 diabetes
• Mental health conditions
• Autoimmune disorders such as rheumatoid arthritis and multiple sclerosis
• Dementia
• Osteomalacia (and rickets in children)
• Muscle weakness
• Increased frequency and severity of respiratory infections

Why Is Vitamin D So Important?

Vitamin D is often associated with calcium absorption and bone health, but its role goes much further than that.

It behaves more like a hormone than a vitamin, helping to regulate genes involved in:

• Immune system function
• Brain health
• Inflammation control

This is why deficiency can have such wide-ranging effects on the body.

What Causes Vitamin D Deficiency?

In the UK, Vitamin D deficiency is defined as blood levels below 25 nmol/L (25-hydroxy Vitamin D).

There are several reasons why people become deficient, including:

• Limited sunlight exposure (especially October to March)
• Poor dietary intake
• Higher body fat levels
• Ageing
• Genetics
• Darker skin tones
• Regular use of high-factor sunscreen

For many people, it’s not just one factor, it’s a combination.

How to Improve Your Vitamin D Levels

The good news is that improving your Vitamin D levels is relatively simple once you know how.

1. Get Safe Sun Exposure (April – September)

During the lighter months, sunlight is your best source.

Spending just 10–15 minutes outdoors between 11am and 3pm can generate approximately 1000–2000 IU of Vitamin D.

This happens when UVB rays interact with cholesterol in your skin to produce Vitamin D.

For best results:
• Expose areas like your arms, legs or face
• Avoid sunscreen during this short window only
• Take care not to burn

People with darker skin may need 25–40 minutes of exposure, as increased pigmentation reduces the rate of Vitamin D production.

2. Focus on Diet (October – March)

During the winter months, the sun simply isn’t strong enough in the UK to stimulate Vitamin D production.

This means your diet becomes more important.

Good sources include:

• Oily fish (salmon, mackerel, sardines)
• Egg yolks
• Fortified foods (such as cereals and wholegrain products)

3. Consider Supplementation

For many people, especially in winter, supplementation is a practical solution.

Daily doses of up to 4000 IU of Vitamin D3 are generally considered safe for adults.

If you’re unsure, it’s always best to speak with a healthcare professional before starting.

4. Maintain a Healthy Body Composition

Vitamin D is a fat-soluble vitamin, meaning it can be stored in body fat.

Higher levels of body fat can reduce how much Vitamin D is actively circulating in the bloodstream.

This is why regular exercise is important.

A combination of:
• Aerobic exercise
• Strength training

can help improve body composition and support overall Vitamin D function in the body.

The Bottom Line

Vitamin D plays a far bigger role in your health than most people realise.

From immune function to muscle strength and mental wellbeing, maintaining healthy levels is essential, especially in the UK where deficiency is so common.

Small changes like getting outside more, improving your diet, and considering supplementation can make a meaningful difference.

If you would like any advice, you can ask our experts a question any time you wish, here.

Many people are told the same thing:

“It’s just wear and tear.”
“You just have to manage it.” Or, “live with it.”

But that’s not the whole story. While arthritis itself cannot always be reversed, there are effective ways to reduce pain, improve movement, and help joints function better. At Physiofusion, we’ve introduced advanced Laser Therapy for Arthritis to help people do exactly that.

Using state-of-the-art technology, we’re proud to offer one of the most advanced non-invasive treatments available for joint pain in Burnley and Padiham.

What Is Laser Therapy for Arthritis?

Laser therapy, often referred to as photobiomodulation therapy, uses targeted laser light energy to stimulate the body’s healing processes. Unlike treatments that rely on medication or injections, laser therapy works by activating biological processes within your cells.

When the laser light penetrates the tissue around a joint, it helps to:

• Increase circulation
  • Reduce inflammation
  • Stimulate cellular repair
  • Improve tissue healing

The result is often less pain, improved joint movement, and better function. Importantly, the treatment is completely non-invasive, meaning there are no injections, no surgery, no downtime and most importantly, pain-free treatment.

Why Arthritis Pain Happens

To understand why laser therapy can help, it’s important to understand arthritis itself. Arthritis occurs when the structures within a joint become irritated or worn, leading to inflammation, stiffness and reduced mobility. Over time, the surrounding tissues can also become tight, weak or protective of the joint.

This is why many people experience:

• Persistent joint stiffness
  • Pain during or following activity
  • Reduced mobility
  • Muscle tightness around the joint

The key to managing arthritis effectively is treating the joint and the surrounding tissues together. That’s where modern physiotherapy and laser therapy work extremely well together.

How Laser Therapy Helps Arthritic Joints

Laser therapy works at a cellular level, which is what makes it such an exciting development in musculoskeletal treatment. The light energy stimulates the mitochondria inside your cells, which are responsible for energy production. When stimulated correctly, these cells become more efficient at repairing tissue and regulating inflammation.

For arthritis sufferers, this can lead to:

Reduced Pain: Laser therapy stimulates the body’s natural pain-relieving chemicals and reduces irritation in the joint.

Reduced Inflammation: Chronic inflammation is one of the biggest contributors to arthritis pain. Laser therapy helps calm this process.

Improved Joint Mobility: By reducing swelling and relaxing surrounding tissues, joints can move more freely.

Faster Tissue Repair: Laser therapy encourages cellular activity that supports healing and recovery.

Patients report their joints feel looser, more comfortable and easier to move following treatment.

What Happens During your Laser Therapy Treatment?

One of the reasons laser therapy is becoming so popular is how simple and comfortable the treatment is. This is boasted by hands on physio techniques provided at the same time as your laser therapy eg joint mobilisation or muscle release as well as tailored exercise advice specific to the joint your physio has just assessed.

During a session:

1. Your physiotherapist will assess your joint and identify the areas needing treatment.
2. The laser device is applied directly over the affected area.
3. The treatment typically lasts a few minutes per joint.
4. Most patients feel a gentle warmth or nothing at all.
5. Manual therapies then follow to improve the mechanics of the joint and its surrounding tissue. This takes several minutes per joint usually.

The laser procedure is pain-free and safe, and you can return to your normal activities immediately afterwards

Why We Introduced Laser Therapy at Physiofusion

At Physiofusion, we are always looking for ways to improve the outcomes we achieve for our patients. For many people with arthritis, traditional advice has often been limited to:

• Pain medication
• Waiting Lists
• Managing symptoms

We believe people deserve better options than simply being told to live with the pain. That’s why we invested in high-intensity, medical-grade laser technology to offer a treatment that addresses the root causes of joint pain rather than simply masking symptoms. This technology represents a significant investment, but it allows us to deliver one of the most advanced arthritis treatment options currently available in private physiotherapy clinics.

Why This Treatment Is Rare in Lancashire

High-quality medical laser equipment is expensive and requires specific training to use effectively. For that reason, very few clinics in Lancashire offer advanced laser therapy for arthritis. At Physiofusion, our clinicians are trained in how to apply the correct dosage, wavelength and treatment protocol for different joint conditions. This level of precision is essential because the effectiveness of laser therapy depends heavily on how it is applied.

Who Can Benefit From Laser Therapy?

Laser therapy can be beneficial for many common arthritic conditions affecting joints such as:

• Knees
• Hips
• Shoulders
• Hands and wrists
• Neck and back

It may also help people who experience:

• Long-term joint pain
• Stiffness affecting daily movement
• Flare-ups of inflammatory symptoms
• Reduced mobility due to arthritis

Your physiotherapist will always assess whether laser therapy is appropriate for your individual condition before recommending treatment.

A Results-Driven Approach to Arthritis Care

At Physiofusion, we don’t believe in passive treatment alone. While laser therapy can significantly reduce pain and inflammation, the best long-term results come from combining it with physiotherapy rehabilitation.

This may include:

• Strengthening exercises
• Mobility work
• Joint stability training
• Lifestyle advice to protect the joint

The aim is not just to relieve pain temporarily, but to help you move better, feel stronger and reduce future flare-ups.

Arthritis Doesn’t Have to Control Your Life

If you’ve been told there’s nothing that can be done for your arthritis, it can feel incredibly frustrating.

But modern physiotherapy has evolved. With the right combination of advanced treatment technology, expert assessment and structured rehabilitation, it is possible to significantly improve how your joints feel and function. Laser therapy is one of the most exciting developments in this area, and we’re proud to bring it to patients in Burnley, Padiham and across Lancashire.

Book Laser Therapy in Burnley or Padiham

If arthritis pain is affecting your daily life, the first step is understanding what treatment options are available to you. At Physiofusion, our experienced physiotherapists can assess your joint and determine whether laser therapy for arthritis could help you.

You can learn more about the treatment here: https://physiofusion.co.uk/clinical-therapies/laser-therapy-for-arthritis/

Or book an appointment online with our team today.

Because even when arthritis can’t be cured, it doesn’t mean that nothing can be done!

The most important thing is that we return home safely without and injury or incident, so let’s make sure we’re well-prepared!

Essential Equipment For Outdoor Adventures:

1.Communication and Navigation

Fully Charged Phone and Battery Charger! It sounds obvious, but so many people often encounter dead batteries when they need them most. In the age of technology, a reliable phone is crucial for emergencies or unforeseen circumstances. Not just to notify someone of an issue, but to make it easy to pinpoint your exact location and even send that location to someone! What’s better than a fully charged phone? 2 fully charged phones. Well… at least a battery pack to full recharge your current one if it runs out.

Map and Compass: While modern technology aids navigation, never underestimate the importance of traditional map-reading skills. Carry a detailed map of the area and a compass you wish to walk to navigate in case electronic devices fail. On occasions, you may be in and out of signal, so these tools are vital for guided outdoor adventures, ensuring you stay on track.

Hydration and Nutrition: Staying hydrated is essential, especially in elevated terrains. Give ourselves a head-start and drink plenty of water before we even set off! Don’t let the temperature of the day catch us out! It’s surprising how much water we lose through working hard and sweating. Carry enough water to last the entire day and consider scheduling an amount to drink so that we don’t drink it all in one go, and then desperate for more later on! Use sachets to add to our water that have electrolytes in it that gives us that little bit of extra energy for the

Breakfast! Some would argue the most important meal of day. Setting ourselves up for the day with a full stomach (packed with nutrition of course) will significantly help us throughout the day. Think about packing nutrient-rich snacks and meals to keep our energy levels up. Consider portable options like energy bars, nuts, and fruits. Proper nutrition is crucial for maintaining stamina during our outdoor adventure.

2.Clothing and Personal Gear

Walking Shoes: INVEST IN FOOTWEAR! We treat so many problems that stem from incorrect footwear. Sturdy, comfortable and well-fitted shoes to provide traction and support on all types of terrain are essential.

Walking Socks: Look to wear moisture-wicking socks to prevent blisters that also keep our feet comfortable throughout our journey.

Fully Waterproof Clothing: Weather, particularly in Britain can be unpredictable. Just because it says there isn’t any rain forecast for today, doesn’t mean there won’t be any rain… Ensure clothing is waterproof and layered to accommodate weather and temperature changes.

Spare Clothing: A spare set of clothes can be a game-changer, especially if we encounter unexpected weather conditions. Not to mention, should we slip or fall and get wet and muddy. At the very least, we want to make sure we’re comfortable!

Dry/Plastic Bag for Essentials: Keep important items like keys and electronic devices in a sealed dry bag to protect them from the elements. Think about this with your spare clothing too. It’s not likely, but if we ever find ourselves in a situation where we need to get wet on our journey, its better to have dry clothes to change into if we need it.

3.Safety Equipment

Whistle/Rope/Spray Can: A whistle is a simple yet effective tool for signalling in emergencies. It can carry over long distances and is an essential addition to our safety gear. Rope is a survival guides number one item to bring on a hike. It can be an incredibly versatile item. We appreciate spray cans might seem a little extreme, however, in the event of a worst-case scenario, being able to mark our journey could be vital.

4.Warm up and stretch

You wouldn’t like us to forget we are Physios would you? If we are carrying an injury, we should try to do exercises before we start a walk to maximise the effectiveness of our injured area. Don’t forget, we can stop and stretch at ay point if we feel any niggles along the way. At the end of a walk, if there have been no flat sections to finish on, we can try a little walk around the car park perhaps to loosen the legs and stop the shock of a hard walk. Keep drinking fluids after the walk to help flush out any lactic acids and keep those muscles well hydrated!

Don’t forget, injuries are not the only thing to think about…worn and torn joints may also need a nice warm-up, stretch-off and cool-down too. If we take care of our body, our body will take care of us.

Conclusion

Preparation (in all scenarios) is absolutely the key to a successful and enjoyable hill and mountain walk. By ensuring we have the essential equipment for outdoor adventures, we not only enhance our safety, but also create the opportunity to fully immerse ourselves in the pleasure of our adventure. If we have been given any advice from our Physio, or even your Podiatrist, we must do our best to try and follow it. It means seeing less of us in the future ; )

If you have any questions or queries about an injury or issue, you can reach out to use for FREE using our Ask A Physio service, here. You can also ask us question about essential equipment for your outdoor adventure if you’re concerned about any risk

Let’s take one of the most common features in wearable technology, for example. Counting steps and step tracking. This feature has been around for a long time, with the majority of us using it to reach that “optimum” target of 10,000 steps a day. This figure has varied over time and will no doubt continue to do so, however, whatever the figure is, it’s always been a target that the “average” person should be able to manage.

It’s this notion that can offer some guidance on whether or not we should have that hip or knee replacement. In a recent study (here), it shows a case for 7000 steps a day being the cut off point for anyone considering hip or knee replacements, and that patients who cannot reach this target due to severity of pain are the ones most in need of a replacement.

It is also important to note that joint replacements are still somewhat risky procedures, leading to more medical complications than conservative care, so making this decision shouldn’t be taken lightly.

Deciding when it is time to have a knee replacement, it may be worth considering alternative information, as opposed to the usual X-ray and MRI scans. Instead, look at cut-off points of 7000 steps per day. Those that clearly can not reach this level due to severity of knee pain are the ones most in need of knee replacement.

Hip versus knee replacements

Generally, hip replacements are considered to be equal to if not superior to knee replacements in terms of outcomes. It is certainly more common to return to higher levels of fitness after hip surgery than it is after knee surgery. It is quite common for people that have had successful hip replacements to go on and compete in what are considered “challenging” activities, such as marathons and triathlons.

Things to consider

As a general rule, the efficiency of surgery is dependent on the amount and quality of bone available to fix the prosthesis in place. This means that hip and knee replacements perform better than ankle replacements and those of us that exercise tend to do better than those of us with sedentary lifestyles.

Use of walking asymmetry as an additional metric

Walking asymmetry is a valuable metric that can provide significant insights into our health, particularly in terms of neurological conditions, rehabilitation progress, fall risk, and overall mobility. The use of modern technology and wearable devices (such as Apple Watch / Health app), makes it easy to incorporate walking asymmetry analysis into various fields, from clinical practice to sports science and everyday health monitoring.

Someone who is taking 8000 steps a day (which is a healthy amount), but with high levels of walking asymmetry (e.g. greater than 20%) may be heading for trouble with an adequate walking amount but limping a lot.

Someone who is only doing 5000 steps a day, but with hardly any walking asymmetry (e.g. less than 5%) can be encouraged to gradually build up to higher step levels, as if walking is very steady, they probably should have the capacity to do higher levels if they have the patience to build up gradually.

If you would like more information on how useful is wearable technology, or you have concerns about a recent hip/knee replacements diagnosis, you can reach out to us for FREE advice at any time, using our “Ask A Physio” service.

This can be particularly prominent in young or athletic people due to the softness and tendency of their feet becoming moist/sweaty from exercise. This can make the skin around the toenails even softer and easier for a nail to pierce.

Some of us naturally just have nails that are more curved and press into the sides of our toes. This doesn’t necessarily mean we have ingrown toe nails. The general rule for concern is that if they are red, inflamed or painful, then there will likely be an issue.

What can I do to help prevent Ingrown Nails?

• Understand how to cut our nails properly! Straight across, making sure not to trim them too low at the edge or down the side. Leave the corner of the nail so it’s visible above the skin. Run a nail file across the sharp edges avoiding taking the nail too far down.
• Avoid moist feet by rotating your shoes and choosing well-fitting socks and shoes made from natural materials.
• If an ingrown toenail develops, you should apply a clean, dry dressing. Use salt water foot baths or antiseptic cream to prevent infection. A Podiatrist can treat the ingrown toenail including those that are swollen and infected. It is best to seek treatment sooner rather than later as delaying treatment can result in longer-term issues.

What can I do to help prevent Thickened Nails?

• You may find cutting them to be difficult, so instead, try filing your toenails once or twice a week to help keep the length down. You can use an emery board or a nail file made of metal or crystal. All are easily available.
• Avoid using home treatments, such as nail thinning products or electric machines to thin the surface of the nail, as this can lead to more damage and the nail becoming thicker and harder to manage. Seek the assistance of a Podiatrist to help reduce the thickness if you’re finding this hard to maintain on your own.

It may seem like such a easy thing to do – knowing how to cut our nails properly – and while it’s not necessarily rocket-science, it’s often the main cause of issues that we treat on a daily basis. Understanding your nail type and the best practice for cutting them shouldn’t be a “one-size-fits-all” approach.

You can use our FREE ask-an-expert service online to talk to our team of Podiatrists about any issues you are facing, here.

This injury recovery time infographic will be particularly helpful for those of us that are particularly physical or active. Whether we’re a seasoned athlete or a weekend warrior, strains, sprains, and other common injuries can occur when we least expect them. While it’s tempting to brush off minor discomfort or “play through the pain,” doing so can lead to more serious consequences down the road.

1. Muscle Soreness

This isn’t generally anything to worry about, however, prolonged muscle soreness could mean an underlying issue. Our muscles are usually sore for a reason, often from overworking them or trying a new exercise.

2. Ligament Sprains

These are among the most common injuries, often occurring due to overstretching or overexertion of muscles and ligaments. While they may seem minor initially, untreated sprains and strains can result in chronic pain, limited mobility, and even long-term joint damage.

3. Muscle Tears:

Muscle tears again can sounds worse than they are. For example, when we lift heavy weights for a certain amount of time, our muscle can be tender to touch. This is because our muscle tears and then re-grows all the time. This is completely normal when building muscle and is only very minimal tearing. However, there are cases when our muscle tears are more serious and need attention as soon as possible.

4. Tendon Inflammation:

Tendonitis, inflammation of the tendons usually caused by repetitive motion or overuse, can significantly impede daily activities and sports performance if left untreated. Early intervention with rest, ice, and physical therapy can prevent the condition from worsening and restore tendon health.

5. Sciatica:

Sciatica can seemingly come from nowhere and at times, completely debilitate us. The sciatic nerve starts just outside the base of our spine (lumbar spine and sacral region). It runs through the top of our gluteus muscles (bum) and down the back of our thighs (hamstrings) and lower legs (calves). That’s quite a significant area that we can experience pain. It’s quite common that where we feel pain isn’t actually where the issue is, so it’s vital you seek a therapist to help locate and treat it as soon as possible.

The benefits of early intervention?

1. Reduced Severity:

Nipping an injury in the bud can prevent it from escalating into a more serious condition. Early intervention allows therapists to address the issue before it worsens, potentially sparing us from prolonged pain and discomfort.

2. Minimised Treatment:

Treating an injury in its early stages often requires simpler and less invasive interventions. By seeking prompt help, me may avoid the need for extensive procedures or surgeries down the line, saving us time, money, and potential complications.

3. Quicker Healing Time:

The sooner we start treatment, the sooner our body can begin the healing process. Addressing an injury promptly can kickstart rehabilitation efforts, promoting tissue repair, and restoring function at a faster rate. This means less time spent side-lined and more time doing what you love.

4. Enhanced Long-Term Outcomes:

By prioritising early treatment, we set the stage for a more successful recovery and improved long-term outcomes. Taking proactive steps to address an injury demonstrates a commitment to our well-being, setting us up for a smoother transition back to our regular activities.

In essence, treating an injury as early as possible is a proactive approach that pays in the long run. Whether it’s seeking professional therapy, implementing home exercises, or modifying activity levels, taking swift action can make all the difference in our recovery journey. Remember, our health and well-being are worth prioritising, so don’t delay in addressing any signs of injury or discomfort.

For personalised guidance on injury treatment and rehabilitation, use our FREE Ask A Physio advice service to see how we can help you today.

As well as the loads placed through them, our Achilles are more at risk of injury with age, excess weight, muscle imbalances, fatigue or leg length discrepancies. Therefore, it is important that we continuously consider these factors when trying to stay healthy and injury-free.

The Achilles, like all tendons appear white on diagrams and models. This is because they are avascular; in simpler terms, they have limited blood supply to them. Because of the limited supply, this also makes the healing process longer, so it is even more important that we avoid injuries!

Types of Achilles Injuries?

Achilles Tendinitis

Achilles Tendinitis indicates inflammation of the tendon. This is most common in overuse injuries, whereby repetitive “micro trauma” and strain caused by continuous overload causes the Achilles Tendon to become inflamed and painful.

This can be characterised by the feeling of a stiff Achilles and lack of flexibility. Our Achilles may feel thicker and we may also get pain in the tendon that worsens with active or passive movements going into the calf muscles. In some instances, whereby the tendonitis occurs at the insertion point in the heel bone, you may start to form a bone spur (a hard projection along bone edges).

Treatment options that have been found to be useful include; rest and ice, NSAIDs, soft tissue treatments, electrotherapy, prescription exercises, strapping, orthotics and injections or surgery.

Achilles Tendinosis

If an Achilles Tendinitis goes unnoticed or mistreated, Achilles Tendinosis may creep in. Achilles Tendinosis is a chronic condition where there is a structural change of the tendon. Causes of this are usually down to repetitive micro traumas/overuse with a lack of healing, and can be more common with age (age decreases blood supply).

Although treatment of an Achilles Tendinopathy is similar to that of Achilles Tendinitis; because of the nature and structure of a chronically injured Achilles, treatment may be more complex and recovery time would be longer.

Achilles Ruptures

Achilles Ruptures can differ in severity; from partial tears of the fibres to a complete tear. Ruptures can occur in anyone, but are more common in those of us that are particularly active or athletic. This is because the common mechanism of injury for an Achilles rupture is that of a sudden force applied through the tendon that it is unable to withstand. Ruptures are often characterised by an initial feeling or sometimes audible ‘pop’, followed by swelling, bruising and pain. There may be a visible deformity in the Achilles and/or calf muscle, along with a weakness and sometimes the inability to point the foot.

Achilles injuries left untreated can significantly worsen and as a result, increases the recovery time, as they are already a particularly tricky injury to “heal” quickly as it is.

Please contact your local Physiotherapists for advice if you feel you have any issues with your Achilles and calves, alternatively, you can use out FREE Ask A Physio service.

Unfortunately, in recent years, I have been quite prone to catching flu (to the point where I was getting it twice a year) so I can recognise it and know all the symptoms. For the last three years I have been getting the flu vaccination, which has prevented me from catching it. This is what I thought was very strange about being unwell in February 2020; along with the different symptoms.

The symptoms I experienced during the time of catching the virus were fever, constant cough that was different to before covid, shortness of breath (even at rest), loss of taste/smell, headache, fatigue and an upset stomach. I also experienced body aches. The loss of taste and smell was the strangest symptom and something I’d never experienced before when having flu and because of this I had very little appetite. To this day I still struggle with a limited sense of smell.

My symptoms after covid included relapses of the above symptoms, as well as loss of concentration and ability to think clearly, poorer memory and poorer mental health. I also experienced fatigue and lack of energy, along with shortness of breath during routine activities such as general walking and climbing stairs and shortness of breath during exercise. The latter having an impact on my mental health, as prior to the start of 2020 I was fit and active. I walked a lot and went to the gym 3 times a week to do a variety of activities such as powerlifting, circuits and HIIT. Further post-covid symptoms were chills/fever – feel I’m unable to regulate my temperature sometimes, joint/muscle aches, headaches, palpitations/racing heart, sore throat, chest pain and chest heaviness. The latter resulting in a cough when I exerted myself. I often felt like there was something ‘stuck’ in my chest. I often got a ‘tickly’ throat too.

Covid Treatment

After dealing with all the above for over a year, I booked in for a ‘Post-Covid’ Initial Assessment at Physiofusion. Prior to my assessment, I was asked to complete an online survey about my symptoms and the issues I was experiencing. I also had to complete a Peak Flow test, which was done by breathing into a device that measures your peak expiratory flow (PEF).

I saw Caroline who is one of the physiotherapists there. I had a thorough assessment and we discussed the results of my peak flow test and all of the symptoms I listed in the survey. Caroline also explained about the symptoms of long-Covid and what we know from the latest research on it. She also did a variety of treatments on me, including manual therapy and breathing techniques. She also gave me breathing exercises to do at home along with advice on activities to do to get back into exercise, without pushing myself too hard and hindering my recovery.

I had a thorough follow-up appointment with Caroline where we reviewed how my treatment has gone, any progress made and issues that arose. She also did more manual therapy, reviewed the breathing exercises to ensure I was doing them correctly and advised on a treatment plan going forward. I felt comfortable to continue with the advised treatment at home and book reviews when I felt I needed to.

Overall, I found the covid treatment very beneficial and would highly recommend it. It has been massively helpful to gain a better understanding of covid and how it affects us. Although simple, the breathing exercises have been very effective and have helped with my recovery. I feel much better than I did initially and confident that the post-covid treatment has been a major factor in this so I’d like to say a huge thank you to Caroline and also to Physiofusion for introducing this effective, important and much needed treatment.

If you have or are struggling with the after affects of covid, drop our experts a message and find out how our covid treatment can help you, here.

A great positive about some assisted stretching exercises is that they can often be simply performed by an individual once prescribed and taught, however there are types of stretching which require assistance from a Physiotherapist. More complex types of stretching called muscle energy techniques which use the contraction of a muscle to increase its flexibility can in certain circumstances have quicker results than standard passive stretching.

When we feel tightness or pain in our body, we often feel the need to stretch in order to relieve our symptoms. This is a good instinct! Stretching can help to relieve tight pain, as well as increasing the movement in our body. However, there are numerous reasons why we may feel tight, stiff and restricted and would therefore be beneficial to seek professional advice before continuing.

A reduction in range of motion in the body is typically due to either a restriction in the joint or an increase in tension of the muscle. Also, other issues such as weakness or a history of serious pathology could cause significant restriction. A structured programme of stretching has been shown in a majority of cases to increase the range of movement in the body where the restriction is caused by soft tissue tightness such as muscular restriction.

At times, there is a danger in wanting to be as stretched as possible, however, it is actually important for us to have SOME tension in our muscles. It is also natural for some muscles to be shorter and tighter than others and part of this is determined by our activities and needs. What is important is to address areas of the body where a restriction in movement is likely resulting in pain, discomfort or a loss of function.

A Physiotherapist will be able to perform an assessment to determine the likely cause of any restriction in movement, as well as to analyse whether these restrictions are detrimental to health and function, working out how best to resolve them if required. There are numerous types of stretching techniques, including static, dynamic and contraction based stretches. The type which is appropriate for your needs is dependent on multiple unique factors which will be determined during assessment.

Overall, if used appropriately, assisted stretching can be an incredibly beneficial exercise and the right guidance from a Physiotherapist can ensure that you get the most from it.

If you have any questions or queries, please reach out to our experts for FREE using our online service. Alternatively, you may call us on 01282 453 110 to book in with a therapist.

If you would our help with assisted stretching, you can choose your preferred location to be treated from. Select from our Burnley and Padiham clinics.