Specialists

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External Impingement

SYMPTOMS

There is gradual onset of pain in the shoulder on overhead activity involving internal rotation and abduction. Typically, the pain is worst in one specific position or during a certain movement but often the shoulder gradually stiffens up, restricting abduction and rotation. It is painful to sleep on that side and movement becomes […]

Biceps Tendon Rupture

SYMPTOMS

There is acute onset of pain over the anterior part of the shoulder with a lump typically forming at the mid-biceps from the retracted muscle bulk (the ‘Popeye sign’). Usually the biceps longus tendon, originating from the anterior superior labrum, ruptures and the short biceps tendon originating at the coracoid is intact. This […]

De Quervain’s Tenosynovitis

SYMPTOMS

There is localised, sometimes intense exercise-induced pain and swelling over the radial part of the wrist. This is common in racket sports.

AETIOLOGY

These symptoms are caused by compression of the abductor pollucis longus and extensor pollucis brevis by swollen, inflamed or hypertrophied tendon sheaths.

CLINICAL FINDINGS

There is tenderness on palpation over […]

Patella Tendon Rupture

SYMPTOMS

Acute sharp pain to the anterior part of the knee and inability to walk and extend the knee. Patella tendon ruptures are rare.

AETIOLOGY

This is an injury that typically occurs after previous cortisone injections to the area or when using anabolic steroids, which weaken the tendon. Long-term use of corticosteroids in […]

Peroneus Tendon Rupture

SYMPTOMS

The patient presents with a history of sharp pain over the lateral posterior part of the ankle joint, often mistaken for a sprain. Sometimes the athlete refers to a ‘pop’ when the tendon ruptures or dislocates. Two snaps are typical for dislocationrepositioning.

AETIOLOGY

Peroneus tendon rupture is uncommon in young athletes but can […]

Turf Toe

SYMPTOMS

There is a gradually increasing stiffness and diffuse aching pain around MTP I. Commonly affects team sports players who wear studded shoes.

AETIOLOGY

Common theories include repetitive minor trauma to the capsule and cartilage of MTP I from ill-fitting shoes, direct impact and playing on hard turf with shoes that get stuck. […]

Tarsal Coalition

SYMPTOMS

There is diffuse exercise-induced aching pain around the sub-talar joint, sometimes after previous sprain.

AETIOLOGY

The aetiology is unclear. Sub-talar structures fuse over time by fibrosis or callus formation.

CLINICAL FINDINGS

There is tenderness on palpation over the sub-talar joint (sinus tarsi), decreased mobility and swelling.

INVESTIGATIONS

X-ray may show talo-navicular coalition; talo-calcaneal coalition […]

Sub-Talar Instability and Pain

SYMPTOMS

There is increasing stiffness or sense of instability combined with diffuse aching pain around and below the talo-tibial ankle joint, often occurring after previous sprain.

AETIOLOGY

The aetiology is unclear but the trauma may have caused structural damage to the region that can be missed.

CLINICAL FINDINGS

There is tenderness on palpation over the […]

Sesam Bone Stress Fractures

SYMPTOMS

There is gradually increasing exerciseinduced pain and swelling around and below MTP I or diffuse pain in the forefoot on forefoot landings and running.

AETIOLOGY

This injury is usually caused by excessive direct impact from landing on the forefoot on hard surfaces.

CLINICAL FINDINGS

There is distinct tenderness on palpation over the medial or […]

Plantar Fasciitis

SYMPTOMS

There is increasing sharp or aching localised pain around the insertion of the plantar fascia at the anterior inferior part of the calcaneus, without preceding trauma. This condition commonly occurs in middle-aged athletes who run or jump repeatedly on the forefoot but is also common in manual orkers who stand on hard surfaces in […]