Desk Related Conditions

Desk-Related Conditions

Most of us spend long hours sitting by the office desk, some 10 hours or more a day. Whilst some desk and chairs are ergnonomical enough so as to prevent bad posture, the hard truth is that we cannot hold our posture for very long. To make matters worse, a lot of office workers don’t engage in any physical activity, and those that do are also in for a shock. According to recent research, 30 or 60 minutes of workout doesn’t offset 10 hours of stillness, can cause muscle degeneration, hip problems (sitting down shortens the hip flexors), circulation problems and weakness in the bones. Chances are you already experience one of the above, plus that neck/shoulder/lower back pain that comes back every couple months.

Available Treatments:




Sports Massage

Now, the good news: we can help!

We work with techniques that will release tight muscles and mobilise stiff joints, and develop exercises tailored to your body that will improve your posture and finally get rid of that niggly pain. Our team of Physiotherapists will work together with you towards those goals so that you can live a life full of health and free of pain.

Here are the benefits of our treatments


Become more active


Eliminate stiffness in your body


Understand your body


Create more body awareness


Become pain free


Live a longer healthier life

Desk-Related Treatments

Some of the most common Desk-Related Conditions we treat here at CBR Clinics are:
Shoulder Pain
Shoulder pain is one of the most common reasons for GP visits. Because the shoulder is such a movable joint, it has a high risk of instability. This instability can lead to many different problems, being the most common the Subacromial Impingement.

The Subacromial Impingement occurs whenever there is narrowing in the space inside the shoulder joint. Normally the soft tissues (bursa and tendons) have enough space to slide inside the shoulder, but due to inflammation these structures swell up, contributing to the loss of space. This loss of space causes the bones to pinch the soft tissues, causing the impingement to occur.

Other common shoulder conditions include:

Frozen shoulder
Adhesive capsulitis

Bursas are small fluid-filled sacs lined by synovial membrane with an inner capillary layer of viscous fluid (similar in consistency to that of a raw egg white). It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement. Bursas are filled with synovial fluid and are found around most major joints of the body.

One of the most common types of bursitis is Trochanteric Bursitis. The greater trochanter of the femur is the bony point on the top/side of the leg bone. Trochanteric bursitis is characterized by painful inflammation of the bursa located just superficial to the greater trochanter. Activities involving running and those involving the possibility of falls or physical contact, as well as lateral hip surgery and certain preexisting conditions, are potentially associated with trochanteric bursitis.
Trigger Points
Between the skin and muscles there is a thin layer of soft tissue called fascia. When the fascia is stressed from overuse or trauma it can tear and adhear together. These adhesions are called “Trigger Points” and decrease muscle flexibility and contractibility. That in turn leads to an increase in muscle stiffness and tenderness, a decrease in range-of-motion and pain. The imbalance created by Trigger Points can go as far as create deformities in posture, such as ribcage twist, a difference in shoulder height, and pelvic torsions. Moreover, they can lead to injury.

The only way to treat Trigger Points is by breaking them down so that the muscle can rebuild with fresh and “clean” muscle fibers. We use Shockwave Therapy in our clinical setting to help break down Trigger Points, and results can be seen in as little as 5 minutes.

Shockwave Therapy is proven to deliver results when treating Trigger Points 3 times as fast when compared to conventional treatments.

What causes Trigger Points?
Muscle weakness and/or imbalance

How do you know you have them?
Most people have Trigger Points on between their shoulder blades, as they sit on a chair 8 hours a day in front of a computer. Muscles fatigue and quickly build up adhesions. You might have felt “knots” on your back which felt like peas when pressed on. Those are Trigger Points.

Sports enthusiasts are known for building Trigger Points due to extensive training. Runners usually have them in their calves and IT band, for instance. Swimmers will build some around the rotator cuff muscles. Muscle usage in general will often lead to Trigger Points, and if left untreated they often lead to injuries.

The main signs of Trigger Points are:
Knots or “pea-like” spots on muscles
Local pain and/or tenderness
Muscle stiffness and lack of flexibility

Tennis & Golfers Elbow
Tennis Elbow and Golfer’s Elbow are tendinopaties on the lateral and medial epicondyles, respectively. Epicondyles are the bony proeminences around your elbow.

These conditions are also known as Epicondylitis. The main clinical symptoms are pain on resisted movements (extension and flexion) and tenderness at the lateral or medial epicondyle. Previously thought to be an inflammatory process, these tendinopathies are now thought to be on a continuum of change. This is now thought not to begin with an inflammatory reaction; rather, it is thought to be the result of a proliferative reaction due to overload. This causes a thickening of the tendon which, if not treated, can progress to tendon disrepair and eventual degeneration. The term ‘Epicondylitis’ is increasingly thought to be a misleading, with clinicians reverting to the informal names of tennis/golfer’s elbow.

What causes Tennis Elbow?
– classically, although less so since the advent of lighter tennis rackets and two-handed backhands. Tennis is not the cause in the majority of people with tennis elbow.

Jobs involving repetitive heavy lifting or the use of heavy tools.

Jobs involving movements in an awkward posture
– ie.: arms lifted in front of the body, hands bent or twisted, and precision movements, particularly squeezing and twisting movements.

New and unaccustomed strains such as DIY, gardening, lifting a new baby, moving house, carrying luggage.

What causes Golfer’s Elbow
Golf and other sports involving gripping or throwing.

Jobs and hobbies using repetitive elbow movements
– ie.: DIY, computer use, gardening, chopping, climbing or painting.

Use of vibrating tools.

Symptoms of Tennis Elbow
Usually gradual onset, worsened with use of affected muscles – ie.: opening jars, unable to hold items due to pain.

Usually unilateral but some cases are bilateral. The dominant arm is involved in 75% of people.

Pain and tenderness over the lateral epicondyle of the elbow, radiating into the forearm, and pain on resisted extension of the wrist, middle finger or both. A tender spot can usually be identified just below the lateral epicondyle on the outside of the elbow.

Symptoms of Golfer’s Elbow
Pain and tenderness are maximal over the medial epicondyle, radiating into the forearm.

Pain when flexing and twisting wrist (pronation).

Dull ache at the medial epicondyle.

The onset of pain is usually gradual and aggravated by trying to grasp objects and shaking hands.

It is worsened with affected muscle use, such as forearm rotation or grasping, opening jars

Neck Pain
Neck pain is a common problem, with two-thirds of the population having neck pain at some point in their lives. Although felt in the neck, it can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the spine. Joint disruption in the neck creates pain, as does joint disruption in the upper back.
The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain.
Lower Back Pain
Lower back pain is a common disorder that affects around one-third of adults in the UK each year. Up to 85% of people worldwide will suffer from back pain during their lives and 50% of the working population will experience back pain symptoms at least once a year. This prevalence is high and is leading cause of disability.

It is more commonly seen in office workers, who sit at a desk for long hours, but it is also visible in sports people with specific under or over developed muscles. Lower back pain can originate from a weak lower back, weak or over developed abdominal muscles, tight hamstrings, weak gluteus muscles, or a combination of any of the above.

Exercise plays a great role in keeping the body strong and healthy. People who exercise have a tendency to develop or have experienced lower back pain before need to make sure they are working out all the core muscles (abdominals, upper and lower back, inner thighs, hips and gluteus) Together they keep all structures around the core healthy, supported and pain free, therefore they should be exercised evenly to avoid any imbalances.

Pilates is a great option for those wanting to strengthen their core muscles to prevent lower back pain from reoccuring. It comes from the principle that in order to attain control of your body you must have a starting place: the center (core muscles). It helps to create stability and build muscle strength, while shaping your body into better alignment.

Knee Pain
The knee joint joins the thigh with the lower leg and consists of two articulations: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body and is very complicated. The knee is a pivotal hinge joint, which permits flexion and extension as well as a slight rotation. Since in humans the knee supports nearly the whole weight of the body, it is vulnerable to both acute injury (ligament sprain, muscle strain, meniscus tear) and the development of diseases.

Knee pain can be caused by trauma, misalignment, and degeneration as well as by conditions like arthritis. The most common knee disorder is generally known as patellofemoral syndrome. The majority of minor cases of knee pain can be treated at home with rest and ice but more serious injuries do require surgical care. One form of patellofemoral syndrome involves a tissue-related problem that creates pressure and irritation in the knee (patellar compression syndrome) causing pain.

The second major class of knee disorder is Patella Tendinopathy, where the patella (knee cap) tendon becomes dysfunctional and inflamed.

Age also contributes to disorders of the knee. Particularly in older people, knee pain frequently arises due to osteoarthritis. In addition, weakening of the muscles around the knee may contribute to the problem.

Cartilage lesions can be caused by:
Accidents (fractures)
Muscle injuries
The removal of a meniscus
Anterior cruciate ligament injury
Posterior cruciate ligament injury
Posterolateral corner injury
Medial knee injuries
Considerable strain on the knee.

Any kind of work during which the knees undergo heavy stress may also be detrimental to cartilage. This is especially the case in professions in which people frequently have to walk, lift, or squat. Other causes of pain may be excessive on, and wear of, the knees, in combination with such things as muscle weakness and overweight.

Common complaints are a painful, blocked, locked or swollen knee. Sufferers sometimes feel as if their knees are about to give way, or may feel uncertain about their movement.

Calcific Tendinitis
Calcific tendonitis is a condition that causes the formation of a small sized calcium deposit within any tendon in the body. The most common place are the tendons of the rotator cuff. These deposits are usually found in individuals at least 30-40 years old. The calcium deposits are not always painful, and even when painful they will often spontaneously resolve after a period of one to four weeks. It is linked to many other conditions, such as Adhesive Capsulitis and Subacromial Impingement.

What causes it?
The cause of calcium deposits within the rotator cuff tendon (calcific tendonitis) is not entirely understood. Different ideas have been suggested, including blood supply and ageing of the tendon, but the evidence to support these conclusions is not clear. One of the most compelling arguments is delayed healing.

Usually the tendon heals through the action of collagen forming cells (fibroblasts). After a period of weeks or months, the fibroblasts become less numerous in the region and are replaced by osteoblasts (bone forming cells). The osteoblasts, in turn stimulate the growth of bone (calcium) in the tendon. Hence the main reason for the development of calcific tendonitis appears to be delayed healing.

​Calcific Tendinitis typical course
Pre-calcification Stage: individuals usually do not have any symptoms in this stage. At this point in time, the site where the calcifications tend to develop undergo cellular changes that predispose the tissues to developing calcium deposits.

Calcific Stage: during this stage, the calcium is excreted from cells and then coalesces into calcium deposits. When seen, the calcium looks chalky, it is not a solid piece of bone. Once the calcification has formed, a so-called resting phase begins, this is not a painful period and may last a varied length of time. After the resting phase, a resorptive phase begins–this is the most painful phase of calcific tendonitis. During this resorptive phase, the calcium deposit looks something like toothpaste.

Postcalcific Stage: this is usually a painless stage as the calcium deposit disappears and is replaced by more normal appearing rotator cuff tendon.

As Calcific Tendinitis is directly linked to Frozen Shoulder and Adhesive Capsulitis, symptoms can be the same as those conditions:

pain on movement
stiffness and lack of movement
painful swelling around the joint
can present bulging tendons due to crystal deposits

What our clients say…

3 doctors mis-diagnosed me with RSI (including a private hand ‘expert’)… CBR diagnosed me correctly as having neck issues before I even arrived – just from my description of symptoms… I just hope I remember to go to a Physio first before a doctor when I next get pains in my joints.

Charlie S.

A very professional team and detail-minded treatment, which provides patient a comprehensive approach for speedy recovery. Reasonable price and nice follow-up. Highly recommended to any Londoners or the tourists.

V. Man

My visit to Bruno are really effective on my back right on the same day. He is a great profesional as well as a really warm person to deal. He make you feel calm and relaxed at the consultation. I have recovered strength on my arm thanks to his treatments. I will definitely recommend anyone to go to his clinic.

Maria A.

Peter was very professional! He identified my problem area, gave me excellent advice and exercise to do. I left feeling very positive, will definitely recommend him to people.

C. Cole

I have been treated by Silvia for a shoulder pain. She is an amazing osteopath, very profesional, knowledgeable and a nice person. Silvia is very easy going and explains things extremely clearly.I have been back a few times since and always had fantastic results. I cant recommend CBR Clinic highly enough. Thank you Silvia for making my shoulder much better!

Natalie H

I have been having treatment at CBR Clinics for over 3 months now and I can honestly say that it is one of the best investments in myself I have made. I have had a bad back for a long period which stems from lots of sport and the office job. After seeing Lyndsy Mills my back has recovered and mornings tend to be much easier 🙂 I would recommend to friends, family and work colleagues.

James B.

A very professional team and detail-minded treatment, which provides patient a comprehensive approach for speedy recovery. Reasonable price and nice follow-up. Highly recommended to any Londoners or the tourists.

V. Man

Really good support throughout the 3 weeks of physio. Great selection of take-home exercises and advice that helped me recover and get back to playing sport a good week before I thought I’d be able to. Would definitely recommend to anyone who’s looking for top quality treatment.

M. Batstone

Bruno & his team are professional, efficient, knowledgeable in a number of different disciplines, treatment was effective and Bruno charming. The clinic’s location is very convenient being directly opposite Waterloo station. Disabled parking is availabe in street behind the clinic.

Patricia P.

I’ve been going to CBR for a few years now and have been treated by three of their staff in that time – all great, especially Bruno. I love the fact you can book online and they’re open late most nights and around on thr weekend too. My current treatment is under Nick who specialises in headaches from which I suffer, not just treating the pain but trying to get me to a position where I don’t have to visit too often. How many osteos do that?

Saffron B.

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