Offseason Tips for Marathoners — Stay Strong & Injury-Free
Hey runner, congrats on crushing your last marathon! Now that the race is done, it’s tempting to just chill— and sure, rest is important. But the offseason is also your secret weapon for coming back stronger, healthier, and ready to smash your next goal. Whether you’re a seasoned marathoner or just getting started, here’s the scoop on how to make the offseason work for you, especially if you’re running around Mumbai and Santacruz West.
The Do’s — What You Should Definitely Be Doing
Keep moving, but keep it chill. Swap your usual heavy mileage for low-impact workouts like swimming, cycling, or yoga. It keeps your cardio strong without beating up your joints. Plus, Mumbai’s coastal areas like Juhu and Versova are perfect spots for some active recovery vibes.
Strength matters. Aim to add strength training two or three times a week. Focus on your core, hips, and legs—helping you run more efficiently and avoid injuries. Bodyweight exercises and resistance bands are simple, effective options.
Rest and fuel right. Make sleep your BFF, stay hydrated, and follow a balanced diet to support muscle repair. Adding anti-inflammatory foods, like turmeric, can really help ease any soreness.
Listen to your body. Pains that won’t quit? Don’t ignore them. Nipping small issues in the bud is key to staying on track.
Check in with a sports physio. Especially if you’re in Santacruz West, a quick visit to Physiocure can help fix any imbalances and get you aligned to run better.
Functional training for runners. Signing up for runner-specific training programs boosts your strength, flexibility, and resilience. Trust us, those classes make a big difference in performance and injury prevention.
The Don’ts — What to Avoid
Don’t skip warm-ups and cooldowns. Even during easy days, these keep your muscles flexible and ready to move.
Don’t brush off pain. That nagging knee or foot ache? It’s probably telling you something important.
Don’t overtrain in the offseason. Pushing too hard now leads to burnout and injuries later. Respect your recovery time—it’s a vital part of training.
Post-Marathon Injury Tips
Marathon training and racing can leave you with common issues like IT band syndrome, plantar fasciitis, or shin splints. Managing these properly is crucial:
Early intervention is everything. Catch problems early by consulting a sports physiotherapist — Physiocure in Mumbai has got your back!
Use therapies designed for healing. From manual therapy to functional rehab movements , have helped a lot of marathoners reduce inflammation and speed recovery.
Take it slow getting back. Resist the urge to jump into running full throttle. A gradual, guided return keeps you injury-free.
Fix your run game. Sometimes your sneaky form is the culprits—let a physio fix that so you can run free and easy next time.
Case Study:
A 43-year-old marathon enthusiast from Mumbai who was working hard with a running coach to improve his times. Even with all that training, he started struggling with persistent pain — classic symptoms of Achilles tendinopathy and patellofemoral pain syndrome (PFPS).
Symptoms he experienced:
Achilles Tendinopathy: Morning stiffness and soreness at the back of his lower leg; pain intensifying during and after running; swelling or thickening around the Achilles tendon; occasional discomfort climbing stairs.
Patellofemoral Pain Syndrome: Pain around or behind the kneecap, worsened by stair climbing, squatting, or sitting long; knee instability sensations and stiffness after runs.
The Red Flags he ignored at first:
Sharp sudden pain or swelling around the Achilles tendon
Popping sounds near the tendon, followed by inability to push off
Severe knee swelling or restricted motion
Persistent leg numbness, tingling, or weakness
If you notice these, seek urgent care — don’t push through!
Intervention at Phsiocure: The sports rehab clinic:
He started a year-round, personalized physiotherapy plan including:
Manual therapy and Interferrential therapy/cold therapy to reduce inflammation
Biomechanical and gait analysis to spot muscle imbalances
Strengthening of calves, quadriceps, hip stabilizers, and core
Tailored runner-specific functional training to improve form and prevent injury
Regular physio integrated with his coach’s plan for steady progress
Results:
After 6 months, pain was substantially reduced. After one year, he ran a marathon pain-free with a personal best time. The comprehensive approach made him stronger, faster, and injury-resilient.
Conclusion:
Working with a professional coach is great, but integrating year-round sports physiotherapy and runner-specific training is key to managing chronic injuries and improving performance. Mumbai runners facing similar issues should consider clinics like Physiocure for expert care that keeps you running strong.
Hamstring Injury Blog Banner by Physiocure Home for everything physio can cureInjuries to the hamstring muscles compromise individual performance and team success in many sports. Hamstrings strain injury ( HSI) is one of the common injuries that plague many sports like football, cricket, running, athletics, and many more but there is no systematic data available stating the prevalence of the injury in India.
The hamstrings are involved in a host of athletic motions that include running, jumping, and kicking. Hamstring function is important to the performance of most sport-related activities, particularly when fast running is required. Furthermore, dancers exhibit a high incidence of muscle injuries. The relevance of hamstring injuries in sports is therefore paramount.
At a higher professional level, most teams, coaches, and the physios on board are aware of the risk factors that may cause hamstring strain and do add a prevention program or prehab just to prevent anything during the peak playing season.
Before we get into details of ,what hamstring exercises should one do, lets try to further understand the injury and the basic anatomy of “the hamstrings muscles”.
What is Hamstrings?
The hamstrings are the back of the thigh muscles. Understanding their anatomy can help you understand why hamstrings pain. Or why does hamstrings injury occur? Or is the hamstring injury serious or not?
ANATOMY:-
The hamstrings are a group of four muscles located on the back of the thigh. Semitendinosus (ST), Semimembranosus (SM), and biceps femoris long head (BFlh) all have their origins at the Hip (that is the pelvis), whereas biceps femoris short head (BFsh) originates along the thigh bone from a particular point.
This group of 4 muscles ends at the knee.
Of the 4 muscles biceps femoris is a 2 joint muscle that is it acts in the hip as well as the knee.
These muscles help in flexion and extension at the knee, they also help in extension at the hip.
Other than that they help in controlling the amount of flexion happening at the hip by forming a couple with the hip joint flexors and they are also active when the leg is kicked outward from the hip, that is abduction.
Along with this information, there are some important biomechanical functions of the hamstring muscles, which must be understood.
BIOMECHANICAL CONSIDERATION:-
The Hamstring muscle group functions over 2 joints and is therefore the hamstrings stretch at more than 1 point.
When challenged to perform high-velocity fast actions, the hamstrings are the group of muscles that can generate power through fast twitch fibers and hence that also makes it predisposed to injury.
Particularly biceps femoris is the most commonly injured muscle the reasons which could be:-
There are 2 nerves that innervate the muscle. Sometimes this may lead to improper stimulation of the muscle reducing its capacity to generate effective tension in turn affecting the movement and leading to injury.
The starting point of the muscle is extensively on the thigh bone. Weakness in the same affects movement not just at the knee but also at the hip.
The muscle ends on the shin bone below the knee and has fascial connections with one of the ankle muscles namely the peroneus longus. So if there is a previous history of knee \ankle injury, it could later function of the joint at the shin level thereby affecting the functioning of this muscle? (speculative)
The hamstring group of muscles especially semimembranosus is closely linked to the knee joint and the ACL ligament via mechanoreceptors. The feedback received from ACL ligament when disturbed affect the hamstring activation increasing the chances of injury.
There is a deep anatomical link between the hamstring, the lower back, and further muscles above the lower back via the superficial back line as explained in the concept of anatomy trains. Hence sometimes a tight lower back can increase the chance of a hamstring injury.
Posterior compartment syndrome of the thigh caused by chronic exercise or following recurrent minor distension injuries or muscle Ruptures-Fasciotomy.
HOW THE HAMSTRINGS STRAIN INJURY OCCURS?
Most people try to understand “why the hamstrings pain” and this article can answer that by making you understand the mechanism or how the HSI occurs. Researchers have reported 2 different injuries-a ‘high-speed running type’ (in sprinters) and a ‘Stretching’ type (in dancers).
Hamstring stretch injury
stretch-type injuries concluded that injuries occur due to extensive hip flexion with simultaneous knee extension. In Australian football, a total of 19% of hamstring injuries occur during kicking, which is a typical stretch-type hamstring injury, given that the end of a kick exhibits both a flexed hip and extended knee position. In addition, suggested that trying to pick up a ball from the ground while running at full speed is the most common hamstring injury situation.
Strength-related hamstring injury
Fatigue while playing football may reduce eccentric hamstring strength, which was suggested to increase the risk of a hamstring injury, while lower hamstring strength endurance was associated with a hamstring re-injury. One study compared muscle activity in athletes with previously injured and uninjured hamstrings and reported that the previously injured athletes had inferior hamstring activation, which contributes to lower hamstring strength. These findings are most probably related to risk factors for suffering a subsequent injury, which may in turn help to improve rehabilitation, rather than being related to the mechanism of a hamstring injury
The initial loss of flexibility and strength was greater in the sprinter than in the dancer.
However, the actual return to sport took longer in the dancer (52 weeks) when compared to the sprinter (16 weeks).
The MRI findings of the sprinter showed involvement of the muscular tissue while the dancer had more proximal tendon involvement.
So Yes as per the research how your leg was injured will make a difference along with the history of previous injuries, age, fitness, and the surface on which the sport is conducted
FOOTBALL is the only high-speed sport where there is a possibility of having this injury due to an overstretch or strength-related issues
RISK FACTORS INFLUENCING HAMSTRING INJURIES: –
The recent researches differentiate these factors into two different categories non-modifiable and modifiable risk factors:-
Non-Modifiable risk factors include: –
Age: – older athletes have a history of injury which makes them vulnerable to a HIS. “old” is difficult to define the cause of HSI. Can influence as early as 24 years of age. The other issue with older athletes is their structural changes, fiber type changes in the muscle, and reaction timing issues which can be the reason they are more susceptible to injury.
Previous HIS: – previous injury can result in structural and neurological injury and result in maladaptation in the form of improper muscle activation of the hamstring muscle, strength deficits, or shift of the muscle load on the shorter units within the hamstring muscle group. Also the longer the deficits in the muscle, the lower the ability of the muscle to handle stress and strain.
ACL injury: – research has claimed 70% of the players post ACL injury are susceptible to a HIS> the mechanism could be proprioceptive deficits, post-op weakness due to graft removal, or altered gait pattern could be the reason.
Previous Knee injury, Ankle ligament injury or Calf strain injury: – either of these or in combination change the mechanics of the lower body when it functions in sport, leading to increased chances of an injury.
Modifiable risk factors:-
Architecture and structure– biceps femoris fascicle length, and hamstring muscle-tendon unit stiffness were associated with risk but the level of evidence is low over various articles.
Strength and strength-endurance tested in single-leg bridge or Nordic eccentric curls did point out a risk but there is conflict. Low eccentric strength as tested in Nordic does not mean you are predisposed to HSI. Nor does isokinetic testing reflect on HIS possibility.
How high you jump or the power generated does not matter but a reduced single-leg hope distance means that you are susceptible to a hamstring strain.
Research says that flexibility-related issues do not have any relation with HIS.
Reduced trunk muscle activity and increased activity in one of the hip muscles found in athletes running at the speed of 12-15km/hr have an increased risk of HIS.
When kinematics or how effectively your run was measured, runners with increased side bends while running and anterior pelvic tilt in the back swing phase of the leg have high chances of a HIS.
“MODIFIABLE LIST OF FACTORS CAN BE WORKED UPON DURING A PRESEASON TRAINING SESSION OR IN GENERAL WITH PREHAB PROGRAM SPECIFIC TO THE SPORT”
With more and more and people pursuing active lifestyles, hip injuries in sports have become a concern in terms of loss of time and talent. A lot of the regular people have taken up regular cycling, football, running, etc. type of sports to maintain their health and/or as a leisure sport. We have seen a rise in the cases of hip injuries in athletic as well as active individuals in the clinic, since the lockdown in March 2020 because inspite of being active the overall sitting time or time indoors was found to be a bit high.
It came to my notice that, its the end of 2022 and many of these sports enthusiaists, runners and active sports players have not been able to completely get rid of the hip injury yet, so i decided to just put up my perspective about hip injuries in various sports.
Hip injuries can really disable the injured as it may affect the daily activities as well the ability to perform the sport. Secondly, hip injuries can also be confusing, cause the injured may not experience pain directly at or around the hip, but pain can be felt at the lower back or the pelvis.
Sports that have displayed a higher prevalence of hip injuries include ballet, soccer, hockey, baseball, golf, and running. Depending on the sport, the athlete’s hip may be subjected to various extra physiological forces that are capable of causing acute or chronic injury to the hip.
To understand the hip let’s first go through the basic making of the hip joint.
Anatomy of the hip joint:-
The Hip joint is made up of two bones named femoral head and acetabulum which appear like a ball and socket.
The depth of the socket is not enough to accommodate the larger femoral head which is why there is a fibrocartilaginous ring or labrum which deepens the acetabulum and helps to stabilize the hip joint, increasing the contact area and decreasing the joint stress.
The labrum has some sensory nerve endings which means that any damage occurring to it will be signaled to the brain. Any tear in the labrum will lead to joint pain and destabilize the joint which will eventually contribute to increased stress on the hip joint.
Hip joint capsule: The hip joint capsule is strong and dense which covers the femoral head and neck like a sleeve and gives more stability to the hip joint.
Ligaments around Hip joint: The 3 main ligaments around the hip joints are the Iliofemoral ligament, Pubofemoral ligament, and Ischiofemoral ligament which is also called the capsular ligament they reinforce the joint capsule.
The Ilio-femoral ligament is a very strong and thick ligament situated anteriorly to the joint. It is a “Y” shaped ligament. It reinforces the capsule anteriorly to stabilize the hip joint. The
The pubofemoral ligament connects the pubic bone to the femur bone. It strengthens the anterior and inferior aspects of the capsule
Ischiofemoral ligament is a spiral-shaped ligament that attaches at the body of the ischium behind and below the acetabulum proximally and attaches distally at the superior part of the neck and root of the greater trochanter.
All 3 ligaments restrict and control the different movements of the hip. The iliofemoral and pubofemoral ligaments restrict lateral rotation (outward turning) and ischiofemoral ligament restricts medial rotation (inward turning) of Hip joint.
Blood supply to Hip joint: It receives blood supply from medial and lateral circumflex arteries, obturator arteries, and superior and inferior gluteal arteries
Nerve supply: The nerve supply to the hip joint is from the femoral and obturator nerves from the Lumbar plexus and the superior gluteal nerve and the nerve to quadrates femoris from the Sacral plexus.
Muscles around hip joint:
Hip flexors: the primary hip flexors are Ilio-psoas, rectus femoris, tensor fascia lata, and Sartorius
Hip extensors: the hip extensors are one joint gluteus maximus muscle and two joint hamstring muscle
Abductors: The primary hip abductors are the gluteus medius and gluteus minimus and secondary muscles are ITB and TFL.
Adductors: the adductors of the hip are Pectineus, Adductor longus, adductor brevis, adductor magnus, and gracilis Lateral rotators: Obturator internus and externus, gammellus superior and inferior, quadratus femoris and piriformis Medial rotators: Anterior portions of Gluteus medius and TFL.
Causes of Hip Injuries in Sports:-
Causes can be intrinsic ( that is due to faults in the shape of the bones or tight or loose muscles) or they can be extrinsic ( from factors which are related to your work or sport and affect our hip joint structures).
In this section we will elaborate on the cause of the hip Injuries sportwise:
Hip Injuries in Cyclists: –
For a regular cyclist or a triathlete reading this, you must know that the hip will work the most while you are cycling and even when you are not.
Normally biomechanical overloading of the hip joint causes more injuries than direct trauma.
for example, the action of cycling involves repeated hip flexion with the hip never full extending, which can cause tightness or even a shortening of the hip flexor muscle over time. Prolonged periods of time sitting also contribute to tight hip flexors, such as time spent at a desk or driving. so it very common for cyclists with hip/lower back injuries to have tight hip flexors
It’s also known that a poor bike fit puts all the wrong pressure in the saddle area which in combination with intrinsic factors like poor flexibility and or faulty leg alignment while cycling leads to most hip injuries. A poor bike fit can also cause tendinopathies in the hamstrings as well as the hip flexor tendons.
moreover, a poor bike fit can worsen the already existing arthritis, as the cyclists might have to flex it beyond the available range. Leading to more strain and worsening of the inflammation in the hip joint.
overtraining or incorrect seat height can fire up the iliotibial band. It is often accompanied by trochanteric bursitis and is characterized by pain and point tenderness over the greater trochanter. In some cases, crepitus or clicking may be audible. Iliotibial band syndrome can also produce symptoms at the knee joint or its insertion site on the tibia. Signs and symptoms include pain with motion at the lateral femoral epicondyle or Gerdy’s tubercle.
Hip Injuries in Running:
One of scariest cases in the clinic was a 50-year-old female runner diagnosed with stress fracture while she was training for her full marathon. Sadly, she never completed the full marathon but here is a list of reasons why you may get a hip injury while running.
Hip injuries in runners are due to interactions of intrinsic and extrinsic factors that adversely affect the complex regional anatomy. acute or chronic hip pain are a challenge to diagnose as the symptoms are vague and may arise from parts of the body other than the hip.
Most running-related injuries affecting the lower extremities are due to preventable training errors, and some may necessitate medical evaluation or a significant reduction in training.
what we have seen is that less experienced runners and runners with higher body mass index, end up being more prone to injuries in general.
Strong evidence that found that previous or existing lower body running injury can cause a new or the same injury again. Hence we have so many clients who keep getting IT band-related issues again and again until they complete the rehab pin to post.
Apophysitis and avulsion fractures may affect younger runners and produce localized pain at muscle attachment sites.
Stress fractures are potentially serious conditions that affect women more frequently than men. They are more common in females due to a wider pelvis which places the body weight at a different angle compared to men with a narrow pelvis.
While running at each step there is a point where each leg bears the weight of the whole body while the other leg is in the air. If there is a lack of mobility, then the muscles supporting the hip will restrict the movement of the joint leading to more strain in each step you run. if there is a lack of stability then muscles supposed to be working will not come into action leading to pressure on the stance leg, which may lead to various running injuries of the hip.
Muscle strains and tendonitis are the most common causes of hip pain and typically result from sudden increase/decrease of speed while running, direction changes, or eccentric contractions.
Hip Injuries in Football: –
Usually, hip injuries are more common in two muscles in footballers. Namely
Iliopsoas. (hip flexor)
Adductors. (groin muscles)
The most common mechanism is sprinting, kicking, and change in directions. Adductor and psoas strains are typically noncontact injuries and usually result from eccentric loading when attempting to kick a ball. eccentric load means the muscle is loaded when it is in a stretched position.
In my experience, I have seen hip injuries occur usually due to: –
shooting practices where the player takes multiple kicks.
Goalie practices where the goalkeeper rehearses goal kicks or punts over and over.
repetitive sprint training
no proper rest in between back-to-back games.
improper rest and early return to sport in a previous muscle strain injury.
A measure of total hip rotation less than 85 degrees – means the hip mobility is on the lesser side and the chances of injuries higher. So we always add a few hip mobility drills for such a player.
Low strength ratios of inner thigh muscle compared to outer thigh muscles, means the overall stability of the hip is compromised and chances of getting the hip injury are higher.
As per research, differences have been identified in the star excursion balance test of posterolateral reach and altered intersegmental biomechanics in various cutting tasks in those with HAGI (hip and groin injury). This means while testing the star excursion balance test if the player has a weaker posterolateral reach, he or she is more susceptible to hip injuries.
Hip impingement is also one of the common injuries affecting footballers. Sometimes the cause of such injuries can also be the shape of the pelvic bones. Research conducted on soccer players with hip pain noted that a faulty shape of the iliac bone leads to impingements in soccer players.
Both type II and III morphologic variations decrease the space available for soft tissue recoil and may cause mechanical impingement of hip motion (mainly hip flexion and internal rotation)
Hip Injuries in Dancers: –
Dancers move various body segments in a repetitive rhythmic fashion to demonstrate their artistic expression and athletic prowess while placing significant physical demands on their bodies. This often requires extreme ranges of motion, particularly of the hip, as well as controlled displays of strength to obtain optimal form.
While professional dancers were more prone to hip/groin injuries than their student counterparts, the etiology is unclear: It may be secondary to higher levels of training or skill, increased exposure time, or older age. As a group, professional dancers tend to be older, with hip injuries in dancers occurring with increasing age.
Dance injuries can be classified as either traumatic or overuse, a factor considered in 3 studies presented. Not surprisingly, given the repetitive nature and extreme ranges of motion required in dance, overuse injuries of the hip are more common than acute traumatic injuries among dancers.
Hip and groin injuries are an important health issue for dancers of all skill levels, presenting with an injury rate of 17.7% in this systematic review.
Research has also shown snapping of the hip flexor as the highest occurrence among dancers followed by snapping of the hamstring tendon due to moves requiring extreme ranges.
Hip Injuries in Cricket
Hip injuries in cricket are rarely reported often at a professional level. There is no research which talks about them but they are happening in less experienced and adolescent cricketers.
There are researches done, which state that women cricketers with lesser neuromuscular control are susceptible to injuries but they do not specify only hip injuries, they can be in the lower back/groin/knee/ankle.
In my personal experience of working with adolescent cricketers, I feel that a weakness in the lower body chain which must activate during the bowling or batting action can become a cause for a hip injury. For example, for a fast bowler, chances of hip injuries are higher due to faulty landing on the pitch or improper run-up to take a jump while bowling.
Mainly, female cricketers who are training to be better fast bowlers and have to change their bowling style every other season may be a party to a hip injury. In addition to that, when the foot lands for bowling there is a force pushing the knee inward called the knee valgus force. Say if the cricketer has poor neuromuscular control or balance, the feedforward mechanisms of the muscle chain are delayed to prevent this force and the hip or back muscles may not support the knee landing….leading to wear and tear, which may trigger early arthritic changes in the hip.
Common Hip Injuries in sports: –
Muscle strain and tendinopathies:- common muscle strains in the hip area on the hip flexor tendon (iliopsoas strains), inner thigh muscles ( adductor strains), upper hamstrings strain, piriformis strain and last is the buttock muscles (gluteus medius tendinopathies) at the greater trochanter. They can range from a minor strain that recovers in 2 to 4 weeks to complete tear which required 12 weeks minimum to recover, or they can be due to the irritation of the tendon at the site of insertion.
Hip impingement: Impingement means that the space between the two bones has decreased either due to overgrowth/ undergrowth of one bone which causes pain with movement as the bone doesn’t have enough space to move leading to increased stress. Impingement also leads to grinding of the cartilage and the labrum in that area.
Bursitis of the hip joint: – bursitis in the hip means swollen fluid sac located on the outer side of the hip at a bony prominence called the greater trochanter. 2 of the buttock muscles come and insert on the GT. There is usually pain at the outer side of the hip with walking, climbing stairs, running, getting in and out of the car.
Labral tear in the hip: labral tears can occur in any age group, but mostly affects young active adults and females more than males. Labral tears occur due to repeated microtrauma from twisting motions. Labral tears if left untreated may lead to degenerative changes in the hip joint.
Adolescent hip injuries: The incidence of avulsion fractures is increasing, among teenage athletes because of the growth in competitive sports participation. Avulsion injuries are common among skeletally immature athletes due to the weakness across the open apophysis. It is mainly caused by sudden, violent, or unbalanced muscle contraction, and are common in sports such as soccer, ice hockey, gymnastics, and sprinting, which involve kicking, rapid acceleration and deceleration, and jumping
Snapping hip syndrome: It’s is a symptom complex characterized by pain and an audible or perceived snapping of the hip during movements. Snapping hip (also known as coxa saltans)may be the result of intraarticular (within the hip joint), extra-articular (outside the joint) pathology.
In cases of external coxa saltans, the history can be extremely helpful in establishing the diagnosis. Patients will explain a “snapping, painful” sensation over the lateral hip and commonly localize pain to the greater trochanter when asked to identify the area of maximal tenderness. Traditionally, the external snapping hip has been associated with a thickened posterior border of the iliotibial (IT) band or anterior border of the gluteus maximus, which predisposes the IT band to slip back and forth over the greater trochanter. The thickened IT band lies posterior to the greater trochanter as the hip sits in extension, and as the hip is flexed, the band forcefully slides anteriorly over the trochanter, producing pain and an audible sound. The greater trochanteric bursa, which lies between the IT band and the greater trochanter, can become inflamed as the band continuously slides over the bursa, leading to inflammation and contributing to the patient’s painful symptoms.
Patients with internal coxa saltans typically describe a painful clicking/popping sensation emanating from the deep, anterior groin. It is now well accepted that the source of pain and audible snapping is produced by subluxation of the iliopsoas tendon during hip range of motion.
Hip cartilage injuries: Chondral injuries are wear and tear of the cartilage in the hip joint that can occur in association with labral tears,femoroacetabular impingement, posterior dislocation,dysplasia, and osteoarthritis and can lead to cartilage erosions, deformity of the femoral head, and loose bodies.
Stress fracture of the hip joint:- stress fractures occur usually in bones that are fatigued. They are also called fatigue fractures. In active population, usually, stress fracture will develop as microfractures that don’t get a chance to heal because there is a small amount of bearable load being put on the hip continously. Additionally, if there is an imbalance between bone resorption and bone formation, then the chances of stress fractures are high.
Inflamed /Arthritic hip joint:- developing wear and tear in the hip is a known fact, but pursuing an active lifestyle with the arthritic hip can be tricky. If the joint is not taken care of while playing the sport, the inflammation may get worse and cause more arthritis. Hip osteoarthritis may also produce persistent pain that worsens with running.
Examination of hip injuries:-
Examination starts from the point the client walks in….
We check the walking pattern as the client walks in
A detailed history is recorded to understand how the injury occurred
The normal body movements are tested in standing as well as lying down.
Special tests to reach a diagnosis are done. Tests like FABER, FADIR, muscle strain tests, Trendelenburg’s test, leg length discrepancy test, squeeze test, etc. are done only if the client is pain-free and able to bear the strain.
Also, functional movements are examined to test, if the client is able to do sit to stand, stairs, walk-run, squat assessment, or a particular sport-specific action is tested to see if it aggravates the pain.
For sports-related injuries, mobility and stability movements are also tested to understand the movement deficiencies.
The ergonomic assessment for work-related hip injury is also discussed.
Nevertheless, we check the entire lower back, the knee as well as ankle for any restrictions to design an appropriate rehab program.
Clinical presentation
Altered walking/ running pattern. Have u seen a runner limp while running?
Change in weight-bearing status on the injured side maybe there while performing exercise or sports.
Restricted movements of the hip in all or some directions
Altered length of the muscles- they may be tight or too elongated. For example, if the muscle is elongated then you might have difficulty controlling that particular hip movement but if it is tight you might not be able to perform that particular hip movement)
Altered / faulty posture of the lower extremity. For example, If you have knock knees then your hip bone may be turned inward as a structural or a functional deformity which means the posture is faulty at the hip level too.
Pain may be dull aching, widespread (that is your lower back or knee or ankle may hurt as well), or it may be sharp shooting pain in certain positions or activities only.
Management of Hip Injuries in Sports:-
Management of hip injuries is complex but simple. We believe in treating the client as a whole and not looking at the problem from just one single joint injury perspective. The goals of managing hip injuries in sports or regular individuals’ via physiotherapy are
To improve the strength of the hip muscles and the muscles in the chain (lower back, knee, ankle, core strength)
To improve the functional movements (walking climbing, sitting for regular individuals and sports-based movements for athletes)
To educate the client regarding the injury and motivate them to follow the rehab till the end.
There are some facts, which the researchers have been able to verify in regards to multiple aspects of physiotherapy management for hip injuries in sports as well as regular people. They are:-
Physiotherapy rehabilitation costs lesser than surgical management in the case of FAI (hip impingement).
Physiotherapy treatment which includes manual therapy plus hip strengthening for 3 months had better outcomes for hip OA compared to surgical management.
Sports injuries like FAI are well managed via physiotherapy compared to arthroscopy. But the return to sport varied up to 16+ months whether the client was managed surgically or with physio alone. Hence researchers have quoted “ Arthroscopic surgery could be recommended as a second-line treatment for patients who have not responded adequately to a physiotherapist-led treatment program.“
For hip pain, the research claims that physiotherapy treatment is more effective in a span of 3 months, but the researchers are not sure about the quality of life improvement. Secondly, the research also claims that post hip arthroscopy for hip pain, there was small positive improvement at 8 to 9 months.
Physiotherapist-led interventions on physical impairments had variable effects. For hip range of motion, the largest positive effects pre-physiotherapist-led to post-physiotherapist-led treatment were seen following a 3-month intervention strengthening exercise, manual therapy and education.40 The greatest hip muscle strength gain was seen with a strengthening exercise programme of 3 months duration,40 and largest in hip adductor muscles. Greater hip adductor strength following hip arthroscopy is associated with better hip-related QOL,46 suggesting that it may be an important target.
Research also says that most people who opt for early surgery are teenagers or young adults who want an early return to sports. But however, the return to sport time remains the same with or without the surgery.
Returning to pre-injury sport and activity is important to young and middle-aged people with hip pain, and often the reason they seek surgical and/or non-surgical treatment.However, only two studies in this review had a specific return to sport/return to physical activity component within the physiotherapist-led intervention.Only 17% of people returned to optimal performance and full sports participation at 33±16 months following hip arthroscopy. Given the importance of returning to sport in this active patient group and the disappointing rates of returning to optimal performance reported,future studies should incorporate key functional and sporting components.
Our hip injury management style: –
On the first day of the clinic visit mainly the symptoms which are aggravating the pain are addressed via manual therapy or electrotherapy and exercises.
A rehab program is devised customizing the client’s sporting needs. For example, a runner with hip injuries will be given a progressive rehab program close to a running pattern.
Pain is usually addressed via various manual therapy techniques, dry needling, electrotherapy, and supportive taping.
We also provide advice for certain do’s and don’ts to deal with hip injuries. The ergonomics of the work setup is assessed and corrections regarding seating position are advised.
For sports injuries, we usually connect to the trainer and coaches and make necessary adjustments in the players playing style to prevent the re-injury.
The treatment program usually lasts between 8 weeks to 6 months wherein the client is usually called for follow-ups and is expected to follow the rehab back at home. Return to sport usually takes 9+ months depending on the severity of the injury and individual factors.
Last but not the least, we believe in educating the client regarding the injury and motivating them to follow the rehab till the end.
here is a list of 9 simple exercises to relieve your hip pain.
For long I’ve discussed with my clients about benefits of regular exercises on the menstrual cycle and working out based on your menstrual cycle. I have personally experienced the benefits of reduced cramps and back pain during the menstrual phase and now I sync my workouts according to my menstrual cycle.
If you are a women who loves to work out just like me, but does not feel like doing the same routine each week, then here is some information to guide you through making a workout schedule that suits your cycle. How? That’s by understanding your menstrual cycle or the effect of hormones that change levels throughout the cycle.
Lets try and understand the basics of a menstrual cycle first.Now the normal menstrual cycle lasts for 28 days and it has 4 phases. Namely;
1. Menstrual phase
2. Follicular phase
3. Ovulation phase
4. Luteal phase
Menstrual Phase:-
During the menstrual phase, your uterus is shedding the lining it has built up throughout the month. This will typically be days 1 to 7 of your cycle. At the very beginning of your period, your progesterone and oestrogen levels will be at their lowest, which along with the loss of blood may cause you to feel depleted of energy. As your period goes on, these hormone levels will gradually increase.
If you experience feeling fatigue during the early days of your period, you may not necessarily feel like doing much intense exercise. However, if you feel physically able, there is no medical reason to not exercise during the menstrual phase of your period.
How should you exercise during the menstrual phase?
Depends on your flow levels actually. If you are someone who experiences low energy and heavy flow then you should choose a restorative form of exercises but if it all you are a woman with a lighter flow and normal energy levels then you can take up heavier work outs.
Here are some suggestions for exercise you could do during the menstrual phase.
1. Relaxing yoga poses or stretching
2. Walking or light cardio
3. Lighter strength training
You can continue to do strength training during the menstrual phase of your period, but at this stage it might be wise to reduce the weights of your workout. Due to increased fatigue, the menstrual phase is not the time to push yourself too hard — so try sticking to where you’re currently at or even taking it a little easier than usual.
Exercising during the follicular phase
This phase starts as soon as your periods are over and is a good phase to progress your levels of work outs or take up challenging workouts. Infact I advise women that if you decide to take a marathon or a tournament your body will work and recover very well during this phase. Why? (more…)
🦵 Sciatica: From Back to Leg – A Sports Physio’s Breakdown
By Physiocure: The Sports Rehab Clinic, Santacruz (W)
What is Sciatica?
“Sciatica” is the term used when pain, tingling, or numbness travels from your lower back or buttock down the leg — following the sciatic nerve.
It’s not a disease but a symptom pattern caused by irritation or compression of the nerve or its root.
According to the National Center for Biotechnology Information (NCBI), sciatica typically arises from lumbosacral nerve root irritation, most commonly at L5 or S1.
👉 Source: NCBI – StatPearls
Anatomy of the Sciatic Nerve
The sciatic nerve is the largest and longest nerve in the body, originating from the L4–S3 spinal nerve roots within the lumbosacral plexus.
It exits the pelvis through the greater sciatic foramen, usually below the piriformis muscle, and travels down the back of the thigh before splitting into:
Tibial nerve
Common peroneal (fibular) nerve
It supplies:
Motor control to hamstrings, most lower-leg and foot muscles
Sensory input from the back of the thigh and leg to the foot
Sciatica occurs when mechanical pressure or inflammation affects the sciatic nerve or its roots.
Common Mechanisms Include:
Disc herniation or bulge: The soft center of a spinal disc presses on a nerve root.
Spinal stenosis: Narrowing of the spinal canal squeezes the nerve.
Piriformis syndrome: The nerve is compressed as it passes under or through the piriformis muscle.
Inflammatory irritation: Chemicals released by injured discs increase nerve sensitivity.
Biomechanical overload: Repetitive bending, twisting, sprinting, or sitting can increase lumbar stress.
Research shows both mechanical compression and inflammatory sensitization contribute to sciatic pain, altering nerve conduction and muscle activation.
👉 Source: British Journal of Anaesthesia
Why Does Sciatica Happen in Active People?
From a sports physiotherapist’s perspective, sciatica often develops from faulty movement patterns:
Core or glute weakness
Hip mobility restrictions
Asymmetrical loading (e.g., one-leg dominant sport actions)
Poor lifting or sprint technique
These factors cause uneven stress on lumbar discs and surrounding fascia, eventually irritating the nerve root.
Do You Need a Scan Before Seeing a Physio?
Not always.
Most cases can be clinically assessed without imaging. Your physio can diagnose sciatica using movement, posture, strength, and neural tension tests.
MRI or CT scan is only required if:
Pain is severe or worsening
There’s groin numbness or loss of bladder/bowel control
Gone are the days of long bed rest.
Modern research clearly shows that prolonged rest slows recovery. Controlled, guided movement helps reduce inflammation, maintain mobility, and restore normal nerve motion.
A 2023 review found that early physiotherapy interventions improve function and reduce pain faster than inactivity.
👉 Source: NCBI – Early PT for Sciatica
✅ Short rest (1–2 days) if pain is severe
🚫 Avoid complete bed rest
✅ Start guided movement as soon as tolerated
Phases of Sciatica Recovery
1️⃣ Acute Phase (0–2 weeks)
Goal: Calm pain, reduce inflammation, and protect the nerve Focus:
Education and posture correction
Gentle nerve mobility and decompression exercises
Light core activation
2️⃣ Sub-Acute Phase (2–6 weeks)
Goal: Restore movement and strength Focus:
Hip and glute strengthening
Controlled mobility
Correcting movement faults
Neural glides and flexibility
3️⃣ Return-to-Sport Phase (6–12 weeks)
Goal: Rebuild performance safely Focus:
Running mechanics, plyometric loading
Core-hip integration
Fascial line rehab (Superficial Back Line and Spiral Line work)
Most mild-to-moderate cases improve in 4–8 weeks with early, consistent physiotherapy.
Athletes with higher training loads may take longer due to repeated lumbar stress, but structured rehab minimizes relapse risk.
Final Word
Sciatica can be frustrating — but it’s highly treatable.
The best outcomes come from early physiotherapy, graded movement, and education.
At Physiocure, we focus on treating the root cause — not just the pain — so you can move, perform, and live pain-free.
Massage Therapist vs Sports Physiotherapist vs Chiropractor: Who Should You Really See for Pain, Injury & Performance?
— A Research-Backed Guide for 2025
Introduction
If you’re dealing with pain, stiffness, a sports injury, or recurring niggles, choosing the right professional is difficult. Each profession — massage therapists, chiropractors, physiotherapists, and even various unregistered providers — markets similar claims. But their training, safety, and scientific evidence are not the same.
This detailed, research-backed article breaks down technical differences, risks, benefits, and scope of practice — and finally explains why a professional sports physiotherapist is the most comprehensive choice for long-term recovery and performance.
Massage Therapist: Great for Relaxation, Limited for Rehab
Massage therapists specialize in hands-on soft tissue techniques like deep tissue massage, sports massage, and myofascial release. These help:
reduce muscle tension
improve circulation
offer temporary pain relief
promote relaxation
However, most massage certifications focus only on technique — not anatomy, diagnosis, biomechanics, or rehabilitation science. Their scope does not include injury management, progression planning, or return-to-sport testing.
Massage is helpful, but studies show exercise + manual therapy is significantly more effective than massage alone, which is why physiotherapists achieve better long-term outcomes (Fernández et al., 2024).
Chiropractor: Effective for Some Cases, With Documented Risks
Chiropractors primarily perform spinal and joint manipulation, especially high-velocity low-amplitude (HVLA) thrusts. Research shows this may produce:
short-term pain relief
temporary range-of-motion improvements (Rivett et al., 2006)
However, cervical (neck) manipulation carries rare but documented risks, including arterial dissection and stroke-like events (Thiel et al., 2007; Michigan Medicine, 2024). Case reports also show vision loss after cervical manipulation due to retinal hemorrhage (MedicalBrief, 2024).
Studies demonstrate that neck manipulation can alter vertebral and carotid artery blood flow (Lanzarini et al., 2019), making regulated screening essential.
Chiropractic care can help certain spinal issues, but it does not address:
Sports physiotherapists combine medical science, exercise physiology, biomechanics, and hands-on therapy.
Their approach is comprehensive:
✔ Evidence-Based Injury Rehabilitation
Progressive loading, strength training, neuromuscular control, and manual therapy — all supported strongly in scientific literature (Fernández et al., 2024).
✔ Injury Prevention
Meta-analyses show physio-guided injury-prevention programs significantly reduce ACL, hamstring, and ankle injuries (Al Attar et al., 2017; Albright et al., 2025).
✔ Performance Enhancement
Sports physios correct movement patterns, improve landing mechanics, and reduce energy leaks.
✔ Return-To-Sport Testing
Sports physio clinics use objective criteria:
hop tests
isokinetic strength ratios
reactive strength index
GPS load metrics
agility and sprint testing
✔ Safety
Research consistently shows physiotherapy is one of the safest musculoskeletal treatments, with very low complication rates (Orthopedics Review, 2022).
Beware of Unregistered or Informal Practitioners
With social media’s rise, many unqualified people now offer treatments like:
“bone setting”
“alignment correction”
cupping without training
dry needling without certification
“sports therapy” without credentials
general massage workers claiming rehab
These practitioners often lack clinical knowledge, risking:
FAQ 3: Does a sports physio also do strength training like a Strength & Conditioning (S&C) coach?
Yes — but with clinical reasoning.
Sports physios prescribe strength training based on:
tissue healing timelines
biomechanics
load tolerance
sport demands
injury history
Research shows injury-prevention strength programs led by physios dramatically reduce sports injuries (Sugimoto et al., 2016).
Difference:
Sports Physio → Strength training for injury recovery & safe return-to-play. S&C Coach → Strength training for performance, speed, and power development.
Both are valuable — but when you’re injured, a physio is essential.
FAQ 4: Is sports physiotherapy better for injuries than chiropractic or massage?
Yes — most research supports physiotherapy as the most comprehensive and safest injury-treatment approach.
Physiotherapy uses graded exercise, the gold standard in musculoskeletal rehab (Fernández et al., 2024).
Chiropractic manipulation has documented risks, especially cervical (Thiel et al., 2007).
Massage offers temporary relief but not long-term correction.
For injuries, sports physio offers the most complete pathway to healing + performance.
FAQ 5: Can a sports physio improve performance or do they only treat injuries?
Sports physio is deeply linked to performance. They work on:
mobility
explosive mechanics
movement efficiency
landing and sprint technique
load management
recovery protocols
This is why nearly every elite team worldwide employs sports physiotherapists.
FAQ 6: Is sports physiotherapy safe?
Yes — extremely safe.
Unlike high-velocity cervical manipulation, physiotherapy rarely involves high-risk techniques and relies on exercise, education, biomechanics, and controlled manual therapy (Orthopedics Review, 2022).
Conclusion
Massage therapists help with tightness. Chiropractors assist with specific joint-related issues but carry certain neck manipulation risks. Sports physiotherapists provide the safest, most comprehensive, evidence-based system for injury recovery, performance enhancement, and long-term prevention.
If your goal is to fix pain, prevent recurrence, and return to high-level activity — sports physiotherapy is the research-supported choice.
References:-
Al Attar, W. S. A., et al. (2017). The effectiveness of injury prevention programs in reducing lower limb injuries. Sports Medicine, 47(7), 1337–1353.
Albright, J., et al. (2025). Meta-analysis of injury-prevention programmes. Healthcare, 13(13), 1530.
Fernández, J. et al. (2024). The role of physiotherapy in sports injuries.
Lanzarini, S., et al. (2019). Effects of cervical manipulation on arterial flow.
MedicalBrief. (2024). Vision loss after cervical manipulation.
Michigan Medicine. (2024). Chiropractic neck manipulation and stroke risk.
Orthopedics Review. (2022). Managing sports injuries.
Rivett, D. A., et al. (2006). Short-term effects of cervical HVLA.
Sugimoto, D., et al. (2016). Compliance on injury prevention programs.
Thiel, H. W., et al. (2007). Safety of chiropractic manipulation.
An ankle sprain happens when your foot suddenly twists and stretches the strong bands (ligaments) that support your ankle beyond their limit. This usually affects the ligaments on the outer side of the ankle, causing pain, swelling, bruising and difficulty putting weight on the foot. Ankle sprains are extremely common in everyday life and in sports like marathon running, cricket, squash, tennis and dance.
How does an ankle sprain happen in daily life?
In non‑athletes, ankle sprains often happen during simple day‑to‑day activities. Typical examples include missing a step on the staircase, slipping off the edge of a pavement, walking on uneven ground or stepping into a small pothole or gap. The foot rolls inwards, the ankle rolls outwards, and the ligaments on the outside of the ankle get overstretched or torn.
Sport‑specific mechanisms of injury
In sport, the same basic twist happens, but often at higher speed and force:
Marathon runners: Fatigue, uneven roads, potholes and sudden changes in direction at aid stations can cause the foot to roll inwards during landing or push‑off, especially when the runner is tired late in the race.
Cricketers: Bowlers and fielders are at risk when sprinting, cutting, turning quickly to chase the ball, or landing awkwardly from a jump or dive; landing on an uneven patch or another player’s foot is a common trigger.
Squash, tennis and other racquet sports: Fast side‑steps, sudden stops, split‑steps and landing on an opponent’s or partner’s foot can all cause the ankle to roll sharply inwards. Video studies in court sports show many sprains happen when landing from a jump or changing direction with the foot fixed to the floor.
Dancers: Repeated jumps, turns and work on demi‑pointe/pointe put the ankle at risk when landing poorly, losing balance in turnout or rolling over the foot at the end of a jump
In all of these, the common pattern is a sudden inward twist of the foot with the body weight moving over it too fast for the muscles to protect the ligaments.
What is a chronic ankle sprain?
Sometimes the ankle never fully recovers from the first sprain, or it keeps getting sprained again and again. This is often called a “chronic ankle sprain” or “chronic ankle instability.” It means the ligaments and supporting muscles are no longer giving the joint the firm support and balance it needs, especially during quick or unpredictable movements.
Typical symptoms of chronic ankle problems include:
Repeated “giving way” or rolling of the ankle on uneven ground or during sport
A constant feeling of weakness or wobbliness in the ankle
Swelling or ache after walking, running, training or dancing
Stiffness or tightness, especially in the morning or after sitting
Fear or lack of confidence while running, jumping or changing direction
Chronic ankle issues do not usually improve with rest alone. Without proper sports physiotherapy and ankle sprain rehab exercises, they can lead to more sprains, early joint wear‑and‑tear and ongoing pain.
Key sports physiotherapy principles :-
After an ankle sprain, the goal is not to just “rest it” but to protect it briefly, control the swelling, and then start gentle, pain‑free movement as soon as it is safe. This early movement and gradual loading help the ligaments heal stronger and reduce stiffness.
As the pain settles, the focus shifts to building strength, balance and coordination around the ankle, often using a brace or taping for extra support while you move and train. These exercises train the muscles and nerves to react quickly again, which lowers the chance of the ankle rolling over in the future.
Instead of clearing you to play simply after a set number of days, your rehab should follow clear stages, from light everyday activity to full training and competition. At each stage your physiotherapist checks whether your strength, balance, hopping and sport‑specific skills match the other leg, and only then moves you to the next level or back to sport
Sports‑specific biomechanics and pathomechanics
Marathon runners: Repetitive loading at mid‑stance and push‑off demands optimal dorsiflexion, elastic calf function and dynamic peroneal stability; limited dorsiflexion and poor neuromuscular control increase re‑injury risk, even when gross running gait looks “normal.”frontiersin+1
Cricketers: Bowlers and fielders experience high inversion moments during cutting, landing and boundary stops; lateral instability alters kinetic chain alignment, affecting knee, hip and lumbar mechanics during bowling and throwing.pmc.ncbi.nlm.nih+1
Squash/tennis/racquet sports: Multi‑directional lunges, split‑steps and rapid deceleration place high demand on frontal‑plane control; impaired proprioception and peroneal latency compromise change‑of‑direction mechanics and increase risk in side‑stepping and cross‑over steps.sciencedirect+1
Dancers: Repeated demi‑pointe, jumps and landings require end‑range plantarflexion control; lateral ligament injury disrupts alignment in turnout, landing mechanics and pointe control, increasing risk of chronic instability.pmc.ncbi.nlm.nih+1
Acute vs chronic ankle sprain
Acute ankle sprain
This is a “fresh” injury that has just happened, usually within the last few days or weeks.
The main features are sudden pain, swelling, bruising and difficulty walking after you twist or roll your ankle. The focus here is ruling out a fracture, calming pain and swelling, and then starting early, guided rehab so it heals well.
Chronic ankle sprain / chronic ankle instability
This refers to ankle problems that keep going for months, or repeated sprains over time.
People often describe the ankle as weak, wobbly or “giving way,” especially on uneven ground or during sport. There may be on‑and‑off swelling or aching after activity, and confidence in the ankle is usually low. Chronic cases need a full strengthening and balance programme, sometimes extra bracing, and occasionally surgical opinion if rehab alone is not enough.
Grading of acute ankle sprains (Grade I–III)
Most research and clinical guidelines still use a three‑grade system to describe how badly the ligaments are hurt:
Grade I (mild)
The ligaments are stretched but not torn.
There is mild pain and swelling, but you can usually walk with only slight discomfort. Recovery is often quick with proper care.
Grade II (moderate)
Some of the ligament fibres are torn.
Pain, swelling and bruising are more obvious, walking is painful and the ankle may feel a bit unstable. Rehab takes longer and needs structured physiotherapy to fully restore strength and balance.
Grade III (severe)
The ligament is completely torn, and sometimes more than one ligament is involved.
There is significant pain, swelling and bruising, weight‑bearing is very difficult, and the ankle feels very unstable. Recovery is longer, and in some cases a specialist may discuss more intensive treatment or, rarely, surgery, along with a long, detailed rehab plan.
Management of ankle sprains:-
“Treatment is planned according to how new the sprain is and how badly the ligament is damaged, rather than using a ‘one size fits all’ approach.”
Type / Grade
What it means (simple)
Main goals of treatment
Typical support & activity level
Acute – Grade I (mild)
Ligament is stretched but not torn; mild pain and swelling; you can usually walk with some discomfort.
Calm pain and swelling quickly, protect the ankle briefly, then start gentle movement and gradual loading so it does not get stiff or weak.
Short period of protection (brace/taping), home care for swelling, early comfortable movement, then gradual return to walking, daily tasks and light sport.
Acute – Grade II (moderate)
Some fibres of the ligament are torn; more pain, swelling and bruising; walking is painful and ankle may feel a bit unstable.
Protect the joint while it settles, then carefully restore full movement, strength and balance so the ankle feels stable again.
Stronger external support (brace/taping, sometimes crutches for a few days), clinic‑based rehab, step‑by‑step return from daily activities to jogging and then sport, usually over several weeks.
Acute – Grade III (severe)
Ligament is completely torn (often more than one); marked swelling and bruising; very hard to put weight on the foot.
Give the ligament time to heal in a protected position, then follow a long, structured rehabilitation plan to regain movement, strength, balance and confidence.
Firm support (boot or rigid brace) and reduced weight‑bearing at first, followed by closely supervised rehab; gradual return to normal walking, then sports; sometimes a specialist opinion if the ankle stays very unstable.
Chronic ankle sprain / chronic instability
Ankle feels weak or “keeps rolling” months after the first injury, or there are repeated sprains.
Improve long‑term stability, reduce “giving way,” and prevent further sprains by training the muscles, balance and control around the ankle.
Detailed assessment, longer rehab programme focusing on stability and control, possible regular use of brace/taping for higher‑risk activities, and ongoing “maintenance” exercises to keep the ankle strong.
Sport‑specific rehab and return‑to‑play
Sport
Rehabilitation Focus
Return-to-Play Principles
Marathon Runners
Early gradual return to running, progressive walking to jogging, strength building for calf muscles, improved balance and coordination to support running mechanics even if gait looks normal
Gradual increase in running load and pace, ensuring pain‑free movement and stability in running pattern before full return
Cricketers
Phased running drills starting with straight-line running progressing to curves, cutting, sliding, and landing; strengthening of trunk and hips to support complex movements like bowling and fielding
Systematic progression through cricket-specific movement patterns, working towards full bowling and fielding actions under supervision
Racquet Sports (Squash, Tennis, etc.)
Focus on single-leg strength, lateral balance and agility, multi-directional movement drills including split steps and lunges tailored to court demands
Increasing intensity of court-specific drills and match-like movements only after achieving adequate strength, balance, and control
Dancers
Gradual progression from controlled barre work to centre stage, enhancing single-leg endurance, landing control, and supporting complex turns and jumps
Slowly advancing to full choreography and performance, often with external support (like taping) during early return phase to reduce risk of recurrence
All Sports
Supervised physiotherapy focusing on neuromuscular training and proprioception (body awareness), with clear, objective criteria to measure progress before returning to sport
Phased rehabilitation models emphasizing return to activity, sport, play, and competition steps using strength, balance, hop, and sport-specific functional tests
If you play a sport — whether it’s Cricket at Juhu Beach or Balkanji bari turf or at MIG Cricket Club in Bandra East, Badminton at Willingdon Gymkhana or in Prabodhankar Thackeray Krida Sankul for Pickle ball, football turf sessions at TurfPark | St Andrews, or Early-morning Marathon training at Carter Road or with STriders or mUmbai runners— chances are your body is dealing with far more load, impact and repetition than you realise.
And with increasing sports participation in Mumbai, sports injuries are becoming extremely common: knee pain while running, shoulder pain while smashing a shuttle, ankle sprains while playing football, lower-back stiffness from gym training.
This is exactly where sports physiotherapy makes the difference.
Why Sports Physiotherapy Is Not the Same as General Physiotherapy
A lot of people still believe physiotherapy is only for pain relief. But sports physiotherapy works differently — it focuses on movement, muscle coordination, sport-specific loading, and performance.
Unlike general physiotherapy, sports physio looks at:
What movement pattern caused the injury
How your biomechanics affect performance
What strength or mobility deficits created overload
Whether you are loading too much, too soon
How to return you to sport safely
Most of the times I have noticed atheletes or weekend warriors playing with injuries. they just dont feel like/ dont want o/ dont have time to get it assesed. many a times they visit the medical doctors take basic meds and dont adress it completely and then once the tournament or pain has subsided they dorectly hit the gym and expect gym trainers to do the therapy they should have gone to in the first place.
A sports physiotherapist bridges that gap by keeping training:
✅ Safer ✅ Smarter ✅ Stronger ✅ More sustainable
Most Common Sports Injuries Seen in Mumbai Athletes (2025 Trends)
Across clinics in Santacruz, Juhu, Bandra and Andheri, the most common injuries reported by athletes today include:
1️⃣ Knee pain in runners
IT Band syndrome
Runner’s knee
Patellar tendinopathy
2️⃣ Shoulder injuries in badminton & tennis players
Rotator cuff irritation
Shoulder impingement
Scapular muscle weakness
3️⃣ Ankle sprains in footballers & recreational athletes
Lateral ligament sprains
Balance/proprioception deficits
4️⃣ Tendon injuries in gym-goers
Biceps tendinopathy
Achilles overload
Elbow tendon pain
5️⃣ Lower-back tension due to poor mobility
Especially in cricketers (fast bowlers) and people doing heavy lifts.
The trend across all areas? Most injuries are preventable with early load management, movement correction and sport-specific rehab.
What a Sports Physiotherapist Actually Does (Beyond Pain Relief)
A modern sports physio today uses an integrated approach:
To analyse running form, jumping mechanics, landing technique, racket swing pattern, treadmill gait, etc.
✔ Manual Therapy
Soft-tissue release, joint mobilizations, and myofascial techniques to restore mobility.
✔ Strength & Conditioning
Structured progression for:
Strength
Mobility
Power
Agility
Endurance
starting 2025 we conduct only strengthe and conditioning classes at Physiocure. we conduct Mat Pilates on monday, wednesday and fridays and we conduct align and activate posture fitness class on tuesdays and thursdays. you can call us for further details.
✔ Sport-Specific Rehab
Every sport in Santacruz/Bandra/Juhu has unique demands:
A critical but often ignored step that prevents re-injury.
Hop tests, gait analysis, Y-balance tests, sprint tests — depending on the sport.
Why Athletes from Santacruz, Bandra & Juhu Actively Seek Affordable Sports Physiotherapy Today
1. Turf culture
Football turfs across Santacruz & Bandra have exploded in popularity, increasing high-speed injuries. we can help turf footballers continue playing while we help them recover through sports injuries smoothly
2. Running communities
Running clubs like Striders, Bombay running, Nike running club, Mumabi Road Runners, Asics Runners club and self practicing runners around bandra, Khar, santacruz dont know that we run a runner specific injury prevention prorgram. we also do Normatech leg recovery sessions for post marathon or on regular trainig days and help with all kinds of running injuries.
3. Fitness studio boom
witht he changing trends some really cool multifunction gyms like FLOFIT BOX in Bandra and MMA Matrix centre in Khar/ sanatcruz linking road and some really cool gyms around sanatcruz like Fitness First, dessus fitness , Transform gyms and some yoga centres like the body temple yoga, we definetly know people here like to go to the fitness centres and many a time they may need a sports physio for them to address the aches and niggles. we are happy to serve all kinds of fitness freaks so they continue their fitness journery pain free.
4. Competitive amateur athletes
Badminton players, tennis enthusiasts and cyclists train hard but recover poorly — leading to breakdown.
5. Early rehab awareness
People now realise physio is not last-minute treatment — it’s performance enhancement.
2025 Insights: What The Latest Research Says
Sports physiotherapy worldwide is shifting to:
📌 Load-based tendon rehab (not rest)
Achilles, patellar & shoulder tendons heal through progressive loading — not through avoiding activity.
📌 Strong evidence for isometrics + eccentrics
Particularly in runners and racket-sport players.
📌 Mobility + control > flexibility alone
High-performing athletes don’t just stretch — they stabilise.
📌 Strength symmetry before return-to-sport
Especially after ACL and ankle injuries.
📌 Train the movement, not the muscle
Sport-specific rehab gives faster results than isolated strengthening.
Sports We Commonly Work With (Based on Real Clinic Cases & Field Trends)
From everyday athletes to competitive players, sports physio in Santacruz commonly manages:
With advance in newer treatment techniques, it is imperative as a physio for me to make you understand different kinds of shoulder pains. Another reason to pursue this topic is to provide readers help for rotator cuff pain and understand the differences in rotator cuff pain vs frozen shoulders. In this article we will be discussing mainly about Rotator cuff injuries (RCI) which occur in normal individuals. RCI includes the terms tendinitis, tendinosis, tendinopathy, partial thickness tear(PTT), full thickness tear(FTT) used for the rotator cuff injuries.
There is an increased incidence of shoulder pain in individuals who participate in repetitive overhead activities including repetitive throwing sports like baseball or volleyball, occupations such as painting or carpentry. Rotator Cuff Tendinopathy(RCT) is seen as the most common type of shoulder pain as it is seen in about 30% of the overall population.
RCT incidence also increases with age, which needs to be considered when we talk about Rotator Cuff Injuries.
Before getting to the details of this syndrome, its necessary to know about the anatomical structures involved.
ANATOMY AND BIOMECHANICS OF ROTATOR CUFF:-
In earlier days the area of pathology was identified mainly affecting the subacromial arch, the sub acromial bursa, the supraspinatus tendon. Recent research, adds to the affection of rotator cuff also. These rotator cuff muscles get pinched between the bones that form your shoulder leading to shoulder pain, this is a basic defination of RCS
The RC comprises of 4 muscles namely; the supraspinatus, subscapularis, infraspinatus and teres minor tendons. These RC tendons blend together with the biceps, the coracohumeral ligament and the capsule (Matava, Purcell & Rudzki, 2005 p. 1405-6). They form an aponeurotic tendon surrounding the head of the humerus that contribute to the stability, movement and sensory motor control of the GHJ.
This structure helps the RC to resist failure, since load is distributed over a wider area.
Rotator cuff tendon structure:-
rotator cuff pain location
Also known as the rotator cable described as a point of attachment of 4 rotator cuff muscles onto the arm bone. (The white area where the muscles are ending in the picture.) This area is a critical zone as the blood supply is limited and hence when subject to wear and tear it tends to develop tear and contributed to rotator cuff pathology.
CAUSES OF RCS:-
Intratendinous degeneration or tendinosis might occur as a result of the combination of limited vascularity in Codman’s critical zone and external compression of the tendon structures in the subacromial space’
As these tendons become weak, indirectly the function of the rotator cuff muscle gropu becomes inefficient/ weak which affects the joint normal biomechanics. What happens is everytime the arm is lifted, the arm bone (humerus) tends to ride up hitting the sub acromial bursa/acromion bone, causing irritation.
Nho et al. (2008, p. 988) suggest the influence of age and activity on the shape of the acromion, as well as environmental causes such as age, co-morbidities (like diabetes mellitus and smoking) and overuse in impairing the healing processes of the tendon.
It seems that superior translation of the humeral head plays a significant role in the pathology (Lewis 2009a, p. 239).
Chronic impingement can lead to bursal inflammation, tendonitis and can eventually cause degenerative changes and tears of the cuff tendons if not treated (Lin, Weintraub & Aragaki 2008, p. 627; Nho et al. 2008, p. 988).
In summary the etiology of Rotator Cuff disease is multifactorial, including both intrinsic and extrinsic factors. It is believed that articular side tears are associated with intrinsic changes to the tendon and bursal side tears associated with SA impingement
Signs & Symptoms:-
RC pathologies (including SAIS) can manifest in anterolateral shoulder pain
patient usually grabs the whole shoulder when describing the location
aggravated in overhead activities,
described as constant ache and
night pain.
Pain may radiate to the scapula/ neck/ elbow/ fingers, not in a dermatomal way
Examination
A thorough physiotherapy objective examination includes few rotator cuff syndrome tests:-
Testing of the neck including ROM, palpation and provocation tests are done to rule out referred pain.
The shoulder girdle is examined for atrophy, weakness and for shoulder blade and arm muscles asymmetry
Active and passive shoulder ROM is assessed (where in we find that limited Active should er movements but passive movements are full
strength in all planes is tested once the pain is in control.
Tests for rotator cuff impingement or tears are performed, as well as a detailed neurovascular assessment is done.
Rotator Cuff Syndrome Radiology:-
MRI and ultrasound have comparably high accuracy for finding RC tears and biceps pathologies, clinical tests have moderate accuracy for both conditions.
At Physiocure we base our diagnosis and treatment based on this model.
The new model is based on the model by Cook and Purdam (2008), suggesting a continuum of tendon pathology. Each of the stages can be identified by imagery tools and has its own cause and clinical manifestation.
Stage of Pathology
Signs & Symptoms
Treatment principals
Under-loaded tendon–
Inappropriate physiological stress will lead to tendon degradation. That stage is reversible if the tendon is properly loaded.
‘reload the tendon in controlled and graduated manner’ (Lewis 2009c, p. 7).
Reactive tendinopathy–
Commonly seen in overloaded tendon (usually unaccustomed activity) and can involve the SAB.
In this stage the RC are unable to control the superior migration of the humeral head, leading to irritation of the RC by the acromion and the coracoacromial ligament.
relative rest, biomechanical unloading interventions, reduction of pain and swelling, low load exercises, dietary changes (Lewis 2009c, p. 7-8).
Tendon disrepair-
This stage is associated with movement and activity. It’s characterized by substantial swelling, tendon degeneration, effusion and areas of neovascularity in the bursa.
Reduction of pain and neovascularity, exercises (gradually reloading the tendon), dietary changes, and consider surgery (Lewis 2009c, p. 7-8).
Degenerated tendon–
This stage characterized by substantial structural failure such as partial, full thickness or massive RC tears.
As in previous stage, unless massive tear is present.
Treatment for rotator cuff syndrome:-
Exercises are effective in reducing pain
Home exercise is effective as supervised exercise.
May be better effect if combined with manual therapy
Activity modification; NSAID’s; physiotherapy to reestablish/maintain normal shoulder kinematics and stretch contracted capsule; thermal modalities to reduce pain and increase motion. Once pain decreases and ROM improves, strengthening of RC and the periscapular muscles should begin. Core and lower limb strength should be applied as well.
A Cochrane review (2003) concluded that ‘for rotator cuff disease, subacromial steroid injection was demonstrated to have a small benefit over placebo in some trials however no benefit of subacromial steroid injection over NSAID was demonstrated’
Correcting posture (scapula + thorax) with taping, increase Flexion and Abduction ROM and delayed the point at which pain was first experienced, but didn’t change pain intensity. The purpose of the tape was to extend the thoracic spine, and retract, depress and posteriorly tilt the scapula.
Multiple Systematic Research studies concluded that using US is of minor value in the treatment of shoulder pain; therefore using US is of no value for treating impingement syndrome.
‘There is no data for or against the use of cold or heat as a modality; thus, their use must be optional at this point’.
Combining nerve block with standard rehabilitation program can decrease severity and frequency of pain, improve the compliance with physiotherapy, and makes sleep better compare with standard therapy alone for patients suffering from RC tendinitis.
These 9 points on various types of treatments preferred for RCIS are based on systematic research studies and are usually followed at our Physiocure once the patient is examined and diagnosed correctly.
check out these rotator cuff syndrome exercises for strengthening the injured rotator cuff treatment at home.
Systematic research studies on Indication for Rotator cuff Repair
The indications for surgery are poorly described in outcome studies (Marx et al. 2009, p. 450).
Two studies (Wolf, Dunn & Wright 2007. p. 1014; Codsi 2007, p. 486) mentioned that duration of symptoms, acuity and size of tear, weakness, muscle atrophy and fatty infiltration are of importance as indicators for surgery.
Duration of symptoms -Several studies stated that tears might increase with time. Therefore, it makes sense to treat patients with Full Thickness Tear( FTT) conservatively for up to 3 month monitoring their improvement. Longer duration of symptoms can lead to histological changes to the muscle which can be irreversible and increase the difficulty of repair (Wolf, Dunn & Wright 2007, p. 1009). Matava (2005, p. 1412) and Codsi (2007, p. 486) suggest considering surgery if 3-6 months of conservative management had failed, but other patient factors, like activity level, can shorten that period.
Weakness- Strength less than 4/5, with positive shrug during active elevation, positive lag signs or positive drop arm sign are probably unlikely to respond to non-operative treatment (Wolf, Dunn & Wright 2007, p. 1013).
They recommend starting every treatment of symptomatic FTT with physical therapy and NSAID’S for up to 3 months (Oh et al 2006, p. 60). In addition activity level could be good demographic parameter to consider before recommending surgery (Oh et al 2006, p. 61).
Conclusion:-
Rotator cuff syndrome and subacromial impingement are well connected and can predispose to one another. Many theories have been suggested to try and explain the pathoaetiology of these disorders, but it is still a mystery to some extent.
The new approach is leading toward a continuum model of tendinopathy and might be of great help in the future, recognizing the need of adjustable management to a specific tendon state.
Finally, if conservative approach has failed, surgical treatment can be considered.
References:-
Beaudreuil, J, Nizard, R, Thomas, T, Peyre, M, Liotard, JP, Boileau, P, Marc, T, Dromard, C, Steyer, E, Bardin, T, Orcel, P & Walch, G 2009, ‘Contribution of clinical tests to the diagnosis of rotator cuff disease: A systematic literature review’, Joint Bone Spine , vol. 76, pp. 15-9.
Kuhn, JE 2009, ‘Exercise in the treatment of rotator cuff impingement: A systematic review and a synthesized evidence-based rehabilitation protocol’, Journal of Shoulder and Elbow Surgery, vol. 18, pp. 138-60.
Ainsworth, R & Lewis, JS 2007, ‘Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review’, British Journal of Sports Medicine, vol. 41, pp. 200-10.
Lewis, JS, 2009c, ‘Rotator cuff tendinopathy: A model for the continuum of pathology and related management’, British Journal of Sports Medicine, DOI:10.1136/bjsm.2008.054817.
Ainsworth, R, Lewis, J & Conboy, V 2009, ‘A prospective randomized controlled clinical trial of a rehabilitation programme for patients with a diagnosis of massive rotator cuff tears of the shoulder’, Shoulder & Elbow, 1, pp. 55-60.
Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD004016. DOI: 10.1002/14651858.CD004016.
Cumpston M, Johnston RV, Wengier L, Buchbinder R. Topical glyceryl trinitrate for rotator cuffvdisease. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD006355. DOI: 10.1002/14651858.CD006355.pub2.
Ejnisman B, Andreoli CV, Soares BGO, Fallopa F, Peccin MS, Abdalla RJ, Cohen M. Interventions for tears of the rotator cuff in adults. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD002758. DOI: 10.1002/14651858.CD002758.pub2.
Hughes, PC, Taylor, NF & Green, RA 2008, ‘Most clinical tests cannot accurately diagnose rotator cuff pathology: a systematic review’, Australian Journal of Physiotherapy, vol. 54, pp. 159-70.
Lin, JC, Weintraub, N & Aragaki, DR 2008, ‘Nonsurgical Treatment for Rotator Cuff Injury in the Elderly’, Journal of American Medical Directors Association, vol. 9, no. 9, pp. 626-32.
Oh, LS, Wolf, BR, Hall, MP, Levy, BA & Marx, RG 2006, ‘Indications for Rotator Cuff Repair’, Clinical Orthopaedics and Related Research, no. 455, pp. 52-63.
Nho, SJ, Yadav, H, Shindle, MK & MacGillivray, JD 2008, ‘Rotator Cuff Degeneration’, The American Journal of Sports Medicine, 36, no. 5, pp. 987-93.
Marx, RG, Koulouvaris, P, Chu, SK & Levy, BA 2009, ‘Indications for Surgery in Clinical Outcome Studies of Rotator Cuff Repair’, Clinical Orthopaedics and Related Research, no. 467, pp. 450-6.
Lorenzo, LD, Pappagallo, M, Gimigliano, R, Palmieri, E, Saviano, E, Bello, A, Forte, A, Deblasio, E & Trombetti, C 2006, ‘Pain relief in early rehabilitation of rotator cuff tendinitis: any role for indirect suprascapular nerve block?’, Europa MedicoPhysica, 42, no. 3, pp. 195-204
It’s high time a layman knows some facts about meniscal injuries that happen while playing various sports. one of them and the most important being u don’t need surgery to recover properly from a meniscal tear!!
This Meniscal injury is common in sports such as football, rugby and other high-intensity contact sports but is also common, with no major trauma, as degenerative tears in older athletes or sedentary individuals. They occur either in isolation or combined with a ligament injury, for example, of the MCL or ACL Injury (all 3 together injured are known as the unholy triad)
WHAT ARE MENISCI?
The menisci are cartilaginous structures that deepen their respective tibial articular
By increasing the concavity of the tibia, they play a role in stabilizing the knee. In addition, the menisci contribute to joint lubrication and nutrition.
The menisci have an important role as a buffer absorbing some of the forces placed through
the knee joint, thus protecting the otherwise exposed articular surfaces from damage.
The medial meniscus is crescent shaped and attaches to the tibia in front of the ACL and in the intercondylar fossa at the back
The lateral meniscus is more circular and attaches to the tibia in front of the ACL and posteriorly behind the tibial eminence but anterior to the medial meniscus.
It also is attached to many other ligaments which connect the tibia and the femur within the knee joint.
The front portion of the menisci (known as the anterior horn) are further connected with each other via a ligament and are more stable while,
The back portion of both the menisci (known as the posterior horn) is connected to different structures.
The back portion of the medial menisci is the most susceptible to injury.
Thus, it is important to preserve as much of the menisci as possible after injury
MECHANISM OF INJURY:-
For Acute injuries:- usually startes with uncontrolled pivot in the knee or during cutting activity in any game. initailly the knee swells up and there will be pain in the innner portion of the knee. if the tear is bad then the knee might get locked up during the episode, rendering the athelete unable to play.
TYPE OF MENISCAL TEARS:-
Meniscal tears can be classified as acute or degenerative.
Acute tears are from excessive force applied to a normal knee and meniscus.
This is different from a degenerative tear, which results from repetitive normal forces acting upon a worn down meniscus.
Tears can also be described based on pattern and location.
These tear patterns include vertical longitudinal, oblique, transverse (radial), horizontal, meniscal root, bucket-handle, and complex.
Tears can located in the avascular or vascular zone (e., white, red-white, red-red), which influences healing potential either spontaneously or after surgical repair.
RISK FACTORS FOR MENISCAL INJURY:-
A systematic research study showed strong evidence that age (older than 60 years), gender (male), work-related kneeling and squatting, and climbing stairs (greater than 30 flights) were risk factors for degenerative meniscal tears. They also found strong evidence that playing soccer and playing rugby were strong risk factors for acute meniscal tears. Waiting longer than 12 months between the anterior cruciate ligament injury and reconstructive surgery was a strong risk factor for a medial meniscal tear but not for a lateral meniscal tear.
PHYSICAL EXAMINATION:-
Usually acute knee injuries show the signs and symptoms below, however they may be symptomless in case of degenerative tears
Effusion,
Joint line tenderness,
Pain with squatting, and
A positive McMurray test.
Locked knee, which cannot reach full extension, may be caused by a “bucket handle” meniscal tear that has displaced centrally into the joint, blocking a full range of motion.
INVESTIGATIONS REQUIRED:-
Usually an X-ray and MRI are suggested. Acute isolated meniscal injuries rarely produce changes
on plain radiograph, whereas chronic meniscal pathology may produce the Fairbank’s
changes previously discussed. MRI imaging is useful in cases of questionable meniscal
damage
MANAGEMENT OF MENISCAL INJURIES:-
An athlete with effusion and suspected meniscus injuries should be seen by an on field health care provider who usually follows the Acute injury management protocol & is further responsible for directing the athlete to an orthopaedic or a sports physio . A regular individual walking into clinics or hospitals with knee pain history indicating of degenerative meniscal tear is usually send for rehab with a physio first. At Physiocure we practice evidence based therapy. Below are lists of factor which help health care providers decide whether to send the patient for surgery or rehab.
Factors that may indicate that conservative treatment is likely to be successful
Factors that may indicate that surgery will be
required
· Symptoms develop over 24–48 hours after injury
· Injury minimal or no recall of specific injury
· Able to weight-bear
· Minimal swelling
· Full range of movement with pain only at end of range of motion
· Pain on McMurray’s test only in inner range of flexion
· Previous history of rapid recovery from similar injury
· Early degenerative changes on plain radiographs
· Severe twisting injury, athlete is unable to continue playing
· Locked knee or severely restricted range of motion
· Positive McMurray’s test (palpable clunk)
· Pain on McMurray’s test with minimal knee flexion
· Presence of associated ACL tear
· Little improvement of clinical features after 3 weeks of conservative treatment
WHAT DOES RESEARCH SAY ABOUT SELECTING TREATMENT OPTIONS?
Treatment options for meniscal tears fall into three broad categories; non-operative, meniscectomy or meniscal repair.
Selecting the most appropriate treatment for a given patient involves both patient factors (g., age, co-morbidities and compliance) and tear characteristics (e.g., location of tear/age/reducibility of tear).
There is evidence suggesting that degenerative tears in older patients without mechanical symptoms can be effectively treated non-operatively with a structured physical therapy programme as a first line.
Even if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated surgically.
Partial meniscectomy is suitable for symptomatic tears not amenable to repair, and can still preserve meniscal function especially when the peripheral meniscal rim is intact.
Meniscal repair shows 80% success at 2 years and is more suitable in younger patients with reducible tears that are peripheral (g., nearer the capsular attachment) and horizontal or longitudinal in nature.
However, careful patient selection and repair technique is required with good compliance to post- operative rehabilitation.(6)
WHEN SHOULD YOU START REHABILITATION?
Rehabilitation should commence prior to surgery. In this period it is important to:
• reduce pain and swelling with the use of electrotherapeutic modalities and gentle range
of motion exercises
• maintain strength of the quadriceps, hamstrings, and hip abductor and extensor muscles
• protect against further damage to the joint (patient may use crutches if necessary)
• explain the surgical procedure and the postoperative rehabilitation program to the patient
Rehabilitation principles after arthroscopic partial menisectomy are:
• to control pain and swelling
• to regain pain-free active range of motion
• graduated weight-bearing
• progressive strengthening within the available range of motion
• progressive balance, proprioceptive, and coordination exercises
• return to functional activities
WHAT DOES RESEARCH SAY ABOUT REHABILITATION?
There was wide variation in rehabilitation protocols among clinical studies. Biomechanical evidence from small cadaveric studies suggests that higher degrees of knee flexion and weight-bearing may be safe following meniscal repair and may not compromise the repair. An accelerated protocol with immediate weight-bearing at tolerance and early motion to non-weight-bearing with immobilising up to 6 weeks postoperatively is reported. Accelerated rehabilitation protocols are not associated with higher failure rates following meniscal repair.
There are wide opinion differences on whether to start the rehabilitation and weight bearing early or late amongst the orthopaedics. Well the above systematic research study says that an accelerated rehab protocol for meniscal injuries that is improving ROM and weight bearing early is acceptable and that it is not associated with failure rates. Hence the athletes can be put through an accelerated rehab program based on their findings based on the above evidence
Surgery (partial excision, timing or meniscus suture) will allow a return to professional sports in two weeks to several months. The knee will be more vulnerable to stress at the site of meniscus excision and in the long term, 10 to 20 years, the risk of developing local osteoarthritis is significant compared to a non-injured knee
CONTACT US FOR MENISCAL REHAB ON 9821066050 OR EMAIL US AT BOOK AN APPOINTMENT
REFERENCES:-
Clinical Sports Medicine (3rd edition- by Peter Brukner and Karim Khan with collegues
The sports injuries handbook, diagnosis and management by Christofer Rolf
Sports Injuires: Mechanisms, Prevention, Treatment (2nd edition) by Freddie H. Fu (Editor), David A., M.D. Stone (Editor)
Risk factors for meniscal tears: a systematic review including meta-analysis.
Massage is helpful, but studies show exercise + manual therapy is significantly more effective than massage alone, which is why physiotherapists achieve better long-term outcomes (Fernández et al., 2024).
Dancers: Repeated jumps, turns and work on demi‑pointe/pointe put the ankle at risk when landing poorly, losing balance in turnout or rolling over the foot at the end of a jump
