Common Misdiagnosed Injuries
Don’t let your injury drag on longer than necessary!
If your injury is not getting better, despite numerous efforts by other physiotherapists, please feel free to read through our list of commonly misdiagnosed injuries. You may recognise some of the symptoms detailed as your own and in doing so be better equipped to find a cure to your problem.
Hip Pain
This is possibly the most common area of the body involved in wrong diagnosis. Patients quite often complain of pain in the hip and surrounding area, possibly round the back and high up in the gluteal region (the big muscle on your bum). Patients are lead to believe that their injury is being caused by degenerative changes in the hip joint. An x-ray may show some degenerative changes, but this is true of just about anyone over the age of 40, so this may not be the true origin of your pain.
It may be the cause of some of the pain, but it is also possible that the pain will be coming from a problem with the lower back, quite often the sacro-iliac joint stiffening up. This is basically where the hip meets the spine, it’s the bump or dimple in the small of your back and there is one on either side. If it tightens or locks, it causes pain that can travel into the groin area.
This type of problem can be rectified with physiotherapy treatment quiet quickly with hands on treatment such as mobilisations and manipulation. We may also encourage you to perform some kind of core stability exercises to stabilise the pelvis region and remove the likelihood that the problem will resurface.
Groin Pain/Hernia
As above, this type of pain may be caused by a problem originally from the back. For example, if a disc in your lumbar spine (lower back) is touching a nerve, it is possible that this will be sent to the groin area. We call this referred pain. It also makes the muscles in the area very tight and extremely sensitive to touch. Commonly misdiagnosed as a groin strain.
There is also the possibility that your groin pain is being caused by a hernia. This is basically a hole or a weakness in the lining of the stomach which allows for its contents to protrude into the groin region, causing pain. A hernia is very common in those who are extremely active and in sports which involve a lot of twisting and rotation. Patients are usually pain free at rest, yet the groin area is extremely painful to touch and pain is at its worse mid way to the end of any exercise or activity. Coughing and sneezing will also reproduce the pain of a hernia. A long history of back pain or weak spinal muscles is a good indicator of a person who may be at risk of a hernia.
The pain the groin caused by a bad back can be eased with physiotherapy. For the hernia problem, unfortunately this usually requires key hole surgery and a maximum recovery of 4-6 weeks with physiotherapy from us. The only intervention that can be considered by a physiotherapist pre operation would be intense core stability exercise programme, but the success rate is limited and is dependent upon the advance nature of the hernia.
Frozen shoulder
An injury that we don’t see a lot in the physio room, however it is an injury that a lot of our patients seem to have been told that they have. This is a very easy term to apply to an injury of the shoulder given its obvious restrictions in movement. The misdiagnosis happens because as a patient presents to a GP or A&E they are usually in considerable pain. With this high level of pain us usually accompanied by a restriction in movement.
However, the difference between a true frozen shoulder and an acute shoulder injury is the ability of the patient to have their shoulder lifted into certain positions by another individual. With an acute shoulder injury, the person with the bad shoulder may not be able to lift the shoulder above head height, but the therapist will be able to achieve full range of movement, albeit painful. A true frozen shoulder is such that the arm will physically not move despite the force of attempt of the therapist. The movements of placing the arm out to the side, reaching behind your head and up behind your back are severely limited and extremely painful. There is almost a physical block at the end of the movement that can be achieved.
Physiotherapy can not cure, merely maintain and possibly increase the current range of movement of the shoulder. A regular deep tissue massage by a physiotherapist of the shoulder muscles can often help reduce pain and discomfort. May take anywhere between 6-18months to recover. Surgery can help and is often successful and physiotherapy will be required after the operation.
Achillies tendon pain
This type of injury is often misdiagnosed because pain in the achillies tendon can happen without any major trauma or accident. This type of pain is often progressive be pain free at rest thus by the time you co me to visit the doctor there are no obvious signs of an injury.
However, the injury is very real and an indication of an achillies tendon injury is its thickness. Try to look in the mirror or ask someone to compare the size of both of your tendons, often the injured one is much thicker than the good one. Patients often say that the pain is worse when first getting up and out of bed. This is because the tendon has stiffened through the night and has shortened. When you begin to walk around the blood circulates and the tendon relaxes slightly. Then as you walk on it too much, the pain returns and it begins to shorten again. It becomes a vicious circle.
Usually caused by over use, or excessive walking in hilly areas. Physiotherapy can help and this type of injury requires hands on treatment.
Calf pain
It is common to think that pain in the calf muscle is being caused by soft tissue damage as a result of an over stretch or over use. However, pain in the calf may be as a result of a problem in your lower back leading to an irritation of the sciatic nerve. Similar to the hip and groin, pain can be referred down the sciatic nerve which runs through the calf muscle.
Usually a physiotherapist will try deep tissue massage, stretching and exercises but the injury will not respond. This is because the soft tissue isn’t damaged, its just highly sensitive as a result of the sciatic nerve being damaged high up in the back. The sciatic nerve may tighten, causing the calf muscle to tighten likewise. This makes it very difficult for a physiotherapist to distinguish between the two types of injury.
The key to the diagnosis is in the history of the patient’s condition i.e. how did it happen and is there a history of recent back pain
Shin Splints
This a very common injury in runners, particularly in the summer when many people are in training for the Great North Run who wouldn’t other wise be running such distances. The term shin splints is a very loose diagnosis as there are multiple types and causes, but it is usually applied to patients with pain on the half way and inside of the shin bone. Usually occurs when running long distances on hard surfaces.
Often running such long distances can put the shin bone under immense stress and pressure and may cause what is commonly known as a stress fracture. Very similar to the pain and symptoms of shin splints, however a stress fracture is much more sinister and requires immediate rest and medication. Shin splints can be managed effectively with controlled activity, painkillers, orthotics and ice treatment. An MRI or bone scan is required to accurately diagnose this problem as a standard X- ray will not provide enough detail.
