THE HFS
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Physiotherapy

Physiotherapy in London

Before actually treating a problem, one must first have a diagnosis.  Traditionally this has focused on which tissue is causing the pain and to what degree has this tissue become less healthy or damaged.  At HFS Clinics, not only are our Physiotherapists able to provide you with an accurate tissue diagnosis, but also with the likely underlying clinical and lifestyle issues that actually lead to the pain or injury you have in the first place.  By treating the underlying cause of a problem as well as the outward symptoms, the problem is more likely to get better (and more quickly), and importantly less likely to recur.

HFS physiotherapists are all expert manual therapists and so you can expect the same type of manipulative treatment that an osteopath or chiropractor might use.  In this way we are actually quite similar.  With most spinal or sporting injury, easing pain and restoring movement is actually the easy bit.  The real trick is going that extra bit to try and prevent the same or similar problems from recuring.  This is where we apply our unique programme of postural and movement pattern re-education so that you learn to hold yourself and move more efficiently wether it is during your work related activity, daily routine or in a sporting environment.  If your body moves more efficiently you tend to find things wearing out less quickly.  Whilst physiotherapy as a profession is criticised for not using enough active exercise as an integral part of treatment, physiotherapists at HFS Clinics excel at it.
What to expect from your Physiotherapy Programme

We allocate 45 minutes for your first appointment.  It is important that we take time to listen to what you have to say about the problem and to understand how it affects you.  We then marry up what you are telling us to various physical tests to reach the diagnosis.  You should leave your first appointment knowing what the problem is, why it is there (if it is not an obvious traumatic event) and with a rough prognosis i.e. what is going to be involved for a successful outcome and how long you should expect this to take. 

Sometimes more analysis is needed and you may be asked to see other Specialists to assess the problem further.  Often with lower limb aches and pains this might involve seeing the Podiatrist for video anlysis or your walking and running style to assess if there are any movement problems that might be helping to create the aches and pains you have.  We also work closely with many of London’s leading Medical and Orthopaedic Specialists and can help you to access these where necessary for second opinion and diagnostic imaging such and ultrasound and MRI. 

Follow-up appointments are 30 minutes. This is usually a mix of manual therapy to get things moving comfortably again as well as exercise so that your body can re-learn and repeat simple normal movement patterns and integrate them into your daily activity and sporting technique.  At the end of your session we are happy for you to stay and use the facilities to practice exercises, in fact we encourage it.

Our clinics are located at Aldgate (EC3)and Liverpool Street (EC1), Harley Street (W1)and West Hampstead (NW6). 

Contact us now to take an appointment for a physiotherapy session.

Acupuncture

Acupuncture as practiced by members of the Acupuncture Association of Chartered Physiotherapists (AACP) is an holistic approach to musculoskeletal pain relief based on over 2000 years of development and refinement in the Far East. All members of the AACP must observe a code of practice which lays down stringent standards of hygiene and sterilisation of needles. These procedures provide protection against the transmission of infectious diseases.

According to traditional Chinese philosophy our health is dependent on the body’s natural energy “Qi” moving unhindered through a series of unseen channel “meridians” which are located beneath the skin. Recent research has shown that a large number of the traditional acupuncture points located in these meridians correspond to physiological features known as “trigger points”. A trigger point is an area of increased sensitivity and tone within a muscle which is said to cause a characteristic pattern of referred pain in a related segment of the body. An example might be tender areas in the muscles of the neck and shoulder which can cause headaches.

Most people find acupuncture a pleasant and relaxing experience. There should be little or no pain during the insertion of needles if the physiotherapist is fully trained and experienced. When the practitioner carefully inserts the needles, you may feel a slight tingling sensation. This indicates that the treatment is beginning to have some effect. Sometimes you may feel numbness at the point of entry or an energy transfer along the meridian to another part of the body. Needles are inserted either for a second or two, or left in place for up to 20 minutes, depending on the effect required.

Recent scientific research has shown that Acupuncture stimulates neurotransmitters in the brain such as serotonin and opiods which can dampen down the “pain messages” being sent from the brain. When used in conjunction with other physiotherapy treatment techniques such as manual therapy and appropriate exercise rehabilitation Acupuncture can be extremely effective.

Podiatry

Podiatry and Pain in the Foot

We spend a significant amount of time on our feet during our lifetime so it should come as no surprise that from time to time we develop pain in foot and other problems which need the expert attention of a Podiatry specialist.

Podiatry covers the diagnosis and management of a range of foot conditions and we at HFS specialise in the identification of structural issues that can be associated with pain or injury – looking at the foot as part of a dynamic lower limb system.

The foot is our body’s ‘interface’ with the ground we walk on. When we walk or run the way our feet ‘interact’ with the ground causes associated movement in the lower limb, lumbar spine and pelvis. This is a normal occurrence, but sometimes subtle variations in the shape and mobility of our feet lead to changes in this ‘interaction’ with the ground, often placing excessive stress and strain on not only the foot but also other parts of the body.

Podiatry at HFS

The Podiatrists at HFS Clinics are expert at analysing these movements and use sophisticated analysis to determine if your gait (the way you walk) is causing your problem.

They understand that to get to identify the underlying cause of your problem they need to consider not only the foot, but also how the trunk, pelvis and entire lower limb move and interact with one another. Changes in foot function with the use of orthotic devices and / or exercise therapy can change the way the lower limb functions and reduce the damaging forces that ultimately give rise to pain and injury.

Our clinics are located at Aldgate, Moorgate and Harley Street in the City of London and the West End. We also offer a variety of health and fitness solutions for other pains and sport related injuries. Contact us now to take an appointment for a podiatry session to relieve the pain in your foot and other foot conditions.

Gait Analysis

Whilst it is easy to observe running styles in other people it is often very hard to appreciate how we are moving ourselves. High speed video analysis allows us to look frame by frame at your walking and running movement patterns and marry this with the aches and pains you may have associated with these weight bearing activities.

Think of your body like a machine. Like the moving parts of any machine they tend to wear out eventually but they do so more quickly if they are moving badly. If you can learn to run more efficiently not only do you significantly reduce your risk of getting recurring over-use injuries but you also stand to improve your performance at the same time. Our patients often report big improvements in their PBs when they return to running after treatment.

Many problems in the lower limbs and even in the pelvis and lower back are associated with the way we walk and run. The real skill is in interpreting this information and relating it to your clinical problems. This is not something that we feel you should do with confidence in the running shoe shops; remember that they are sales assistants not podiatrists and whilst generic advice may be enough for some people we would recommend that you get an expert opinion for something this important.

With the use of orthotic devices and or physiotherapy rehabilitation it is then easy to correct the biomechanical imperfections observed on video. The podiatrist can also provide the best running shoe advice – again something best left to the experts rather than someone in a shop recommending something that they happen to stock at the time!

Orthotics

An orthotic device (or orthoses) is a shoe insert which you may be recommended following a biomechanical assessment / gait analysis with a Podiatrist. These can be either pre-fabricated devices (not bespoke to an individual but a cheaper option) or custom made devices which are manufactured from a plaster cast of the feet and a bespoke prescription.

Orthoses can benefit individuals in many ways:

Improve shock absorption
Improve stability (proprioception)
Alter problematic foot mechanics
Change moments around joints (e.g. decrease pronation at the sub-talar joint)
Reduce force within injured tissue

Orthoses will usually feel very strange at first and a period of slow and gradual introduction is often advised. You can often play sport on an orthotic device within 2 weeks of its issue, although everyone is different with respect to how they adapt to this change in position and movement of the foot.

Orthoses have been show to be of benefit in many lower limb conditions such as:

Big Toe Problems
Metatarsalgia
Foot Tendon Problem
Rigid Foot Types
‘Flat Feet’
Heel Pain and Plantar fasciitis
Shin Pain (’Shin splints’)
Knee Pain
Back Pain

Custom made orthoses often come with a lifetime guarantee against breakage, but may require some maintenance to prolong their life, whereas pre-fabricated orthoses can often only last 1-2 years. A Podiatrist can advise you of the expected life span of a particular device depending on its structure and the activities being performed upon it.

Individuals seeing the Podiatrist under their private medical insurance should note that orthotic devices are not covered by any UK insurance provider so the cost has to be met by the patient.

Headaches & Migraine

Headaches affect a large number of us through our lives and are one of the most common causes for visiting the GP. Seeing your GP is a sensible first step to take but only very rarely does medical investigation tell us that something is wrong.

This is reassuring enough but at the same time leaves lots questions unanswered. Most patients go on to rely on a life time of medication that masks the problems rather than solves them.

It is well documented that headaches can be caused by pain referred from disorders in the upper part of the neck. We call these types of headaches cervicogenic i.e. coming from the cervical spine. At first this is not something that most people would normally consider but actually the nerves in the upper part of the neck link directly to a part of the brain that we know is sensitised in people with headaches, the trigeminal cervical nucleus.

Cervicogenic headaches are acknowledged by the International Headache Society (IHS), but in our clinical experience the role of the neck as both a cause and a trigger for many types of headache including migraine has been considerably underestimated. Without expert assessment of the joints and soft tissues in the upper part of the neck a cervicogenic headache cannot be ruled out especially given that lots different types of headaches including migraine present in very similar ways.

90% of the patients who have come to see us complaining of headaches (including migraines) have been successfully treated. Accurately stressing stiff tissues in the upper part of the neck temporarily reproduces the patients head pain and this is one of the key diagnostic criteria set by the IHS to differentiate cervicogenic headache from other types. Once the exact location in the neck has been confirmed carefully aimed, gentle manipulation of these stiff spinal segments is used to then ease the symptoms and most patients find that generally their pattern of headaches starts to change very quickly.

If on examination there are no relevant disorders to be found in your neck or upper back, treatment would not be recommended and we would refer you back to your GP. We also work closely with Consultant Neurologists so that the medical aspects of various types of headaches are also managed effectively.

“I suffered daily headaches for over 10 years before a neurologist referred me to HFS. Gentle manipulation of my neck started to ease the pain almost immediately. I was also shown how to correct my posture and set up my work station properly and I have not had a headache for over a year” (Stephanie – Insurance Broker)

Common underlying causes of cervicogenic headaches include poor sitting posture (especially head/neck position), an adverse workstation / desk environment, and altered muscular control of the shoulder blade. Treatment therefore involves managing these underlying causes with manual therapy to loosen joint and soft tissue restrictions, posture correction, and specific exercises to improve muscular control of the head/neck and shoulder blades. The majority of people with cervicogenic headaches tend to work at desks and as such optimising this environment through ergonomic assessment is often the key to successful management of this problem.

Chiropody

Chiropody in London

Chiropody is devoted to the study, diagnosis, treatment and management of disorders and conditions affecting the leg, ankle and foot.

The range of conditions that can be treated by our chiropodist include:

- Skin conditions such as callous and corns, and more complicated conditions such as eczema and psoriasis

- Nail conditions, such a thickened and deformed nails, and fungal nails, painful or ingrown toenails

- Verrucae

- Infections such as fungal infections, infected wounds, bites or ingrown nails

- Circulatory / vascular problems affecting the foot e.g. chilblains

- Foot ulcers / wounds

- Neurological problems such as painful neuropathy and changes to foot structure

- Complications from long term conditions such as rheumatoid arthritis, gout and MS

- Chronic foot pain and pain in the lower limb

Our clinics are located at Aldgate, Moorgate and Harley Street in the City of London and the West End. We also offer a variety of health and fitness solutions for other pains and sport related injuries. Contact us now to take an appointment.

Sports Massage

Massage in one form or another has been around for centuries. In fact Physiotherapy as a profession has it’s origins in massage, and today massage techniques continue to form a part of many physiotherapy treatments.

Soft tissue massage is essentially manual therapy specifically targeting soft tissues (muscle, tendons, and fascia) and can be used to treat soft tissue abnormalities such as increased muscle tension, trigger points, and abnormal thickening of connective tissue.

Soft tissue massage as an isolated treatment generally will only lead to short term benefit, but when it is used as a component of a holistic treatment approach that identifies and manages the underlying cause of a problem it can be very effective.

The soft tissues of our body (muscles, tendons, and fascia) are generally organised in layers that need to slide and glide over one another for movement to occur normally. Lack of this ‘sliding and gliding’ can lead to restriction of movement in a body region, with the development of harmful altered movement patterns to compensate for this restriction. Soft tissue massage techniques can ‘loosen up’ these restrictions, lessening the need for the compensatory movements, while also making retraining of the correct movement patterns more achievable.

As well as having an effect on how the body moves soft tissue abnormalities can also be a primary source of pain. ‘Trigger points’ (muscle knots) are well known to cause pain, and also may adversely effect how a muscle functions. Elimination of these trigger points can significantly reduce pain and additionally may assist rehabilitation of specific muscles.

Ergonomics

Ergonomic DSE Assessments

We are Display Screen Equipment (DSE) specialists, providing complete Health and Safety solutions for office computer users and those who work from home.

Our mission is to minimise the number of hours that you and your team have to dedicate to the assessment process, giving you peace of mind that your DSE requirements have been fulfilled. A comfortable and injury free workforce can only be an asset to an employer. Our assessment process is designed to identify and lower risks, and we implement appropriate precautions where necessary. Our services can be tailored to meet your specific requirements making sure we get it right for you. We manage the entire process, leaving you free to concentrate on your own responsibilities.

Having worked in the DSE Health and Safety industry for over 13 years, we have extensive experience of working with a wide variety of clients, assisting them to achieve display screen equipment compliance. Our tried and tested product range provides display screen equipment to satisfy your needs, no matter how complex and no matter what your budget.

Health and Fitness Solutions are proud to be working with dse Assessments Ltd. Our clinicians are experts in the treatment of back pain, neck pain and headaches all of which are frequently caused by poor work station set up and chairs. We seek to find long term solutions to the problems suffered by our clients and in our experience correct desk and chair set up is essential in preventing and treating pain. Most people will gain all the improvements required from the excellent work done by dse Assessments. Health and Fitness Solutions will provide the clinical expertise in creating specific adaptions for those clients with complex problems who require a combined approach. We strongly believe that working together enables us to find ergonomic solutions for everyone. In addition to DSE assessments and other physiotherapy courses, we also offer special ergonomic assessments where our specialists will visit your place of work to carry out a thorough assessment of each individual workstation and offer advice on chair position, posture, exercise, breaks etc. to ensure good health at work.
For more information please contact us today.

Ergonomic Assessment

Our clinicians will come into your place of work and do a thorough assessment of your individual workstation – above and beyond the minimum Health and Safety guidelines.

We will advise you on the optimal requirements your chair should offer – not just is it legal! It is important your chair fits you and actually does what an office chair is supposed to do (most do not, despite being ‘ergonomic’).

We then ‘marry’ you and your chair to your desk to ensure ideal posture and recommend changes based on what you need if a perfect ‘marriage’ is not possible.

Accessories used on your desk e.g. mouse, document holder are then positioned to best fit your job requirements, but whilst still maintaining ideal posture.

We also recommend additional things an employee can do to improve their musculoskeletal health whilst at work i.e. advice on exercise levels, hydration and breaks from the computer.

This reduces the factors that contribute to issues such as back-ache, neck pain or RSI.

Running School

Running is one of the most popular methods of exercising and if you can manage to stay injury free it is certainly one of the best ways to keep fit. However runners do tend to get frequent injuries usually through a combination of poor technique combined with doing ‘too much too soon’.

Think of your body like a machine; like the moving parts of any machine your joints will tend to wear out eventually but this happens more quickly if they are moving badly. If you can learn to run more efficiently not only do you significantly reduce your injury risk but you will also improve your performance at the same time.

At HFS we only use experienced physiotherapists and podiatrists to deliver this service as we find that their medical training gives them far more insight into movement analysis and the reasons why we don’t always move correctly or efficiently. You should not expect anything less with something this important. Our bodies are often not an exact mirror image from left to right and subtle differences in leg length and exact shapes the joints and bones in the legs and feet are very common. With these skeletal differences one side is not expected to move and look the same as the other. To miss these things sometimes has disastrous consequences……

Once you have completed an examination of your muscle and skeletal systems, each session will identify your movement pattern “imperfections” or “weaknesses”, through detailed analysis of your whole body posture and movement. We use state of the art high speed video gait analysis to identify movement pattern faults and relate these to muscle performance and skeletal findings. Specific coaching drills and muscle conditioning exercises are then prescribed and practiced with regular video feedback so that you are able to see immediately as the improvements are made.

People often run awkwardly due to things that are out of their control and referral to sports massage or physiotherapy to get stiff joints and muscles loosened up or to podiatry to balance foot posture might also be required to get the body working efficiently again. It is not just about the skill of running.