Glossary

D

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DOMS (Delayed Onset Muscle Soreness)

Muscular pain, stiffness, and tenderness that typically begins 12–24 hours after unaccustomed or eccentric exercise, peaks at 24–72 hours, and resolves within 5–7 days. DOMS is thought to result from microscopic damage to myofibrils and the subsequent local inflammatory response. It is a normal adaptation signal and does not indicate injury; however, it should be distinguished from acute muscle tears, which present with immediate, localised pain.

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Dry Needling

A physiotherapy technique using a fine, sterile needle (without medication — hence "dry") inserted into myofascial trigger points to elicit a local twitch response and reduce pain. The twitch response is thought to reset abnormal sarcomere contraction and normalise local neurochemistry. Dry needling is distinguished from acupuncture by its basis in Western musculoskeletal anatomy rather than traditional Chinese meridian theory, though both use similar needles.

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E

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Eccentric Loading

Exercise in which a muscle generates force while lengthening under load. Eccentric contractions place higher mechanical demands on tendon and muscle than concentric contractions and are a cornerstone of tendinopathy rehabilitation. The Alfredson protocol (high-volume heel drops for Achilles tendinopathy) is the most researched example. Eccentric loading promotes collagen synthesis and tendon remodelling when progressed appropriately.

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G

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Gait Analysis

The systematic study of human walking or running, used to identify biomechanical deviations that may contribute to injury or inefficiency. Clinical gait analysis may be observational or instrumented, using video, force plates, or motion capture systems. It assesses parameters including cadence, stride length, foot strike pattern, trunk lean, and pelvic drop. Findings inform orthotic prescription, footwear advice, and exercise rehabilitation.

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H

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Hypermobility

An increased range of joint movement beyond normal limits, which may be generalised (affecting multiple joints) or localised. Generalised joint hypermobility can be scored using the Beighton scale. When associated with musculoskeletal pain, fatigue, and proprioceptive deficits, it may be diagnosed as hypermobile Ehlers-Danlos Syndrome (hEDS) or Hypermobility Spectrum Disorder (HSD). Physiotherapy focuses on strength, proprioception, and education about joint protection strategies.

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M

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Manual Therapy

A broad term encompassing hands-on physiotherapy techniques applied to joints and soft tissues, including mobilisation, manipulation, massage, myofascial release, and neural mobilisation. Manual therapy is used to reduce pain, restore joint range of motion, decrease muscle guarding, and improve neuromuscular function. It is typically combined with therapeutic exercise rather than used in isolation, consistent with a biopsychosocial model of care.

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Mobilisation

A hands-on physiotherapy technique in which a therapist applies graded, oscillatory passive movements to a joint within its range of motion. Grade I–II mobilisations are used primarily to reduce pain; Grade III–IV mobilisations aim to restore range of motion. Mobilisation differs from manipulation in that it does not involve a high-velocity thrust and can be controlled and stopped at any point.

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Myofascial Release

A manual therapy technique that applies sustained, low-load pressure to the myofascial connective tissue to release restrictions and restore normal tissue extensibility. Fascia is the connective tissue that surrounds and interpenetrates muscles, nerves, and organs. Restrictions can arise from trauma, inflammation, or poor posture, contributing to pain, reduced mobility, and altered movement patterns.

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P

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Patellofemoral

Relating to the joint between the patella (kneecap) and the femur (thigh bone). The patellofemoral joint transmits quadriceps force during knee flexion and extension. Patellofemoral pain syndrome produces aching around or behind the kneecap, typically aggravated by stairs, squatting, and prolonged sitting. It is common in runners and cyclists and is managed with quadriceps and hip strengthening, activity modification, and taping.

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Plantar Fascia

A thick band of fibrous connective tissue running along the sole of the foot from the calcaneus (heel bone) to the base of the toes. It supports the medial longitudinal arch and plays a role in the windlass mechanism during toe-off. Overload or degeneration of the plantar fascia causes plantar fasciitis, characterised by sharp heel pain on first steps in the morning and after prolonged rest.

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Proprioception

The body's ability to sense its own position, movement, and force in space without relying on visual input. Proprioceptive signals are generated by mechanoreceptors in muscles (muscle spindles), tendons (Golgi tendon organs), and joint capsules. Following injury or surgery, proprioceptive deficits are common and are addressed through balance and neuromuscular control exercises as part of rehabilitation.

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R

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Range of Motion

The degree of movement available at a joint, measured in degrees using a goniometer. Active range of motion (AROM) is produced by the patient's own muscle contraction; passive range of motion (PROM) is produced by an external force. Restricted range of motion may result from joint capsule tightness, muscle shortening, pain, or structural pathology and is a key assessment parameter in physiotherapy.

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S

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Scapula

The triangular, flat bone at the posterior thorax, commonly known as the shoulder blade. The scapula serves as the attachment site for 17 muscles and forms the glenoid fossa of the glenohumeral (shoulder) joint. Scapular dyskinesis — abnormal positioning or movement of the scapula — is associated with rotator cuff pathology, shoulder impingement, and thoracic spine stiffness. Physiotherapy targets the serratus anterior and lower trapezius to restore scapular control.

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T

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Tendinopathy

A broad term for tendon dysfunction that includes both tendinitis (acute inflammatory change) and tendinosis (chronic degenerative change without inflammation). It presents as localised tendon pain and load-related stiffness, most commonly affecting the Achilles, patellar, and rotator cuff tendons. Management includes load management, progressive tendon loading exercises, and — in persistent cases — shockwave therapy or injection.