Patients often arrive at their physiotherapy assessment with some idea of what is wrong… ”I’ve got Achilles tendonitis/runner’s knee/tennis elbow…” Not unreasonably, this conclusion is based on the fact that it is their Achilles tendon/knee/elbow that hurts.

However, for many patients, the pain they are experiencing in one part of their body is actually caused by a problem elsewhere.

This is referred pain.

Left arm or jaw symptoms felt during a heart attack is a familiar example of referred pain. Although the exact mechanism explaining this sort of pain remains unclear, pain scientists believe it is linked to the way we are ‘wired up’. For instance, the nerves from your Achilles tendon share the same route to your brain as the nerves in your lower back, and your brain can’t always tell the difference between the two.

If you have referred pain, the onset of pain may be hard to explain – there is no memorable injury or significant change to your training schedule or workload, the pain may be hard to find – moving and poking the painful area doesn’t quite illicit the symptoms as you would expect (though the area may still be tender to touch) and ‘treating’ the painful area (ice, massage, stretches) doesn’t work.

As experts in movement and function, physiotherapists assess the human body as a whole (we could be thought of as human engineers) enabling us to find and treat the primary source of the pain in order to maximise pain free movement and function elsewhere. You just might be surprised at what we end up treating!