Health Grove Clinic
Physio & Osteo in White Waltham
If shoulder, elbow or hand pain is holding you back, specialist treatment can help you recover with confidence.
These are complex areas of the body, and the right expertise can make a real difference. Our upper limb specialist physiotherapist focuses exclusively on shoulder, arm, elbow and hand problems, with 20 years’ experience in specialist hand units.
You’ll be assessed and treated by someone who understands these conditions in depth, helping you get the right care from the start.
If shoulder, elbow or hand pain is holding you back, specialist treatment can help you recover with confidence.
These are complex areas of the body, and the right expertise can make a real difference. Our upper limb specialist physiotherapist focuses exclusively on shoulder, arm, elbow and hand problems, with 20 years’ experience in specialist hand units.
You’ll be assessed and treated by someone who understands these conditions in depth, helping you get the right care from the start.
Trauma injuries cover the sudden damage caused by falls, accidents, sports impacts or a heavy lift gone wrong – anything from sprains, strains and torn muscles or ligaments to dislocations and fractures. Because the shoulder, elbow, wrist and hand are intricate, mobile joints, even a seemingly minor injury can leave you with lasting pain, stiffness, weakness or loss of confidence in the arm if it isn’t rehabilitated properly.
What causes it?
Most upper limb trauma comes from a specific incident – landing on an outstretched hand, a fall onto the shoulder, a sporting collision, or a sudden wrench or twist. The visible injury is only part of the picture: surrounding muscles, tendons and soft tissues are often affected too, and protective guarding after an injury can quickly lead to stiffness and reduced movement.
How is it treated?
Recovery starts with a careful assessment to understand exactly what’s been injured and how it’s healing. From there, treatment is staged to match your recovery: early on, the focus is on settling pain and protecting healing tissue while keeping safe movement going; as things improve, hands-on manual therapy, mobilisation and a progressive exercise programme rebuild range of movement, strength and control. Where a fracture or significant injury has been managed by a surgeon or fracture clinic, physiotherapy plays a vital role afterwards in restoring full function and preventing long-term stiffness.
Why choose us?
Upper limb injuries are exactly what Minal has focused on throughout her career. With over 25 years’ experience and a specialist background in shoulder, elbow, hand and wrist rehabilitation, she can assess a trauma injury accurately, recognise when something needs onward referral, and guide you safely back to full use of your arm. Treatment is always tailored to you, your injury and the activities you want to get back to.
Arthritis describes pain, stiffness and swelling in a joint caused by wear, inflammation or damage to the cartilage that allows it to move smoothly. In the upper limb it commonly affects the small joints of the hand and the base of the thumb, as well as the shoulder and elbow, leading to aching, reduced grip, morning stiffness and difficulty with everyday tasks like opening jars or dressing.
What causes it?
The most common form is osteoarthritis, where cartilage gradually wears with age, previous injury or repeated load. Rheumatoid and other inflammatory types of arthritis are driven by the immune system rather than wear. Family history, previous fractures or joint injuries, and high-demand manual work can all increase the likelihood of developing it.
How is it treated?
While physiotherapy can’t reverse arthritis, it’s one of the most effective ways to manage symptoms and protect function – and staying active is consistently recommended over rest (versusarthritis.org). Treatment focuses on keeping joints moving with gentle exercise, building the supporting muscles to take load off the joint, hands-on techniques to ease stiffness, and practical advice on joint protection and pacing. For the hand and thumb, a hand therapist can also provide supportive splints and targeted exercises that reduce strain and keep you doing the things that matter.
Why choose us?
As a certified Hand Therapist accredited by the British Association of Hand Therapists (BAHT) with over 25 years’ experience across the upper limb, Minal understands how arthritis affects each joint differently. She’ll build a plan that keeps you mobile and comfortable, combining hands-on treatment, tailored exercise and – where helpful – splinting and self-management strategies, so you stay in control of your symptoms long term.
Surgery is often only the first half of recovery. What you do afterwards – guided, well-timed rehabilitation – frequently determines how well and how quickly you regain strength, movement and confidence. Post-surgical rehab covers structured physiotherapy following operations on the shoulder, elbow, wrist or hand, such as rotator cuff repair, shoulder replacement, carpal tunnel release, or tendon and ligament repair.
What’s involved?
After surgery, tissues need to heal in a protected way before they can be loaded and strengthened. Done too cautiously, joints stiffen and muscles waste; done too aggressively, healing repairs can be put at risk. Good rehabilitation walks that line precisely, following the surgeon’s protocol while adapting to how your body is actually recovering.
How is it treated?
Treatment is carefully staged. Early sessions protect the repair while restoring safe, gentle movement and managing swelling and pain. As healing progresses, hands-on therapy and a graded exercise programme rebuild range of movement, then strength, then the functional control needed for daily life, work or sport. Throughout, your therapist keeps in step with your surgical team so your recovery stays on track.
Why choose us?
Post-operative rehabilitation is a particular strength of Minal’s. Having spent time as part of the team at the prestigious Reading Shoulder Unit and maintaining close working relationships with local shoulder surgeons – notably alongside Giuseppe Sforza – she understands surgical procedures and their recovery protocols from the inside. As a BAHT-certified Hand Therapist she also expertly guides recovery after hand and wrist surgery. That combination means your rehabilitation is in genuinely experienced, well-connected hands.
Tendonitis and bursitis are common causes of upper limb pain. Tendonitis (more accurately tendinopathy) is irritation or degeneration of a tendon – the strong tissue connecting muscle to bone – while bursitis is inflammation of a bursa, one of the small fluid-filled cushions that reduce friction around a joint. Both cause pain, tenderness and discomfort with movement, often worse with the activities that triggered them.
What causes it?
The usual culprit is overload – doing more of an activity than the tissue is conditioned for, whether that’s a sudden increase in training, repetitive work tasks, or a new hobby. Poor technique, a previous injury, and the natural changes in tendons as we age can all contribute. In the shoulder, tendon and bursa problems often occur together.
How is it treated?
The good news is that most cases respond well to physiotherapy without injections or surgery. Treatment starts by identifying and modifying what’s overloading the tissue, then uses hands-on therapy to ease pain and a carefully progressed strengthening programme – the single most effective tool for restoring a healthy, resilient tendon. Acupuncture and other techniques may be used alongside this to help settle pain. The aim isn’t just to calm symptoms but to rebuild the tissue so the problem doesn’t keep returning.
Why choose us?
Tendon and bursa problems across the shoulder, elbow and hand are everyday territory for Minal. With over 25 years’ experience and a holistic, personalised approach that combines hands-on treatment with techniques such as acupuncture, she’ll pinpoint what’s driving your pain and build a recovery plan that addresses the cause – not just the symptom – so you get lasting relief.
Repetitive strain injury (RSI) is an umbrella term for pain and discomfort in the muscles, tendons and nerves caused by repeated movements and sustained postures, most often related to work or hobbies. It typically builds gradually, starting as an ache or tightness during an activity and progressing to pain, weakness, tingling or fatigue that lingers afterwards (nhs.uk/conditions/repetitive-strain-injury-rsi).
What causes it?
RSI develops when tissues are loaded repeatedly without enough recovery – think long hours of typing or mouse use, repetitive gripping or assembly tasks, or activities held in awkward positions. Workstation set-up, poor posture, high workload and a lack of breaks all play a part, which is why RSI often needs more than just treatment of the painful area.
How is it treated?
Effective treatment looks at the whole picture. Hands-on physiotherapy and targeted exercises ease the irritated tissues and restore strength and mobility, while a careful look at your activities, posture and workstation tackles the root cause. Your therapist will help you modify aggravating tasks, introduce pacing and recovery strategies, and build resilience so symptoms don’t simply return when you go back to normal activity.
Why choose us?
RSI rarely sits in just one place – it can involve the neck, shoulder, elbow, forearm and hand together, which is where Minal’s whole-upper-limb expertise really counts. Drawing on over 25 years’ experience and her specialist hand therapy training, she’ll assess the full chain, treat the affected tissues, and give you the practical strategies to stop the problem coming back.
Carpal tunnel syndrome happens when the median nerve – which runs from your forearm into your hand through a narrow passage at the wrist called the carpal tunnel – becomes compressed. This nerve controls sensation in the thumb, index, middle and part of the ring finger, so when it’s squeezed you’ll often feel tingling, numbness, pins and needles, or aching in those fingers. Symptoms are frequently worse at night or first thing in the morning, and many people find themselves shaking the hand to “wake it up.” Left unaddressed, it can progress to weakness, clumsiness, or difficulty gripping and pinching.
What causes it?
The carpal tunnel is a tight space, so anything that increases pressure within it or causes swelling around the nerve can trigger symptoms. Common contributors include repetitive or sustained hand and wrist movements (typing, manual work, repetitive gripping), wrist positions held for long periods, and previous wrist fractures or injuries that alter the shape of the tunnel. Hormonal changes during pregnancy, and conditions such as arthritis, diabetes or an underactive thyroid, can also raise the risk. Often it’s a combination of factors rather than a single cause, which is why a proper assessment matters – treating the wrong thing rarely helps.
How is it treated?
The good news is that most mild to moderate cases respond well to conservative, non-surgical treatment – and current NHS and NICE guidance recommends trying this before considering surgery (NICE CKS). Physiotherapy and hand therapy are central to that approach.
Treatment usually begins with a detailed assessment to confirm the diagnosis and rule out other causes of similar symptoms, such as nerve irritation coming from the neck. From there, hands-on physiotherapy plays a key role: manual therapy and soft-tissue techniques to release tightness in the forearm and wrist, gentle mobilisation of the wrist and the small carpal bones to ease pressure in the tunnel, and specific nerve-gliding and tendon-gliding exercises that help the median nerve move freely again. This is often combined with a wrist splint – particularly useful worn at night – to keep the wrist in a neutral position and take the strain off the nerve while it settles.
Just as importantly, your therapist will look at why the problem developed in the first place, offering practical advice on activity, workstation setup and grip technique to reduce the load that’s aggravating the nerve. Where symptoms are more advanced, or conservative care hasn’t resolved them, your therapist can guide you on next steps – including referral for further investigation or a surgical opinion – and provide expert rehabilitation afterwards if you do go on to have surgery such as carpal tunnel release.
Why choose us for carpal tunnel treatment?
Carpal tunnel syndrome sits right at the heart of Minal’s specialist hand and wrist expertise. As a certified Hand Therapist accredited by the British Association of Hand Therapists (BAHT), with over 25 years’ experience, Minal can accurately assess what’s driving your symptoms, combine skilled hands-on treatment with the right exercises and splinting, and tailor it all to your hand and your lifestyle. And because she treats the upper limb day in, day out, she’ll know quickly whether conservative care is the right path for you – or whether you’d benefit from onward referral – so you don’t waste time on treatment that won’t help. You’ll be in genuinely expert hands.
Shoulder impingement, also known as sub-acromial pain syndrome, is one of the most common causes of shoulder pain. It occurs when the tendons of the rotator cuff and the bursa beneath the bony arch at the top of the shoulder become irritated and compressed during movement. The classic sign is pain when lifting the arm out to the side or reaching overhead, often with a painful arc partway through the movement, and discomfort that can disturb sleep.
What causes it?
Impingement usually develops from a combination of factors rather than a single event: repetitive overhead activity (at work, in the gym or in sports like swimming and racquet sports), weakness or imbalance in the muscles that control the shoulder blade and rotator cuff, postural habits, and age-related changes in the tendons. Because several factors are often at play, an accurate assessment is key to effective treatment (cks.nice.org.uk/topics/shoulder-pain).
How is it treated?
Impingement responds very well to physiotherapy, and the large majority of people improve without surgery. Treatment centres on a tailored exercise programme to restore the strength, control and coordination of the rotator cuff and shoulder blade muscles, supported by hands-on manual therapy to ease pain and restore movement. Your therapist will also address contributing factors such as posture and activity technique. Acupuncture may be used alongside this to help manage pain in the early stages.
Why choose us?
Shoulder rehabilitation has been Minal’s specialist focus since 2008, including time as part of the team at the renowned Reading Shoulder Unit. As an active member of the British Elbow and Shoulder Society (BESS) who has presented at the Reading Shoulder International Conferences, she brings deep, up-to-date expertise to shoulder problems like impingement – assessing precisely what’s driving your pain and building the targeted programme that gets the shoulder working properly again.
Trigger finger is a condition where a finger or thumb catches, clicks or locks as you bend or straighten it, sometimes becoming stuck in a bent position before snapping straight. It’s caused by a problem with the tendon that bends the finger and the sheath it glides through, and it can be uncomfortable or even painful, particularly first thing in the morning (nhs.uk/conditions/trigger-finger).
What causes it?
The flexor tendon that bends your finger normally slides smoothly through a tunnel-like sheath. In trigger finger, the tendon or sheath becomes thickened or inflamed, so the tendon no longer glides freely and instead catches as it passes through. It’s more common in people who do repetitive or forceful gripping, and in those with conditions such as diabetes or rheumatoid arthritis. It often develops without any obvious single cause.
How is it treated?
Many cases can be helped with conservative hand therapy, especially when addressed early. Treatment may include a small splint to rest the affected finger and break the catching cycle, gentle tendon-gliding exercises to keep the tendon moving smoothly, hands-on techniques and activity advice to reduce the load on the tendon. If symptoms persist, a steroid injection or, occasionally, a minor surgical procedure may be recommended, after which hand therapy supports a full return of movement.
Why choose us?
Trigger finger falls squarely within Minal’s specialist hand therapy expertise. As a BAHT-certified Hand Therapist with over 25 years’ experience, she can confirm the diagnosis, provide the right splinting and exercises to settle the problem, and advise clearly on whether further intervention is needed – giving you the best chance of resolving it without surgery, and expert rehabilitation if you do need a procedure.
Shoulder instability means the shoulder joint is too loose or moves more than it should, sometimes to the point where the ball of the joint partially (subluxation) or fully (dislocation) comes out of its socket. The shoulder is the most mobile joint in the body, which makes it powerful and versatile but also more prone to instability than any other joint. Symptoms include a feeling that the shoulder might “give way,” pain, weakness, and apprehension during certain movements (nhs.uk/conditions/dislocated-shoulder).
What causes it?
Instability can follow a traumatic dislocation – typically a fall or sporting injury that forces the shoulder out of place and stretches or tears the supporting structures. In other people it develops without a clear injury, due to naturally lax ligaments or repeated overhead activity that gradually loosens the joint. Once a shoulder has dislocated, it can be more likely to do so again, which makes good rehabilitation important.
How is it treated?
Physiotherapy is central to managing most instability, particularly the non-traumatic type. The cornerstone is a progressive exercise programme that builds the strength, control and coordination of the rotator cuff and shoulder blade muscles, restoring dynamic stability so the joint stays centred during movement. Hands-on therapy and graded return-to-activity work support this. Where instability follows significant trauma or repeated dislocations, your therapist will advise on whether a surgical opinion is appropriate – and provide the rehabilitation that’s essential before and after any surgery.
Why choose us?
Shoulder instability needs a clinician who truly understands the joint, and that’s Minal’s core specialism. With shoulder rehabilitation as her focus since 2008, time spent at the Reading Shoulder Unit, BESS membership and close links with local shoulder surgeons, she’s ideally placed to assess your shoulder accurately, deliver an effective stability programme, and coordinate seamlessly with surgical care if it’s needed.
Frozen shoulder is a painful, stiffening condition in which the capsule surrounding the shoulder joint becomes inflamed, thickened and tight, dramatically restricting movement. It typically progresses through three overlapping phases – a painful “freezing” stage, a stiff “frozen” stage, and a gradual “thawing” stage – and although it usually resolves in time, that process can take many months to a couple of years, so the right treatment can make a real difference to comfort and recovery (nhs.uk/conditions/frozen-shoulder).
What causes it?
In many cases frozen shoulder appears without an obvious cause. It’s more common in people aged 40 to 60, in women, and in those with diabetes or thyroid conditions. It can also follow a period of shoulder immobility – for example after an injury, surgery or another shoulder problem that kept the arm still for a while.
How is it treated?
Treatment is matched to the phase you’re in. In the painful early stage, the focus is on managing pain and maintaining what movement you can, sometimes supported by a steroid injection. As pain settles, hands-on therapy and a carefully graded stretching and mobility programme work to restore range of movement, followed by strengthening as the shoulder recovers. Good guidance through each stage helps you avoid both pushing too hard too soon and losing more movement than necessary.
Why choose us?
Frozen shoulder can be frustrating and slow, which is exactly why specialist guidance helps. As a shoulder specialist since 2008 with experience at the Reading Shoulder Unit and ongoing involvement with BESS, Minal understands how this condition behaves and how to treat each phase appropriately – keeping you as comfortable as possible and helping you regain movement as efficiently as the condition allows.
A fractured (broken) or dislocated shoulder is a significant injury that usually follows a fall, sporting impact or accident. A fracture involves a break in one of the bones around the shoulder – commonly the top of the upper arm bone or the collarbone – while a dislocation means the joint has come out of its socket. Both are typically very painful and need prompt medical assessment, but what happens after the bone or joint has been stabilised is just as important to your long-term recovery.
What causes it?
These injuries are almost always caused by a specific traumatic event: landing heavily on the shoulder or an outstretched arm, a direct blow, or a high-impact sporting collision. Bone health and age can influence how the injury occurs and heals, with some fractures more common in older adults after a fall.
How is it treated?
The immediate injury is managed by a hospital or fracture clinic, often with a period of immobilisation in a sling or, in some cases, surgery. Physiotherapy then becomes essential. Once healing allows, treatment progresses carefully from gentle movement to restore range, through to hands-on therapy and a structured strengthening programme that rebuilds the muscle and control lost during immobilisation. The goal is to prevent lasting stiffness and weakness and return you to full function.
Why choose us?
Rehabilitating the shoulder after fracture or dislocation is precisely where Minal’s specialist experience pays off. Having worked within a dedicated shoulder unit and alongside shoulder surgeons for many years, she understands these injuries and their recovery timelines in depth, and will guide your rehabilitation at the right pace – protecting your healing while rebuilding a strong, confident shoulder.
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, holding the ball securely in the socket and powering much of the shoulder’s movement. Rotator cuff injuries range from irritation and partial tears to full-thickness tears, causing pain (often on the outer arm and at night), weakness when lifting or reaching, and difficulty with overhead tasks. They’re among the most common shoulder problems, particularly from middle age onward.
What causes it?
Cuff problems develop in two main ways: gradual wear, where the tendons weaken and fray over time with age and repeated overhead load, and sudden injury, such as a fall or a forceful lift that tears the tendon. Repetitive overhead work or sport, previous shoulder problems and the natural changes in tendons as we age all increase the risk.
How is it treated?
Reassuringly, many rotator cuff injuries – including a good proportion of tears – are successfully managed with physiotherapy rather than surgery (cks.nice.org.uk/topics/shoulder-pain). Treatment focuses on a progressive, individually tailored exercise programme to strengthen the cuff and the surrounding shoulder blade muscles, restoring strength and control, supported by hands-on therapy to ease pain and improve movement. Where a tear is large or doesn’t respond to rehabilitation, your therapist will advise on whether a surgical opinion is worthwhile – and deliver the rehabilitation that’s crucial both before and after any repair.
Why choose us?
Rotator cuff rehabilitation is at the very centre of Minal’s specialism. With shoulder care as her focus since 2008, experience at the Reading Shoulder Unit, BESS membership and strong relationships with local shoulder surgeons including Giuseppe Sforza, she can assess your cuff injury precisely, build the right strengthening programme, and ensure that if surgery is ever needed, your care is properly coordinated and your recovery expertly managed.
Tennis elbow and golfer’s elbow are common, often stubborn causes of elbow pain. Both are forms of tendinopathy where the tendons attaching to the bony points of the elbow become irritated and painful. Tennis elbow affects the outer elbow (where the wrist and finger extensor tendons attach) and golfer’s elbow the inner elbow (the flexor tendons). You’ll typically feel pain and tenderness over the affected point, often spreading into the forearm, and worse with gripping, lifting or twisting (cks.nice.org.uk/topics/tennis-elbow).
What causes it?
Despite the names, you don’t need to play tennis or golf to get them. They’re usually caused by overload – repeated or unaccustomed gripping, lifting, twisting or manual work that strains the tendon faster than it can recover. A sudden increase in activity, poor technique and previous episodes can all contribute. They tend to be most common between the ages of 35 and 55.
How is it treated?
These conditions usually settle with the right physiotherapy, though patience is needed as tendons heal slowly. The key is a progressive loading programme – specific strengthening exercises that gradually rebuild the tendon’s capacity – which the evidence consistently shows outperforms passive treatment alone. This is supported by hands-on therapy to ease pain, activity and technique advice to reduce the aggravating load, and sometimes a brace or acupuncture for symptom relief. Getting the loading right, at the right pace, is what makes the difference.
Why choose us?
Elbow tendinopathies need a clinician who understands tendon rehabilitation and the wider upper limb, and that’s Minal’s daily work. With over 25 years’ experience treating elbow conditions and a holistic approach that combines progressive exercise with hands-on treatment and techniques such as acupuncture, she’ll get to the root of what’s overloading your tendon and guide you through a recovery that lasts – not just a temporary fix.
Dupuytren’s contracture is a condition in which the layer of tissue under the skin of the palm (the fascia) gradually thickens and tightens, forming nodules and cords that can pull one or more fingers – most often the ring and little fingers – into a bent position that’s difficult to straighten. It usually develops slowly over months or years and isn’t typically painful, but it can interfere with everyday tasks like shaking hands, putting a hand in a pocket or flattening the palm (nhs.uk/conditions/dupuytrens-contracture). Scar management, meanwhile, addresses the tightness, sensitivity and restricted movement that can follow hand injuries or surgery.
What causes it?
The exact cause of Dupuytren’s isn’t fully understood, but it tends to run in families and is more common in men, in people of northern European descent, with increasing age, and in those with diabetes or who smoke or drink heavily. Scarring, by contrast, is a normal part of healing after a wound or operation – but without the right care, scar tissue can become thick, tight or adherent and limit how well the hand moves.
How is it treated?
Dupuytren’s contracture itself can’t be reversed by hand therapy, and established disease is usually treated by a surgeon (through needle release, collagenase injection or surgery) once it affects hand function. This is where specialist hand therapy is invaluable: after a procedure, a hand therapist provides the splinting, scar management and targeted exercises that are essential to regain full finger movement and prevent the contracture returning. For scar management more broadly, treatment includes scar massage, desensitisation, mobility work and splinting to keep healing tissue supple and functional.
Why choose us?
Post-procedure rehabilitation and scar management are core hand therapy skills, and Minal is a certified Hand Therapist accredited by the British Association of Hand Therapists (BAHT) with over 25 years’ experience. She’ll guide your recovery after Dupuytren’s treatment or hand surgery with the splinting, exercises and scar techniques that make the difference between a stiff hand and a fully functional one – working alongside your surgeon to get the best possible result.
A wrist sprain is an injury to the ligaments – the tough bands that connect bone to bone and hold the wrist’s small joints together – usually from a sudden stretch or force. Instability develops when those ligaments are stretched or torn enough that the wrist no longer feels solid, leading to pain, swelling, weakness and a sense that the joint “gives” or clicks during certain movements or when bearing weight through the hand.
What causes it?
The classic cause is a fall onto an outstretched hand, but sprains also happen through sporting impacts, a sudden twist, or catching and wrenching the wrist. Mild sprains involve overstretched ligaments; more severe injuries can partially or fully tear them, and these are the ones most likely to lead to ongoing instability if they aren’t rehabilitated well. It’s also why persistent wrist pain after a “simple” sprain is always worth assessing – some ligament injuries are easy to underestimate.
How is it treated?
Most wrist sprains settle well with the right physiotherapy (nhs.uk/conditions/sprains-and-strains). After an initial period of protecting and settling the injury, treatment progresses through restoring movement, then rebuilding the strength and control of the muscles that stabilise the wrist, and finally returning you to full activity. Hands-on therapy helps ease stiffness and pain, while proprioceptive and strengthening exercises restore the wrist’s stability and your confidence in it. Where instability is significant or a more serious ligament injury is suspected, your therapist will advise on further investigation or a specialist opinion.
Why choose us?
Wrist injuries need someone who understands the joint’s complex mechanics, and that’s core to Minal’s hand and wrist expertise. As a certified Hand Therapist accredited by the British Association of Hand Therapists (BAHT) with over 25 years’ experience, she can tell a straightforward sprain from something needing closer attention, and deliver the staged rehabilitation that restores a strong, stable, confident wrist.
The biceps muscle attaches to the shoulder by two tendons at the top and to the elbow by one at the bottom, and problems can affect any of them. The most common is irritation of the long head of the biceps tendon at the front of the shoulder, causing aching or sharp pain at the front of the shoulder that’s often worse with lifting, reaching or overhead activity. Less commonly the tendon can partially or fully tear, sometimes producing a visible change in the muscle’s shape.
What causes it?
Biceps tendon problems usually develop from overuse – repeated lifting or overhead activity that irritates the tendon over time – or as part of wider wear in the shoulder, since the biceps tendon works closely with the rotator cuff and often suffers alongside it. A sudden heavy load or lift can cause a more acute injury or tear. Age-related changes in the tendon increase the risk, as they do throughout the shoulder.
How is it treated?
Most biceps tendon irritation responds well to physiotherapy without surgery. Treatment focuses on settling the irritated tendon, then a progressive strengthening programme for the biceps and the wider shoulder, particularly the rotator cuff and shoulder blade muscles, since biceps pain rarely sits in isolation. Hands-on therapy eases pain and restores movement, and activity advice reduces the load that’s aggravating the tendon. Where a significant tear has occurred, your therapist will advise on whether a surgical opinion is appropriate and guide your rehabilitation accordingly.
Why choose us?
Because biceps tendon pain so often overlaps with rotator cuff and wider shoulder problems, it needs a clinician who sees the whole shoulder clearly. Shoulder rehabilitation has been Minal’s specialism since 2008, including time at the Reading Shoulder Unit and ongoing involvement with the British Elbow and Shoulder Society (BESS) – so she can pinpoint exactly what’s generating your pain and treat the real source, not just the symptom.
Cubital tunnel syndrome is the second most common nerve compression in the arm after carpal tunnel syndrome. It occurs when the ulnar nerve – the “funny bone” nerve – becomes compressed or irritated as it passes through a narrow channel on the inner side of the elbow. This causes pins and needles, numbness or tingling in the little and ring fingers, aching on the inner elbow or forearm, and, if it progresses, weakness of grip and fine hand movements (bssh.ac.uk/patients/conditions).
What causes it?
The nerve is stretched and squeezed when the elbow is bent, which is why symptoms are often worse when holding the phone, sleeping with bent elbows, or leaning on the elbow at a desk. Repeated or prolonged elbow bending, direct pressure on the nerve, a previous elbow injury or arthritis can all contribute. As with other nerve conditions, people with diabetes are at slightly higher risk. Often, though, there’s no single obvious cause.
How is it treated?
Mild to moderate cases frequently improve with conservative treatment, especially when caught early. The first step is reducing what’s irritating the nerve – modifying activities, avoiding sustained elbow bending and leaning, and sometimes wearing a soft splint at night to keep the elbow in a more neutral position. Nerve-gliding exercises help the ulnar nerve move freely through the tunnel, while hands-on therapy addresses any tightness in the surrounding tissues. Your therapist will also advise on workstation and posture adjustments. Where symptoms are severe, persistent or involve muscle weakness, onward referral for a surgical opinion may be appropriate, with rehabilitation afterwards.
Why choose us?
Nerve problems around the elbow and hand sit right within Minal’s specialist area. As a BAHT-certified Hand Therapist with over 25 years across the upper limb, she can distinguish cubital tunnel syndrome from the other conditions that mimic it, deliver effective conservative treatment, and recognise clearly when symptoms warrant a specialist referral – so you get the right care at the right time.
The acromioclavicular (AC) joint sits at the top of the shoulder, where the collarbone meets the highest point of the shoulder blade. You can usually feel it as the small bump on top of the shoulder. Injuries here range from mild sprains to more significant separations, and they’re a common cause of pain right on top of the shoulder – particularly when reaching across the body, lifting overhead, or lying on that side.
What causes it?
The most frequent cause is a direct fall or blow onto the point of the shoulder – common in cycling, rugby, football and other contact or collision sports – which sprains or tears the ligaments holding the joint together (a “shoulder separation”). The AC joint can also develop wear-related arthritis over time, especially in people who do a lot of overhead lifting or have a history of shoulder use under load, causing aching and tenderness localised to the top of the shoulder.
How is it treated?
The majority of AC joint sprains and lower-grade separations are managed very successfully without surgery. After an initial settling period, physiotherapy restores movement and then rebuilds the strength and control of the shoulder so it can take load comfortably again, with hands-on therapy to ease pain and stiffness. For AC joint arthritis, treatment focuses on managing load, strengthening the shoulder and modifying aggravating activities. More severe separations occasionally need a surgical opinion, with rehabilitation playing a key role in recovery either way.
Why choose us?
Getting an accurate read on shoulder-top pain – is it the AC joint, the rotator cuff, or something else? – is exactly where specialist experience counts. With shoulder care as her focus since 2008, experience at the Reading Shoulder Unit, BESS membership and close links with local shoulder surgeons, Minal can assess your shoulder precisely and build the right plan to get you back to full, pain-free movement.
Minal Desai has over 25 years experience as a physiotherapist, including 20 as a specialist upper limb physio working in dedicated clinics including the prestigious Reading Shoulder Unit.
She is registered with the HCPC and CSP and accepts all major health insurances.
Minal takes a personalised, holistic approach to care, taking the time to fully understand each patient and creating a bespoke treatment plan.
Minal Desai has over 25 years experience as a physiotherapist, including 20 as a specialist upper limb physio working in dedicated clinics including the prestigious Reading Shoulder Unit.
She is registered with the HCPC and CSP and accepts all major health insurances.
Minal takes a personalised, holistic approach to care, taking the time to fully understand each patient and creating a bespoke treatment plan.
Questions about our treatments or how we can help?
Just contact us using the form opposite and Minal will be in touch personally to offer advice.
