Pain-relieving. A medication that reduces or eliminates pain. A remedy that relieves or allays pain.


A disease causing painful inflammation and stiffness of the joints.

Back Pain

Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine. Back pain may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas.

Biomechanical Assessment

Complex evaluation of feet, legs and body position.


The application of mechanical principles to living organisms. Biomechanics is the study of the structure and function of biological systems by means of the methods of mechanics. Therefore biomechanics uses expertise from disciplines such as engineering, anatomy, aerospace, rehabilitation, medicine, orthopaedics, sport science, and many others. It studies animal, human, and plant structure and motion.


Bronchiectasis is the abnormal dilation of small airways called the bronchi caused by destruction of the muscular and elastic components of the airway walls. It occurs as a result of damage caused by conditions such as TB, whooping cough, measles, breathing a foreign body into the lungs or severe bacterial pneumonia, although sometimes it occurs in the absence of a history of these illnesses (idiopathic bronchiectasis). Symptoms include chronic sputum (mucous) production (sometimes several cupfuls a day), regular and persistent chest infections, chronic cough, disturbed sleep, and generalised fatigue.

It is essential that people with bronchiectasis clear their airways of sputum on a daily basis to prevent the chest infections, reduce cough, and improve sleep quality and energy levels. It also reduces the risk of further damage to the airways.

Physiotherapy for bronchiectasis uses a variety of mechanisms for maintaining clear airways, including postural drainage, manual techniques on the chest wall, breathing exercises, and devices such as the Flutter or PEP mask, which act by producing a negative pressure and a vibration in the chest to help with secretion clearance.

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) can help to change how a client thinks (Cognitive) and what they do (Behaviour). These changes can help them feel better. Unlike some of the other talking treatments, it focuses on the “here and now” problems and difficulties, looking for ways to improve the state of mind now. It is used to treat anxiety, depression, panic, agoraphobia and other phobias, social phobia, bulimia, obsessive compulsive disorder, post traumatic stress disorder and schizophrenia.

How does CBT Work?

A problem, event or difficult situation can trigger thoughts, emotions, physical feelings and actions. Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it. There are helpful and unhelpful ways of reacting to most situations, depending on how you think about them. CBT can help to make sense of overwhelming problems by breaking them down into smaller parts.

Chest infections

Physiotherapy can assist in the removal of stubborn sputum (mucous) with the use of breathing exercises, manual techniques on the chest wall and postural drainage (if appropriate).


(often called podiatry) is the diagnoses and treatments of abnormalities of the lower limb.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease or COPD is an umbrella term for emphysema and chronic bronchitis. Emphysema is characterised by enlargement of the air spaces in the very small airways (alveoli) and destruction of their walls, leading to a loss of surface area for oxygen and carbon dioxide to transfer into and out of the blood. The lungs trap air leading to overinflation which, along with reduced oxygen levels, causes the main symptom – breathlessness. Sputum (mucous) production is minimal. On the other hand, chronic bronchitis is characterised by excessive sputum production. The glands which produce sputum enlarge and the small airways are inflamed and swollen. The sufferer often has many chest infections requiring antibiotics and shortness of breath on exertion is common. Both are thought to be caused by cigarette smoking, but environmental factors, air pollution and hereditary factors may play an important part.

Treatments for the management of breathlessness include breathing pattern retraining, use of postural positions to optimise the function of the respiratory muscles, and individual exercise programmes. These exercise programmes (also known as pulmonary rehabilitation) have been well-researched and many studies show improvements in muscle bulk, rib cage flexibility and overall fitness, resulting in reduced breathlessness on exertion. Treatments are also offered for the clearance of excess sputum including breathing exercises, postural drainage (if appropriate), manual techniques on the chest wall, and advice about devices such as the Flutter.


Endogenous opioid compounds produced by the pituitary gland and hypothalamus. They produce analgesic and a feeling of well being.

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is a therapy developed by psychologist Dr. Francine Shapiro. She made the chance observation that eye movements can reduce the intensity of the disturbing thoughts. She noticed her own stress reactions diminished when her eyes swept back and forth as she walked through a park one day. EMDR involves recalling a stressful past event and “reprogramming” the memory in the light of a positive, self-chosen belief, while using rapid eye movements to facilitate the process.

How does EMDR therapy work?

At the time of a traumatic event, strong emotions interfere with our ability to completely process the experience and one moment becomes “frozen in time”. Recalling the traumatic event may feel as though the person is reliving the event all over again because the images, smells, sounds, and feelings are still there and can be triggered in the present. When activated, these memories cause a negative impact on our daily functioning and interfere with the way we see ourselves, our world and how we relate to others. EMDR therapy appears to directly affect the brain, allowing the individual to resume normal functioning while no longer reliving the images, sounds, and feelings associated with the trauma.  The memory is still there, but it is less upsetting.

Hyperventilation Syndrome (HVS)

Hyperventilation is a very common respiratory disorder caused by breathing too much. The term hyperventilation conjures up images of panic attacks and breathing into paper bags, and acute hyperventilation may present in this way, but the vast majority of sufferers overbreathe in a way that doesn’t necessarily feel abnormal or unusual. This is called chronic hyperventilation in which over-breathing becomes a habit. Over-breathing is achieved by periodically increasing the size or depth of each breath, and/or increasing the breathing rate, leading to a more erratic breathing pattern. Some sufferers also sigh and yawn too much.

Chronic HVS is common in the following groups of people: asthmatics and those with chronic lung disease, menopausal or pregnant women, and those under prolonged stress, including teenagers and the high achievers or workaholics amongst us who put huge pressures on themselves. Short periods of stress may also lead to chronic HVS – the bride arranging a wedding, the new mother, those studying for exams, etc.

The chronic over-breathing has many physiological effects, causing an alarming array of symptoms. Symptoms are caused by too little carbon dioxide in the bloodstream. Carbon dioxide dissolved in the blood acts as a powerful determinant of the body’s pH (acid/alkali balance). Too little carbon dioxide (as in chronic HVS) leads to the body being too alkaline. This is called a respiratory alkalosis. The nerve cells and the autonomic nervous system (responsible for heart rate, blood pressure) are affected by this, leading to dizziness, tingling hands, feet or face and increased heart rate (palpitations). Body cells start to produce lactic acid to correct the alteration in the body’s pH, causing symptoms such as chronic fatigue and stiff hands. When the body is in an alkaline state, the red blood cells hang on to the oxygen they carry, and less oxygen is offloaded to the tissues. Feelings of poor concentration or confusion are common symptoms of HVS, caused by the brain having its oxygen supply cut in this way. Other symptoms include ‘air hunger’ (the feeling of not being able to get enough air in), breathlessness at rest for no apparent reason, bloated stomach (caused by air swallowing), and chest pains (caused by over-stretching of the intercostal muscles or costo-chondral junctions where the cartilage and bone ends join in the ribs).

An altered, dysfunctional breathing pattern is necessary to perpetuate chronic HVS. The first step in the physiotherapy treatment of HVS is therefore to change the breathing pattern to a rhythmic diaphragmatic pattern. Respiratory rate and depth are then monitored with strategies to correct them if necessary. Nose breathing and sigh and yawn recognition are important as well as taking time out to follow a relaxation schedule.


A natural state of relaxation often described as an altered state of consciousness, where one is neither awake nor asleep. In reality, it is a state of heightened “focus” or “awareness” accompanied by a deep sense of calmness. It is similar to the feeling one has just before going to sleep or drifting into a daydream. Unlike the image created by the media or stage hypnosis and contrary to popular misconception, it is in no way controlling. One freely enters into a trance-like state, remaining fully aware throughout the treatment session and waking up naturally as one would following normal sleep.


The process of using the state of hypnosis for therapeutic purposes in the treatment and relief of a variety of somatic and psychological symptoms.


Having to do with the muscular and skeletal systems, which provide form, stability and movement to the human form.


Any hormone produced by neurosecretory cells, usually in the brain.


Devices to support or correct abnormalities. Foot orthoses are designed to allow the muscles, tendons and bones of the feet and lower legs to function at their highest potential.


The treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.

Sports Injury

Sports injuries are injuries that occur in athletic activities. They can result from acute trauma, or from overuse of a particular body part.

Sports Podiatry

Is concerned with treating lower injury affecting hip, knee, leg, ankle and foot using gait analysis, biomechanical assessment and orthotics.

Transactional Analysis (TA)

Transactional Analysis (TA) is the treatment of psychological problems, based on the relationship between the client and the therapist. Transactional Analysis psychotherapy in practice is used for personal growth and to help resolve depression and manic depressive disorders, anxiety states, and other specific behavioural difficulties and relationship problems. The therapist helps the client to identify what they want and how they can use their resources to achieve their goals, rather than remaining ‘stuck in their problem’. This leads to living in the present, rather than living in the past or being afraid of the future.

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