Common Injuries

How physiotherapy helps

Treatment is a combination of three things. First, a thorough assessment to work out which structures are driving your pain and what's keeping it going. Second, hands-on treatment to settle pain and free up movement. Third, a progressive exercise programme to rebuild strength through the hips, core, and trunk so the pain doesn't keep coming back.

Clinical guidelines are clear that staying active is more effective than bed rest for almost all types of back pain. Prolonged rest tends to make things worse, not better. Most people see meaningful improvement once they're moving again with the right plan in place.

When to seek urgent care

Most lower back pain settles with the right treatment. There are a few warning signs that need urgent medical attention rather than a physio appointment: loss of bladder or bowel control, numbness around the saddle area (groin or inner thighs), or progressive weakness in both legs. These can be signs of cauda equina syndrome and need same-day assessment at A&E.

How physiotherapy helps

Assessment first works out which structures are involved, then treatment combines hands-on manual therapy with a progressive exercise programme. Manual therapy can quickly settle pain and free up restricted movement in the neck joints. Exercise rebuilds strength and endurance in the deep neck muscles and the postural muscles between the shoulder blades, which are usually the part that's been letting the neck down in the first place.

For neck pain with referred symptoms into the arm or hand, the assessment also screens for nerve involvement. Treatment in those cases includes specific neural mobilisation techniques alongside the standard approach.

What about posture?

Posture matters, but probably less than most people think. There is no single "perfect" posture that prevents neck pain. The body adapts to whatever load you give it, so the real protection is variety of movement and underlying strength, not sitting up straight all day. Treatment focuses on building the capacity to handle the postures your work and life actually require.

How physiotherapy helps

The starting point is an accurate diagnosis, because the different causes of shoulder pain need different treatment. Assessment works out whether the problem is coming from the rotator cuff and subacromial bursa, the joint capsule, the AC joint, or the neck, and screens for anything that needs onward referral.

For rotator cuff-related and subacromial pain, the treatment with the strongest evidence is a progressive strengthening programme for the rotator cuff and the muscles that control the shoulder blade, combined with hands-on treatment to settle symptoms and short-term changes to whatever is aggravating it. High-quality trials have shown that, for most people, this kind of structured rehabilitation is as effective as surgery, and that keyhole subacromial decompression offers little benefit over a placebo procedure. Loading the tendon correctly is what builds lasting capacity, rather than resting it or relying on injections alone.

Frozen shoulder and warning signs

Frozen shoulder (adhesive capsulitis) is a separate condition that is often mistaken for rotator cuff pain. It causes a gradual, marked loss of movement in every direction, not just overhead, and moves through painful, stiff, and then thawing phases over many months. It is more common between the ages of 40 and 60 and in people with diabetes, and it responds to a different approach focused on managing pain and preserving movement, which is why getting the diagnosis right matters.

A sudden inability to actively lift the arm after a fall or trauma can point to a significant rotator cuff tear that needs imaging and a surgical opinion, and a shoulder that has dislocated should be assessed before starting rehabilitation. The assessment screens for these so the right cases are directed to the right place.

How physiotherapy helps

Treatment depends on the severity of the sprain. Grade 1 (mild ligament stretching) usually settles in one to three weeks. Grade 2 (partial tear) takes around three to six weeks. Grade 3 (complete tear) can take eight to twelve weeks or longer and sometimes needs surgical opinion.

Beyond the immediate management of swelling and pain, the focus is on restoring strength, balance, and proprioception (your body's sense of where the joint is in space). Proprioception is the bit that almost always fails after a sprain, and the bit that prevents the next one. Single-leg balance work, hopping and landing drills, and sport-specific movement form the second half of a proper ankle rehab programme.

When to seek urgent care

Severe pain immediately after the injury, inability to weight bear, obvious deformity, or pain along the bone (rather than just the soft tissue) can suggest a fracture and needs an X-ray. If there is any doubt, get it assessed in A&E or a minor injuries unit before booking physio.

How physiotherapy helps

The most important part of treatment is load management. That means finding the level of running or training your body can currently tolerate, building from there, and identifying the biomechanical factors that have made you vulnerable in the first place. Common drivers are weakness through the hip and calf, sudden jumps in training volume, hard surfaces, and footwear that isn't right for your foot type.

Treatment also includes hands-on work to settle the irritated tissue, a structured strength programme for the calf, hip, and foot, and a return-to-running plan that gradually builds the bone and muscle capacity to handle full training. Rushing back early is the single biggest reason shin splints become chronic.

When to seek further investigation

Shin pain that's localised to a single, very tender point on the bone, or that wakes you up at night, can be a sign of a stress fracture rather than shin splints. If those signs are present, an imaging referral may be needed before continuing rehab.