Condition library
Conditions We Treat
Detailed, honest guides to the musculoskeletal conditions we treat most often at Bluebell. What they are, how we treat them, realistic timelines and when you need urgent medical attention instead of physiotherapy.
Hand Therapy for Wrist and Hand Pain
Hand therapy can include physiotherapy assessment and rehabilitation for wrist, thumb and hand symptoms. The useful starting point is the task you cannot manage comfortably, such as gripping, lifting or using a keyboard. Bluebell’s existing wrist and hand information covers tendon problems, thumb arthritis and nerve-related symptoms. This guide focuses on hand function and appointment choices, rather than treating every painful or tingling hand as the same condition.
Read the guideGroin Strain: Treatment and Physiotherapy
A groin strain can involve the adductor muscles on the inside of the thigh, which work during kicking and changes of direction. Treatment starts with assessment because not all groin pain is a muscle strain. Bluebell’s existing groin information describes distinguishing adductor symptoms from hip, hernia and other problems before discussing strengthening and return to activity. This guide focuses on an injury and rehabilitation plan, rather than the broader aching hips and groin topic.
Read the guideMeniscus Tear Physio: Assessment and Rehabilitation
Meniscus tear physio starts with your knee symptoms, movement and any medical advice already received. Bluebell’s existing knee services include meniscus problems and rehabilitation after meniscus repair. This guide explains how to prepare for that discussion and how care relates to daily activity or sport. It does not diagnose a torn meniscus from pain, clicking or a scan description, and it does not decide whether an operation is needed.
Read the guideScoliosis and Physiotherapy: Managing Pain and Movement
Scoliosis is a sideways curvature of the spine. It can be present from childhood or develop later, and for many people the main day-to-day issues are pain, stiffness, fatigue with certain positions and confidence with activity rather than the curve itself. Physiotherapy cannot correct or cure a spinal curve, but it can help you manage symptoms, stay mobile and keep doing the things that matter to you. This page explains what an assessment looks at, how treatment typically helps, and when your GP or a specialist should be involved.
Read the guideThoracic Outlet Syndrome: Symptoms, Assessment and Physiotherapy
Thoracic outlet syndrome (TOS) describes symptoms thought to come from nerves or blood vessels being compressed in the space between your neck and shoulder. It can cause pain, tingling, numbness or weakness in the arm and hand, often worse with certain positions or activities. Because similar symptoms can come from the neck, shoulder or wrist, a careful assessment matters. This page explains what physiotherapy looks at, how it typically helps manage symptoms, and when your GP or a specialist should be involved.
Read the guideSciatica
Sciatica is the term used for pain caused by irritation or compression of the sciatic nerve (or the nerve roots that feed it in the lower back). It's a symptom rather than a diagnosis — the underlying cause is usually a disc, a joint or tight muscle putting pressure on the nerve as it exits the spine.
Read the full guidePlantar Fasciitis
Plantar fasciitis is irritation of the plantar fascia — the thick band of connective tissue running from your heel bone to the base of your toes. It typically starts as sharp under-heel pain, worst on the first steps in the morning or after a period of sitting.
Read the full guideFrozen Shoulder
The shoulder capsule (the sleeve of tissue around the joint) becomes inflamed, thickens and contracts. The joint literally loses room to move. It progresses through three overlapping stages: painful (freezing), stiff (frozen) and recovery (thawing). Total duration is typically 12–24 months from onset to full recovery — physio's job is to shorten that and stop compensations elsewhere becoming permanent problems.
Read the full guideTennis Elbow
Tennis elbow — properly called lateral epicondylalgia — is a load-tolerance problem at the common extensor tendon on the outside of the elbow. The tendon has been asked to do more than it can currently handle; the pain is your nervous system asking you to change something.
Read the full guideDisc Bulge & Herniation
The discs between your vertebrae are shock-absorbers made of a tough outer layer (annulus) and a jelly-like inner (nucleus). A 'bulge' means the outer layer is deformed; a 'herniation' means some of the nucleus has pushed out. Both can — but don't always — irritate the nerves nearby. What matters clinically is your symptoms and function, not just the scan report.
Read the full guideLower Back Pain
Most lower back pain is what clinicians call non-specific, meaning no single structure can be blamed with certainty. Muscles, discs, joints and nerves all share the same pain pathways, so the exact tissue often matters less than how the back is loading, moving and recovering. That is not a fudge, it is why treatment focuses on restoring movement and load tolerance rather than chasing a label.
Read the full guideNeck Pain and Headaches
Headaches that come from the neck are called cervicogenic headaches. Irritation of the upper neck joints and the muscles around them refers pain into the base of the skull, behind the eye or over the temple. They often sit alongside general neck ache and shoulder tightness, and can be confused with migraine or tension headache.
Read the full guideShoulder Pain
Rotator cuff related shoulder pain describes irritation of the tendons that control the shoulder, often with weakness and a painful arc of movement. Frozen shoulder (adhesive capsulitis) is a progressive tightening of the joint capsule, where movement is lost in every direction, including when someone else moves the arm for you.
Read the full guideKnee Pain
The most common presentation is patellofemoral pain, felt around or behind the kneecap, where load through the joint outpaces what the surrounding muscles are controlling. Other frequent presentations include tendon pain just below the kneecap, irritation on the outside of the knee in runners, and joint related pain where movement quality and strength matter more than the picture on a scan.
Read the full guideGolfer's Elbow
The tendons of the forearm muscles that bend the wrist and fingers attach to a bony point on the inside of the elbow. When demand on those tendons outstrips their capacity, the attachment becomes painful and sensitive to grip and load. The medical term is medial epicondylalgia. Tennis elbow is the same problem on the outer side.
Read the full guideHip Pain
Groin sided hip pain usually involves the hip joint itself, including osteoarthritis or the labrum. Pain on the outer hip is most often gluteal tendon related, sometimes described as bursitis, and is classically painful when lying on that side. Buttock pain that travels down the leg is frequently referred from the lumbar spine rather than the hip at all.
Read the full guideAnkle Sprain
A sprain is an overstretch or tear of the ligaments supporting the ankle, usually on the outer side after the foot rolls inward. Alongside the ligament, the injury affects balance and position sense, which is the part that quietly persists and makes the next sprain more likely.
Read the full guideSports Injuries
Sports injuries broadly split into sudden onset injuries, such as a muscle tear, sprain or impact injury, and gradual onset overload injuries, such as tendon pain or shin pain that builds over weeks. The two need different handling, which is why the same advice cannot cover both.
Read the full guidePain Between the Shoulder Blades
The area between the shoulder blades is the thoracic spine, its rib joints and a busy layer of muscle. Pain felt there can be produced locally, referred down from the neck, or referred from the shoulder itself. It can also be referred from organs in the chest and abdomen, which is a smaller group of causes but the reason no honest guide can tell you that pain in this area is always mechanical.
Read the full guidePins and Needles in the Hand or Arm
Pins and needles is a symptom, not a diagnosis. Nerves running from the neck to the fingertips can be compressed or irritated at several points along the way, and each point produces a recognisable pattern. Thumb, index and middle finger symptoms that wake you at night point towards the wrist. Little finger and ring finger symptoms that come on with a bent elbow point towards the elbow. Symptoms in a stripe down the arm with neck stiffness point towards the neck. General tingling in both hands and both feet points away from a mechanical cause altogether and towards a medical one.
Read the full guideRunner's Knee
The clinical term is patellofemoral pain, meaning pain arising from the joint between the kneecap and the thigh bone. During bending and straightening the kneecap glides in a groove at the end of the femur, and the surrounding tissue is richly supplied with nerves. When the load through that area exceeds what it is currently conditioned for, whether because of a jump in training, a change in running surface, or weakness at the hip and thigh, the area becomes sensitive. It is a load tolerance problem far more often than a structural one, which is why strengthening and load management form the backbone of treatment.
Read the full guideHamstring Strain
The hamstrings are three muscles at the back of the thigh which decelerate the lower leg during the swing phase of sprinting. A strain occurs when the demand exceeds what the muscle tissue can tolerate at that moment, most often during high speed running or a sudden stretch such as an over reaching tackle or a slide. Strains are commonly graded from mild, involving a small number of fibres, to severe, involving a substantial tear or an avulsion where the tendon pulls away from bone. The grade influences the pathway, which is one reason an early assessment is worthwhile.
Read the full guideAchilles Tendinopathy
Tendinopathy describes a tendon that has become painful and less able to tolerate load, with changes in the structure of the tendon tissue itself. It is not the same as inflammation, which is why anti inflammatory approaches alone tend to disappoint. Achilles tendinopathy is usually described as either mid portion, a few centimetres above the heel bone, or insertional, right where the tendon attaches to the heel. The distinction matters, because insertional problems tolerate compression poorly and need a different loading approach in the early stages.
Read the full guideRotator Cuff Injury
The rotator cuff is a group of four muscles and their tendons wrapping around the shoulder joint, holding the ball of the joint centred in a shallow socket while the larger muscles move the arm. Problems range from tendon overload and irritation, sometimes described as impingement, through to partial and full thickness tears. Importantly, tears are found on scans in a large proportion of people over fifty who have no shoulder pain at all, so a scan finding on its own does not dictate the treatment plan or the need for surgery.
Read the full guideKnee Replacement Rehab
Total knee replacement involves resurfacing the ends of the thigh bone and shin bone, and often the back of the kneecap, with metal and plastic components. Partial replacements resurface only one compartment. Either way, the surrounding muscles, particularly the quadriceps, are typically weak going into surgery and weaker still immediately afterwards. Swelling limits how much the quadriceps can contract, which is why swelling management is not a cosmetic concern but a functional one. Your surgical team's protocol always takes precedence over general advice.
Read the full guideHip Replacement Rehab
Total hip replacement replaces the ball at the top of the thigh bone and the socket in the pelvis with artificial components. Surgical approaches differ, and the approach used influences which precautions apply and which muscles are most affected, so your surgeon's specific instructions always come first. The gluteal muscles are usually weak going into surgery after a long period of altered walking, and rebuilding them is the main task of the middle phase of rehabilitation.
Read the full guideACL Reconstruction Rehab
The anterior cruciate ligament is one of the main stabilising ligaments inside the knee, resisting the shin bone sliding forwards and controlling rotation. Reconstruction replaces the torn ligament with a graft, usually taken from the hamstring tendons, the patellar tendon or the quadriceps tendon. The graft goes through a biological process of integration and remodelling over an extended period, which is why the pathway is phased rather than continuous, and why your surgeon's protocol governs the early stages.
Read the full guideWhiplash and Neck Injury
Whiplash associated disorder describes the collection of symptoms that follow a rapid forwards and backwards movement of the neck, most often in a road traffic collision but also in sport or a fall. The rapid movement strains the muscles, joints and ligaments of the neck. Symptoms are usually classified by severity, and the great majority of cases involve no fracture or nerve damage, which is why emergency departments frequently discharge people without imaging after applying established clinical rules.
Read the full guidePelvic Floor Problems
The pelvic floor is a group of muscles at the base of the pelvis. It helps support the pelvic organs and contributes to bladder and bowel control. Symptoms do not always mean the muscles are simply weak. They may be difficult to coordinate, slow to relax, sensitive, or working differently after pregnancy, childbirth, surgery or a change in activity. That distinction matters because repeatedly squeezing a tense or poorly coordinated pelvic floor is not the same as following an assessment-led programme. A useful plan starts with your symptoms and goals rather than assuming every person needs the same exercise.
Read the full guideFoot and Ankle Pain
The foot and ankle contain many joints, muscles, tendons, ligaments and nerves that share load whenever you stand, walk or run. Pain can follow a clear twist or impact, but it can also build when activity increases faster than the area can tolerate. Location alone does not give a reliable diagnosis. Heel pain, for example, can relate to the plantar fascia, the Achilles tendon, local joints or other structures. Assessment looks at the story, swelling, movement, strength, balance, footwear and the way the whole leg manages load.
Read the full guideOsteoarthritis
Osteoarthritis describes changes inside a joint, including the smooth cartilage that covers the bone ends and the tissues around it. The joint is constantly repairing itself, and in osteoarthritis that process does not fully keep up. X-ray changes and symptoms do not always match: some people with marked changes on a scan have little pain, while others with mild changes struggle a great deal. That is why a physiotherapy assessment focuses on what you can and cannot do, how the joint responds to activity, and which muscles, habits and movements affect it, rather than on the scan alone.
Read the full guideCarpal Tunnel Syndrome
The carpal tunnel is formed by the small wrist bones and a firm band of tissue across the front of the wrist. The median nerve and the tendons that bend the fingers all share this space. When pressure inside the tunnel rises, from swelling, fluid changes, repeated gripping or a bent wrist held for long periods, the nerve becomes irritated. Carpal tunnel syndrome is common in pregnancy, with repetitive hand use and in some medical conditions such as diabetes and thyroid problems. It can affect one hand or both.
Read the full guideBursitis
Bursae sit at points of friction around the body. When one is pressed on repeatedly, knocked or overloaded, it can become swollen and painful. At the hip, pain over the bony point on the outside of the thigh is common, and it frequently sits alongside irritation of the gluteal tendons that attach there, sometimes called greater trochanteric pain syndrome. At the elbow, olecranon bursitis causes a soft swelling at the tip of the elbow, often after leaning on it or a knock. Bursitis can also affect the shoulder and knee.
Read the full guideShin Splints
When you run, the shin bone and the muscles attached to it absorb repeated load. If training increases faster than the tissues can adapt, the lining of the bone and the muscle attachments along the inner shin become irritated. Pain is often felt along a stretch of several centimetres rather than at one exact point. Shin splints are common in people starting to run, returning after a break, increasing distance for an event or changing to harder surfaces or new shoes.
Read the full guideCostochondritis
Costochondritis is inflammation or irritation of the cartilage that joins the upper ribs to the breastbone, known as the costochondral joints. It causes sharp, aching or pressure-like pain at the front of the chest, usually on one side, and the area is often tender to press. It can follow a chest infection with heavy coughing, a strain from lifting or a new exercise, or appear with no obvious trigger. It is not dangerous in itself, but because chest pain has serious causes, the diagnosis should come from a doctor first. A similar condition called Tietze syndrome also involves visible swelling over the joint.
Read the full guideHip Flexor Strain
The hip flexors are a group of muscles, mainly the iliopsoas and the rectus femoris, which runs from the front of the pelvis down the thigh to the knee. They work hard when you sprint, kick, climb stairs and lift your leg into a car. A strain happens when the muscle is stretched or contracted beyond what it can handle, causing small tears in the fibres. Strains are often graded as mild, moderate or more severe. This is different from general hip joint pain, which tends to be deeper and linked to stiffness, and from a groin strain, which affects the adductor muscles on the inside of the thigh.
Read the full guideMorton's Neuroma
A Morton's neuroma is a thickening of the tissue around one of the small nerves that run between the long bones of the forefoot towards the toes. When the forefoot is squeezed, for example in narrow or high heeled shoes, or loaded repeatedly in running and standing work, the nerve becomes irritated and the surrounding tissue thickens. It most often affects the space between the third and fourth toes, and sometimes between the second and third. It is more common in women, and it is different from general foot and ankle pain or plantar heel pain because the symptoms are nerve-like and sit in the forefoot.
Read the full guideSI Joint Pain
Each SI joint is a strong joint held firmly by ligaments, with only a small amount of movement. It transfers load between the spine and the legs every time you walk, stand or lift. Pain can come from the joint itself or the tissues around it. It is common in pregnancy and after birth, after a fall onto the buttock, in people with uneven loading such as a leg injury, and in some inflammatory conditions. Because low back pain, hip pain and nerve pain can all feel similar, a careful assessment matters more than the label.
Read the full guideDe Quervain's Tenosynovitis
Two tendons that move the thumb run together through a narrow tunnel at the side of the wrist. When they are overloaded, the tendons and the sheath around them become irritated and thickened, so movement through the tunnel becomes painful. It often develops with repeated pinching and lifting, such as caring for a newborn, using hand tools, gardening or racket sports. Hormonal changes in pregnancy and after birth may also play a part. It is different from carpal tunnel syndrome, which causes tingling in the fingers, and from wrist arthritis, which tends to sit at the base of the thumb.
Read the full guideDiastasis Recti
The two sides of the rectus abdominis muscle are joined down the middle by a band of connective tissue called the linea alba. As the baby grows, this tissue stretches and the muscles move apart. After birth the gap often reduces, but in some people it stays wider, or the midline feels soft, and a doming or ridge appears down the tummy when they sit up or lift. Research suggests that the tension and control of the midline matter more than the exact width. Diastasis recti can appear alongside back pain, pelvic floor symptoms or a feeling that the core is weak.
Read the full guideBroken Ankle Rehab
An ankle fracture is a break in one or more of the bones that form the ankle joint, usually the lower end of the fibula on the outside, the tibia on the inside, or both. Some fractures are treated in a cast or boot, and others need an operation with plates and screws. Either way, weeks of protection leave the joint stiff, the calf weak and the balance system out of practice. Rehabilitation after a fracture is different from rehab after an ankle sprain, because the bone needs time to heal and your hospital team will set limits on how much weight the ankle can take.
Read the full guideOsteoporosis
Bone is living tissue that is constantly being broken down and rebuilt. With osteoporosis, bone is lost faster than it is replaced, so the bones become thinner and weaker. It is most common after the menopause and in older age, but it can affect men and younger people too, particularly with some medications, medical conditions or a family history. The most common fractures are in the wrist, hip and spine. Spinal fractures can cause back pain, loss of height or a more stooped posture. Osteoporosis is diagnosed and treated medically by your GP or a specialist, and physiotherapy works alongside that care.
Read the full guideAnkylosing Spondylitis
In ankylosing spondylitis, inflammation affects the joints and the places where ligaments and tendons attach to bone, especially in the lower back and sacroiliac joints. Over time, some people develop stiffness through the spine and rib cage, and a few develop new bone that limits movement. It often starts in late teens or early adulthood and can also affect the hips, shoulders, heels and eyes. Medication from a rheumatologist is a key part of treatment, and regular exercise is recommended to maintain movement and posture.
Read the full guidePelvic Girdle Pain
The pelvis is a ring of bones joined at the front by the symphysis pubis joint and at the back by the two sacroiliac joints. In pregnancy, hormonal changes, a growing baby and changes in how you move all alter the load through these joints. For some people this causes pain at the front of the pelvis, at the back near the buttock dimples, in the groin or down the inner thigh. PGP is common and is not harmful to your baby. It usually settles after birth, although some people continue to have symptoms afterwards.
Read the full guide