Our knowledge and experience of managing and providing the specific rehabilitation plans post operations is extensive.  Our skills learned from working in both the elite sports and non elite sector gives us the necessary tools to formulate an appropriate plan following your surgery

When attending the clinic following an operation we take an extensive history of the condition and surgical procedure. The initial assessment will involve goal setting between the therapist and client to ensure that rehabilitation has direction to achieve those goals whether it be a return to sports or to manage pain free in day to day life.

We rehabilitate a broad spectrum of clients following surgery with the most common conditions listed below:

• Knee and Hip Replacement.
• Anterior Cruciate Ligament reconstruction.
• Knee Arthroscopy – Cartilage or ligament surgery
• Ankle Fusion.
• Shoulder Reconstruction.
• Ankle ligament Reconstruction.
• Surgery to repair Bone following a fracture

We also have strong links with the local Sports Medicine and Pain departments who perform less invasive procedures that need speific rehabilitation plans , such as:

• Joint Injections  – Steroids and Hyaluronic Acid
• Spinal injections  – Epidural and Facet joint
• Nerve Ablations – Lower back
• Tendon Injections – Platelet Rich Plasma (PRP) treatments

Achilles and Patella tendon pain can be debilitating and very difficult to resolve. Often a described by the client as a gradual onset of pain and caused by overuse activities such as running, jumping or repetitive movements in the workplace.

Tendinopathy is defined as a failed healing response within the tendon creating an abnormality in the function of the tendon creating pain and swelling.  Due to the complex make up of Tendons, having limited blood and oxygen supply, rehabilitation and resolution of pain and function will often take a significant period of time.

At Rob Leather Physiotherapy we have developed a very successful rehabilitation protocol for the management of Tendinopathies.  We use a 5 stage progressive loading programme to stimulate healing within the tendon allowing a full return to sports.  All the stages within the  rehabilitation protocol are objectively measured to ensure your progressions are appropriate and well timed according to you pain.

5 Stages of our Progressive Loading Programme :

1. Isometric Loading
2. Heavy Slow Resistance Loading (HSR)
3. Introduction of Plyometrics (bouncing / jumping)
4. Controlled introduction of sports/ Work specific activity
5. Graded return to sport.

Lower back pain forms the most commonly treated complaint at Rob Leather Physiotherapy.  Often associated with our posture and our daily habits both at home and work, clients often present with pain related to posture and muscle imbalances.

At Rob Leather Physiotherapy we specialise in corrective therapy to manage all aspects of your back pain. We identify the causes and aggravating factors of your condition, examine your movement, posture and and muscle imbalances and highlight a clear pathway to rehabilitate your lower back condition.

Most commonly we use a core strength training plan that can be carried out successfully at home or at work, derived from the key principles of keeping the core controlled as we pursue our daily activities.

Common Back pain complaints seen are:

1. Posture related Back or Neck Pain
2. Disc related Lower back pain (“slipped disc”)
3. Sciatica
4. Facet joint pain – Lower back
5. Whiplash
6. Neck Pain – involving nerve entrapment

A Lumbar stress injury is a specific injury to the lower back  that is most commonly associated with the adolescent and developing athlete. It occurs when the bone within the spine is subjected to repeated stress, presenting as a lower back pain. This specific type of injury is associated with certain sports and activities

• Cricket – Fast bowling
• Soccer
• Tennis
• Gymnastics and Ballet

These injuries vary in severity presenting initially with some bony bruising (oedema) and if left unmanaged, developing into a stress fracture in the vertebra.  If a stress injury is suspected, we will often use MRI or CT scans to gain a clear diagnosis of the stress response

There are 4 main causes of Stress injures:

1. Workload – The athlete may be training and playing too much, not allowing appropriate recovery times
2. Strength – A lack of core strength in the adolescent athlete creates increased lower back loading forces with activity- creating bone stress
3. Biology – Low back Stress injuries are commonly found in Athletes who are actively growing.
4. Technique – Poor technique when performing sports can increase the stress within the spine, increasing risk of injury.

Most commonly when identifying the cause of a stress injury with an athlete, a combination of all 4 causes can be highlighted.

At Rob Leather Physiotherapy we have developed a very clear rehabilitation protocol for managing Lumbar spine stress injuries.  we utilise our experiences from professional cricket to ensure we deliver the appropriate level of rehabilitation. Your Programme will address the highlighted causes of your stress injury in order for you to return to your sport successfully.

Stress injuries take a long period of time to recover depending on the level of stress identified.  Commonly rehabilitation programmes will range between 3 months and 12 months to ensure a successful return to sport.

At Rob Leather Physiotherapy we see a number of clients with a variety of shoulder conditions that require specific rehabilitation programmes. Commonly these conditions and injuries are associated with 3 main causative factors – Muscle imbalances, Instability or Trauma

When we provide rehabilitation for shoulder conditions within the clinic, we identify the main causation of the condition, addressing these issues, with the aim to enhance normal movement patterns leading to improved function and importantly reduction in your painful symptoms

Common Shoulder Conditions:

There are a broad and diverse list of shoulder conditions, however the list below identifies the shoulder conditions we see most frequently within the clinic, with our rehabilitation programmes tailored to meet the specific needs of each condition and client.

Muscle Imbalances

• Shoulder Impingement Syndrome
• Rotator Cuff Tendinopathy
• Referred pain involving neck, shoulder and upper limb

Instability

• Shoulder Impingement Syndrome
• Labral tears – (often needing surgical fixation)
• Shoulder subluxation

Trauma

• Shoulder Dislocations – (often need surgical intervention)
• Rotator cuff Muscle Tear
• Fractures to the clavicle
• AC joint injury – ligament

Ligaments are a crucial part of any joint, connecting bone to bone and providing stability to our joints.  They are strong structures that have varied amounts of elasticity.  Injury to a Ligament normally requires a significant amount of force taking the joint into an abnormal position, such as a tackle in rugby or a fall when skiing.

The overstretch of the joint can result in a damage to the ligaments, which  can be classified into specific categories

Grade I Sprain

• Represents a mild injury without stretching of the ligament on a significant level.
• Clinical testing shows normal range of motion on stressing the ligament
• Mild – little swelling and tenderness with minor impact on function.

Grade II Sprain 

• Significant Ligament stretching, but the ligament remains intact.
• Involves a considerable proportion of the fibres.
• Stretching of the joint and stressing the ligament show increased laxity but a definite end point.
• Moderate – moderate swelling, pain and impact on function, reduced Proprioception, ROM (range of motion) and instability
• Often require Immobilisations in a brace / boot

Grade III Sprain

• Complete tear or rupture of the ligament with excessive joint laxity and no firm end point.
• Initially they are often very painful, However, grade III sprains can also be pain-free as the fibres are completely torn in the injury.
• Severe – complete rupture, extensive swelling, tenderness, loss of function and marked instability
• Often requiring Surgical reconstruction

Common Ligament Injuries:

• ACL Injury – Knee
• PCL Injury  – Knee
• MCL Injury – Knee
• LCL injury – Knee
• Lateral Ligament Injury Ankle

Rehabilitation

At Rob Leather Physiotherapy we are very experienced in delivering effective rehabilitation programmes for Ligament injuries, whether it be for a Grade I injury or following a surgical reconstruction of a grade III injury.

We stage our rehabilitation programmes to ensure there is maximum healing potential as well as developing function and control through the joint in question. We have excellent relationships with both Local and national Orthopaedic specialists, ensuring that our rehabilitation programmes are progressive, cutting edge and in line with the current guidance from the Surgeon.

Running is a popular form of exercise and fitness, with approximately 10 million runners in the UK.  Whilst running carries huge health benefits, there is always a risk of developing an injury or painful symptoms associated with running.  Reports suggest that 50% of runner will develop an injury every year with varied severity.

Running related injuries vary in presentation due to numerous factors such as

• Type of running
• Speed and mileages
• High Workloads
• Inadequate recovery
• Reduced Fitness and conditioning levels
• Poor Biomechanics and footwear

Many of the common injuries that plague runners are chronic, developing over a longer period of time, as opposed to injury caused by sudden trauma, such as muscle strains.

Common overuse injuries include:

• Stress reactions or fractures, (shin splints)
• Achilles tendinopathy,
• Iliotibial band syndrome,
• Patellofemoral pain
• Plantar fasciitis.
• Lower back pain

At Rob Leather Physiotherapy we assess all aspects of your running injury, identifying a clear diagnosis and the causative factors associated with your symptoms.  We then provide a specific rehabilitation programme to address the specific needs of your injury as well as ensuring we focus on your running goals.

Our Running specific rehabilitation programmes will always provide you with a specific measured return to running plan, whether this be to achieve a 5km Park Run or to deliver a PB in a marathon.  We have extensive experience in preparing athletes to perform at their highest possible levels.

Muscle injuries are among the most common injuries associated with sports and exercise. The main injury sustained by muscles is a Strain or a tear which can be caused by numerous factors:

• Inadequate Warm up
• Insufficient joint Range of motion
• Excessive muscle tightness
• Fatigue / overuse / inadequate recovery
• Muscle imbalances
• Previous injury
• Faulty techniques
• Spinal dysfunction

Muscle are strained or torn when some or all of the fibres fail to cope with the demands placed upon them. Muscles that are commonly affected are the Hamstrings, Quadriceps and Calf muscles as they all work across two joints making them more vulnerable to injury.

Muscle strains are Categorised into three grades

Grade I

• Involves a small number of muscle fibres
• Localised pain
• No loss of strength
• 7-14 days Rehabilitation period

Grade II

• Involves a significant number of muscle fibres
• Pain with muscle contraction
• Swelling /bruising often present
• Muscle strength is reduced
• Mobility is restricted by pain.
•  3-12 weeks Rehabilitation period

Grade III

• Complete tear of the muscle
• Often at the point the muscle meets the tendon.
• Muscle activation / strength is significantly reduced.
• Surgical Fixation is often required
• Rehabilitation takes often greater than 12 weeks.

Rehabilitation of Muscle Injury:

Our Rehabilitation programmes follow a clear staged protocol where we safely progress both mobility and strength within the injured muscle as rapidly as possible.  We respect the healing timelines needed by muscle as well as challenging the speed of recovery by working the muscle safely to ensure you make a swift return to activity.

Our experiences from Professional sports provided us with the knowledge and skills to accelerate the rehabilitation of muscle injuries safely, reducing time away from sports and activity.  This enables us to get you back to your chosen activity quickly and with a low risk of re-injury.