Ask the Experts - Injury

Questions for Sean Fyfe:

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1. Hello I am a new personal trainer. I have been in the whole of fitness for over 15 years now. I teach and train a number of group classes. I have a new client who has kyphosis (curvature of the spine). What upper body exercises do you feel are best for a person who has this condition? (Refer to answer here)
   

2. I have a persistant adductor pain problem. It flared up accutely a year ago probably due to speed work and particularly doing hills ( for triathlon/duathlon). Tests apparently discounted Oestitis Pubis and any neural component due to lumbar disc degeneration L3/4. The closest physio diagnosis got, was to suggest weak glut Medius allowing femoral head to translate forward. Anterior and deep hip pain also seems to occur as a secondary symtom.

   Stretching and Massage to trigger points and tender attachments and muscle belly didnt seem to alleviate next session. When I resumed training it felt more like a hamstring niggle which didnt worsen although recently with step up in training it has been more noticeable, but quickly eases with a day of rest. It dramatically deteriorated last week when orienteering over a steep course! Pain even to walk has persisted for several days. Very frustrating.(Refer to answer here)

3. I read your article "What all physiotherapists should know , but don't" in Peak Performance with great interest. I am a 71 year old triathlete, in the British Team for my age group. I am fit and train for around 2 hours per day. For some time now I have experienced varying degrees of back pain. Recently I had a scan and discovered that I have osteoporosis in my lumbar spine, together with slight lateral curvature. I am now taking calcium and vitamin D, plus Risedronate sodium. Your example of a rehabilitation program for a tennis player with a lumbar stress fracture struck me as being an ideal program for me to adopt to stimulate a strengthening of my lumbar spine. I would be interested to hear your comments. I am very familiar with free weights. (Refer to answer here)

4. At first I didn't realise that I'd done anything even slightly serious slightly overstretching when playing football with a four-year-old in Spain. That was in April this year.

   Slowly over a month or so I became aware of some pain in my right Achilles tendon. I rested. Took things really easy apart from a few stretching exercises. In July in Spain a doctor gave me (I think it's called a back slab?) plaster of paris under the sole of my foot and up my calf, held in place by a crepe bandage. It lasted two weeks. Total comfort, and I thought all was well again, although the area was still slightly swollen.

   But the pain returned quite quickly, with only minor exercise. In England during August a physiotherapist treated it with ultrasound, without any noticable effect. Two doctors and the physio have said it's tendonitis.

   I have been doing the exercises recommended in Sports Injury Bulletin. The swelling and the pain persist: a fierce burning sensation when walking - as I transfer my weight to the ball of the foot. What do you recommend? (Refer to answer here)

5. I have had a clicking noise in my left shoulder for a few years but it did not really affect my exercise routine and i avoided lifts that caused the noise. Towards the end of last year I started to train for a sprint triathlon, I built up slowly but as I started to do more swimming the noise got more frequent, sometimes painful and left me with a dull ache.
   
   I went to my GP who suggested i try anti-inflammatory medication (ibuprofen) but this did not make any difference and gave me digestive problems! I went back and he referred me to a rheumatologist who I have now seen. I had x-rays and I was told I had damaged a ligament in the rotor cuff and needed physiotherapy, this could mean a wait of up to six months on the NHS. I am keen to get back into training but realise that I will have to wait until next year now.
   
   I have searched my copies of your personal trainer and the injury supplement but have not been able to find any reference to rotor cuff injuries. I am doing gentle stretching exercises but wondered if there was anything you could advise, any help with this is much appreciated.
   
   Thank you for your time. (Refer to answer here)

6. I am suffering from constant knee pain lately. I had an ITB injury in October last year after doing a trail run. For months nothing helped - cortisone injections, orthotics, physio, a LOT of stretching, knee rehabilitation with biokineticists and eventually dry needling. The dry needling helped and I have been running since August again. But now I have knee pain in both knees. What am I doing wrong? Please help me - I am desperate!
   Thank you and kind regards (Refer to answer here)

7. I am suffering from a painful knee injury on the medial side of the knee.  It’s especially bad when I run and I actually cannot run as a result of the pain.  I weigh 90kg, do you have any advice?(Refer to answer here)