Whether your goal is to be able to walk pain-free to and from your workplace or compete in a major sporting event like a triathlon or a marathon, we strive to help you attain a higher level of fitness and health than before your injury.
What does a Physiotherapy session involve?
Your initial appointment very much depends on why you’ve come to see us. The majority of our clients come for help - assessment and treatment of a specific problem such as back pain, neck pain, a sports injury, shoulder pain or knee pain, but we also offer:
- Advice - what to do while waiting for NHS treatment for a painful condition
- Check-up - of an ongoing problem or exercise review to ensure that you are doing the right things to help yourself
- One-off consultation - if you don’t live near us or have funds for ongoing private treatment and you just want a diagnosis and advice on a management programme and exercises that you can do yourself at home
More information on the the most common conditions that we see:
Back Pain and Neck Pain
Knee Pain, Shoulder Pain and Hip Pain
Treatment for Sports Injuries and Sports Therapy
Aches, Pains and Sprains
Pre and Post-operative Treatment and Rehabilitation for hip joint replacement, knee joint replacement, shoulder surgery, knee ligament repair, bunion surgery and many more operations that affect your ability to move fully and without pain.
Initial Assessment & Diagnosis
The first thing to do is to try and find out what structure/s are contributing to your pain or symptoms. By a careful history-taking where you tell us your story of how your symptoms started, how they've changed over time, what helps and aggravates, etc and answer specific questions designed to rule in or out certain structures, we can get a good picture of what structures might be involved in your problem or causing your pain. Other details such as your previous medical history, previous treatments tried, medication and your work and activity levels are also discussed if relevant to your problem.
In a physical examination we then test your movement, muscle strength, nerve mobility and joint stability as appropriate. If your problem is related to specific movements such as walking or running, we may look at you performing these movements and may use photos and video analysis to help. We examine by touch (palpate) the specific area to assess for swelling, tenderness, movement, temperature changes etc. From all of these tests, we can narrow down the possible causes of your problem and a clinical diagnosis can be reached.
A proposed treatment plan is outlined if appropriate* and functional outcomes are agreed with you. Functional outcomes are the activities that you want to be able to do and can vary from running a marathon in 2 weeks time (or less!) to going on a pre-booked activity holiday, to being able to manage stairs in your home. The treatment programme is always tailored individually to you and your requirements and is regularly updated during your course of treatment depending on your progress.
(* 'If appropriate' is used throughout the descriptive text and can be confusing to readers - in very rare cases we may see a new client that comes for physiotherapy assessment and treatment and we feel that they need to see a different medical professional, usually their GP or A&E, e.g. if we suspect a fracture or an infection. In such cases, we would perform an assessment but may not continue to any treatment and instead advise them as to what to do next ).
How long does it take?
The initial consultation takes approximately 45 minutes and usually includes treatment as well if appropriate. Homework may be given in the form of specific exercises, stretches or postural corrections.
A follow-up appointment can be made at the end of your initial session if you wish. Follow up appointments are generally booked for 30 minutes, but longer sessions can be arranged for complex or multi-site problems.
You are under no obligation at any time to book a follow-up appointment. Some clients only require one initial assessment to get the information and advice that they require, others may wish to go away and see how they feel and then decide if they wish to re-book for a follow-up appointment.
Treatment very much depends on the findings of the assessment and the possible contributing factors identified. Techniques we use often include the following:
- joint manipulation or mobilisation (a more gentle form of manipulation)
- soft tissue massage
- trigger point therapy
- fascial release techniques
- acupuncture or dry needling (the western medicine version of chinese acupuncture)
- electrotherapy - ultrasound, tens or interferential therapy
- neural gliding techniques
- taping techniques to protect joints, correct posture or give feedback
- posture correction
- advice on ways to change movements and habits to reduce or eliminate the pain such as during work or sports activities.
If you have had pain for a period of time it is highly likely that some of your muscles will be affected or have become weak as a result of not being used properly. To achieve optimum longstanding or permanent results, in many cases an exercise programme is a vital component of your treatment. This can vary from some stretching exercises that you can add to your daily routine to muscle building exercises, to a course of clinical Pilates exercises.
Some people love exercises and want as many as possible to speed their progress. Many people however have very busy lives and want to do the minimum of exercises to see a result or get rid of their pain. Our treatment plans can accommodate this and your exercise plan can be geared to your time availability and preferences.
If you are having a few treatments or a course of treatment there is constant assessment and evaluation to ensure that you are making progress and that your goals continue to be met.
You do not need a referral to see us and can book in an appointment at a time to suit you. Consultations are by appointment only. Patients can normally be seen within 24 hours of booking their appointment.
We also accept referrals from your GP, Consultant, Company Doctor or Employer. We will liaise with your GP or Specialist (subject to your consent) where appropriate informing them of our findings and plans for treatment and regularly updating them on your progress.
We have an extensive network of reliable medical Consultants and Specialists in the Greater London area that we can recommend if you need further investigations, e.g. Neurologists, Neurosurgeons, Orthopaedic Surgeons, Rheumatologists, Podiatrists.
Further tests, X-rays & scans
We do not have direct access to imaging investigations such as X-rays, MRI or Ultrasound scans. However, if we feel from our initial assessment or at any stage during your treatment that you require further investigations or tests, we will write to your GP outlining our concerns and in many cases can liaise with your GP regarding what tests you should have or what specialist you should see.
We have close contact with the local NHS GP and hospital services and we also have an extensive network of known and trusted Specialists such as Orthopaedic Surgeons, Neurologists and Rheumatologists that we can recommend to your GP or Consultant if you have private medical insurance or wish to see a specialist privately.
Our qualified Physiotherapy specialists
All our Physiotherapists are qualified to Masters level or equivalent and keep fully up-to-date on their physiotherapy knowledge.
The clinic aims to recruit the most qualified, Specialist Musculoskeletal Physiotherapists available. A Masters qualification is a high industry standard for post-graduate level qualifications and many of our physiotherapists have achieved this level or higher. In physiotherapy education there are also other routes to achieve a Specialisation and further education and these are also taken into account in our recruiting process. Our main criteria in recruiting our therapists is relevant qualifications and experience, proven commitment to their continuing professional education and a passion for helping people. While all of our therapists have a generalist training, many of us have special interest areas where we have specific experience or a personal passion and further information on these can be found in our Team page.
|On-Line Physiotherapy Consultation - Standard
||Please allow up to 30 minutes for your appointment
|On-Line Physiotherapy Consultation ** - Extended
||Please allow up to 45 minutes for your appointment|
|Face-To-Face Physiotherapy Appointment
||Please allow up to 30 minutes for your appointment |
* Private Medical Insurance fees may vary depending on any contracts we hold with them
** An Extended session may be more suitable for an initial consultation or more complex problems
Please contact the Physio Solutions clinic on 020 7713 7780 to speak to a physiotherapist or for any other queries
Potential clients and patients often ask us about the types of conditions that we treat and can help with. We have therefore put together some case studies from our files that outline some of the cases that we have been able to help with and offer a flavour of what we do in our clinic.
30 year old architect with hip & low back pain
- Particularly bothersome in sitting, could not cross his legs, put shoes or socks on/off etc.
- Examination showed L5/S1 lower lumbar spine reproducing his hip pain.
Treated with spinal mobilisations, spinal manipulation, hamstring stretches and dry needling on his hip.
Four sessions of treatment led to a full recovery.
24 year old professional super-heavy weight boxer with shoulder pain
Symptoms & Assessment
- Unable to effectively throw a punch
- Attended on Thursday - needed to fight the following Saturday
- Examination showed decreased internal rotation of the shoulder to 0
- Diagnosis GIRD (glenohumeral internal rotation deficiency)
- Treatment addressed the biomechanics of his thoracic and shoulder rotation and elbow and wrist movement.
- Treatment consisted of mobilisation of his spine and shoulder, muscle energy techniques to repower his shoulder, soft tissue work, neuromobilisation, dry needling of the back of his shoulder and scapula.
- After an extended session on Thursday he regained 45 degree of rotation (60 on L), he was already pain free
- After another long session on Friday he regained full flexibility of his shoulder, elbow and wrist.
He was completely pain free during the fight on Saturday and went on to win.
His training programme was adapted after the fight to address the strength defects and muscle imbalance that had contributed to the problem.
31 year old pregnant lady with low back and pelvic pain
Symptoms & Assessment
- 31 years old, 26 weeks pregnant
- Pain with walking causing her to limp.
- She was treated with soft tissue massage, mobilisations to her lower back and acupuncture to her gluteal muscles (all in side lying).
- She was also advised to buy an SIJ (sacroiliac joint) belt and shown how to use it.
After two sessions she was much better and walking again pain free.
10 year old boy with heel pain
Symptoms & Assessment
- 10 year-old schoolboy playing a minimal amount of sport at school
- Pain and moderately sized swelling/lump over the back of the right heel
- Had started to spread up into the calf and down into the sole of his foot.
- Aggravated by playing football, running and walking.
- His GP had X-rayed the foot to clear a bony tumour, and then referred him to the clinic, with Sever’s Disease as the suspected condition (common condition causing heel pain during growth spurts in children)
- On assessment walking with a limp and turning his foot out to the side to avoid putting a full stretch on his calf
- Also stiff big toe (possibly from kicking a heavy piece of furniture a couple of months before), a tight sole of the foot and tight calf on that side.
- Lower ankle joint also stiff and absorbing less impact as a result. His football boots were found to be slightly tight due to a recent growth spurt.
Self management strategies with some in-clinic treatments.
- Home: Ice, Anti inflammatory gel, no tight footwear for school (and none at all at home), new football boots, home stretches for the calf and foot
- Clinic: Soft tissue release to sole of foot, tight toe tendons and calf
- Joint mobilisations for heel and big toe joint
- Progressive calf loading exercises.
After the first week, his symptoms had reduced by 50% and he was re-treated as before.
Then another week of self-management, during which he restarted playing football. Reviewed at the 2 week period with no symptoms and a much smaller heel lump. Some stiffness remained in the calf and the forefoot, so these were re-treated and he was then sent away with an ongoing plan and to call a week later with an update.
A week later, there were no pains on playing football, running and other strenuous activities and the lump was almost non-existent. He was then discharged with an ongoing set of stretches to do, bearing in mind his current growth patterns.
He remained pain-free at the 6 week stage.
71 year old retired solicitor referred following hip replacement
Symptoms & Assessment
Referred by their orthopaedic consultant 4 weeks following a total hip replacement.
- Physiotherapy was recommended to strengthen his hip abductor muscles and to help correct his gait after a prolonged period of limping.
- Some issues also with ankle swelling and difficulty putting on socks.
- Goal: to get back to walking without a limp and without a stick and be back to full normal activities.
Consisted of a progressive exercise programme to strengthen his hip muscles, some soft tissue work over the operation scar to improve scar mobility.
Some gentle joint mobilisations to help achieve sufficient hip flexion to put on socks comfortably.
Advice given on management of the ankle swelling.
Attended for 4 sessions in total, back to full normal function with reduced swelling left ankle and able to complete a two hour walk with no ill-effects.
63 year old primary school teacher with foot pain
Symptoms & assessment
- 63 year old teacher - on her feet a lot
- Regular gym and running (up to 5 kms)
- 4 month history of right forefoot pain and swelling
- Keen to have check-up, diagnosis and advice on exercises to fix it
- Assessment showed moderate swelling in the web space between the 1st and 2nd toes, marked stiffness of the right 1st toe and also right hip into internal rotation and stiffness of the mid-spine. Slight swelling of both knees were also noticed even though client had no knee symptoms.
- Diagnosis: biomechanical contribution to overloading onto big toe -possible early degenerative changes at big toe and also knees (family history).
- Aimed at improving the mobility of the mid-spine, hip and big toe along with a strengthening programme for the muscles around the hip. Strengthening exercises were also shown for the knees to lessen loading on the joints
- Client worked on the home exercise programme and attended for a few sessions of joint mobilisation and soft tissue release for the toe.
Swelling resolved in knees and toe. Residual but improving toe stiffness. Back to normal exercise routine.
51 year old professional violinist musician with shoulder and neck pain
Symptoms & Assessment
- Pain in right shoulder following doing lunges in the gym with a 2kg weight
- Now affecting playing her instrument, interrupting her sleep and getting worse.
- Unable to do her usual exercise which was swimming due to the pain.
- On examination, pain with shoulder movements above shoulder level and also with neck movements on palpation. Stiffness of the neck and upper spine, tenderness of the rotator cuff muscles of the shoulder.
Diagnosis: Rotator cuff strain of the shoulder aggravating early degenerative changes in the neck.
Worked on soft tissue work around the shoulder, spinal joint mobilisations and a home programme of stretches and strengthening exercises.
Pain started to improve following the 2nd treatment session and by treatment no. 5 the main problem was neck stiffness after playing.
Taping techniques to improve postural awareness while playing were helpful in improving the spinal stiffness and patient was given a revised gym programme to build up her shoulder and core strength.
No further problems with the shoulder.
58 year old amateur musician with hand pain
Symptoms & Assessment
- 58-year old pianist with pain in both thumbs and 'sensitivity' of the left hand
- main exercise is walking, Pilates and Alexander technique
- keen to learn techniques to improve thumbs
- On examination, imbalance of shoulder girdle muscles causing overuse of upper trapezius muscles, weakness of lower trapezius postural holding muscles and ultimately overloading of hands and arms whilst playing.
- some altered neurodynamics in left hand.
Client was shown a range of stretches for the upper limb and some hand strengthening exercises. Her Pilates class was covering shoulder girdle strengthening.
Reviewed after 3 weeks when all was much better and hand muscle strength tests were improved.
She did not require any further treatment.
33 year old, right handed cyclist seen following shoulder surgery
Symptoms & Assessment
- cycling injury causing collar bone joint disruption, surgically repaired.
- advice given by surgeon to mobilise below shoulder level and avoid lifting and loading for 6 weeks.
- seen at 7 weeks for rehabilitation and to 'top up' his NHS physiotherapy.
- treatment aims were to restore full mobility and get him back to full function
- on examination, main movement restriction was overhead and crossing the arm across the body with a tendency to overuse the chest muscles.
Mainly exercise programme to regain full movement and early strengthening within the limits of pain.
Lots of work on improving the shoulder girdle strength and stability to counteract the dominant chest muscles.
Attended for 5 sessions in total until back to full function and normal exercise.
29 year-old runner with knee pain
Symptoms & Assessment
A keen runner who was preparing for the marathon attended the clinic complaining of knee pain following increasing his running distance.
On examination, the source of the pain was found to be under the kneecap. Tightness of the thigh muscles and poor leg control were also identified as possible contributing factors.
Treatment and Outcome
During the appointment, the client was treated with soft tissue release and stretches. He was given home exercises to help improve his leg control while running. He was also advised on how much running load he could undertake on the following days and how he could optimise his training in preparation for the event.
Taking everything on board, he successfully completed the marathon he was scheduled for and was planning to continue his stretches and home exercises to prevent recurrence.
"The exercises you worked out for me were wonderful. They had an immediate effect so that by the end of the following week I actually had a pain-free day. Seeing you was really the turning point and I am extremely grateful."