Category Archives: Shoulder

Acupuncture – how does it work? And will it cure Man-Flu?

A lot of people ask us about acupuncture. Not only the obvious things like: Does it hurt? How big are the needles? But also, How does it work? And, Will it help my sciatica/mood/tight muscles?

Sensible questions all round! Here, we try to provide some (mostly sensible) answers. Watch out for the science (anyone else remember Jennifer Aniston in the L’Oreal advert?) Let’s start at the beginning.

What is Acupuncture?

It’s the insertion of very thin needles into specific points on the skin. Part of Chinese medicine that’s been around for over 2000 years, it has been used commonly in Western societies since the 1970s. Physiotherapists use acupuncture for many different purposes, but the main ones are: to relieve pain, to reduce muscle tension, and to promote the body’s own healing processes as an accompaniment to other treatments such as manual therapy and relaxation teachniques.

Acupuncture (Copyright First Class Physiotherapy 2014)How Does Acupuncture Work?

*Science bit* By creating a very small and controlled amount of “sterile trauma” with the needle, acupuncture stimulates the body to produce endorphins (happy/pain-relieving hormones) and their receptors (which means not only do you have more hormone to create an effect, you also have a greater catchment area to “feel” that effect), as well as serotonin (stress-busters). The needle also stimulates A? nerve fibres. This produces another chemical which blocks the C fibres – the nerve endings for PAIN – from accepting input. Long story short: you swap the pain sensation for something more like a tingling or a heaviness, or a nice relaxed feeling instead.

Does it Hurt?

Well, not any more than you might expect from a very small needle (each one is about the width of a human hair). And quite often, a whole lot less than you’d expect. It depends what area we’re working on. Some parts of the body have more concentrated nerve endings per unit area, and these will natually be more sensitive (your hands and feet, for example). Some have fewer nerve endings (thighs, back etc). If there is a lot of muscle tension in the area, you can get a very strong sensation but conversely, you may not feel the needle at all.

So What Will I Feel?

Alongside the tingling or warm, heavy feeling, you may feel a little sleepy or even giggly (this one more common in men in my experience). Some people feel a little light-headed, and there can be side-effects that aren’t as much fun, like nausea or fainting. Usually the treatment won’t feel unpleasant at all, but if you don’t wish to proceed at any time, we’ll take the needles out immediately. ( (

Where Will the Needles Be Put?

This will depend on what your symptoms are and where you feel them. Because of the way the channels are lined up in your body and along your limbs (think of them kind of like a long train track with lots of stations along it), you wouldn’t necessarily have to have the needles exactly where your pain is to still get a good effect. There are some points that are usually used in conjunction with others (called “formula” points), for instance the “4 gates”, which are points in both hands and both feet and help relieve pain. And there are points away from the spine, as well as closer to the spine on those “tracks” or Meridians, which will help send those messages along the appropriate nerve fibres to give you relief where you need it.

Are the Needles Sterile?

Yes, every one is individually packed and disposed of in our sharps boxes after a single use. Each needle also comes in its own plastic guide tube so your physiotherapist will not touch the part inserted into your skin.

How Many Sessions Will I Need?

Most conditions are treated with good effect in fewer than 6 appointments, but you might feel better after only one or 2 sessions. It will generally be clear after 2-3 sessions if the acupuncture is of benefit.

I Have (select an option) Epilepsy/a Pacemaker/Man-Flu, Can I Still Have Acupuncture?

Well, unfortunately no is the answer for some conditions like unstable heart conditions or over infected or broken skin, or for women in their first trimester of pregnancy. For people with diabetes, hepatitis, high/low blood pressure or a history of metal allergies, blood disorders or cancer, we’ll help you decide with more in-depth questions whether it’s best to proceed with acupuncture or not. We’ll also work with you to make sure that any treatments given are the current best practice for your specific condition, and in many cases, this doesn’t include acupuncture (man-flu included.)

When Can I BoGet In Touchok?

Any time by sending us an email (, giving us a phone (0141 2372 721) or popping in to see us. We offer a free 15 minute consultation, where you can tell us what ails you and we’ll let you know if physiotherapy would be advised (and if acupuncture is an option, how we suggest proceeding.)

Foam Party

What is foam rolling?

iliotibial band foam rollingFoam rolling is used more and more as a tool which allows self myofascial release. In other words it is being used as an aid for self-massage to release muscle tightness (trigger points) and to target the damaged fascia of the muscle.


So what is the fascia?

Fascia covers and protects your tissues, tendons, bones, ligaments, organs and, last but not least your muscles. Its main role is to prevent injuries by resisting internal and external forces that are placed on these structures. Its structure enables it to contract and relax; making it perfect for stabilisation, mobilisation and flexibility of your joints.

When a muscle is over exerted the fascia can be left with areas of scarring and rigidity (trigger points). This in turn can create tension in surrounding structures, which can produce pain, known as trigger points; this has a knock on effect throughout the body. Additionally it can reduce blood flow to particular areas, causing further damage and reduced healing times.


piriformis foam rollingPiriformis foam rolling

Okay, but how can foam rolling help?

Through applying pressure to specific trigger points, you are able to aid in the muscles recovery and assist in returning them to normal function. It can release these areas of damaged/ hardened tissue; in turn restoring blood flow and letting the muscles return to their ordinary strength and flexibility.

It can help your muscles go back to being elastic, healthy, and quick to respond when required. Finally, rolling your muscles can increase the flexibility, mobility and stability of your joints; leaving you less prone to injuries (yippee!).

Foam rolling or stretching?

Well, the simple answer is …BOTH!

Studies have found that the greatest results in flexibility and mobility, and decreased occurrence of injuries are shown when foam rolling and dynamic stretching are combined (C.Goad et al, 2014). The benefits of stretching alone before exercising is a grey area, with reports it lowers performance and energy.


So when should I use the foam roller?

foam rolling, trunk, back

As mentioned above, the foam roller is a great way to warm up a muscle prior to exercising; it also works well for increasing muscular recovery.

After a big workout or run, we can often feel quite sluggish and those ‘few stairs’ seems to bear more of resemblance to Mount Everest. This is called DOMS (delayed onset of muscle soreness) and the peak of this pain is normally 48 hours post exercise (hence the ‘delayed’ part). One of the most popular uses of the foam roll is to decrease the incidence and the severity of the DOMS experience; allowing athletes to return to training and normal muscle functioning earlier.

Foam rolling with First Class Physiotherapy

As Physiotherapists we have seen the benefits of incorporating foam rolling into our patient’s home exercise / running programmes; so much so that we have introduced a class which is suitable for all individuals no matter your previous rolling experience.

As a runner I personally do not know what I did before rolling; my patients and current class would tell you that I am a big fan of the ‘game changer’ – the foam roller.

Classes run on Wednesday evenings from 5.15pm and can be booked by phone or email.

If you have any further questions or would like to give it a go, please do not hesitate to contact us.

Best ‘Foam party’ you will attend.

It’s a frozen shoulder… isn’t it?

The pitfalls of self-diagnosis

Ever had a little niggle that just doesn’t seem to go away? Did you give it a name (and I’m not talking Gertrude or Bobby), like “frozen shoulder” or “arthritis”? It’s easy to self-diagnose a problem, especially if you’ve had similar pain before or you know someone with the same symptoms. And although having the occasional pain is one thing, when you’re bothered with a pain that just won’t seem to go away, that’s quite another.

So how can you help yourself? Well, first thing’s first. Get an accurate diagnosis of the problem, that way you can focus your treatment in the right direction.

I’m going to use the shoulder as an example here, to show how easy it is to misdiagnose a problem, and how this can result in symptoms that last a lot longer than they really should.

frozen shoulder pain physio physiotherapy glasgow

Many people assume that the shoulder pain they have is a frozen shoulder (Sunday name: adhesive capsulitis), either because they know someone with similar symptoms or because their pain has been around for so long that they’ve stopped using that arm as much and now their movement is restricted (or “frozen”).

So what is a frozen shoulder? Found in just under 5% of the general population (although much more common in people with diabetes), it is one of the most common musculoskeletal problems seen by health professionals. Frozen shoulder is the thickening of the underside of the capsule, a supportive and protective soft encasing of the joint. The onset of pain (although it can be brought on by a mild trauma) is usually fairly gradual, and normally only one shoulder is affected at a time. The most typical patient is a female aged 40-60.

*Misdiagnosis point: if you have pain in both of your shoulders, it will most likely not be a frozen shoulder, but could quite possibly be a referred pain from your neck (see our previous blog on referred pain here).

What are the symptoms of frozen shoulder?

The first things you’ll probably notice will be pain (no joke) and a loss of active and passive range of motion. This means you may not be able to move your shoulder fully by yourself, or even if someone was to stretch the joint for you. This phase normally lasts at least 3 months and can take as long as 9 months.

*Misdiagnosis point: sometimes a sore shoulder can be moved throughout range passively (i.e. by someone else), even though it is painful. Unless the stiff phase is experienced, the problem is unlikely to be a frozen shoulder.

Stiffness is one of the other main symptoms, and the stiff or “frozen” phase usually follows the pain phase, lasting anywhere between 4 and 12 months. Usually at this time, pain does start to decrease, and towards the end of the stiff phase, you might find you have no pain at all.

*Misdiagnosis point: if your shoulder pain lingers for longer than 4 months, or worsens rather than improves, it could be a sign that there is more going on than a frozen shoulder. If your pain stays the same for much longer periods of time, it’s worthwhile having it checked out as it could be an impingement (another common shoulder problem).

frozen shoulder pain relief glasgow physio

Depending on the stage of your frozen shoulder, treatment will usually involve some pain relief, stretching and specific strengthening around your shoulder and arm. You might also find that you benefit from postural advice and exercises to help you keep your upper body in good condition.

*One important thing to remember is that the exercises which work for someone else may not always work for you. Much like prescription medication: unless it’s been prescribed especially for you, don’t take them as they may do you more harm than good (and prolong your pain). It’s important to get your problem checked by a professional, that way you can embark on the right treatment for you sooner rather than later. And get rid of all those “little niggles” too.

If you’d like to speak with a qualified chartered physiotherapist, or make an appointment with us to have your problem checked out, please call us on 0141 2372 721 or email