Physiotherapy at Ten

Manual therapy

With a number of manual therapy and joint mobilisation techniques at our disposal, our Physiotherapists can improve quality and range of movement, reduce pressure on the nerve, decrease pain, promote recovery and enable patients to return faster to activity (or to a strengthening programme).

All manual therapy techniques are preformed following a thorough assessment, and while some post-treatment soreness is usual, you can expect to be able move more freely though the affected area afterwards.

Soft tissue treatment

A combination of massage and trigger point release to reduce pain and promote healing. The technique focuses on a specific area of muscle, ligament or tendon to lengthen, desensitise or numb the tissue.

Mobilisation

The application of specific force or pressure onto stiff joints or tissue to allow a greater range of movement.

Dry needling

Dry needling is a minimally invasive treatment technique similar to acupuncture, which uses small filament acupuncture needles to release tight, dysfunctional or injured muscles.

Dry needling helps to deactivate and desensitise painful trigger points by stimulating a healing response in the treated tissue, releasing the trigger point and reducing the biomechanical stress at that muscle group; allowing for more effective treatment.

Evidence-based research indicates that dry needling improves pain control, reduces muscle tension, normalises biochemical and electrical dysfunction of motor end plates, and facilitates an accelerated return to active rehabilitation. It’s also a recommended treatment option for people suffering with chronic low back pain.

Acupuncture

The oldest documented form of medicine known to man, there are two generally held views on how Acupuncture works.

The traditional Chinese view is that it helps free blockages in the flow of Qi energy around the body. The western view is that it works by stimulating the body's own painkillers such as endorphins and enkephalins, and that although initial pain relief may only be short term, repeat treatments can bring long term benefits.

Even though there is no overall agreement on how, or why it works, it has been shown to be an effective method not only of relieving symptoms but also of dealing with a problem at its root cause.

At Ten, Acupuncture can be administered either as a treatment in its own right, or as part of an overall programme of therapy.

Sports injury management

Sports injuries are split into two categories – traumatic and non- traumatic.

Traumatic injuries are usually the result of impact or accident (sprains and dislocation for example). Non-traumatic injuries are generally caused by overuse or underpreparation – i.e. the body has not adapted for the stresses and demands of a particular sport or activity.

Our Physiotherapists are experienced at dealing with both types of injury, and are up-to-date with the latest sports injury research and rehab programmes.

All have personal sports interests and experience, and most have specific and extensive experience working with elite athletes. As a result they understand the pressures and frequency of training, and the need to create rehabilitation programmes that are both fast and effective.

As most of Ten’s Physios have been active sportsmen and women themselves - several performing or competing at elite level - many also have first hand experience of a wide range of injuries.

Stretching

Stretching can be very important tool to increase flexibility, reduce pain and take pressure off joints or injuries. For optimal results, stretching should be specific and targeted, done at the right time of day and held for the correct duration.

Your Physiotherapist will teach you which stretches are best for your problem and how much you need to do.

Foam rolling

The foam roller is something everyone should own if they sit at a desk for several hours a day, use a phone or laptop, exercise, suffer from sore or tight muscles, have less than perfect posture – or, in short, live in the 21st Century.

It’s also an excellent tool that you can use between treatments to keep certain areas of your body loose and improve the rate and speed of recovery. By rolling specific body parts over the roller, you can massage muscles and fascia, relieve tight or sore muscles, reduce pain and help prevent future injuries

NB: Done properly, foam rolling will and should be painful - but not unbearable.

Strengthening

Most of the up-to-date research shows that almost all injuries require some form of strengthening, loading or stabilisation as part of the rehabilitation programme.

Depending on the nature of your injury, your Physiotherapist will create a specific and bespoke programme to help improve the speed and effectiveness of your treatment. They will ensure that you understand the exercises you need to do, can perform them with proper technique and form, and are clear how often, and how many reps of each you should do.

Most of these programmes can be repeated at home, either as basic body weight exercise, or using therabands and occasionally dumbells.

Exercise therapy and prescription

To help maximise the speed and effectiveness of your treatment, your Physiotherapist will provide you with 2 or 3 specific targeted home exercises.

They may include stretches/foam rolling to reduce the pressure on injured tissue or stabilisation/strengthening exercises to improve joint stability and help prevent recurrence of your injury.

At all our sites, we have dedicated rehabilitation areas and gyms where your Physiotherapist can go through your exercises or use the well equipped spaces to enhance your overall treatment or injury management programme.

Gym-based exercise

At all our London Physiotherapy clinics, we have dedicated rehabilitation areas and gyms where you can work through your exercise rehabilitation, injury management or performance enhancement sessions. Your Physiotherapist will be present to coach you through the techniques, monitor your progress, and adapt specific exercises or sequences as your needs and capabilities change.

Biomechanical correction

Much of the pain or dysfunction that results from repetition or overloading injuries (without trauma) is likely to have a biomechanical cause. Certain muscles will be too tight and conversely, the opposing muscles will be too weak, resulting in abnormal biomechanical patterns.

Your Physiotherapist will focus on correcting these imbalances - this could involve anything from gluteal strengthening to exercises designed to load the rotator cuff. Rather than simply treating the symptoms, this approach is paramount to addressing the root cause and preventing future recurrence.

Postural correction

Posture-related musculoskeletal issues are becoming ever more common - largely due to the prevalence and postural impact of computers, smartphones, laptops and tablets, and our increasingly sedentary 21st century working patterns and lifestyles.

If you have pain that occurs while you are seated or inactive, chances are your posture is a massive causative factor – whether due your neck protruding forwards, shoulders rolling forwards or a rounding through the thoracic and lumbar spines.

Our Physiotherapists can help you reset your neck and spine to a more natural posture, and show you some simple stretches and exercises to help you keep it there.

Pre / post natal

A woman’s body goes through a number of significant physical and hormonal changes in preparation for childbirth and again during the months afterwards.

Many of these changes can result in pain, dysfunction and increased susceptibility to injury. However with proper management and treatment, the adverse effects of these changes can either be prevented or successfully treated.

Our Physiotherapists are highly trained and experienced in dealing with pre and post natal issues, and can apply a number of techniques and treatment options to help manage any existing problems or help prevent any future occurrences - often involving postural correction, stretching, soft tissue treatment and specific strengthening exercises.

Circle of care

Unlike the traditional Physiotherapy model where therapists work in isolation, Ten’s Physios work collaboratively with our Sports Massage, Rehabilitation and Training teams.

By sharing expertise, insights and client history, we are able to provide clients with a seamless progression from treatment and rehabilitation through to full recovery and functional fitness. And with all the disciplines under the same roof, we’re able to continually monitor and adapt your programme to maximise its effectiveness and help you help achieve your goals faster.

Read more about our Circle of care

Injections

Cortisone, epidural, nerve root block or facet block injections into the spine and joints are often administered to reduce pain, inflammation and any pressure on the joint or nerves,

Counterintuitive as it may seem, they are considered to be surgical procedures, as many require either general or local anaesthetic.

These injections provide a relatively short (around six weeks) window of opportunity. During this time, the reduction in pain and inflammation enables your Physiotherapist to improve the range of motion around the affected joint, strengthen the supporting muscles, progress a specific rehabilitation programme and address the underlying cause.

Less intrusive than conventional surgery, injections are often very successful treatment options. (For maximum benefit, you should see your Physiotherapist within 5-7 days.)

Injections into the hip joint are often used more as a diagnostic tool more than a curative treatment, however if they are successful in reducing pain, they also create a similar six week timescale in which your Physiotherapist can work on increasing mobility and addressing the underlying cause.

Injections are not common in the knee joint as they are thought to advance osteoarthritis.

Lumbar spine surgery

Some of the more common conditions that may require spinal surgery (micro discectomy, laminotomy/foraminotomy, or laminectomy) include:

- Large disc protrusions/prolapses
- Referred pain, pins and needles, weakness and numbness
- Sciatica
- Spinal stenosis
- Inflammation or pressure on the nerve
- Fractures

The better prepared your body is for spinal surgery, the more successful the outcome is likely to be. To that end, we will work with you to create a pre-operative treatment plan that will improve the range of motion and stability of your spine, muscles and nerves.

Post-surgical treatment plans are designed to be safe, gentle and progressive, targeting range of motion, neural mobility, core stability and progressive functional retraining.

Once you have regained basic stability we would generally advise Pilates, Gym Based Physio and Physio-Led Clinical Pilates for further rehabilitation and progression.

We maintain constant correspondence with your Specialist throughout the process.

Cervical spine surgery

Some of the more common conditions that may require spinal surgery (including micro discectomy, disc replacement or fusion) include:

- Large disc bulges
- Chronic pain
- Referred pain, pins and needles, weakness and numbness
- Spinal canal stenosis
- Degeneration
- Instability

If you are having surgery, it is important that you prepare yourself for it with a proper pre-operative programme. (The more understanding, movement, strength and neural mobility you have going into surgery, the better the outcome is likely to be and the faster you will recover from its effects.)

We would always recommend a post-surgical Physiotherapy programme to restore range of motion, maintain neural mobility, improve posture, and for upper back/deep neck flexor strengthening.

We keep in constant correspondence with your Specialist throughout the process.

Shoulder surgery

Some of the more common conditions that may require shoulder surgery include:

- Chronic impingement (bursitis, calcification)
- Rotator cuff tears
- Instability, typically following dislocation
- ACJ dislocations
- Labral tears (cartilage)
- Chronic capsulitis (frozen shoulder)
- Osteoarthritis
- Complex fractures

The more movement and strength you have going into surgery, the better you will be coming out. Our Physiotherapists can create a pre and post-operative treatment plan to improve the success and recovery time of your surgical procedure, including shoulder replacements, sub-acromial decompression, rotator cuff repair, ACJ debridement, shoulder stabilization (with or without labral repair) and manipulation under anesthetic (with or without hydrodilation).

The goal of Physiotherapy following surgery is firstly to restore range of motion, then regain specific scapula stability and shoulder strength (specific programmes will depend on the severity of your condition and the type of shoulder surgery that you have had).

We keep in constant correspondence with your Specialist throughout the process.

Hip Surgery

Some of the conditions that may require hip surgery include:

- Impingement
- Labral tears
- Osteoarthritis
- Fractures

If conservative management of your condition has failed, your Consultant may opt for surgery, which could include femoroacetabular impingement, humeral re-shaping, arthroscopic debridement, labral repair and total hip replacement

Our Physiotherapists can create a programme to help you prepare for your surgery, most commonly focusing on improving range of movement, and increasing the strength and stability of the supporting muscles.

Following surgery, your Physiotherapist will take you through a specific rehabilitation programme (depending on the procedure), focusing on restoring the joint's range of motion, increasing your weight-bearing tolerances, restoring gluteal strength and then functional retraining. It is likely that post op, your programme will largely be exercise and gym based.

We keep in constant correspondence with your Specialist throughout the process.

Knee Surgery

Some of the more common reasons for orthopaedic referral and potential knee surgery are the result of an acute trauma that limits stability or range of movement of the joint. Conditions include:

- Meniscal tears
- Ligament ruptures (ACL, MCL)
- Chondral injuries
- Fractures

If conservative management of your injury has failed, surgical options include ligament reconstructions (ACL/MCL), meniscal repairs, arthroscopic debridement, tendon scraping or total/partial knee joint replacement.

To improve the effectiveness and recovery time of your surgery, our Physiotherapists will create a specific pre-operative Physiotherapy programme, focusing on range of movement through the joint and strength of the supporting muscles (particularly the quads).

Following surgery, your post-operative Physiotherapy programme will be about regaining range of motion (extension before flexion), restoring the inner range of the quads and VMO, progressive improvement of weight-bearing and walking, functional retraining and then depending on the patient, high end sports specific plyometrics and sports specific retraining.

We keep in constant correspondence with your Specialist throughout the process.

Foot & Ankle surgery

Some of the conditions that may require foot or ankle surgery include:

- Ligament ruptures
- Chronic bunions and/or hammer toes
- Complex fractures
- Chronic Achilles tendonopathy

If more conservative treatment options have failed, surgical options include ligament reconstructions, tendon scraping, bunion or hammer toe corrections, fusion and open reduction and/or internal fixation of displaced fractures

If you do require surgery, it is important that you have a pre-operative Physiotherapy programme in place, as the more movement, strength and proprioception that you have before the procedure, the better and faster your progress will be afterwards.

Depending on the nature of your treatment, the goal of post-operative Physiotherapy is to restore weight-bearing tolerances, get you off crutches, reduce swelling, restore range of motion and build proprioception and strength.

We keep in constant correspondence with your Specialist throughout the process.