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MOST COMMON INJURY

 

Most Common Injury In Physiotherapy

What is a Clicking or Clawcking Jaw?

A clicking jaw usually refers to a popping or clicking sound when you open or close your mouth. It’s often a sign of Temporomandibular Joint Dysfunction (TMJD) — a problem with the joint that connects your jaw to your skull.

🦴 Causes of Clicking Jaw:

  1. Disc Displacement in the TMJ
  2. Muscle Imbalance or tightness (especially pterygoids, masseter)
  3. Teeth Grinding (Bruxism)
  4. Arthritis or joint degeneration
  5. Jaw injury or stress-related clenching

🔎 Common Symptoms:

  • Clicking/popping sound when chewing or talking
  • Jaw pain or tightness
  • Limited range of motion
  • Headaches, ear pain, or facial pain
  • Locking of the jaw in open or closed position

🩺 Assessment (for Physios):

  • Palpate TMJ during opening/closing
  • Observe deviation in jaw movement
  • Check for muscle tenderness (masseter, temporalis)
  • Use Auscultation or 2-finger test
  • Assess cervical spine (often linked)

💪 Physiotherapy Management:

  • Heat therapy & soft tissue release
  • Posture correction (head forward posture = more strain)
  • TMJ mobilization techniques
  • Jaw muscle strengthening & coordination exercises
  • Relaxation techniques to reduce clenching
  • Avoid chewing gum or hard foods during flare-ups

 

What is Whiplash?

Whiplash is a neck injury caused by a sudden forceful movement of the head — typically backward and then forward, like the motion of a whip. It’s common in rear-end car accidents, falls, or contact sports.

⚠️ Mechanism (Biomechanics):

  • During impact, the lower cervical spine hyperextends, and the upper cervical spine hyperflexes, causing strain on muscles, ligaments, discs, and joints.
  • Often involves the sternocleidomastoid, scalenes, longus colli, and facet joints.

💢 Common Symptoms:

  • Neck pain and stiffness
  • Headaches (especially at the base of the skull)
  • Dizziness
  • Shoulder and upper back pain
  • Reduced range of motion
  • Fatigue or blurred vision (in severe cases)

🩺 Whiplash-Associated Disorders (WAD):

Graded I–IV based on severity (per Quebec Task Force):

  • Grade I: Pain, no physical signs
  • Grade II: Pain, musculoskeletal signs (↓ROM, tenderness)
  • Grade III: Pain + neurological signs (↓reflexes, weakness)
  • Grade IV: Fracture or dislocation

🏥 Management (Physiotherapy):

  • Early phase (0–4 days): Rest, ice, pain relief, posture education
  • Subacute phase: Gentle ROM, isometrics, stretching
  • Chronic phase: Strengthening, manual therapy, functional retraining
  • Avoid rigid collars long-term — they delay recovery

🧊 Frozen Shoulder (Adhesive Capsulitis)

📌 Definition:

A condition where the shoulder capsule becomes inflamed, thickened, and stiff, leading to restricted movement and pain.

🔄 3 Stages:

  1. Freezing Stage (Painful) – Gradual onset of pain & ↓ ROM
  2. Frozen Stage – Less pain, but marked stiffness
  3. Thawing Stage – Gradual return of motion

⚠️ Causes/Risk Factors:

  • Diabetes
  • Prolonged immobilization
  • Post-surgery or injury
  • 40–60 years age, especially in women

🏥 PT Management:

  • Early stage: Pain relief (heat, modalities), pendulum exercises
  • Mid-stage: Passive ROM, stretching
  • Late stage: Strengthening, joint mobilizations
  • Manual therapy: Maitland or Kaltenborn glides

🦵 Calf Injuries

📌 Common Types:

  1. Gastrocnemius Strain (aka "Tennis Leg")
  2. Soleus strain (common in long-distance runners)
  3. Achilles Tendonitis or Rupture

⚠️ Symptoms:

  • Sudden sharp pain (gastroc strain)
  • Stiffness, swelling, or bruising
  • Pain when walking or pushing off the foot

🩺 Clinical Tests:

  • Thompson Test – For Achilles rupture
  • Palpation and resisted plantarflexion for muscle strain

🏥 PT Management:

  • Acute Phase: RICE, heel lifts, gentle mobility
  • Subacute: Soft tissue release, isometrics, stretching
  • Chronic: Eccentric strengthening, balance drills, gait training

💥 Chest & Thoracic Pain — Physiotherapy Overview

Chest and upper back (thoracic) pain can stem from musculoskeletal, neurological, or even visceral sources. It’s vital to rule out cardiac causes first, then assess for postural or biomechanical dysfunctions.

🫁 Common Causes (Non-cardiac):

🧍‍♂️ Musculoskeletal:

  • Costochondritis – Inflammation at costosternal joints
  • Rib dysfunction – Subluxation or joint sprain
  • Thoracic facet joint strain
  • Postural syndrome – Rounded shoulders, kyphosis
  • Muscle strain – Intercostals, pecs, serratus anterior

🧠 Neurological:

  • Thoracic disc herniation – Rare but possible
  • Nerve entrapment – Intercostal neuralgia
  • T4 Syndrome – Upper back pain + autonomic symptoms (e.g. hand tingling)

❤️ Visceral Referral (to rule out):

  • Cardiac (angina, MI)
  • GI (GERD, gallbladder issues)
  • Pulmonary (pleurisy, PE)

🧪 Clinical Signs (Red vs. Yellow Flags):

  • Red flags: Chest pressure, shortness of breath, radiating jaw/arm pain
  • Yellow flags: Chronic poor posture, anxiety-related chest tightness

🏥 Physiotherapy Assessment:

  • Postural observation (kyphosis, scoliosis)
  • Palpation of thoracic spine, ribs, sternum
  • ROM & resisted tests – Rule in/out muscle or joint issues
  • Neurological screen – Dermatomes, reflexes
  • Breathing pattern assessment

🧘‍♀️ Management Plan:

  • Manual therapy – Rib mobilization, thoracic manipulations
  • Stretching – Pecs, intercostals, thoracic spine
  • Strengthening – Postural muscles (rhomboids, mid-traps)
  • Breathing retraining – Diaphragmatic exercises
  • Postural re-education – Ergonomics, scapular setting
  • Modalities – Heat, TENS, IFT for pain relief

Golfer’s Pain (Golfer’s Elbow) – Medial Epicondylitis

📌 What It Is:

Golfer’s Elbow is pain and inflammation on the inside of the elbow, where the forearm flexor tendons attach to the medial epicondyle of the humerus.

Despite the name, it can affect non-golfers too — from repetitive wrist flexion or gripping, common in manual workers, athletes, and physiotherapists!

💢 Causes (Biomechanics):

  • Overuse of wrist flexors & pronator teres
  • Poor swing mechanics in golf
  • Weak grip strength or poor shoulder/scapular control
  • Repetitive stress: lifting, typing, throwing, or racket sports

🔍 Symptoms:

  • Pain/tenderness on medial elbow
  • Worse with gripping, lifting, or wrist flexion
  • May radiate to forearm
  • Weak grip strength or stiffness in the morning

🩺 Clinical Tests:

  • Medial Epicondylitis Test: Pain with resisted wrist flexion & pronation
  • Palpation: Tender over medial epicondyle
  • Tinel’s sign: Rule out ulnar nerve involvement

🏥 Physiotherapy Treatment:

  • Rest & activity modification
  • Ice or cryotherapy in acute phase
  • Soft tissue release of flexor-pronator group
  • Wrist & elbow stretching
  • Eccentric loading of wrist flexors (evidence-based!)
  • Forearm strengthening – Grip trainers, theraband pronation
  • Bracing or taping may help offload tendon
  • Address kinetic chain: scapular, shoulder, and core control

Carpal Tunnel Syndrome (CTS) – Simplified Physio Guide

📌 What Is It?

Carpal Tunnel Syndrome is a compression of the median nerve as it passes through the carpal tunnel in the wrist.

It causes numbness, tingling, and pain in the thumb, index, middle, and half of the ring finger.

🧠 Causes / Risk Factors:

  • Repetitive wrist movements (typing, lifting, driving)
  • Poor wrist posture
  • Pregnancy (fluid retention)
  • Hypothyroidism, diabetes, RA
  • Prolonged gripping or vibration exposure

🔍 Symptoms:

  • Tingling or burning in fingers (especially at night)
  • Numbness in thumb & first 2–3 fingers
  • Weak grip or hand clumsiness
  • Pain that may radiate up to forearm

🩺 Clinical Tests:

  • Phalen’s Test: Wrist flexion for 30–60 sec = symptoms
  • Tinel’s Sign: Tapping over carpal tunnel reproduces tingling
  • Durkan’s Test: Direct pressure over carpal tunnel causes symptoms

🏥 Physiotherapy Management:

  • Wrist splinting in neutral (especially at night)
  • Nerve gliding exercises for median nerve
  • Stretching: forearm flexors
  • Postural correction: reduce forward head and rounded shoulders
  • Activity modification: ergonomic changes
  • Manual therapy: soft tissue work on forearm, wrist mobilizations
  • Modalities: Ultrasound, TENS (pain relief)

🦵 Groin Strain – Adductor Muscle Injury Simplified

📌 What Is It?

A groin strain is a tear or overstretching of the adductor muscles, most often the adductor longus. It typically occurs due to sudden directional changes, kicking, or slipping.

🧠 Causes:

  • Sudden lateral movements or twisting
  • Poor warm-up or flexibility
  • Weak core or hip stabilizers
  • Overuse in sports: football, hockey, sprinting

🔍 Symptoms:

  • Pain/tenderness in the inner thigh or pubic region
  • Pain worsens with hip adduction or resisted movements
  • Swelling or bruising (in moderate-severe strains)
  • Difficulty walking or sprinting

🩺 Clinical Tests:

  • Adductor Squeeze Test – Reproduce pain when squeezing knees together
  • Resisted adduction – Pain = positive
  • Palpation of adductor origin or belly

🏥 Physiotherapy Management:

🔹 Acute Phase:

  • RICE (Rest, Ice, Compression, Elevation)
  • Gentle isometric adductor contractions
  • Pain-free range of motion

🔹 Subacute Phase:

  • Stretching: Adductors, hip flexors
  • Strengthening: Hip adductors, abductors, glutes, core
  • Balance & proprioception drills

🔹 Return to Sport:

  • Sport-specific drills (cutting, sprinting)
  • Plyometrics, agility
  • Focus on symmetry and gradual loading

🦴 Osteoarthritis (OA) – Simplified Physio Guide

📌 What Is It?

Osteoarthritis is a degenerative joint disease where the cartilage that cushions the ends of bones wears down over time, leading to pain, stiffness, and reduced mobility.

It’s most common in weight-bearing joints like the knee, hip, spine, and hands.

🧠 Causes & Risk Factors:

  • Ageing – natural wear & tear
  • Obesity – increases joint stress
  • Joint injury or overuse
  • Muscle weakness
  • Genetics or bone deformities
  • Women > men (especially post-menopause)

🔍 Symptoms:

  • Joint pain (worse after activity)
  • Morning stiffness (<30 mins)
  • Swelling or crepitus (cracking sounds)
  • Decreased joint flexibility
  • Muscle weakness around the joint

🩺 Common Sites:

  • Knee OA – pain with walking, stairs
  • Hip OA – groin pain, limp
  • Spine OA – lower back stiffness
  • Hand OA – Heberden’s or Bouchard’s nodes

🏥 Physiotherapy Management:

🔹 Exercise is key!

  • Strength training – quadriceps (for knee), glutes (for hip)
  • Low-impact cardio – cycling, swimming, walking
  • Stretching – maintain joint mobility
  • Weight management
  • Joint protection techniques (avoid overloading)

🔹 Adjuncts:

  • Hot/cold therapy
  • Manual therapy (for pain relief and mobility)
  • Bracing or supportive footwear
  • TENS or ultrasound as needed

🦵 Hamstring Tear – Physio-Friendly Overview

📌 What Is It?

A hamstring tear is an injury to one or more muscles in the hamstring group — biceps femoris, semitendinosus, and semimembranosus — typically from sprinting, jumping, or a sudden stretch.

🧠 Causes:

  • Sudden explosive motion (e.g., sprinting starts)
  • Inadequate warm-up or flexibility
  • Muscle imbalances (weak glutes or tight quads)
  • Fatigue or poor neuromuscular control

📊 Grades of Tear:

  • Grade 1: Mild strain, tightness or cramp
  • Grade 2: Partial tear, pain + weakness
  • Grade 3: Complete tear, severe pain, bruising, and function loss

🔍 Symptoms:

  • Sudden sharp pain in back of thigh
  • Swelling or bruising
  • Difficulty walking or extending the leg
  • Tenderness on palpation

🩺 Clinical Tests:

  • Passive SLR (Straight Leg Raise)
  • Resisted knee flexion (painful in acute phase)
  • Palpation to locate tear

🏥 Physiotherapy Management:

🔹 Acute Phase (0–5 days):

  • RICE (Rest, Ice, Compression, Elevation)
  • Gentle ROM (pain-free)
  • Isometric hamstring exercises

🔹 Subacute Phase:

  • Progress to concentric/eccentric loading
  • Soft tissue massage
  • Core and glute strengthening
  • Hamstring stretching

🔹 Return to Play:

  • Sprint drills, agility work
  • Plyometric training
  • Hamstring:quad ratio balance

🦴 Wear & Tear / Joint Pain – Simplified Explanation for Patients & Physio Content

📌 What Is It?

“Wear & tear” joint pain typically refers to osteoarthritis or degenerative changes in a joint due to long-term use, aging, or repetitive stress.
It’s not a sudden injury—it happens gradually over time.

🧠 Common Causes:

  • Age-related cartilage breakdown
  • Repeated joint overuse (work/sports)
  • Previous injuries
  • Poor posture or biomechanics
  • Obesity (increased joint load)

🔍 Typical Symptoms:

  • Dull, aching pain in the joint
  • Stiffness, especially in the morning or after rest
  • Swelling and mild warmth
  • Cracking or grinding (crepitus) during movement
  • Reduced flexibility

🩺 Commonly Affected Joints:

  • Knees
  • Hips
  • Spine (especially lumbar & cervical)
  • Shoulders
  • Hands (especially base of thumb, finger joints)

🏥 Physiotherapy Approach:

🔹 Exercise Therapy

  • Strengthening muscles around joints (e.g. quads for knees)
  • Stretching tight muscles
  • Low-impact aerobic activity (e.g. cycling, walking, pool exercises)

🔹 Joint Protection:

  • Weight management
  • Postural correction
  • Proper footwear or orthotics
  • Avoid overloading joints

🔹 Pain Relief:

  • Hot/cold therapy
  • TENS
  • Manual therapy
  • Bracing/taping if needed

🦵 Aching Knee – Causes & Physiotherapy Insight

📌 What Is It?

An aching knee can result from muscle imbalance, overuse, joint degeneration, or poor biomechanics. It’s one of the most common complaints across all age groups.

🧠 Common Causes:

  1. Osteoarthritis – cartilage wear & tear
  2. Patellofemoral pain syndrome (PFPS) – pain around kneecap
  3. Tendinitis – inflamed tendons (esp. patellar or quadriceps tendon)
  4. IT band friction – outer knee pain
  5. Meniscus tear – locking/clicking, pain with twisting
  6. Weak quadriceps or glutes – poor shock absorption
  7. Flat feet or improper footwear

🔍 Symptoms to Note:

  • Dull or sharp pain (varies by activity)
  • Stiffness, especially in the morning
  • Swelling after use
  • Pain during stairs, sitting long, or squatting
  • Clicking or grinding sensation

🏥 Physiotherapy Management:

🔹 Phase 1: Pain Control

  • Ice or heat as needed
  • TENS or ultrasound
  • Taping or bracing for patella tracking

🔹 Phase 2: Strengthening

  • Quad strengthening: mini squats, leg raises
  • Glute activation: bridges, clamshells
  • Core & hamstring focus

🔹 Phase 3: Mobility & Balance

  • Stretching: quads, hamstrings, calves
  • Balance drills
  • Gait correction

🏃‍♂️ Sports Injuries – Quick Physio Overview

📌 What Are Sports Injuries?

Sports injuries are musculoskeletal injuries that occur during physical activity, sports, or exercise. They can affect muscles, ligaments, tendons, joints, or bones and range from minor sprains to major fractures or dislocations.

🧠 Types of Sports Injuries:

🔹 Acute Injuries (Sudden onset):

  • Sprains – overstretched ligaments
  • Strains – torn/stretched muscles or tendons
  • Fractures – broken bones
  • Dislocations – joint out of place
  • Contusions – bruises

🔹 Overuse Injuries (Gradual onset):

  • Tendinitis – inflamed tendons (e.g., Achilles)
  • Shin splints
  • Stress fractures
  • Runner’s knee / Jumper’s knee
  • Tennis/Golfer's elbow

🔍 Common Signs & Symptoms:

  • Pain (sharp or dull)
  • Swelling
  • Bruising
  • Limited movement
  • Weakness or instability
  • Decreased performance

🩺 Physiotherapy Role:

🔹 Acute Phase (RICE)

  • Rest, Ice, Compression, Elevation
  • Reduce pain & inflammation
  • Protect the injured area

🔹 Subacute to Recovery:

  • Restore mobility & strength
  • Prevent stiffness
  • Retrain balance and coordination
  • Sport-specific rehab for return-to-play

⚠️ Injury Prevention Tips:

  • Proper warm-up & cool-down
  • Strength and flexibility training
  • Correct technique and equipment
  • Listen to your body – don’t ignore pain

🦶 Achilles Tendinitis – Simplified Physio Explanation

📌 What Is Achilles Tendinitis?

Achilles tendinitis is inflammation or irritation of the Achilles tendon, the strong band connecting your calf muscles to your heel bone. It’s common in runners, athletes, or anyone who overuses the ankle.

🧠 Main Causes:

  • Sudden increase in activity or intensity
  • Poor calf flexibility or tight muscles
  • Improper footwear
  • Flat feet or overpronation
  • Inadequate warm-up or recovery

🔍 Symptoms:

  • Pain and stiffness along the back of the ankle
  • Worse in the morning or after activity
  • Tenderness or thickening of the tendon
  • Swelling or creaking sensation when moved
  • Pain when standing on tiptoes

🏥 Physiotherapy Management:

🔹 Initial Phase:

  • Rest and activity modification
  • Ice therapy 10–15 mins
  • Heel lifts or proper shoes
  • Taping for tendon support

🔹 Rehab Phase:

  • Eccentric calf strengthening (e.g., heel drop exercises)
  • Stretching of gastrocnemius and soleus
  • Tendon loading programs
  • Ankle and foot mobility work
  • Address biomechanics/posture if needed

🔹 Avoid:

  • Running/jumping in early phase
  • Aggressive stretching too soon

Arch Collapse (Flat Feet / Fallen Arches) – Simple Physio Breakdown

📌 What Is Arch Collapse?

Arch collapse (also called fallen arches or flat feet) happens when the arch of the foot flattens, causing the entire sole to touch the ground. It may occur in one or both feet, and can be flexible or rigid.

🧠 Causes:

  • Weak or overstretched foot muscles & ligaments
  • Genetics (inherited flat feet)
  • Overuse or injury (e.g., tibialis posterior dysfunction)
  • Obesity or pregnancy
  • Aging or joint conditions (e.g., rheumatoid arthritis)

🔍 Symptoms:

  • Pain in the arch, heel, or ankle
  • Tired or achy feet after standing/walking
  • Overpronation (foot rolls inward)
  • Knee, hip, or back pain due to poor alignment
  • Uneven wear on shoes

🩺 Physiotherapy Treatment:

🔹 Phase 1: Support & Pain Relief

  • Orthotic insoles or arch supports
  • Proper footwear with good arch and heel support
  • Taping to support medial arch
  • Ice massage if inflamed

🔹 Phase 2: Strengthening & Stability

  • Foot intrinsic strengthening (e.g., towel curls, marble pick-up)
  • Tibialis posterior strengthening
  • Calf and ankle stability exercises
  • Balance training

🔹 Postural Correction:

  • Check pelvic, hip, and knee alignment
  • Improve core and glute strength to reduce compensations

👣 Bunion Pain – Simple Physio Guide

📌 What Is a Bunion?

A bunion is a bony bump at the base of the big toe, where it angles outward, often overlapping the second toe. It causes pain, swelling, and difficulty wearing shoes.

🧠 Common Causes:

  • Genetics (inherited foot structure)
  • Wearing tight, narrow, or high-heeled shoes
  • Flat feet or abnormal foot biomechanics
  • Arthritis (especially in older adults)
  • Overpronation

🔍 Symptoms:

  • Bulging bump on the outside of the big toe
  • Redness, swelling, or soreness
  • Pain while walking or wearing shoes
  • Restricted motion of the big toe
  • Development of corns or calluses

🩺 Physiotherapy Management:

🔹 Pain & Pressure Relief

  • Footwear changes – wider toe boxes, soft soles
  • Toe spacers or bunion pads
  • Icing to reduce swelling
  • Night splints or soft braces

🔹 Strength & Mobility

  • Toe stretches and mobility exercises
  • Towel scrunches, toe spreading, marble pick-up
  • Strengthening of intrinsic foot muscles
  • Arch support to correct biomechanical load

🔹 Manual Therapy & Taping

  • Mobilization of 1st MTP joint
  • Kinesiotaping for joint alignment
  • Gait retraining

 

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