Tendon Pain Clinic
Tendon problems are very common and can be painful. They can often be quite debilitating, severely limiting our daily activities and sports performance. Tendinopathy issues are often poorly understood, leading to further long term issues and delays in recovery.
At the Cardiff Tendon Pain clinic, we provide an accurate diagnosis which will guide personalised treatments and rehabilitation programs, driven by clinical evidence and our own experience in the field of elite sports medicine. Our Specialist team have extensive experience working with recreational and elite athletes with tendon injuries. All therapeuatic treatments and rehabilitation programs are performed in our Cardiff clinic, utilising the latest and best technology and treatments.
Conditions that we treat
Tennis / Golfers Elbow
Plantar Fasciitis / Heel pain
Patella (Knee) Tendinopathy
Trochanteric (Hip) pain syndrome
An initial assessment with one of our specialist team involves a 45 minute initial consultation. This will include an examination exploring the history of the injury, possible causes including biomechanic assessment, and its relation to your to physical activity and or your specific sport. Part of the diagnostic process may include further investigation by MRI or Diagnostic Ultrasound scanning.
If a tendinopathy is diagnosed, one of the primary interventions is a specific rehab exercise program. This is coupled with reviewing your specifc training load. Incorrect exercises and inappropriate training loads can significanty aggravate the problem. Getting your training load right and performing the correct rehabilitation exercises can help to allow many tendinopathies to be cured, allowing individuals to return to their normal levels of performance.
Advanced Treatment for Tendinopathy Pain
It is important to note that the majority of tendon problems do not require surgery. Unfortunately, in a significant number of cases exercises alone will not cure tendinopathies, especially when the problem has been going on for some time. In these cases we introduce additional treatment methods, always starting with treatments that involve no injections and no surgery.
For the first time in Cardiff, Health & Sports Physiotherapy tendon clinic brings together a group of clinicians with significant experience in elite sport and expert skills in diagnosing and treating tendon conditions. We use the latest techniques and treatment technology including;
Musculoskeletal (MSK) Diagnostic Ultrasound - Musculoskeletal diagnostic ultrasound is an injury diagnosis assessment technique that uses sound waves to create images of muscles, tendons, ligaments and joints throughout the body.
MSK ultrasound serves as an excellent imaging tool and is extensively utilised as an assessment technique by sport and exercise medicine professionals, offering an objective method to confirm clinical examination findings. We use diagnostic ultrasound for imaging examination of the various tendoninopathy conditions and associated tissues.
Our sports and musculoskeletal specialists are fully trained in MSK diagnostic ultrasound. They will utilise this assessment modality to complement their clinical findings, to offer patients a more accurate diagnosis and therefore a more targeted treatment and rehabilitation plan.
Shockwave Therapy - Radial Shockwave Therapy (RSWT) is a procedure where shock waves are passed through the skin to the injured part of the body being treated, using our Swiss Dolorclast® Shockwave Unit.
The shockwaves are mechanical and not electric. They are audible, low energy sound waves, which work by increasing blood flow to the injured area. This initiates an inflammation-like response in the injured tissue, accelerating the body’s healing process by increasing cell generation and dissolving calcium deposits.
Shockwave therapy can be very successful in patients who have failed to respond to conservative treatment of tendon pain. The combination of shockwave therapy and a graded tendon re-loading rehab program with our physiotherapists is recommended to give increased treatment benefits. You will usually require a course of up to six treatments, 7 to 10 days apart.
The National Institute for Health and Care Excellence (NICE) have deemed this procedure to be safe. Studies have shown shockwave therapy be an effective treatment for a number of common issues such as plantar fasciitis, tennis elbow, patella tendon and achilles tendon tendinopathy injuries. .
Graston Technique - Graston Technique® is a unique, evidence-based form of instrument-assisted soft tissue mobilisation (IASTM) that enables clinicians to effectively address scar tissue, fascial restrictions and range of motion, resulting in improved patient outcomes.
The unique protocol uses specially designed stainless steel instruments, along with appropriate therapeutic exercise, to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.
The instruments also are used diagnostically to follow the kinetic chain, to locate and treat the cause of the symptom as well as the specific area of pain.
Graston Technique® (GT) is accepted worldwide by clinicians, elite athletes and everyday patients as a trusted and effective treatment for rehabilitation.
Non-conservative intervention for Tendinopathy Pain
For those individuals who do not improve with rehab and conservative treatment, further options are available. We work in collaboration with leading Consultant Sports Physician, Dr Geoff Davies, who can also offer diagnostic ultrasound scans when needed, as well as non-surgical options including Platelet Rich Plasma , Autologous (own) blood and modified high volume injections as needed..
In addition we can advise on the most appropriate surgical intervention techniques and leading surgeons in this field.
Meet the Team
Daniel graduated from the University Of Wales College Of Medicine in 2003, with a BSc Honours degree in Physiotherapy. Throughout his career he has developed a broad range of clinical experience, from working with the general public to elite sports athletes.
He has previously worked in New Zealand, Australia and the U.K., with a specialist interest in musculoskeletal and sports medicine and has completed an MSc in Sports Physiotherapy at Cardiff University.
Daniel has worked with a number of professional sports teams including Worcester Warriors, Gloucester Rugby and the Welsh Rugby Union as Head Physiotherapist to the Wales National 7s Squad. He is currently Senior Physiotherapist for Guinness Pro 12 team the Cardiff Blues. Dan has recently been selected as part of the Medical Team for Team Wales at the 2018 Commonwealth Games in Gold Coast, Australia.
John Miles MCSP AACP
Senior Chartered Physiotherapist
John brings a wealth of experiece to the team at Health & Sports Physiotherapy, having worked in Elite level professional sport for a number of years. Having started his career as a Senior Physiotherapist with Llanelli Scarlets, John went on to become Head Physiotherapist for the London Broncos rugby league team in 2009.
During this period he was Senior Physiotherapist to the England National Rugby League team and also worked as a HQ Physiotherapist with Team Wales at the Delhi Commonwealth Games in 2010.
John returned to Wales in 2012, as Head of Medical Services for Wales' Capital Region, Cardiff Blues. John combines this role with consulting at our Cardiff tendon pain clinic, with a specialist interest in sports injury rehabilitation and the graston technique.
Helen Welch MACP MCSP AACP
Clinical Specialist Physiotherapist
Helen combines the role as a Consultant Physiotherapist to Health & Sports Physiotherapy, with her role as an extended scope practitioner for the Cwm Taf Health Board.
Helen is also a member of the Musculoskeletal Association of Chartered Physiotherapists (MACP), a group of Physiotherapists recognised for their standard of excellence in neuro-musculoskeletal physiotherapy. Having previously held a post with the Cardiff & Vale NHS trust as a Spinal orthopaedic practitioner, Helen has a specialist interest in spinal pathology and rehabilitation.
Helen holds a post graduate certificate in musculoskeletal diagnostic ultrasound. Helen holds the prestigious position as one of only two physiotherapists trained in sonography in South Wales. Health & Sports Physiotherapy provide an MSK Diagnostic Ultrasound service from our Cardiff clinic led by Helen.
Dr Geoff Davies
Consultant Sports Physician
Dr Geoff Davies is a full time Consultant Sports Physician dividing his time between professional rugby, the NHS and the Ministry of Defense. Dr Davies is the Welsh Rugby Union national team doctor and is the only Cardiff based consultant Sports Physician, one of only 2 such specialists in Wales.
Geoff has previously worked extensively for a variety of the Wales Football Squads as well as Wales U18 rugby for 6 seasons and Cardiff Blues Rugby for almost 10 years. He is able to provide a comprehensive Sports & Orthopaedic medicine service for a very wide range of clinical problems.
Geoff is also an examiner for the Faculty of Sports & Exercise Medicine in Edinburgh as well as working as a clinical tutor and examiner for the Sports & Exercise Medicine MSc courses in Bath University & Cardiff Metropolitan University.