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.
Sciatica
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 guide