Symptoms of tennis elbow

• Tenderness in the outer aspect of the elbow
• Pain when bending or straightening the elbow
• Pain in resisted extension of the wrist
• Increased tension in the forearm muscles
• Pain when holding objects forcefully or twisting objects

Physiotherapy for tennis elbow

Electrotherapy Electrotherapy such as ultrasound and IFT can increase blood circulation at the elbow so as to decrease inflammation.

Manual therapy Deep friction massage can increase the local blood circulation. Joint mobilization can help to mobilize the stiff elbow joint.

Exercise therapy Strengthening and stretching exercise to the muscles around the elbow protects them from further injury.

Acupuncture According to the individual conditions of each patient, the therapist will choose appropriate acu-points to relieve the pain from tennis elbow.

Prevention and maintenance

• Ice can be applied to acute injury
• Reduce the use of the forearm muscles during an onset
• Avoid repetitive use of wrist and fingers
• A tennis elbow brace may be used to decrease the stress on the forearm when working
• Do frequent stretching exercises

Symptoms of plantar fasciitis

• Heel pain, especially when getting out of bed or standing up after prolonged sitting
• Heel pain after prolonged standing or walking
• Swelling or temperature increase on the plantar side of the foot
• Tightness in the calf muscle
• In serious conditions, pain is felt anytime the foot is bearing weight

Physiotherapy for plantar fasciitis

• Manual therapy
  Deep friction massage on the plantar fascia can increase blood circulation and the flexibility of the fascia.
• Cryotherapy
  Cryotherapy can be used to control the swelling and pain.
• Electrotherapy
  Electrotherapy such as ultrasound and IFT can be used to increase blood circulation and thus reduce inflammation.
• Acupuncture
  Certain Acu-points can be used to decrease the heel pain.
• Exercise
  Appropriate stretching exercise can increase the flexibility of the calf muscles and the plantar fascia.
• Foot care suggestions
  Appropriate shoe wear and insole can improve the alignment of the foot.

Prevention and maintenance

• Adequate rest for the foot. Avoid prolonged standing or walking.
• Appropriate exercise such as stretching for the calf and thigh muscles.
• Appropriate shoe wear, such as shoes with soft bottom and good shock absorption function; avoid wearing high heels or shoes with too thin a bottom.
• Adequate exercise and balanced diet; avoid overweight.

疼痛和壓痛

• 疼痛表現為痠痛或鈍痛。
• 早期：肩部疼痛劇烈及脹痛明顯，甚至放射至同側肘部，遇寒濕時疼痛加重，日輕夜重，影響睡眠。
• 後期：肩部疼痛減輕，但活動障礙顯著，在肩部周圍能找到明顯壓痛點。

活動障礙

• 病情越長，活動障礙越明顯。常常不能完成穿衣、洗臉、梳頭等動作。
• 肩關節被動上舉、後伸、內斂、外展、內旋等動作受限。日久，肩部功能幾乎完全喪失，而成凍結狀，但疼痛減輕。

肌肉萎縮

• 病情久者，因疼痛與廢用，出現肩部肌肉廣泛性萎縮。

中醫針灸及骨傷推拿對治療五十肩皆有很好療效，有需要可以詢問中醫師。

• Landing on balance pad

• Single leg hopping

Proprioception

Proprioception is the sense of joint within its alignment which directly related to balance. Weak proprioception can be caused by previous injuries or improper joint alignment. The risk of injury is high as the body does not know if the joints are in correct position and thats when sprain injuries occurs. Proprioception training is a way to solve the issue.

• Single leg balance training

• Single leg squats

Eccentric strength

Muscles act as a break of joints preventing it from going too far and causing sprain injuries.  Meanwhile, eccentric strength is the force generated by muscle to contract itself when it is being stretched. Insufficient eccentric strength prohibit the muscle to contract with enough force to stop the joint from going too far. Resistance training with slow and decelerating movement enhance eccentric strength.

• Squats with slow downward movement

• Calf raise with slow downward movement

Muscle Strain

Muscle strain is another major injury observed in Taekwondo athletes. Hamstrings strain are common among Taekwondo athletes where poor eccentric strength and flexibility are major risk factors of muscle strain.

Eccentric strength

Eccentric strength is essential to muscles being stretched repetitively as protection from strain injuries. Strain injuries are caused by sudden stretch in muscles and tissues unable to hold itself together thus leading to tissue tear. Training like continuous kicking on target or sudden movements and vigorous change of direction in sparring training require good eccentric strength for injury prevention. Improved eccentric strength prevents muscle from sudden stretch and thus prevent strain injuries.

• Nordic hamstrings curls

• Resisted knee extensions with slow kicking movement

Insufficient flexibility

Good flexibility can provide more room for the muscle to be stretched. Muscle strain is due to overstretch on tight muscle in exercise sometimes. Common movements like turning kick and snap kick require a lot on hamstrings flexibility. Insufficient flexibility in hamstrings is directly related to strain injuries. Improving flexibility by stretching and foam rolling are ideal training on flexibility.

• Hamstrings stretching

• Foam rolling on hamstrings

Special credit to Ngai Mo Alliance Taekwondo – Kwun Tong for providing photos.

Snap Kick

Turning Kick

Flexibility

Dynamic stretching

Static stretching assisted with dynamic stretching is adopted as training for flexibility. Forward and backward circumduction are popular dynamic warm up exercise for hip joint. Dynamic flexibility and range of movement of hip joint is improved while muscle surrounding the joint is activated.

Static stretching

Static stretching including side split and front split are adopted to improve range of motion of hip joint. Side split stretches hip adductors which improves hip abduction and higher turning kick can be attained. Front split stretches hamstrings which allows larger hip flexion range and snap kick height is enhanced.

Sparring training

Agility

Agility training trains the ability of athletes to evade and counter. Shifting training is a way to train agility of athletes. Forward and backward shifting is the first step of shift training. Athletes can get used to the motion and aware the joint position during shifting which reduce the risk of sprain injury. Complicated movements like lateral and diagonal shift will be included in later stages to further improve agility in sparring setting.

Reaction

To train reaction, target chasing and kicking on stationary target are two popular trainings. Target chasing requires athlete to chase a target while the target allowing a certain area for the athlete to attack. Such training can reduce thinking time of athletes to evade and attack. Kicking on stationary target requires athlete to kick on a stationary target after receiving a signal. This training can shorten reaction time to stimulation which can convert to quicker reaction to sudden change in sparring competition. Such improvement allows athletes to get use to sudden change in sparring competition and able to protect themselves.

Kicking training

Vacate and spinning are major components in high ranking kicking skills like 360 turning kick, 540 reverse kick and jump double snap kick. Landing skills are the first thing to be introduced to athletes and then vacating. Jump and landing is an elementary training to improve landing mechanics and promote reaction of muscles to joint movements in jumping and landing. The training acted as a springboard to vacate training with spinning as correct landing mechanics reduce injury risk in landing. Vacate training without kicking movement takes place to introduce the shift of center of gravity within jumping and spinning. Excluding kicking movement can avoid further change on center of gravity preventing injury. Kicking movement will be included in the last step to complete the movement. The movement should not be too vigorous to reduce the effect on center of gravity. Compact movements reduce instability in movement so injury risk is reduced.

Special credit to Ngai Mo Alliance Taekwondo – Kwun Tong for providing photos.

After getting injured, players should stop any training. Ice is good for reducing the swelling and pain. Also, electrotherapy can promote muscle healing.

Rehabilitation exercises are important to enhance the muscle flexibility and strength which preventing recurrent muscle strain. Usually, players can start with isometric muscle strengthening such as bridging to prevent muscle waste. Hamstrings stretching should be performed in pain free range to maintain the muscle flexibility.

Lack of muscle recovery after exercise is one of risk factors of hamstring strain. In addition to stretching, the player can also use the foam roller to directly press the hamstrings releasing the muscle tension.

Besides, the Kinesio tape is suggested to apply on strained hamstrings to promote blood circulation which can facilitate muscle healing.

Stretching of Hamstrings muscle

Using foam roller for muscle relaxation

Hamstrings curl with theraband

Strengthening of Quadriceps muscles

Stretching of Quadriceps muscles