Real Time Ultrasound

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ESIC is one of the few clinics in Edinburgh to offer Ultrasound (US) imaging in the rehabilitation of the core.

Back pain and injury change how the core muscles work. This can result in a chronic pain cycle, poor athletic performance and after pregnancy it can limit the recovery of the pelvic floor.

Once this cycle has been developed it can become very difficult to reverse.

Real time US is used to scan the core muscles so that the timing and development of strength can be seen and monitored.

This visual reinforcement of the correct timing of the muscular contractions allows for a more effective and faster recovery.

Podiatry

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Correct alignment and function of the foot is fundamental to achieving optimum performance and reducing the risk of injury. The use of custom made insoles can assist in this by restricting or improving the function of the foot and ankle. They work alongside the other treatments prescribed by your therapist.

Voice Issues

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At ESIC we are fortunate to work with professionals from different areas. Many speech problems can cause stress and tightness in the thorax and upper back.

Should the problems with speech last for a while then the musculoskeletal problems become fixed. Joints reduce their movement and muscles weaken. This lack of movement in your ribs and thorax limits the improvements your voice coach can achieve.

Our therapists have found that by mobilizing the rib cage and upper back, and returning normal function to the muscles, it allows your voice coach to achieve better results.

Chronic Back Pain

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This is characterized by recurrent episodes of acute pain followed by a return to a period of low level pain, or even pain free periods.

Within hours of the first episode of back pain, the deep muscles that support the spine ( the core muscles ) stop working properly. This leaves the back weak and vulnerable. In order to try and protect the spine, the brain uses other muscles to fulfill this role. Over a period of time the back becomes increasingly stiff and weak, making it more likely to be injured.

Treatment involves finding the initial cause of the problems to ensure that future outside influences will not cause a recurrence. Joint dysfunctions are identified and dealt with by a mixture of home exercises , soft tissue massage, muscles energy techniques and manipulation. Once the body’s scaffolding is in place, the task of retraining the correct muscles in the correct order starts. The core is retrained giving a base from which all other exercises take place. The increase in strength of the core muscles leads to an increase in stability and a decrease in pain. With the appropriate training program normal function slowly returns and the pain cycle is broken.

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Post Partum Issues

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Millions of women give birth every year and continue on with a pain free, fully functional life. There are some however who do not. Some women will experience low back pain or pubic pain, while others fail to regain urinary continence.

Nine months of pregnancy along with the birthing process can give malalignments of the sacroiliac joints. Combine this with the changes that occur in the ligaments due to the release of relaxing, and the result is often a weak and unstable pelvis and lower back.

At ESIC we assess the whole of the body, as changes that occur during pregnancy are whole body changes. We find areas of tightness and dysfunctions, and plan our treatment appropriately. Joint dysfunctions inhibit the contraction of the core muscles including the pelvic floor. Realignment of the sacroiliac joints and opening up of the thorax is generally required. It is followed by a progressive exercises program, closely monitored and altered when necessary .We aim to get your body back into shape so that you can fully enjoy life as a mother.

Osgoods-Schlatters Disease

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This is common in growing children, particularly boys, and manifests in pain and swelling at the top of the tibia just below the kneecap. It occurs mainly in sporty children and usually during a period of rapid growth and increased exercise.

The increased tension of the thigh muscles can pull on the pelvis and cause a malalignment of the sacroiliac joint, a leg length discrepancy, and incorrect foot biomechanics. This in turn changes the mechanics of the knee causing an increased strain of the quadriceps muscle, resulting in pain and inflammation as it inserts into the tibia.

Treatment may involve realignment of the back and pelvis, the use of insoles to correct foot biomechanics, ice, massage and progressive stretching and strengthening exercises.

Skeletal

Scoliosis

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A scoliosis is a side to side curve in the back. It can progress significantly in teenage years when more growth occurs. Once a person has matured it is less likely to increase. In some severe cases it can decrease lung capacity and cause restricted movement in the spine.

Treatment involves mobilising the spine, correcting alignment from the base of support, and addressing the muscle imbalance that occurs during the condition. We try to encourage the spine to move as correctly as possible and use the body’s own strength to stabilize the spine and reduce the deformity. The result is a more functional spine.

Disc Problems

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Disc problems of in the lumbar spine are more common than the cervical spine, with disc issues in the thoracic spine being more rare.

When a lumbar disc bulges and puts pressure on part of the sciatic nerve then symptoms such as numbness, pain, and tingling can occur any where from the back to the foot. Symptoms down the leg are often referred to as sciatica, and about 90% of cases of sciatica are caused by trauma to one or more of the lumbar intervertebral discs.

The most common level for this to occur is between the 5th lumbar vertebra and the sacrum.
Treatment incorporates the whole of the spine and the pelvis, and not just one segment. By ensuring correct alignment and normal function of all other areas the amount of work that the lower back has to do is minimized. Often kinesiotape is used to support the area but maintain a functional range of movement, while a specific program of core exercises and kinetic chain work is given. This allows the body to regain its efficiency of movement and minimizes the chances of any future disc issues.

Sacroiliac Dysfunctions

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The sacroiliac joint lies between the sacrum ( at the bottom of the lumbar spine) and the pelvis. Dysfunction here can cause a number of symptoms including pain in the buttock, sometimes radiating into the groin and down the leg.

Sacroiliac joint dysfunction can go undetected for a considerable period of time, and as such further dysfunctions can occur as the body tries to compensate for the poor biomechanics. It is important that the correct starting point for treatment is found. Realignment of the Sacroiliac joint will usually involve muscle energy techniques, core exercises and kinetic chain work.

Musculoskeletal Problems

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This is damage to the muscle or skeletal systems usually due to the result of strenuous exercise. Occasionally it is not obvious what the cause of injury is, however it is imperative that every effort is made to find the source of the problem, so that the injury does not reoccur.

Various techniques are used during treatment. These will be individual to the patient and the diagnosis of the injury.