Month: October 2025

Shoulder Pain: Shoulder Impingement Syndrome

Posted on by Dr Dharam

What is Shoulder Impingement Syndrome?

Shoulder Impingement Syndrome occurs when the tendons or bursa within the shoulder joint are compressed during arm movement. Pain, inflammation, and limited motion are the results of this compression. Among athletes and active people, it is one of the most frequent causes of shoulder pain.

We specialize in treating shoulder impingement at Elite Physiotherapy and Sports Injury Centre using cutting-edge evaluation methods and contemporary physiotherapy treatments for a quicker recovery.

Causes of Shoulder Impingement

  1. Overuse from weightlifting, badminton, or swimming
  2. Shoulder rounding due to poor posture
  3. Weak scapular or rotator cuff muscles
  4. The subacromial space’s structural constriction
  5. Inappropriate lifting methods or biomechanics

Clinical Features and Symptoms

  • Severe pain when moving overhead
  • Sleeping on the afflicted side causes pain.
  • Weakness in reaching or lifting
  • A clicking or snagging feeling in the shoulder
  • Restricted range of motion in the shoulder

Diagnosis and Physiotherapy Assessment

A thorough clinical examination aids identification of impingement. Elite Physiotherapy’s physiotherapists conduct a thorough shoulder evaluation that includes:

  • Observation: Verifying muscular symmetry, scapular alignment, and posture
  • Palpation: Finding pain in the subacromial or rotator cuff area
  • Range of Motion (ROM): Evaluating shoulder mobility, both active and passive

Special Physiotherapy Tests

  1. Neer Impingement Test:
  2. Hawkins-Kennedy Test:
  3. Painful Arc Test:
  4. Empty Can Test:

Physiotherapy Management at Elite Physiotherapy and Sports Injury Centre

When treating Shoulder Impingement Syndrome, physiotherapy is essential. Pain relief, mobility restoration, and shoulder complex strengthening are the main goals of treatment at Elite Physiotherapy.

1. Pain and Inflammation Control

  • Shock Wave Therapy: Promotes healing in the rotator cuff tendons and aids in the breakdown of calcific deposits.
  • Super Inductive System (SIS): Uses high-intensity electromagnetic fields to induce deep muscle activation and modulate pain. It significantly lowers inflammation and speeds up tissue repair.
  • High-Intensity Laser Therapy (HILT): Deep tissue heating and cellular regeneration are two benefits of High-Intensity Laser Therapy (HILT). It quickly lessens pain and improves blood flow.
  • Dry needling: Eases tension in the muscles surrounding the shoulder and scapula and relieves myofascial trigger points.
  • Cupping therapy:  Increases tissue mobility, decreases adhesions, and improves local blood circulation.

2. Manual Therapy and Joint Mobilization

Soft tissue techniques and joint mobilizations are used once pain has been managed.
To restore mobility, physiotherapists execute inferior and posterior glides of the glenohumeral joint.
Techniques for myofascial release and scapular stability are used to reduce tension and enhance movement patterns.

3. Strengthening Phase

  • External and internal rotations with resistance bands
  • Scapular retraction and depression drills
  • Prone Y, T, and W exercises for scapular stability
  • Closed-chain strengthening for shoulder control

4. Postural Correction and Biomechanical Training

A crucial component of rehabilitation is postural reeducation.
We concentrate on scapular alignment, thoracic extension mobility, and ergonomic adjustments for desk workers and athletes.
Athletes frequently employ video analysis and corrective exercises to maximize their movement patterns.

5. Functional and Sport-Specific Rehabilitation

Sport-specific exercises are incorporated after strength and mobility are restored.
This gives athletes the confidence to resume overhead exercises like lifting, swimming, and throwing.
For full functional rehabilitation, our physiotherapists combine proprioceptive and plyometric training.

Why Choose Elite Physiotherapy and Sports Injury Centre

At Elite Physiotherapy, every shoulder impingement case is evaluated through a detailed biomechanical and functional assessment.
Our treatment blends evidence-based physiotherapy with advanced modalities like Shock Wave, SIS, HILT, Dry Needling, and Cupping for superior results.
We aim for faster, pain-free recovery and safe return to sport and daily activity.

Conclusion

Shoulder Impingement Syndrome can severely affect performance and daily function if not managed properly.
Through precise assessment, modern physiotherapy techniques, and personalized care, Elite Physiotherapy and Sports Injury Centre ensures complete recovery and long-term prevention.

Anterior Shoulder Pain

Posted on by Dr Dharam

Pain in the front of the shoulder joint is referred to as anterior shoulder pain. It frequently arises from irritation, inflammation, or damage to the structures surrounding the shoulder capsule, rotator cuff, or biceps tendon. Athletes, exercise fanatics, and even office professionals may experience this pain as a result of bad posture or repetitive strain.

At Elite Physiotherapy and Sports Injury Centre, we regularly treat athletes who suffer from anterior shoulder pain as a result of repetitive tension and muscular imbalance, particularly those who play overhead sports like badminton, swimming, and wrestling.

Causes of Anterior Shoulder Pain

Several musculoskeletal and soft-tissue conditions can lead to pain in the front of the shoulder, such as:

  • Biceps Tendonitis: Inflammation of the long head of the biceps tendon.
  • Subscapularis Tendinopathy: Overuse of the subscapularis muscle that causes discomfort is known as subscapularis tendinopathy.
  • Labral Tear (SLAP lesion): An injury to the superior labrum, where the biceps tendon attaches, is known as a labral tear (SLAP lesion).
  • Shoulder Impingement Syndrome: Compression of soft tissues during arm raising.
  • Acromioclavicular (AC) Joint Pathology: Pain radiating to the anterior aspect is known as acromioclavicular (AC) joint pathology.
  • Postural Dysfunction: Overload is caused by postural dysfunction, which includes a rounded shoulder position and scapular dyskinesia.

Clinical Features

Front shoulder pain, particularly while lifting or performing overhead tasks.

  • Weakness when flexing or rotating inside.
  • A catching or clicking feeling in the shoulder.
  • Nighttime discomfort, particularly when lying on the affected side.

Diagnostic Methods and Examination

A detailed clinical examination is essential for accurate diagnosis. Physiotherapists at Elite Physiotherapy perform a biomechanical assessment, posture analysis, and palpation to locate tenderness.

Special Tests Used:

  1. Speed’s Test: Evaluates the pathophysiology of the biceps tendon.
  2. Yergason’s Test: Verifies the biceps tendon’s integrity.
  3. The Hawkins-Kennedy Test detects impingement.
  4. Lift-Off Test: Identifies weakness in the subscapularis muscle.
  5. O’Brien’s Test: Labral involvement is evaluated using O’Brien’s Test.

Imaging tests like MRIs and ultrasounds are used if necessary to confirm the diagnosis and rule out more serious structural damage.

Physiotherapy Management at Elite Physiotherapy and Sports Injury Centre

At Elite Physiotherapy and Sports Injury Centre, physiotherapists provide personalized and evidence-based treatment for anterior shoulder pain. Our approach focuses on pain relief, restoring mobility, and improving shoulder stability through advanced physiotherapy techniques and modern modalities.

1. Pain Reduction and Inflammation Control

  • Shock Wave Therapy: Promotes tendon repair and breaks down scar tissue.
  • Super Inductive System (SIS):  Uses deep electromagnetic stimulation to improve blood flow and ease tense muscles.
  • High-Intensity Laser Therapy: Effectively reduces inflammation and encourages deep tissue repair.
  • Dry Needling and Cupping Therapy: Tight anterior shoulder muscles can have their knots released and their circulation improved with dry needling and cupping therapy.

2. Manual Therapy and Soft Tissue Mobilization

  • Glenohumeral joint mobilizations help relieve capsular tightness.
  • Myofascial release and trigger point therapy target overactive muscles like the pectoralis major and biceps.

3. Restoring Range of Motion (ROM)

Gentle stretching of the anterior capsule and strengthening of the posterior muscles restore balance.

Exercises include:

  • Pendulum swings
  • Shoulder external rotation with the theraband
  • Sleeper stretch
  • Scapular setting exercises

Progressive ROM work ensures pain-free functional mobility.

4. Strengthening and Stabilization

Rehabilitation focuses on the rotator cuff, scapular stabilizers, and core.
Key exercises include:

  • Resistance band external rotation
  • Prone Y, T, and W exercises
  • Scapular retraction drills
  • Closed-chain stability training (wall push-ups, weight shifts)

These exercises help build strength and prevent recurrence.

5. Neuromuscular Re-education

Retraining the shoulder’s movement pattern is essential once the pain subsides. We assist players in regaining shoulder control and stability during dynamic actions like grappling and throwing by using proprioceptive training and SIS.

6. Return to Sport or Activity

We create rehabilitation plans tailored to certain sports once full strength and mobility have returned. For instance, swimmers prioritize rotator cuff endurance and symmetry, whereas wrestlers concentrate on shoulder stability under load, and cricketers concentrate on overall shoulder integrity

Conclusion

If left untreated, anterior shoulder pain can severely restrict daily and athletic activities. In order to provide quicker, more durable healing, we at Elite Physiotherapy and Sports Injury Centre combine cutting-edge modalities like Shock Wave, SIS, High-Intensity Laser, Dry Needling, and Cupping Therapy with sophisticated diagnostic procedures.

Our individualized treatment programs help you return stronger and pain-free by addressing the underlying biomechanical reasons of your pain.

Visit Elite Physiotherapy and Sports Injury Centre right now for professional assessment and cutting-edge physiotherapy treatment if you’re dealing with chronic shoulder pain.

Tennis Elbow : Elbow Pain and its Management

Posted on by Dr Dharam

Introduction

Tennis Elbow, medically known as Lateral Epicondylitis, is a frequent overuse condition that affects the outside elbow region. It is brought on by microtears or repetitive strain in the extensor muscles of the forearm, namely the Extensor Carpi Radialis Brevis (ECRB).
Our goal at Elite Physiotherapy and Sports Injury Centre is to speed healing through accurate evaluation and individualized physiotherapy care with cutting-edge techniques.

What is Tennis Elbow?

Tennis Elbow is an inflammation or degeneration of the tendons attached to the lateral epicondyle of the humerus. In addition to tennis players, it frequently affects anyone who engages in repetitive wrist extension or gripping tasks, such as manual laborers, office workers, and fitness enthusiasts.
Pain starts off slowly and gets worse as you continue to strain.

Causes of Tennis Elbow

  • Repetitive motions of the forearm and wrist.
  • Poor technique in sports like squash, badminton, or tennis.
  • Excessive lifting or clutching when extending the wrist.
  • Overuse in occupations like carpentry or typing.
  • Muscle exhaustion or abrupt, unfamiliar exercise.

Signs and Symptoms of Tennis Elbow

  1. Discomfort across the humerus’s lateral epicondyle.
  2. Forearm pain that radiates.
  3. Tenderness over the root of the common extensor tendon.
  4. Discomfort when lifting, grasping, or extending the wrist.
  5. Hand grip strength weakness.
  6. Difficulty performing everyday tasks like holding a cup, turning a doorknob, or shaking hands.

Examination for Tennis Elbow

A thorough physical examination is necessary for a precise diagnosis. Evidence-based tests are used by the physiotherapists at Elite Physiotherapy to rule out other diagnoses and establish the problem.

Special Physiotherapy Tests include:

  1. Cozen’s Test: When the elbow is extended, the patient opposes wrist extension. A favorable outcome is indicated by pain at the lateral epicondyle.
  2. Mill’s Test: Pain is reproduced by passively stretching the wrist extensors by flexing the wrist and pronating the forearm.
  3. Maudsley’s Test: Pain is felt across the lateral epicondyle when the third finger is not extended.

Physiotherapy Management at Elite Physiotherapy and Sports Injury Centre

At Elite Physiotherapy and Sports Injury Centre, Tennis Elbow management focuses on pain relief, restoring function, and preventing recurrence.
Physiotherapists design each treatment plan after a detailed biomechanical assessment and functional evaluation.

1. Pain Relief and Inflammation Control

The main objective during the acute period is to lessen pain and inflammation.
Physiotherapists make use of:

  • Physiotherapists recommend rest and reduced activity to decrease tendon tension.
  • Using cold, or cryotherapy, can reduce inflammation early.
  • Stretching gently will preserve the range of motion without overtaxing the tendon.

2. Advanced Physiotherapy Modalities

For quicker recovery and pain relief, Elite Physiotherapy incorporates state-of-the-art physiotherapy technologies:

  • Shock Wave Therapy: Encourages collagen synthesis, lessens chronic pain, and speeds up tendon recovery.
  • Super Inductive System (SIS): High-intensity electromagnetic fields are used by the Super Inductive System (SIS) to improve muscle activation, promote tissue healing, and lessen discomfort.
  • High-Intensity Laser Therapy: Reduces inflammation, speeds up tissue repair, and improves blood circulation.
  • Dry Needling: Releases myofascial trigger points, decreases pain, and restores normal muscle function.
  • Cupping Therapy: Promotes tissue regeneration, eases tension, and increases local blood flow.

Physiotherapists combine these modalities based on each patient’s needs for a faster and longer-lasting recovery.

3. Manual Therapy and Soft Tissue Mobilization

  • Myofascial release, joint mobilization, and deep friction massage are examples of manual therapy procedures that increase tissue flexibility and reduce pain.
  • Physiotherapists use radial head mobilization and soft tissue manipulation around the forearm to improve joint mechanics and tendon healing.

4. Therapeutic Exercises

  • Stretching Exercises: To increase flexibility, perform mild wrist flexor and extensor stretches.
  • Eccentric Strengthening: The wrist extension’s controlled lowering motions increase the resilience and strength of the tendons.
  • Isometric Exercises: To preserve strength without causing tendon inflammation, start early.
  • Proprioceptive and Functional Training: Restores neuromuscular coordination for return to daily or sports activities.

5. Maintenance and Prevention

  • Maintenance Exercises aim to stop recurrence once pain has subsided.
  • Athletes are led through flexibility exercises, sport-specific conditioning, and a phased return to play.
  • Regular follow-ups ensure sustained improvement and prevent chronic tendinopathy.

Why Choose Elite Physiotherapy and Sports Injury Centre?

Precision, creativity, and patient-centered treatment are the cornerstones of rehabilitation at Elite Physiotherapy and Sports Injury Centre.
To accelerate healing, we integrate our physical expertise with cutting-edge technologies, including Shock Wave, SIS, High-Intensity Laser, Dry Needling, and Cupping.
Physiotherapists tailor every treatment plan to align with your specific activity goals, occupation, and pain level, ensuring a comprehensive and safe recovery.

Conclusion

If left untreated, tennis elbow can have a major negative influence on both performance and quality of life.
However, healing is quicker and more efficient at Elite Physiotherapy and Sports Injury Centre because of their superior physiotherapy care and evidence-based treatment.
Restoring function and avoiding recurrence requires early diagnosis, enough rest, and planned therapy.

Cupping Therapy: The Secret to Faster Muscle Recovery

Posted on by Dr Dharam

Introduction

An age-old healing technique, cupping therapy has become more relevant in physiotherapy nowadays. It improves circulation, eases tense muscles, and speeds up the healing process by using suction. For faster recovery and enhance athletic performance, we at Elite Physiotherapy and Sports Injury Centre combine evidence-based physiotherapy with cupping.

What Is Cupping Therapy?

In order to create suction, specialized cups are applied to the skin during cupping therapy. Soft tissues are raised by this negative pressure, which also encourages blood flow to the intended location. This method is used by physiotherapists to efficiently treat muscle limitations, discomfort, and stiffness.

Types of Cupping Techniques

  • Dry Cupping: This method involves using suction without making any cuts. It eases muscle tension and improves tissue mobility.
  • Wet Cupping: To remove stagnated blood, superficial skin pricks are performed prior to suction.
  • Dynamic or Sliding Cupping: To increase soft tissue elasticity and loosen fascia, cups are moved across lubricated skin.
  • Fire Cupping: The old-fashioned technique of “fire cupping” uses heat to generate suction inside the cups.

Dynamic and dry cupping are most frequently utilized at Elite Physiotherapy because of their efficacy and safety in sports rehabilitation. Also we Practice Wet cupping in a very professional and hygienic environment which is performed by our skilled therapists

Mechanism of Action

By producing negative pressure, cupping therapy raises underlying tissues and improves local blood flow. This increases the flow of oxygen and speeds up the elimination of waste products from metabolism. Additionally, it stimulates the parasympathetic nervous system, which aids in rest and recovery.

Benefits of Cupping Therapy in Physiotherapy

  1. Reduces Muscle Pain: Suction eases tense muscles and trigger points.
  2. Enhances Blood Flow: Improved circulation supports tissue repair.
  3. Encourages Fascia Release: By releasing fascial adhesions, this technique aids in the restoration of regular movement patterns.
  4. Reduces Inflammation: Facilitates the elimination of toxins and lymphatic drainage.
  5. Increases Flexibility: Increases range of motion and decreases stiffness.
  6. Accelerates Recovery: Perfect for athletes recovering from training or injuries.

At Elite Physiotherapy and Sports Injury Centre, physiotherapists combine cupping with advanced techniques such as the Super Inductive System (SIS), CRET Therapy, Shock Wave Therapy, and Class 4 Laser for faster results.

Clinical Applications of Cupping Therapy

Numerous musculoskeletal and sports injury issues can benefit from cupping therapy, such as:

  • Myofascial pain syndrome
  • Rotator cuff strain and shoulder impingement
  • SI joint dysfunction together with lower back discomfort
  • Tightness in the calf and hamstrings
  • IT band friction syndrome
  • Post-exercise muscle soreness
  • Chronic neck and upper back stiffness

At Elite Physiotherapy, physiotherapists customize every session after a thorough evaluation to ensure safe and effective treatment.

Safety and Precautions

When administered by qualified physiotherapists, cupping therapy is safe. Circular markings or mild redness are common and go away in a few days. Avoid cupping therapy in cases of pregnancy, open wounds, bleeding disorders, and skin infections.

Every session at Elite Physiotherapy adheres to stringent safety and hygiene regulations.

Why Choose Elite Physiotherapy and Sports Injury Centre

At Elite Physiotherapy and Sports Injury Centre, physiotherapists combine advanced techniques and modalities with cupping therapy for optimal results. Our physiotherapists conduct a thorough evaluation of each patient and create a personalized treatment plan. The objective is to use the best scientific methods to improve sports performance, reduce discomfort, and restore mobility.

Conclusion

One useful technique in contemporary physical treatment is cupping therapy. It speeds up healing, increases flexibility, and reduces pain. It offers athletes and patients alike quicker, more durable outcomes when combined with cutting-edge techniques at Elite Physiotherapy and Sports Injury Centre.

Dry Needling and Its Pain Disappearing Magic

Posted on by Dr Dharam

Introduction

Dry Needling is a cutting-edge physiotherapy method for reducing pain and enhancing muscular function. It focuses on myofascial trigger points, which are painful, stiff knots in the muscles. Skilled physiotherapists at Elite Physiotherapy and Sports Injury Centre use dry needling to improve performance and accelerate recovery.

What is Dry Needling?

A tiny, sterilized needle is inserted into particular muscle trigger sites during dry needling. It targets musculoskeletal pain and movement disorders, in contrast to acupuncture. Restoring normal muscular function, enhancing blood flow, and relieving muscle tension are the objectives.

How Does Dry Needling Work?

The muscle’s sensory receptors are stimulated when the needle pierces the trigger spot. A local twitch response is triggered by this, aiding in the release of taut fibers. By increasing the oxygen flow and lowering inflammatory molecules in the area, it also aids in healing.

Clinical Technique of Dry Needling

  1. Through evaluation and palpation, the target muscle is located.
  2. The space is sterilized and cleaned.
  3. Controlled depth and angle are used to insert a tiny needle into the trigger point.
  4. To get a twitch reaction, the therapist softly moves the needle.
  5. Physiotherapists gently compress the area after removing the needle.

This approach deactivates the trigger point and restores normal muscle function.

Conditions Treated with Dry Needling

  • Pain in the shoulders and neck
  • Sciatica and low back discomfort
  • Golfer’s elbow and tennis elbow
  • Syndrome of Myofascial Pain
  • Plantar fasciitis
  • Patellar tendinopathy and knee discomfort
  • Muscle tightness in athletes

For greater results, Elite Physiotherapy and Sports Injury Centre frequently combines it with manual treatment, exercise, and cutting-edge modalities like Class 4 Laser treatment and the Super Inductive System (SIS).

Benefits

  1. Lessens pain and stiffness in the muscles
  2. Increases joint range of motion and flexibility.
  3. Improves tissue repair and blood flow
  4. Reduces inflammation and nerve irritation
  5. Accelerates the healing process following sports injuries

It is an important component of contemporary physiotherapy and sports rehabilitation because of these advantages.

Safety and Precautions

When performed by qualified physiotherapists, It is a safe technique. Although minor bruising or Soreness may occur, these side effects normally go away quickly. Patients should constantly make sure the therapist adheres to stringent cleanliness guidelines and uses sterile needles.

Dry Needling at Elite Physiotherapy and Sports Injury Centre

At Elite Physiotherapy and Sports Injury Centre use dry needling as a component of their all-encompassing treatment strategy. Physiotherapists tailor every session to the patient’s condition, activity level, and recovery goals.
It is more effective when combined with SIS therapy, CRET therapy, and high-intensity laser therapy, which results in quicker and more durable pain alleviation.

Conclusion

Dry needling is an effective, evidence-based method for reducing pain and promoting muscle repair. It facilitates the release of tense muscles, restores function, and enhances performance. When paired with cutting-edge physiotherapy techniques, it produces better outcomes for both patients and athletes.

For personalized treatment in Delhi, NCR, visit Elite Physiotherapy and Sports Injury Centre to experience expert care tailored to your recovery needs.

Golfer’s Elbow (Medial Epicondylitis) and its Best Treatment

Posted on by Dr Dharam

What is Golfer’s Elbow?

Golfer’s elbow, often referred to as medial epicondylitis or medial epicondylalgia, is a painful ailment that affects the inside of the elbow. Overuse or repetitive stress on the forearm flexor tendons, which connect to the humerus’ medial epicondyle, is the cause of it.

It’s not just for golfers, despite its name. Anybody who engages in repetitive gripping, throwing, or wrist flexion exercises like baseball, weightlifting, or manual labor may be impacted.

Causes of Golfer’s Elbow

Repetitive microtrauma or overuse of the wrist flexor muscles and tendons is the primary cause. Additional contributing elements consist of:

  • Excessive forearm pronation or wrist flexion
  • Ineffective grip or poor sports skills while playing
  • Weakness in the shoulder or forearm stabilizers
  • Unexpected rise in workload or training intensity
  • Inadequate ergonomics in routine or professional work

Clinical Features / Signs and Symptoms

Patients frequently encounter the following symptoms:

  • Tenderness and pain in the inside of the elbow
  • Pain that travels from the forearm to the wrist
  • Pain when flexing the wrist, rotating the forearm, or gripping
  • Weakness and stiffness in the hand and wrist
  • Decreased strength of grip
  • In severe situations, there may be warmth or edema around the elbow.
  • Resisted wrist flexion or forearm pronation, like swinging a golf club or lifting objects, exacerbates the symptoms.

Diagnostic Methods and Examination

Physiotherapists evaluate functional limitations, muscle strength, and pain patterns. MRIs and ultrasounds can be used to rule out other elbow problems and confirm tendon abnormalities.

Special Physiotherapy Tests

  1. Resisted Wrist Flexion Test: When the elbow is extended, the patient resists wrist flexion in the Resisted Wrist Flexion Test. A favorable outcome is indicated by pain at the medial epicondyle.
  2. Passive Wrist Extension Test: Pain over the medial epicondyle is reproduced by extending the elbow while stretching the wrist flexors.
  3. Palpation: Finding the precise site of damage is aided by local soreness at the flexor-pronator origin.

Physiotherapy Management at Elite Physiotherapy and Sports Injury Centre

Our strategy at Elite Physiotherapy and Sports Injury Centre is centred on accurate diagnosis, pain management, tissue repair, and strength and function restoration. Physiotherapists tailor every treatment plan to the patient’s pain level, sport-specific needs, and job demands.

1. Pain Reduction and Inflammation Control

  • Rest and Activity Modification: Steer clear of painful activities. Reintroduction occurs gradually as healing advances.
  • Cryotherapy: During acute phases, ice packs or cryo-spray can assist reduce pain and inflammation.
  • Bracing or Taping: Physiotherapists use counterforce elbow straps for bracing or taping to relieve tendon stress.

2. Advanced Modalities for Healing

  • Shock Wave Therapy: Encourages collagen synthesis, breaks down scar tissue, and aids in tendon recovery. It facilitates the natural healing process of chronic tendon degeneration.
  • The Super Inductive System (SIS): Uses electromagnetic fields to modulate pain and provide deep muscle activation. It restores muscular activation, speeds up recovery, and improves blood flow.
  • High-Intensity Laser Therapy (HILT): Deep laser penetration promotes cellular healing, enhances microcirculation, and reduces inflammation for a quicker recovery using high-intensity laser therapy (HILT).
  • Dry Needling: Reduces pain, increases muscle flexibility, and targets myofascial trigger points.
  • Cupping Therapy: Promotes muscular relaxation, lessens stiffness, and increases local blood flow.

3. Manual Therapy and Soft Tissue Mobilization

  • In order to release tense soft tissues and restore mobility, manual therapy is essential.
  • Physiotherapists use techniques such as joint mobilization, deep transverse friction massage, and myofascial release to reduce adhesions and restore normal tendon gliding.

4. Strengthening and Rehabilitation Phase

  • Isometric Exercises: Start with wrist flexor isometric holds that don’t hurt.
  • Eccentric Loading: Controlled eccentric activities help to enhance collagen alignment and strengthen tendon fibers.
  • Progressive Resistance Exercises: Physiotherapists use dumbbells, resistance bands, or grip tools to gradually increase resistance.
  • Proximal Strengthening: Physiotherapists prescribe exercises for scapular and shoulder stabilizers to reduce elbow strain.
  • Functional and Sports-Specific Drills: Exercises that replicate motions unique to a sport help athletes regain their peak performance.

5. Ergonomic and Technique Correction

  • Our physiotherapists instruct patients on proper posture, grip methods, and equipment adjustments. Physiotherapists perform swing analysis and equipment modifications for athletes to prevent recurrence.

6. Return-to-Sport or Work Conditioning

  • Physiotherapists conduct functional tests and sport-specific drills to ensure ideal strength, flexibility, and endurance before a full return to action. The purpose of maintenance programs is to stop relapses.

Conclusion

With the appropriate evaluation and individualized physical therapy, golfer’s elbow is a treatable ailment. Our evidence-based strategy at Elite Physiotherapy and Sports Injury Centre incorporates progressive exercise rehabilitation, manual therapy, and cutting-edge modalities like Shock Wave, SIS, High-Intensity Laser, Dry Needling, and Cupping.

Our objective is to help each patient recover stronger, quicker, and more resilient by restoring complete function and performance in addition to treating the pain.

Biceps Strain and Anterior Elbow Pain

Posted on by Dr Dharam

What is a Biceps Strain?

A biceps strain occurs when the biceps brachii muscle or its tendon is torn or overstretched. Usually, a high load or an abrupt force during arm movement causes it. The people most at risk are athletes, weightlifters, and those who lift objects repeatedly.

We frequently see biceps strains in athletes who participate in weightlifting, wrestling, boxing, and racket sports at Elite Physiotherapy and Sports Injury Centre. Early physiotherapy intervention ensures quicker recovery and prevents long-term muscle weakening.

Causes of Biceps Strain

Typically, biceps tension is caused by:

  1. Unexpected eccentric loading when throwing or lifting.
  2. Excessive usage of the arm repeatedly when performing overhead motions.
  3. Direct injury to the upper arm or impact.
  4. Improper lifting technique or improper warm-up.
  5. Loss of control and stability due to muscle exhaustion.

These elements may result in microtears in the tendon or muscle fibers, which would induce discomfort and inflammation.

Classification of Biceps Strain

The degree of muscle fiber damage determines the classification of biceps strains:

  • Grade 1 (Mild): No strength loss, little discomfort, and minimal fiber ripping.
  • Grade 2 (Moderate): Partial tear accompanied by discomfort, edema, and diminished strength.
  • Grade 3 (Severe): Total rupture of a muscle or tendon, frequently accompanied by a protrusion or “Popeye deformity.”

A thorough clinical evaluation at Elite Physiotherapy aids in determining the precise grade and creating a customized rehabilitation strategy.

Clinical Features and Symptoms

Typical signs and symptoms include:

  • The front of the arm hurts sharply.
  • Soreness and swelling above the biceps.
  • Discolouration or bruises.
  • Weakness occurs when the forearms are supinated or the elbows are bent.
  • Tightness in the muscles and trouble lifting things.
  • Obvious deformity brought on by tendon retraction in extreme situations.
  • When the biceps muscle is actively contracted or stretched, pain increases.

Diagnostic Methods and Examination

A thorough patient history and physical examination are the first steps in a clinical diagnosis. To ascertain the injury grade, the physiotherapists at Elite Physiotherapy employ a mix of muscle testing, palpation, and examination.

Special Physiotherapy Tests

  1. Biceps Squeeze Test – Helps detect complete rupture of the distal biceps tendon.
  2. Speed’s Test: Determines whether there is tendinous involvement by measuring pain over the bicipital groove.
  3. Yergason’s Test: Identifies instability in the bicipital groove or pathology in the long head of the biceps tendon.

These tests aid in distinguishing between tendinous damage and muscle belly strain.

Investigations

  • Ultrasound: To detect muscle fiber tears and hematomas.
  • MRI: For severe or chronic cases to assess tendon retraction or complete rupture.

Physiotherapy Management at Elite Physiotherapy and Sports Injury Centre

At Elite Physiotherapy, treatment focuses on pain reduction, restoring strength, and preventing recurrence. Physiotherapists tailor each plan according to the athlete’s sport demands, injury grade, and recovery goals.

Acute Phase (First 3–5 Days):

  • The aim is to reduce pain, inflammation, and swelling through rest, ice, compression, and elevation (RICE) principles. Physiotherapists use advanced modalities such as High-Intensity Laser Therapy (HILT) to accelerate tissue repair and reduce inflammation, while the Super Inductive System (SIS) aids in pain modulation and early muscle activation. Gentle kinesio taping supports the injured muscle and prevents further strain.

Subacute Phase (After 5–10 Days):

  • The focus shifts to restoring flexibility and preventing stiffness. Pain-free active and assisted range of motion exercises are introduced for the elbow and shoulder. Shock Wave Therapy enhances collagen production and promotes tendon healing, whereas Cupping Therapy improves local blood flow and reduces muscle tightness. Physiotherapists apply Dry Needling to deactivate trigger points and reduce muscle tension. Gradual isometric strengthening begins to re-engage the biceps muscle safely.

Strengthening and Functional Phase (After 2–3 Weeks):

  • Once pain subsides, the goal is to rebuild strength and endurance through progressive resistance training, emphasizing eccentric biceps loading. Physiotherapists add functional and sport-specific exercises along with shoulder stabilizer strengthening to improve kinetic chain coordination. The Super Inductive System (SIS) continues to support deep tissue healing and enhance neuromuscular re-education.

Return-to-Sport Phase:

  • The final stage prepares the athlete for competition or full activity. Sport-specific drills, plyometric exercises, and movement retraining are implemented to restore full functional capacity. Physiotherapists conduct postural correction and strength balance assessments to prevent recurrence. Before clearance, the patient must demonstrate full range of motion, pain-free strength, and proper biomechanics.
  • Advanced Modalities Used at Elite Physiotherapy

This combination ensures quicker recovery, reduced pain, and improved performance — helping athletes return to training stronger than before.

Conclusion

If left untreated, a biceps strain can impair arm function and athletic performance. Our state-of-the-art rehabilitation method at Elite Physiotherapy and Sports Injury Centre blends manual treatment with innovative techniques, including Shock Wave, SIS, HILT, Dry Needling, and Cupping.

Athletes who receive individualized care heal more quickly, regain their confidence, and safely resume their best performance.

Triceps Tendinopathy and its Advanced Treatment

Posted on by Dr Dharam

What is Triceps Tendinopathy?

A chronic overuse condition of the triceps tendon, usually around or close to its insertion into the olecranon, is known as triceps tendinopathy. It represents degenerative alterations, collagen disarray, and failed tendon repair rather than acute inflammation. Repetitive microtrauma or overloading the tendon can change its structure, causing discomfort and dysfunction.

Tendinopathy is more degenerative than acute tendonitis, which is inflammatory. Particularly in the early stages, it could coexist with certain inflammatory changes, but in chronic situations, tendon degeneration symptoms are typical.

Causes and Risk Factors

Triceps tendinopathy is predisposed by several factors:

  • Weightlifting, throwing, and pushing activities often involve repetitive overload or overuse, which is characterized by repeated extension or resisted loading.
  • Microdamage builds up when training volume or intensity is abruptly increased and adaptation time is inadequate.
  • Poor technique or biomechanics – inadequate shoulder, elbow, or scapular mechanics that cause the tendon to be loaded asymmetrically.
  • Muscle weakness or imbalance: The triceps tendon is subjected to greater strain if stabilizers or synergists are weak.
  • Deficits in nutrition and tendon vascularity: Because tendons have a small blood supply, inadequate microcirculation may hinder repair.
  • Tendon flexibility decreases with age and degenerative changes.
  • Tendon pathology may be exacerbated by comorbidities, which include systemic illnesses such as diabetes, metabolic disorders, or exposure to corticosteroids.

Clinical Features: Signs and Symptoms

When a patient has triceps tendinopathy, they usually exhibit:

  • Gradual development of elbow pain in the back, usually proximal or posterior to the olecranon aspect.
  • Resisted elbow extension or pushing exercises (such as push-ups or bench presses) exacerbate the pain.
  • Palpation of the triceps tendon reveals tenderness, particularly along the tendon or at its insertion.
  • Near the end range of elbow flexion or extension, pain may be triggered.
  • In more severe cases, a slight grating sensation, known as crepitus, may be present.
  • Mild nodules, localized thickening, or swelling of the tendon.
  • suppression of triceps contraction due to weakness or pain.
  • Potential soreness or stiffness following periods of inactivity (e.g., morning stiffness).
  • Decreased functional ability for resistance training or sports in chronic instances.

Physiotherapy Management

Restoring tendon function safely, permitting return to sport, and preventing recurrence are the objectives of an elite sports injury center. Phases can be used to organize the management:

Phase 1: Pain Modulation and Tendon Offloading

  • Activity modification/relative rest: refrain from or reduce activities that cause discomfort (e.g., dips, heavy pressing).
  • Isometric loading – brief, low-to-moderate-intensity isometric holds—helps maintain tendon homeostasis and lessen pain.
  • Cryotherapy, pulsed ultrasonography, and manual soft-tissue treatments (such as tendon massage and cross-friction massage) are modalities for controlling pain and inflammation.
  • Stabilization of the shoulder and scapula ensures that proximal mechanics does not overload the distal tendon.
  • Mobility exercises include maintaining neighboring joint mobility and gently stretching the triceps (within pain tolerance).

Phase 2: Progressive Loading & Remodeling

  • Progressive eccentric loading is the process of gradually increasing load while controlling lowering under resistance.
  • Isotonic concentric loading: start concentric strengthening as soon as the pain is tolerated.
  • Using heavier, slower loading to encourage tendon adaptation is known as heavy slow resistance (HSR) procedures.
  • Integration of sport-specific movement patterns for transfer is known as functional and sport-specific loading.
  • Neuromuscular control: avoid compensatory patterns (shoulder shrugging, trunk movement) and concentrate on the quality of movement.
  • Soft-tissue mobilization and joint mobilization (of the elbow, shoulder, and thoracic spine) are components of adjunctive manual treatment.

3rd Phase: Return to Sport / High Load & Prevention

  • Once the tendon can withstand it, engage in controlled plyometric exercises, such as medicine-ball tosses and explosive push jobs.
  • Return to full training load gradually; keep a close eye on symptoms and make small improvements.
  • Maintaining and strengthening your muscles can help you develop balanced strength in your triceps, biceps, and shoulder stabilizers.
  • Load monitoring and education: make sure you get enough sleep, raise your load gradually, and get technique coaching to prevent recurrence.
  • Patient education, load monitoring, frequent reassessment, and progressive growth are essential components of an exceptional center.

Advanced / Adjunct Modalities:

Advanced techniques, including Shock Wave Therapy, Super Inductive System (SIS), High-Intensity Laser, Dry Needling, and Cupping, are available to you at the premium clinic. Here’s how they could be combined.

  • Shock Wave Therapy (ESWT / radial / focused)
  • In order to promote neovascularization, collagen production, and pain management in chronic tendinopathies, shock wave therapy has been employed.
  • Usually, it is saved for instances that have not improved after six or more months of conservative treatment.
  • Weekly for three to five sessions, protocols typically use low to moderate intensity, with 2,000 to 2,500 impulses per session.
  • Over neurovascular bundles, open wounds, pacemakers, infections, and cancer are among the contraindications.
  • For faster healing, Elite Physiotherapy uses loading protocols in conjunction with shock waves that are carefully focused in the tendon region.
  • Super Inductive System (SIS)
  • SIS, or pulsed electromagnetic induction, is a type of electromagnetic field therapy that is intended to heat tissues deeply and increase cellular activity.
  • The idea is to increase vascularity, lessen pain, and stimulate metabolic activity in degenerative tendon tissue, even if there is little high-level data in triceps tendinopathy specifically.
  • In practice, loading exercises might be preceded with SIS sessions (e.g., 20-30 min) to increase tissue responsiveness and extensibility.
  • High-Intensity Laser Therapy (HILT)
  • Class IV high-intensity lasers can speed up tissue repair, lessen discomfort, and promote photobiomodulation.
  • Laser therapy may improve collagen remodeling, increase mitochondrial function, and decrease inflammation in tendinopathies.
  • Before or after loading workouts, we can administer HILT in cycles (e.g., 2-3 minutes per zone, numerous passes) across the tendon region at the Elite Center, guaranteeing safety and appropriate dosage.
  • Dry Needling and Cupping

Why Elite Physiotherapy & Sports Injury Centre Approach Matters

  • At Elite Physiotherapy, we adhere to an evidence-based, performance-driven methodology:
  • We provide more than simply symptom-based care; we conduct thorough, impartial evaluations.
  • Depending on the athlete’s sport, strength, and tendon capacity, we customize loading progressions.
  • Instead of depending solely on passive treatments, we mix manual and exercise therapy with cutting-edge modalities (SIS, Shock Wave, Laser).
  • In order to prevent flare-ups and guarantee a safe return to sports, we dynamically monitor and modify load.
  • Aware of the athlete’s training requirements, we place a strong emphasis on teaching, biomechanics correction, and recurrence avoidance.
  • Our patients receive top-notch care that goes above and beyond normal rehabilitation.

Scheuermann Disease/Kyphosis and its Management

Posted on by Dr Dharam

What Is Scheuermann Disease?

A structural spinal deformity known as Scheuermann disease, sometimes known as Scheuermann’s kyphosis or juvenile kyphosis, is typified by anterior vertebral wedging of at least 5° in at least three adjacent thoracic (or thoracolumbar) vertebrae. Hyperkyphosis, or increased forward curvature of the thoracic spine, is the result of the front regions of vertebral bodies growing less than the posterior parts during adolescence.

Scheuermann illness has a stiff curvature that does not fully correct with extension or resting supine, in contrast to simple postural kyphosis.

It frequently manifests between the ages of 10 and 17, and it may continue to cause discomfort or aesthetic issues into adulthood.

Causes / Etiology

Although the exact cause is still unknown, some significant variables have been suggested:

  • Genetic predisposition: Autosomal dominant inheritance has been proposed; a familial tendency is shown.
  • Abnormal endplate/growth plate development: Anterior and posterior vertebral bodies grow discordantly when the vertebral endplates exhibit abnormal ossification or mineralization.
  • Mechanical factors: Growth spurt-related pressures on the spine, repetitive loading, and bad posture might all be involved.
  • Metabolic/biochemical influences: Although there is little evidence, some theories point to osteopenia, endocrine disorders, or variations in the collagen matrix.

Physiotherapy can assist in managing symptoms, reducing progression, and improving function, but it cannot “cure” the underlying developmental anomaly due to the complex nature of the etiology.

Clinical Features / Signs & Symptoms

Scheuermann disease patients may exhibit:

  • Back pain: is typically mild to moderate, centered on the apex or nearby vertebrae, and made worse by extended standing, sitting, or bending.
  • Postural deformity/hump: that gets worse with time is a postural deformity or hump.
  • Stiffness/limited extension: low flexibility of neighboring segments, less capacity to extend the thoracic spine
  • Muscle Tightness: in the muscles, especially in the hamstrings, iliopsoas, pectoralis major and minor, and anterior shoulder
  • Compensatory changes: Increased lumbar lordosis or cervical hyperextension as compensatory measures to preserve balance and vision
  • Neurologic symptoms are uncommon; however, they can manifest in cases of severe curvature or disc disease.
  • Respiratory compromise: thoracic cage constriction may affect pulmonary function in really severe curves (>100°).
  • Psychosocial and cosmetic: body-image disorders, self-esteem problems, and discomfort over appearance

On physical inspection, you may observe:

  • Rigid thoracic kyphosis
  • “Goose-neck” appearance (forward head compensation)
  • Hyperpigmentation or skin alterations over spinous processes close to the apex (due to rubbing)
  • Tenderness was felt close to the apical area
  • tightness in the hamstrings and hip flexors

Differentiation from postural kyphosis: Scheuermann’s curve is primarily stable, whereas postural kyphosis can frequently be reduced by extension or supine lying.

Physiotherapy Management

The physiotherapy plan at Elite Physiotherapy & Sports Injury Centre covers posture correction, strengthening, function improvement, mobility restoration, and pain management. In appropriate situations, we may also incorporate cutting-edge techniques like dry needling/cupping, high-intensity laser, shock wave therapy, and the super induction system as adjuncts. Here is a step-by-step, comprehensive strategy.

Phase 1: Pain relief & initial mobilization (acute/subacute)

  • Thermotherapy / superficial heat: to warm tissues and reduce stiffness
  • Soft tissue mobilization / myofascial release: to pectorals, thoracic paraspinals, rhomboids
  • Joint mobilization / gentle central PA mobilization: low-grade mobilizations in the thoracic region
  • Modalities:
    • Shock Wave Therapy: To lessen discomfort and enhance local blood flow, shock wave therapy can be given to trigger points or the paraspinal area (this is an adjuvant; evidence is coming).
    • High-Intensity Laser Therapy (HILT): High-Intensity Laser Therapy (HILT) to paraspinal muscles or sore areas to reduce inflammation, pain, and encourage tissue recovery.
    • Super Induction System: Deep electromagnetic stimulation can be applied to paraspinal tissues using the Super Induction System, which aims to improve microcirculation and reduce inflammation.
    • Dry needling or cupping: for scapular stabilizers, upper back muscles, and paraspinal trigger points
    • Using interferential current or transcutaneous electrical nerve stimulation (TENS) to treat pain

Phase 2: Flexibility, mobilization & stretching

  • Thoracic extension mobilization: manual mobilization in extension at the mid-thoracic level
  • Self-mobilization techniques: extension over a foam roller or a rolled towel placed at the apex
  • Stretching exercises:
    • Pectoralis major/minor (doorway stretch)
    • Anterior shoulder stretching
    • Hip flexors, iliopsoas
    • Hamstrings (straight leg raise, seated stretch)
  • Thoracic “overpressure in extension” with hands, as tolerated
  • Thoracic rotation/side bending mobilizations
  • Breathing and rib mobility exercises: expand chest wall, accessory muscle stretching

Phase 3: Strengthening, neuromuscular control & postural reeducation

  • Spinal extension strengthening:
    • Prone trunk lifts (“superman”)
    • Prone weighted arm lifts
    • Quadruped opposite arm/leg lifts
  • Scapular / shoulder stabilizers:
    • Rows, scapular retraction, serratus anterior work
  • Core/trunk control:
    • Planks (progressive)
    • Dead bug, bird-dog progressions
  • Postural correction training:
    • Mirror feedback or visual feedback
    • “Mirror image” exercises (counter rotation/extension)
    • Cueing during functional tasks to maintain an upright trunk
  • Functional integration:
    • Incorporate extension posture in daily tasks
    • Use of ergonomic correction (desk height, chairs)
  • Progressive resistive training: weighted exercises focusing on extensors

Phase 4: Maintenance, monitoring & bracing support (if needed)

  • Continue home exercise program
  • Regular follow-up assessment of the curve, symptoms
  • Brace integration (if patient is still growing or moderate-severe curve) – coordinate with orthopedic team
  • Use modalities periodically (shock wave, laser, induction system) for flare-ups
  • Compliance education: posture, load management, avoiding excessive flexion activities

Conclusion

Scheuermann disease is a structural spinal disorder that needs to be identified early and treated specifically. Patients can improve their posture, experience less pain, and live better lives with the correct evaluation and treatment. In-depth assessments, remedial exercises, and cutting-edge techniques like Shock Wave Therapy, Super Inductive System, High-Intensity Laser, Dry Needling, and Cupping are our main priorities at Elite Physiotherapy & Sports Injury Centre. Together with specialist rehabilitation, these contemporary techniques aid in strengthening supporting muscles, restoring spinal movement, and delaying the progression of disease.