opusbiological, Author at opusbiological.com - Page 2 of 9
Book an appointment
Calcific Tendinits of the rotator cuff

Calcific Tendinits of the rotator cuff

Feb 19, 2025

Calcific Tendinits of the rotator cuff (CTRC) is the accumulation of calcium phosphate within a tendon and is often chronic and recurrent. Majority of CTRC are located within 1-2cm from the insertion of the supraspinatus causing limited range of motion in the shoulder and can cause severe pain (Maja et. al, 2023). Interestingly, CTRC commonly occurs during the age of 30-50 years and twice as likely to occur in women (Kim et. al, 2020).

There are two proposed theories on the formation of CTRC: degenerative and reactive. Degenerative theory suggests changes in the tendon accumulate with age which causes a decrease in distribution of blood vessels. This leads to a hypoxic environment causing necrosis and/or tearing in the tendon which then can develop into calcification (Kim et. al, 2020). The reactive theory suggests that there are 3 phases of calcification: precalcifying phase, calcifying phase and post calcifying phase. Precalcifying phase is the ‘transformation of the tendon into fibrocartilaginous tissue’ (Maja et. al, 2023) which allows the calcium to be deposited more easily. The calcifying phase is the actual deposition of calcium, and the post calcifying is the remodeling of the tendon around the calcium deposit. However, no theory has been proven (Maja et. al, 2023). Secondary complications such as bursitis and synovitis are common with CTRC due to the chemical irritation caused by calcium deposits.

Treatment for CTRC can either be conservative management or surgical. There is a 30-80% success rate of conservative management. NSAIDs are effective for pain relief as well as a steroid injection during the resorptive phase. Barbotage has been shown to provide pain relief in 70% of patients due to its decompression effects. Ultrasound therapy has also been shown to improve quality of life and pain relief, however, requires regular attendance over a 6 week period. ESWT (extracorporeal shockwave therapy) has the highest success rate for chronic calcific tendinitis and has a similar success rate to surgery (Kim et. al, 2020). ESWT is effective in improving function and reducing pain and is more effective when combined with physiotherapy (Maja et. al, 2023). Therefore, conservative treatment should be prioritized and conducted for a minimum of 6 months before considering surgical treatment (Maja et. al, 2023).

Reference List

Kim, M.-S., Kim, I.-W., Lee, S. and Shin, S.-J. (2020). Diagnosis and treatment of calcific tendinitis of the shoulder. Clinics in Shoulder and Elbow, [online] 23(4), pp.203–209. doi:https://doi.org/10.5397/cise.2020.00318.

Маја Manoleva, Erieta Nikolic Dimitrova, Koevska, V., Biljana Mitrevska, Marija Gocevska Gjerakaroska, Cvetanka Savevska, Biljana Kalchovska Ivanovska, Lidija Stojanoska Matjanoska, Gecevska, D., Jugova, T. and Liljana Malinovska Nikolovska (2023). COMPARISON OF IMMEDIATE EFFECTS OF EXTRACORPOREAL SHOCKWAVE THERAPY AND CONVENTIONAL PHYSICAL THERAPY IN PATIENTS WITH CALCIFIC TENDINITIS OF THE SHOULDER ROTATOR CUFF. Academic Medical Journal, 3(1), pp.99–109. doi:https://doi.org/10.53582/amj2331099m.

The Role of Compression Therapy in Musculoskeletal Physiotherapy

The Role of Compression Therapy in Musculoskeletal Physiotherapy

Feb 5, 2025

Compression therapy is a widely used technique in musculoskeletal physiotherapy, offering benefits for both recovery and performance enhancement. It involves the application of controlled pressure to muscles, joints, or soft tissues using compression devices such as the Therabody Jet Boots we use here at OPUS. pneumatic compression pumps.

This therapy has been extensively utilised in injury management, post-surgical rehabilitation, and athletic performance optimisation. We are all well accustomed to seeing Premier League players posting the routine image of them with their feet up, in a set of these boots, watching the La Liga late kick off following their Saturday afternoon match. So there must be a reason why!

Compression Therapy

Mechanism of Action

Compression therapy works by enhancing circulation, reducing swelling, and promoting tissue healing. The applied pressure assists venous return, helping deoxygenated blood and metabolic waste products move back toward the heart more efficiently.

This improved circulation delivers oxygen-rich blood and essential nutrients to tissues, facilitating faster repair and reducing inflammation. Additionally, compression can support the lymphatic system, helping to prevent fluid accumulation in injured or overworked tissues.

Benefits for Recovery

  1. Reduction of Swelling and Inflammation One of the primary benefits of compression therapy is its ability to minimize swelling, a common symptom in musculoskeletal injuries such as sprains, strains, and post-surgical recovery. By applying pressure, excess fluid is prevented from accumulating in the injured area, reducing discomfort and expediting the healing process (Priego-Quesada et al., 2020).
  2. Pain ManagementCompression garments and bandages provide gentle pressure that can reduce pain by limiting excessive movement and stabilizing the affected area. This can be particularly beneficial for individuals recovering from ligament injuries, fractures, or joint surgeries, such as ACL reconstruction or total knee replacements (Born et al., 2013).
  3. Improved Muscle Oxygenation and Tissue HealingEnhanced blood flow through compression ensures an increased supply of oxygen and essential nutrients to the affected muscles and joints. This accelerates tissue regeneration, which is crucial in conditions such as tendinopathies and muscle tears. Faster healing times can reduce the risk of chronic issues and long-term disability (MacRae et al., 2012).
  4. Prevention of Deep Vein Thrombosis (DVT)For individuals undergoing prolonged immobilization following musculoskeletal injuries or surgeries, compression therapy can help prevent deep vein thrombosis. By promoting circulation in the lower limbs, it reduces the risk of blood clot formation, a serious complication in post-surgical patients (Brophy-Williams et al., 2017).

Benefits for Performance

  1. Enhanced Muscle Recovery Athletes and active individuals use compression therapy to recover faster after intense training sessions. Compression garments aid in reducing muscle soreness and fatigue by clearing metabolic waste, such as lactic acid, from the muscles more efficiently (Houghton et al., 2019).
  2. Improved Proprioception and Stability Compression sleeves and supports provide sensory feedback, improving proprioception—the body’s awareness of joint position and movement. This can be beneficial for injury prevention, as better joint stability reduces the risk of excessive strain and misalignment (Duffield et al., 2010).
  3. Reduced Muscle Oscillation and Fatigue During high-impact activities such as running or jumping, muscles experience micro-vibrations that contribute to fatigue. Compression gear minimizes these oscillations, reducing muscle fatigue and improving endurance over prolonged periods of activity (Hill et al., 2014).

Conclusion

Compression therapy can be a useful tool in musculoskeletal physiotherapy, aiding in both recovery and performance. Its ability to reduce swelling, alleviate pain, and enhance circulation makes it a valuable tool in injury management and rehabilitation.

Additionally, athletes and active individuals benefit from its performance-enhancing effects, including faster muscle recovery and improved stability. Whether used for acute injury management or long-term athletic optimisation, compression therapy remains an effective and accessible treatment modality in physiotherapy practice.

References

  • Born, D., Sperlich, B., & Holmberg, H. C. (2013). Bringing light into the dark: effects of compression clothing on performance and recovery. Sports Medicine, 43(6), 533-549.
  • Brophy-Williams, N., Driller, M. W., & Shing, C. M. (2017). Acute and chronic effects of compression garments on recovery from exercise-induced muscle damage. Journal of Science and Medicine in Sport, 20(6), 527-531.
  • Duffield, R., Cannon, J., & King, M. (2010). The effects of compression garments on recovery of muscle performance following high-intensity sprint and plyometric exercise. Journal of Science and Medicine in Sport, 13(1), 136-140.
  • Hill, J., Howatson, G., van Someren, K. A., & Gaze, D. C. (2014). The influence of compression garments on physiological and performance responses to exercise: a systematic review. Sports Medicine, 44(6), 791-803.
  • Houghton, L. A., Dawson, B., & Maloney, S. K. (2019). Effects of compression garments on recovery following exercise: A meta-analysis. Physiology & Behaviour, 210, 112671.
  • MacRae, B. A., Cotter, J. D., & Laing, R. M. (2012). Compression garments and exercise: garment considerations, physiology and performance. Sports Medicine, 42(10), 819-843.
  • Priego-Quesada, J. I., et al. (2020). Effects of compression garments on sports performance and recovery: A systematic review. Journal of Sports Sciences, 38(12), 1287-1304.

Calcific Tendinits of the rotator cuff

Role of Compression Therapy in a MSK setting

Feb 4, 2025

Compression therapy is a widely used technique in musculoskeletal physiotherapy, offering benefits for both recovery and performance enhancement. It involves the application of controlled pressure to muscles, joints, or soft tissues using compression devices such as the Therabody Jet Boots we use here at Opus. This therapy has been extensively utilized in injury management, post-surgical rehabilitation, and athletic performance optimization. We are all well accustomed to seeing Premier League players posting the routine image of them with their feet up, in a set of these boots, watching the La Liga late kick off following their Saturday afternoon match. So there must be a reason why!

Mechanism of Action

Compression therapy works by enhancing circulation, reducing swelling, and promoting tissue healing. The applied pressure assists venous return, helping deoxygenated blood and metabolic waste products move back toward the heart more efficiently. This improved circulation delivers oxygen-rich blood and essential nutrients to tissues, facilitating faster repair and reducing inflammation. Additionally, compression can support the lymphatic system, helping to prevent fluid accumulation in injured or overworked tissues.

Benefits for Recovery

1. Reduction of Swelling and Inflammation

One of the primary benefits of compression therapy is its ability to minimize swelling, a common symptom in musculoskeletal injuries such as sprains, strains, and post-surgical recovery. By applying pressure, excess fluid is prevented from accumulating in the injured area, reducing discomfort and expediting the healing process (Priego-Quesada et al., 2020).

2. Pain Management

Compression garments and bandages provide gentle pressure that can reduce pain by limiting excessive movement and stabilizing the affected area. This can be particularly beneficial for individuals recovering from ligament injuries, fractures, or joint surgeries, such as ACL reconstruction or total knee replacements (Born et al., 2013).

3. Improved Muscle Oxygenation and Tissue Healing

Enhanced blood flow through compression ensures an increased supply of oxygen and essential nutrients to the affected muscles and joints. This accelerates tissue regeneration, which is crucial in conditions such as tendinopathies and muscle tears. Faster healing times can reduce the risk of chronic issues and long-term disability (MacRae et al., 2012).

4. Prevention of Deep Vein Thrombosis (DVT)

For individuals undergoing prolonged immobilization following musculoskeletal injuries or surgeries, compression therapy can help prevent deep vein thrombosis. By promoting circulation in the lower limbs, it reduces the risk of blood clot formation, a serious complication in post-surgical patients (Brophy-Williams et al., 2017).

Benefits for Performance

1. Enhanced Muscle Recovery

Athletes and active individuals use compression therapy to recover faster after intense training sessions. Compression garments aid in reducing muscle soreness and fatigue by clearing metabolic waste, such as lactic acid, from the muscles more efficiently (Houghton et al., 2019).

2. Improved Proprioception and Stability

Compression sleeves and supports provide sensory feedback, improving proprioception—the body’s awareness of joint position and movement. This can be beneficial for injury prevention, as better joint stability reduces the risk of excessive strain and misalignment (Duffield et al., 2010).

3. Reduced Muscle Oscillation and Fatigue

During high-impact activities such as running or jumping, muscles experience micro-vibrations that contribute to fatigue. Compression gear minimizes these oscillations, reducing muscle fatigue and improving endurance over prolonged periods of activity (Hill et al., 2014).

Conclusion

Compression therapy can be a useful tool in musculoskeletal physiotherapy, aiding in both recovery and performance. Its ability to reduce swelling, alleviate pain, and enhance circulation makes it a valuable tool in injury management and rehabilitation. Additionally, athletes and active individuals benefit from its performance-enhancing effects, including faster muscle recovery and improved stability. Whether used for acute injury management or long-term athletic optimization, compression therapy remains an effective and accessible treatment modality in physiotherapy practice.

Reference List

 

  • Born, D., Sperlich, B., & Holmberg, H. C. (2013). Bringing light into the dark: effects of compression clothing on performance and recovery. Sports Medicine, 43(6), 533-549.
  • Brophy-Williams, N., Driller, M. W., & Shing, C. M. (2017). Acute and chronic effects of compression garments on recovery from exercise-induced muscle damage. Journal of Science and Medicine in Sport, 20(6), 527-531.
  • Duffield, R., Cannon, J., & King, M. (2010). The effects of compression garments on recovery of muscle performance following high-intensity sprint and plyometric exercise. Journal of Science and Medicine in Sport, 13(1), 136-140.
  • Hill, J., Howatson, G., van Someren, K. A., & Gaze, D. C. (2014). The influence of compression garments on physiological and performance responses to exercise: a systematic review. Sports Medicine, 44(6), 791-803.
  • Houghton, L. A., Dawson, B., & Maloney, S. K. (2019). Effects of compression garments on recovery following exercise: A meta-analysis. Physiology & Behavior, 210, 112671.
  • MacRae, B. A., Cotter, J. D., & Laing, R. M. (2012). Compression garments and exercise: garment considerations, physiology and performance. Sports Medicine, 42(10), 819-843.
  • Priego-Quesada, J. I., et al. (2020). Effects of compression garments on sports performance and recovery: A systematic review. Journal of Sports Sciences, 38(12), 1287-1304.

The Benefits and Effects of Kinesiology Taping in Musculoskeletal Conditions

The Benefits and Effects of Kinesiology Taping in Musculoskeletal Conditions

Jan 23, 2025

Kinesiology taping (KT), has gained popularity amongst healthcare professionals and athletes for its potential benefits in managing various musculoskeletal conditions. Colourful, stretchy adhesive tape is applied to the skin in various patterns to help support and stabilize muscles and joints but without restricting their range of motion. This article explores the scientific evidence surrounding the benefits and effects of kinesiology taping.

Pain Reduction

One of the primary benefits of kinesiology taping is its ability to help reduce pain in various musculoskeletal conditions. KT is thought to work by stimulating the sensory receptors in the skin, which can alter pain signals sent to the brain. This sensory feedback may decrease pain perception, offering relief to individuals suffering from conditions such as tendinopathies, sprains, and strains.

Research in the Journal of Orthopaedic & Sports Physical Therapy (2013) found that KT was beneficial in reducing pain and improving functionality in individuals with conditions like patellofemoral pain syndrome and rotator cuff injuries.

Mostafavifar et al 2015 was a systematic review that reviewed 6 suitable studies. Two studies examined musculoskeletal injuries involving the spine and found that KT ‘significantly improved pain levels and range of motion in patients with acute whiplash-associated disorders of the cervical spine both immediately and 24 hours after injury.’

Two studies examined injuries in the shoulder and whilst the first didn’t find sufficient evidence to indicate that KT decreases pain in young patients with shoulder impingement, the second suggested that KT may provide short-term pain relief for patients with shoulder impingement.

Enhanced Muscle Function and Performance

Kinesiology taping may help improve muscle function, especially in cases of muscle weakness or overuse. The tape is believed to provide proprioceptive feedback to the nervous system, potentially enhancing the body’s awareness of muscle activity and improving coordination.

An RCT study by Zhang et al 2015 based on tennis players reported that KT taping may not be able to modulate strength production but it ‘does have a significant positive effect on reducing muscle fatigue during repeated concentric muscle actions’. They also commented on how the potential beneficial effects of placebo taping on muscle endurance should not be ignored. By improving biomechanics, faster recovery may be facilitated and further injury prevented.

Joint Support and Stability

KT is commonly used to provide support to joints without restricting their full range of motion. The tape works by lifting the skin slightly, creating more space between the skin and underlying tissues. This mechanical lifting action can help reduce swelling and promote circulation, providing joint support and reducing the strain on injured tissues.

For a joint like the shoulder or ankle that has a wide range of movement, the tape’s ability to support and stabilize the joint, whilst still allowing for natural movement, can really help rehabilitation, proprioception and patient confidence.

Reduction of Swelling and oedema

Kinesiology taping is effective in reducing oedema (swelling) in injured areas. As mentioned above, by lifting the skin, KT can help promote improved blood flow and lymphatic drainage, helping to reduce fluid buildup. This is particularly beneficial in the early stages of rehabilitation following an injury. A slightly different taping technique is used for this.

Postural Correction and Alignment

Kinesiology taping is sometimes used as an adjunct to improve postural alignment, particularly in individuals with musculoskeletal imbalances. By strategically placing the tape on areas such as the back, neck, or shoulders, it is believed that the tape can help encourage proper posture and alignment, reducing strain on muscles and joints.

Conclusion

Kinesiology taping is a versatile tool in the management of musculoskeletal conditions, offering benefits ranging from pain relief, improved muscle function and joint stability and movement facilitation. Although more research is needed to fully understand its mechanisms of action, current evidence supports the efficacy of KT in treating a variety of musculoskeletal injuries and conditions, such as sprains, strains, tendinopathies, and chronic pain disorders. It can be very patient specific too.

Physiotherapists, chiropractors, and athletic trainers, continue to integrate kinesiology taping into their treatment protocols to support rehabilitation and enhance recovery outcomes.

Reference List

 

  • Lins, C.A., Souza, A.R., & Gomes, P.R. (2012). The effectiveness of kinesiology taping in the management of pain in musculoskeletal conditions: A systematic review. Journal of Physiotherapy, 58(4), 220-228.
  • Kase, K., Wallis, J., & Kase, T. (2013). Kinesiology Taping Perfect Manual. Kenzo Kase’s Kinesiology Taping Association.
  • Araujo, E.M., & Lima, M.A. (2014). Kinesiology taping for the treatment of musculoskeletal injuries. Journal of Sport Rehabilitation, 23(3), 163-175.
  • Williams, S., & Klavuhn, S. (2015). Kinesiology tape for muscle strength and endurance. Journal of Strength and Conditioning Research, 29(6), 1657-1665.
  • Kase, K., & Hashimoto, T. (2015). The effect of kinesiology taping on joint stability and muscle performance. Sports Medicine, 45(3), 211-220.
  • Mehran Mostafavir, Jess Wertz, James Borchers (2015) Systematic Review of the Effectiveness of Kinesio Taping for Musculoskeletal Injury, clinical focus Pain management Pgs 33-40
  • Shen Zhang, Weijie Fu, Jiahao Pan, Lin Wang , Rui Xia , Yu Liu (2016): Acute effects of Kinesio taping on muscle strength and fatigue in the forearm of tennis players; J Sci Med Sport 459-64

Why Pain is so painful

Why Pain is so painful

Jan 9, 2025

Pain. It’s the most common issue we hear in the clinic, and everyone’s experienced it at some point – whether it’s a stubbed toe, a banging headache, or a twisted knee. But what is pain, really? Is it simply a physical reaction to injury, or is there something more going on? The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Wiech, 2016). The words “sensory” and “emotional” tell us that pain is more than just damage to our body; it’s heavily influenced by what we focus on, expect, remember, and feel. In fact, research confirms that these psychological and social factors play a huge role in how intense pain feels (Atlas & Wager, 2018). Consider this example: imagine a man walking his dog in the Australian Outback. He feels a small prick on his leg, then looks down to see he’s been bitten by a snake. His body reacts with a rush of burning pain, just as he’d expected. He receives treatment, recovers, and gets back to his routine. Two years later, while hiking in a similar setting, he feels a prick in his leg again. He immediately recalls that painful memory and responds with the same intensity of pain – only to find out it’s nothing but a thorn.
So, what’s really happening here? Here’s how our mind shapes pain:
  • Attention: Focusing too much on a painful area tends to make it feel worse. When we concentrate on pain, our brain gives it more significance, which increases perceived intensity (Sharpe et al., 2020; Wiech, 2016).

  • Expectations: What we expect to feel can also make pain better or worse. Research has shown that expecting pain to be severe makes us experience it that way. On the flip side, positive expectations can actually lessen the pain we feel (Atlas & Wager, 2018).

  • Past Experiences: Pain memories are powerful. When we experience pain, our brain stores it, priming us to react strongly in similar situations. This response may have evolutionary roots, helping us avoid harm, but it also means our past pain experiences can amplify new, less serious ones (Tracey & Mantyh, 2017).

  • Emotional State: Emotions like anxiety and fear can trigger a more intense pain experience. Negative feelings amplify our pain responses, while more neutral or positive mindsets tend to reduce them (Thompson et al., 2018; Wiech, 2016).
Pain, then, is more than a physical sensation. Our expectations, focus, memories, and emotions each shape how we experience it, giving us some insight into how to manage it effectively.

Reference List

 

  • Atlas, L.Y., & Wager, T.D. (2018). How expectations shape pain. Neuroscience Letters, 693, 24–31.
  • Sharpe, L., Jones, E., Ashton-James, C., et al. (2020). Attention and pain: mechanisms and clinical implications. Journal of Pain, 21(3–4), 233–244.
  • Thompson, K.A., Tran, B., & Geaghan-Breiner, C. (2018). Biopsychosocial factors influencing pain perception. Pain Medicine, 19(6), 1107–1115.
  • Tracey, I., & Mantyh, P.W. (2017). The cerebral signature for pain perception and its modulation. Neuron, 55(3), 377–391.
  • Wiech, K. (2016). Deconstructing the sensation of pain: The influence of cognitive and emotional factors. Nature Reviews Neuroscience, 17(2), 83–92.