Sports Injuries, Muscle and Soft Tissue Pain

At Spine Plus, our osteopaths and physiotherapists regularly treat athletes and active individuals at all levels, from weekend runners to professional sports players. We address the root cause of sports injuries and provide structured rehabilitation with clear return-to-sport criteria.

Soft tissue injuries often respond well to treatment within a relatively short timeframe with the right approach. Left untreated or poorly managed, they can become persistent, develop scar tissue and lead to re-injury. Early assessment makes a significant difference to outcomes.

Conditions We Treat

Ligament Sprains

Ligament sprains occur when a joint is forced beyond its normal range of motion, over-stretching or partially tearing the ligament. The ankle inversion sprain is the most common sports injury of all. Grading the severity of the sprain (Grade 1, 2 or 3) guides treatment and return-to-sport timelines. Early protected mobilisation, manual therapy and progressive loading typically leads to excellent recovery. The ankle ligaments most commonly involved are the anterior talo-fibular, posterior talo-fibular and calcaneo-fibular ligaments, though other frequent sites include the cruciate and collateral ligaments of the knee, wrist ligament sprains from a fall, and neck ligament sprain (ligamentum nuchae) from whiplash. In a severe sprain, the violent pull on the ligament can pull away a small piece of bone (avulsion fracture), which is why an x-ray or MRI is sometimes needed to investigate.

Muscle Strains, Pulls and Tears

Muscle strains range from minor tightness (Grade 1) to partial tears (Grade 2) and complete ruptures (Grade 3). Treatment involves initial load management, soft tissue therapy, progressive rehabilitation and where indicated, shockwave or laser therapy to accelerate tissue healing. We provide clear guidance on return-to-training timescales based on the grade of the injury. Soft tissue therapy techniques used include remedial massage (soft tissue release, sports massage, cross-fibre massage, friction, lock and key), trigger point dry needling, muscle energy technique, neuro-muscular technique and PNF stretching. For more stubborn strains, we can refer for specialised regenerative injections such as Platelet Rich Plasma, prolotherapy or stem cell injections.

Hamstring Strain

Hamstring strains are among the most common muscle injuries in sport, particularly affecting runners, footballers and sprinters. They carry a high re-injury risk if rehabilitation is incomplete. Our approach addresses the full kinetic chain, including gluteal and hip flexor strength, and follows evidence-based criteria for safe return to speed work and competition. Severity ranges from Grade 1 (under 5% of fibres involved, usually a few weeks to recover) to Grade 2 (incomplete rupture, 2–3 months recovery) to Grade 3 (complex rupture, often requiring surgery). Hamstring strain can also be confused with sciatica from a low back injury, so we use tests such as the straight leg raise to distinguish hamstring tension from neural tension.

Trigger Point Pain (Myofascial Trigger Points)

Trigger points are tight, tender nodules within muscle that can refer pain to distant areas. They are extremely common and are often overlooked as a source of chronic, recurrent or unexplained pain. We use deep soft tissue techniques, acupressure and trigger point dry needling (medical acupuncture) to release trigger points effectively.

Bursitis

Bursae are small fluid-filled sacs that reduce friction between tendons, muscles and bones. They can become inflamed through overuse, direct trauma or altered movement patterns. Common sites include the calcaneal bursa (heel), infrapatellar bursa (knee), trochanteric bursa (outer hip) and subacromial bursa (shoulder). Treatment involves load modification, manual therapy, electrotherapy and where appropriate, injection therapy. The most reliable way to confirm bursitis is usually an ultrasound scan; where bursitis is confirmed, treatment options include shockwave therapy or an ultrasound-guided cortisone injection.

Groin Strain and Femoral Acetabular Impingement (FAI)

Groin strains involving the adductor muscles are common in football, rugby and hockey. Femoral acetabular impingement (FAI) is a condition where abnormal contact occurs between the hip ball and socket, causing pain in the groin and restricting hip movement. Both conditions require thorough clinical assessment to guide appropriate treatment and rehabilitation. We use clinical tests such as the hip quadrant test to indicate the likely diagnosis, usually confirmed by an MRI Arthrogram. FAI is caused by extra bone around the hip joint, a CAM or PINCER deformity. Where surgery is indicated, we work with eminent surgeons such as Professor Schilders at the Wellington Hospital, to whom we often refer such cases and from whom we receive referrals for post-operative care.

Iliotibial Band (ITB) Syndrome

ITB syndrome causes pain on the outer side of the knee, particularly in runners and cyclists. It arises from repetitive friction of the iliotibial band against the lateral femoral condyle. Treatment addresses contributing factors including hip abductor weakness, running mechanics, and training load, alongside soft tissue release and progressive rehabilitation.

Runner's Knee (Patellofemoral Pain Syndrome)

Patellofemoral pain syndrome produces pain around and behind the kneecap, typically aggravated by running, stairs and squatting. It is most effectively treated by addressing hip and knee muscle imbalances, foot mechanics and training load, alongside manual therapy and targeted strengthening exercises. Common causes include torsion between the tibia and femur from dropped arches or weak glutes, genu valgus (knocked knees), patella maltracking from a weak Vastus Medialis Oblique or tight Vastus Lateralis/ITB, and patella dysplasia, where the kneecap is flat or L-shaped rather than the usual V shape.

Shin Splints (Medial Tibial Stress Syndrome)

Shin splints describe pain along the inner edge of the shin bone, common in runners and those who have recently increased their training volume. Treatment involves load reduction, soft tissue therapy to the lower leg, footwear and gait assessment, and a structured return-to-running programme. This can involve the Tibialis Anterior, Tibialis Posterior, Extensor Digitorum, Extensor Hallucis and soleus muscles, and sometimes stress fractures to the shin bone or injury to its lining (periosteum), known as Medial Tibial Stress Syndrome. It is important to distinguish shin splints from acute compartment syndrome, which involves serious swelling and pressure build-up within the shin's muscle compartments and may require prompt surgical intervention.

Preparing for Sporting Events

At Spine Plus we treat and advise many professional and amateur athletes in order to optimise performance, and treat and prevent injuries. This takes the form of semi-regular preventative treatment with our expert sports massage therapists and osteopaths, to iron out stiff muscles and screen for soft tissue injuries, stiff joints and adverse movement patterns that may be brewing. So whether you are a weekend warrior or a serious athlete, with Spine Plus your care will be second to none.

Our Treatment Approach

We take a thorough, evidence-based approach to sports injury treatment:

• Detailed assessment to identify the mechanism of injury and contributing factors
• Manual therapy, soft tissue release and joint mobilisation
• Medical acupuncture and trigger point dry needling
• Shockwave therapy and Class IV laser for tissue healing
• Structured rehabilitation with clear progression criteria
• Return-to-sport guidance based on objective testing
• Gait analysis and orthotics where biomechanical correction is indicated