What I treat

Sports injuries

Sprains, strains and tendonitis, from sport, training or one awkward movement. Most feel better within a couple of weeks, and the first few days make the difference.

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Ioannis A Rafailidis assessing a patient

What it is

A sprain is a torn or twisted ligament. A strain is an overstretched or torn muscle. Tendonitis is a tendon that has swollen after an injury, usually from a sudden sharp movement or from doing the same thing over and over. The ones I see most come from skipping the warm-up, training on tired legs, or ramping up too fast. Overuse looks different depending on what you do: knee pain that is worse on stairs and squats, shin splints, or heel pain at the Achilles or under the arch of the foot.

Your first assessment

I start with how and when it happened, your general health and any medication, then I watch you move and examine the joint and the muscles around it by hand. I am also checking for anything that needs a GP or a hospital rather than me. If I see it, I tell you straight away.

What a plan usually involves

For the first two to three days it is rest, ice, compression and elevation, and no heat, alcohol or massage. After that we keep the area moving. Every plan I build combines hands-on treatment with movement-based rehabilitation and education, and I bring you back to what you were doing in steps rather than all at once: back to sport once movement is full and painless and strength is back. After your first appointment I give you a realistic estimate of how many sessions you may need.

When a doctor needs to be involved

If something about your symptoms worries you, see a GP or call 111 first.

No GP referral needed. If your assessment shows you need imaging, an injection or a specialist opinion, I refer you directly to a sports and exercise medicine doctor, and your osteopathic care continues with me.

Good to know

Not in the first two to three days. After that, keep the injured area moving as long as pain is not stopping you, and stay off sport on a tendon injury until it has recovered. What that means for your sport, we work out together at the first visit.

It depends on the injury. Most sprains and strains feel better after two weeks, I keep people off strenuous exercise for up to eight, and a severe one can take months. You go back to sport when movement is full and painless and strength is back, not before.

Warm up before exercise and stretch afterwards, wear shoes that support your feet, do not push tired muscles, add new activities gradually, and build in rest days. I give you the specifics for your sport.

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Early and late appointments around the working day.

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