• A tendon is a band of tissue that connects muscles to bones.
•  Tendinopathy refers to a group of conditions involving the tendon, which are characterized by structural tendon changes and clinical symptoms of pain and limited function. 
•  Tendons become tendinopathic, when they experience high loads, beyond their capacity. This can often happen when you have increased your training load suddenly.

​How do we manage tendinopathy?

• Since tendinopathy is thought to result from the incongruence between the load placed on the tendon and its load capacity, consideration of the tendon load is essential to its management.
• Whilst you may think rest will help your symptoms, complete rest may only make matters worse, as the tendons capacity is decreased further and therefore your ability to bare load also declines.
• A graded loading programme is key to your management. 
• This may start with isometric exercises, which have been found to have pain relieving effects. Heavy slow resistance programmes or eccentric exercises may then be suggested to rehabilitate the tendon. 
• Knowing how much to load the tendon can be challenging. A physiotherapist can work with you to help guide you through this process.

*New research* - Pavlova AV, Shim JSC, Moss R, et al (2023) ‘Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis British Journal of Sports Medicine 2023;57:1327-1334.

• New research into tendinopathy management released this October, found that exercise programmes that involved added loads (dumbbells, TheraBand’s, weighted machines etc) were found to be more effective for treating tendinopathy than compared to just using body weight exercises.
• Completing rehabilitation sessions at a higher intensity, with added load and then allowing of sufficient recovery was also found to be more effective than a high frequency of sessions at lower intensity.

​Addittional treatment 

• For unresolving tendon pain, Shockwave therapy is also a useful management strategy. 
• The treatment involves low energy soundwaves (shockwaves) being delivered by a handheld device to the painful area to stimulate a healing response.
• You can read more about this on our Shockwave Therapy Page.

If you are suffering with what you think may be a tendinopathy, then call for help and you can discuss with one of our team a plan to get you back to your best! 

In 2022, Incontinence UK stated that at least 7 million people in the UK are living with
urinary incontinence. Urinary incontinence is defined by NHS England as unintentional
passing of urine. It’s a common issue that isn’t often spoken about.

There are several types of urinary incontinence including:

• Stress incontinence – when urine leaks at times when the bladder is under pressure,e.g. coughing, laughing, sneezing, jumping and running.
• Urge (urgency) incontinence – when urine leaks as you feel an intense urge to pee. This can be split into wet or dry meaning that you may not leak when you have a strong urge.
• Overflow incontinence – when you have the urge to urinate but can only release a small amount due to being unable to completely empty your bladder, this may cause frequent leakage.
• Mixed incontinence – you may experience more than one type of urinary incontinence. Most often this is a combination of stress and urge incontinence.

Potential causes of urinary incontinence can vary, often it is the result of weakening or
damage to the pelvic floor muscles. Urge incontinence may be the result of overactivity in
the pelvic floor muscles.

What are the Pelvic floor muscles?
The pelvic floor muscles are made up of a group of deep and superficial muscles which
support your pelvic organs, maintain continence of urine and faeces, and aid in sexual
function. It is difficult to know whether your pelvic floor muscles are weak or overactive as
you can’t see them, if you are experiencing any symptoms of incontinence this is not normal
(even if you’ve had a baby!) and you may benefit from a pelvic floor assessment.

What can I expect from a Pelvic floor Physiotherapy assessment?
During the assessment, we will take a detailed history of the problem you may be suffering
with to determine the cause of the issue. We will also conduct a pelvic exam which involves
an assessment of the health of the tissue around the vagina, an assessment of your pelvic
floor muscles and a treatment plan going forward. This may involve strengthening your
pelvic floor muscles, relaxation techniques, biofeedback or electrical stimulation if indicated.

I think I am suffering from incontinence, what should I do next?
Please go to our webpage for more details
or alternatively call 01225 683007 to book an appointment with our
women’s health physiotherapist Liv. You do not need to detail why you need to the
appointment when booking if you choose not to, this will be discussed with the
physiotherapist at your first appointment.