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Carbery Chartered Physiotherapy are delighted to announce the availability of Shockwave Therapy in our clinic. All of our Chartered Physiotherapists have undergone additional training and are experts in pain management and mobility restoration with the use of Shockwave Therapy.


Shockwave Therapy stimulates and speeds up the healing process allowing your body to repair itself. Research studies have shown approximately 80% success rate once all underlying issues are addressed.


  • Shockwave Therapy is a series of energetic shockwaves applied to the area that needs treatment.
  • A shockwave is a purely mechanical wave, not an electric one. The treatment initiates an inflammation-like condition in the tissue that is being treated.
  • The body responds by increasing the blood circulation and metabolism in the impact area which in turn accelerates the body’s own healing processes.
  • The shockwaves break down injured tissue and calcification


  • Plantar fasciitis with/without heel spur
  • Calcific rotator cuff tendonitis
  • Lateral Epicondylitis (Tennis Elbow)
  • Greater Trochanteric Pain Syndrome
  • Proximal Hamstring tendinopathy
  • Achilles tendinopathy
  • Patellar tendinopathy
  • Myofascial trigger points


  • No anaesthesia
  • Non invasive
  • No medication
  • No surgery
  • Fast treatment – 20 minutes per session, 3-5 sessions required
  • Fewer complications
  • Virtually painless after treatment
  • Significant clinical benefit often seen 6-8 weeks after treatment

For Further information please do not hesitate to contact us on 086 8049526

Shoulder Pain

Shoulder pain affects 15-20% of adults in Europe, with increasing likelihood in those of advancing age. Shoulder pain typically is associated with high levels of chronicity (longer than 12 weeks) and disability (unable to fully carry out normal daily activities). People who suffer with shoulder pain will often be diagnosed with a “Rotator Cuff” injury, tendinopathy, tear or impingement. This diagnosis will usually be confirmed with further investigations such as magnetic resonance imaging (MRI). Overall the initial diagnosis however will describe the condition of pain and weakness associated with shoulder movements.

What is the rotator cuff?
The rotator cuff is a group of four tendons that stabilize the shoulder joint. Each of these tendons attaches to a muscle that moves the shoulder in a specific direction. The four muscles involved are Subscapularis, Supraspinatus, Infraspinatus, and Teres minor muscles.

How can I injure my rotator cuff?
The Rotator cuff typically can be injured in two ways;
Through substantial injury to the shoulder from either a fall on an outstretched arm or accident.
Progressive degeneration or wear and tear of the tendon tissue through repetitive tasks such as overhead activity, heavy lifting over a prolonged period of time. The development of bone spurs in the bones around the shoulder can then irritate or damage the tendon.

What are the symptoms?
The pain associated with a rotator cuff injury may:
Be described as a dull ache deep in the shoulder
Disturbed sleep, particularly if you lie on the affected shoulder
Difficult to comb your hair or reach behind your back
Be accompanied by arm weakness
How can my shoulder pain be treated?
Three major management strategies are available for the treatment of rotator cuff tendinopathy’s are as follows :

1. Physiotherapy and Exercise
Good level of effectiveness with low cost, but not optimal results in all populations or clinical settings.
2. Steroid Injections
Slightly better pain relief at 6 weeks compared to Physiotherapy and Exercise, but no difference after 12 weeks. Potential side effects.
3. Surgery
Equivalent results to exercise at 2 and 5 years, but double the cost, along with added risks.

Therapeutic exercise (physiotherapy and exercise treatment) has a positive effect on pain and function over and above all other interventions (steroid injections and injections), but limited evidence to suggest which parameters of exercise are important.

Structured exercise treatment should be the basis for treatment of shoulder impingement syndrome, with operative treatment offered judiciously until its true merit is proven.

But which Exercises should I Do?
To be sure which exercises are a suitable treatment option for your shoulder pain a full and thorough assessment by a chartered physiotherapist is essential.

To see some examples of a shoulder rehab program please click here.

For further advice and information on shoulder pain please see

Alternatively contact us on 086 8049526

Foam Rolling – To Roll or Not to Roll?

Foam rolling is a self-myofascial release (SMR) technique that is used by athletes and physiotherapists to inhibit overactive muscles. Myofascial release is a soft tissue therapy for the treatment of skeletal muscle immobility and pain. A foam roller is used to supplement the work of a deep tissue specialist; such as a physiotherapist. Using a foam roller correctly, along with your own body weight, is called self-myofascial release (SMR). Myofascial release aims to relax contracted muscles, improve blood and lymphatic circulation, and stimulate the stretch reflex in muscles.

People of varying levels of activity will benefit from foam rolling. Through our daily routine our underlying muscle or soft tissue and fascia within the body can become tight and stuck together. Causes of this include many things from sedentary lifestyles (sitting, standing, static positions too much) to overworked muscles (through work, stress or exercise) as well as limited stretching or previous injuries. Physiotherapists refer to these tight sticky areas as adhesions, knots or trigger points. These knots cause restricted movement which leads to reduced flexibility and reduced muscle efficiency. If these areas persist untreated they can lead to symptomatic pain or discomfort while also increasing the likelihood for injury.

Using a foam roller to perform self-myofascial release helps to break up and eliminate these knots/trigger points, relaxing the tight fascia while increasing blood flow and circulation to the soft tissue. This can help improve range of motion, flexibility, movement, increase blood flow and assist with improved muscle function.

Does Foam Rolling Work?
When evaluating the research surrounding Foam Rolling, like everything else there is significant debate for and against. Mostly on the whole the research supports the effectiveness of Foam Rolling and SMR and we all here at Carbery Physiotherapy would support the use of Foam Rollers. Simply put, Foam Rolling will allow our patients to easily and cheaply experience some level of myofascial release be-it between treatment sessions, before/after training or exercises or on rest/recovery days.
Foam Rolling was typically used in preparation for training or exercise, however recent research published in the Journal of Athletic Training looks at the benefits of foam rolling after training or exercise. This study examines the effect of foam rolling on delayed onset muscle soreness (most commonly known as DOMS). DOMS can be defined as the pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise. For more click here>>>

How do I use my Foam Roller?
1. Roll the entire length of the muscle (8-10 times)
2. Return to any tender areas and maintain pressure
3. Breathe deeply and relax (for between 30-45 seconds)
4. As pain/tenderness disperses (by 50-75%), move onto the next tender area

Where can I Foam Roll?
You can pretty much Foam Roll any muscle group or area of the body. Getting yourself into a comfortable position in order to tackle the muscle group is often half the battle. Some typical areas one might foam roll include the feet, calf muscles, hamstrings, quads, glutes and back. You can get some helpful guidance using youtube or online. Alternatively you can contact us here in Carbery Physiotherapy and we can advise and send on some video tutorials to you by email.

Which type of Foam Roller should I get?
When choosing a Foam Roller you will quickly notice there is a variety of sizes, densities, ones with hollow cores, ones without, ones with lumps and bumps and ones without. Which Foam Roller is right for you really is down to personal preference but some things to consider when purchasing include;
The Cost
The Durability
Your own pain threshold
The solid dense foam rollers are cheapest price but with that they also have the shortest functioning lifespan. With regular use, these Foam Rollers begin to lose their shape and therefore don’t function to the best of their ability. If you suffer from significantly increased muscle tightness, have a lot of knots/trigger points or have a low threshold for pain then these dense foam rollers are probably the ones for you.

The Foam Rollers with a hollow or plastic core are at the higher end of the price bracket. However the plastic hollow core ensures that the Foam Roller maintains its shape thus increasing the lifespan of the product and ensuring the user reaps the benefits of a deeper massage.
Foam Rollers which come with various lumps and bumps are designed to provide you with a further deeper massage and with that will be likely to increase in price.

We would be delighted to answer any further questions you might have about myofascial release, Trigger points or knots, reduced flexibility, muscle soreness or foam rolling. So feel free to give us a call or call in to our clinic here in Ballineen.

In the meantime our advice to you would be to try out the various Foam Rollers, see what works for you and keep on rolling…

For further information please do not hesitate to contact us…Get in Touch

Hip and Groin Seminars.

Staff at Carbery Physiotherapy attended two seminars recently on Hip and Groin pain. The first was titled “Hip and Groin Pain-from research to practice”, presented by Dr. Helen French & Mr. Enda King. The second was “The 3rd Hip and Groin Sports Injury Symposium” held in the Whitfield Clinic in Waterford. The aim of both seminars was to improve the therapist’s knowledge on hip and groin pathologies, to improve knowledge on the variety of rehabilitation, diagnosis and non-operative treatment of hip/groin injuries and to link the theory with the current evidence surrounding hip strengthening and rehabilitation.

Hip and groin pain affects a wide range of people, from the amateur athlete with an acute groin strain to those at risk of osteoporosis or osteoarthritic complications of the hip joint, which could ultimately lead to a total hip replacement. There are many common causes of both groin pain and hip pain. However both can often present with similar signs and symptoms making it difficult for both the patient to identify the source of the pain but also for the health professional to diagnose. On occasion, pain in the hip/groin can be referred from the lower back or pelvic joints. It is also possible to have simultaneous problems in both lower back and hip or hip and groin at the same time. Often a problem in one area can lead to symptoms in the other over time.

Groin Pain
A groin strain is a partial tear of the small fibres of the adductor muscles. The adductors are a group of three muscles located on the inner aspect of the thigh. They start in the groin area and run down the inner thigh attaching to the inner side of the knee. Athletes competing in sports that require running, changes in direction, repetitive kicking and physical contact such as Soccer, GAA, rugby and hockey, are at a relatively higher risk of experiencing episodes of groin injury.

Some facts…
Groin injuries account of 5% to 18% of all sport-related injuries and can take up to 6/12+ to resolve.
Up to 25% may not return to their sport
The term “Groin Pain” is often used to describe multiple and commonly co-existing pathologies
Terminology now moving towards
– Adductor-related groin pain
– Exercise –related groin pain
– Long-standing (adductor-related) groin pain (chronic)

“94% of athletes with long standing adductor related groin pain had signs of FAI when x-rayed”. (Weir et al, 2011)

So what is Femoro-acetabular Impingement (FAI)?
Femoro-acetabular impingement (FAI) is a condition where the bones of the hip are abnormally shaped. Because they do not fit together perfectly, the hip bones rub against each other (head of femur and acetabulum) and cause damage to the joint. Up to 30% of healthy young adults show FAI when examined (Laborie et al, 2011), it most common in those aged between 20-50 and is more prevalent in males over females.

Types of FAI
There are three types of FAI: pincer, cam, and combined impingement.
Pincer. This type of impingement occurs because extra bone extends out over the normal rim of the acetabulum. The labrum can be crushed under the prominent rim of the acetabulum.
Cam. In cam impingement the femoral head is not round and cannot rotate smoothly inside the acetabulum. A bump forms on the edge of the femoral head that grinds the cartilage inside the acetabulum.
Combined. Combined impingement just means that both the pincer and cam types are present.

Some suggest FAI is a developmental hip abnormality, others believe it is caused by excessive friction due to cumulated repetitive movement?
What we do know is that FAI, while sourced at the HIP joint can often present as pain in the groin area. To complicate matters the pain sometimes may be more toward the outside of the hip, can cause sharp stabbing pain with turning, twisting, and squatting, or just present as a constant dull ache.

What can Physiotherapy do?
Physiotherapy can provide you with a thorough musculoskeletal examination determining the actual source of the symptoms in your hip and groin and ultimately tailoring an evidence-based treatment plan. Physiotherapy plays a very important role in the recovery from injury or surgery. It is vital you are assessed so that the appropriate diagnosis can be made and the correct advice regarding treatment may be provided. Some injuries, which require surgery will also benefit from both pre-operative and post-operative physiotherapy. Each patient who requires physiotherapy should be provided with a personal rehabilitation programme.

For those who conservative treatment may not be suitable surgical intervention may be an option. Further information about the procedures available can be found at the following Hip and Groin Clinic…

For further information please do not hesitate to contact us…Get in Touch

‘GAA 15’ Injury Prevention/Warm Up Programme.

The GAA in association with Salaso have released a warm up/injury prevention programme called the ‘GAA 15’ Injury Prevention Programme. Here at Carbery Physiotherapy we find this a useful resource and feedback from our teams and patients have been very positive. The selected injury prevention intervention is based on programmes incorporated internationally by FIFA (the 11+) (FMARC) and by the Santa Monica Orthopaedic and Sports Medicine Research Foundation (PEP) in soccer, the findings from the National Injury database since 2007 and a pilot of the programme in UCD.

The Programme is a series of short videos showing exercises that can be used to prevent injury or as a standard warm up routine prior to a practice session or game. The exercises are broken into 6 key areas, i.e. Running, Strengthening, Sport Balance, Jumps, Hamstrings & Sport Specific.

Anterior Cruciate Ligament (ACL) Seminar – Return to Play after ACL Reconstruction in athletes.

I recently attended a Seminar on Return to Play after Anterior Cruciate Ligament (ACL) Reconstruction in athletes. Speakers on the day were Mr. Declan Bowler, Consultant Orthopaedic Surgeon at the Mater Private Hospital in Cork, and Dr. Phil Glasgow, Head of Sport’s Medicine at the Sports Institute of Northern Ireland. The aim of the Seminar was to give physiotherapists a greater understanding of when an athlete is fit to return to his or her chosen sport after injury.
Firstly, some facts on ACL injury:
– 20% of people who tear their ACL will never return to sport again
– The injury is far more common in females than males, with a ratio of approximately 3:1
– Time from injury to return to sport varies greatly, with some elite athletes returning after 5 months, others taking over a year

There are many factors that can predispose a person to an ACL injury. These include inadequate hip strength, poor trunk stability, altered foot posture, imbalance between quads and hamstring strength and poor landing biomechanics. Other factors such as playing surface and type of boots/studs worn may also have an impact but evidence varies on this.
Once a person sustains an injury, the primary aims are to reduce swelling, restore normal range of movement (ROM) and improve strength around the knee. This is essential prior to surgery and also helps recovery post-operatively.

While traditionally rehabilitation programmes have been built around time-based goals, evidence now suggests that time should not be the most important factor in deciding if a person is ready to move onto the next stage of their rehab, or indeed return to play. Instead, functional outcomes should be the main indicator of a person’s progress, and unless they can complete a series of tasks well, with good movement control, then they should not progress onto the next stage. The time taken to reach these functional goals can vary greatly between people, and often depends on their pre-operative ability, along with the time they have to dedicate towards their recovery. Dr. Phil Glasgow, who works with elite athletes, believes that if a person cannot dedicate at least 4 hours a day to their recovery, then the time to return to play will naturally be lengthened. 4 hours a day may be feasible for a professional athlete but is not a realistic goal for the majority of amateur athletes. It is therefore also not helpful to compare your progress to an elite athlete, or rush your rehab to match theirs.

As well as rehabilitating the knee and surrounding structures, another crucial part of rehabilitation is addressing the underlying reason for the injury in the first place. This may mean working on trunk and core stability, hip strengthening, balance and control of your lower limb, among other issues.

ACL injuries continue to be feared amongst amateur and professional athletes alike, and although the road to recovery can seem daunting, it is crucial to take the time to work through your programme and focus on performing exercises well, and with good form, rather than rushing through or performing large repetitions with poor control. Time is no longer an accurate guideline for return to play, functional goals are far more important.