What is De Quervain's tenosynovitis?

De Quervain's tenosynovitis is a painful condition affecting two tendons on the thumb side of the wrist. The tendons and their surrounding sheath become inflamed and thickened, making thumb and wrist movement painful — particularly with gripping, pinching and lifting. It is one of the most common wrist and hand conditions seen in physiotherapy.

What does De Quervain's tenosynovitis feel like?

Most people describe pain and tenderness at the base of the thumb on the wrist side, that worsens with gripping or pinching. Some notice swelling, stiffness or a snapping sensation when moving the thumb. Pain can radiate up the forearm and is often worse first thing in the morning or after repetitive hand use.

How long does De Quervain's tenosynovitis take to heal?

Many people see significant improvement within 6 to 12 weeks of appropriate physiotherapy. Longstanding or severe cases may take longer. Continuing to overload the tendons without modification tends to prolong recovery.

Is De Quervain's tenosynovitis common in new mothers?

Yes — it is very common in new parents, particularly mothers. Repeatedly lifting an infant using a thumbs-up grip places high load on the tendons at the base of the thumb. Hormonal changes during pregnancy and the postpartum period also affect tendon tissue, increasing susceptibility. The condition is sometimes called mother's wrist for this reason.

Does De Quervain's tenosynovitis go away on its own?

It can improve over time with rest and activity modification, but without addressing the underlying load and movement factors, symptoms often persist or recur. Physiotherapy helps speed recovery, reduce pain and prevent the condition from becoming chronic.

What is the Finkelstein test?

The Finkelstein test is a clinical assessment used to diagnose De Quervain's tenosynovitis. It involves folding the thumb into the palm, wrapping the fingers around it, and tilting the wrist toward the little finger side. Pain along the thumb side of the wrist with this movement is a strong indicator of De Quervain's tenosynovitis.

Is cortisone injection necessary for De Quervain's tenosynovitis?

Not always. Many people recover well with physiotherapy alone. A cortisone injection may be considered if symptoms are severe or not responding to conservative management. Injections tend to work best when combined with a rehabilitation programme rather than used in isolation.

Can De Quervain's tenosynovitis affect both wrists?

Yes, though it most commonly affects one side. Bilateral De Quervain's can occur, particularly in new parents who are repeatedly lifting with both hands, or in people with inflammatory conditions such as rheumatoid arthritis.

What is a SLAP lesion?

A SLAP lesion is a tear of the superior labrum — the ring of cartilage that lines the top of the shoulder socket. The tear runs from the front to the back of the labrum at the point where the biceps tendon attaches. SLAP lesions can cause deep shoulder pain, clicking and instability, particularly with overhead or throwing activities.

Can a SLAP tear heal without surgery?

Many SLAP tears, particularly lower-grade or degenerative tears, can be managed successfully with physiotherapy without surgery. A structured rehabilitation programme focusing on rotator cuff strength, scapular control and load management can lead to excellent outcomes. Higher-grade tears in younger competitive athletes may require surgical repair, but this is assessed case by case.

How long does recovery from a SLAP lesion take?

Recovery time varies depending on whether the injury is managed conservatively or surgically. Physiotherapy-managed SLAP lesions may show meaningful improvement within 3 to 6 months. Post-surgical recovery from a SLAP repair typically takes 4 to 6 months or longer before return to overhead sport.

How is a SLAP lesion diagnosed?

A SLAP lesion is suspected based on clinical assessment including history and specific shoulder tests. An MRI — often with contrast injected into the joint (MRI arthrogram) — is the most common imaging used to confirm the diagnosis.

Is a SLAP lesion the same as a labral tear?

A SLAP lesion is a specific type of labral tear occurring at the top (superior) portion of the labrum. Other labral tears can occur at the front (Bankart lesion) or the back of the socket. The location and type of tear determines the symptoms and treatment approach.

Can I still exercise with a SLAP lesion?

In most cases, yes — with appropriate modifications. A physiotherapist can guide you on which exercises are safe, which to avoid and how to progressively load your shoulder during recovery. Complete rest is rarely required and often counterproductive.

What happens if a SLAP lesion is left untreated?

An unmanaged SLAP lesion can lead to ongoing pain, progressive instability and difficulty returning to sport or work. Compensatory movement patterns may develop over time, placing excess load on surrounding structures. Early assessment and appropriate management leads to better outcomes.

ITB Syndrome Treatment Adelaide

Knee Pain Physiotherapy St Marys

Sharp or burning pain on the outside of your knee when you run or cycle? Pain that kicks in at the same point every run and won’t let you push through?

ITB syndrome is one of the most common causes of outer knee pain in runners and cyclists. It can be frustrating, especially when it keeps cutting your sessions short. At Active Balance, we use hands-on treatment to settle your pain, then a targeted strength and load program to address the cause and get you back to doing what you love.

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itb syndrome Treatment in Adelaide

What Is ITB Syndrome?

Iliotibial band syndrome, or ITBS, causes pain on the outer side of the knee. The iliotibial band (ITB) is a thick band of connective tissue that runs down the outside of your thigh from the hip to just below the knee.

As your knee bends and straightens, the ITB puts pressure on the tissue beneath it, near the outer knee. When repetitive load is more than that area can tolerate, it becomes irritated and painful.

The ITB itself doesn’t “tighten” in a way you can stretch or roll out, despite what many people think. The problem is usually about load: how much you’re doing, and how well your hips and legs control movement while you do it. That’s why strengthening and load management work better than foam rolling alone.

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Who Does ITB Syndrome Affect?

ITB syndrome is most common in people doing repetitive knee bending, including:

Runners, especially distance runners and those increasing their mileage
Cyclists, particularly after a change in bike setup or a jump in riding volume
Hikers and trail runners, especially on long downhill sections
Rowers and field sport athletes
People who’ve recently started running or returned after a break

Contributing Factors & Causes

A sudden increase in training volume, especially running distance
Hip and glute weakness, which reduces control of the knee and thigh
Running downhill or on cambered roads
Running form, such as a narrow stride or crossover gait
Bike fit issues, such as saddle height or cleat position
Not enough recovery between sessions
Worn-out footwear or a recent change in shoes

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Symptoms & Signs

Sharp, burning or aching pain on the outside of the knee
Pain that starts at a predictable point in a run or ride, then gets worse until you have to stop
Pain that’s worse running downhill or going down stairs
Tenderness on the outer knee when pressed
A clicking or snapping feeling on the outer knee in some cases
Pain that settles with rest but returns as soon as you start again

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How Physiotherapy Can Help Manage ITB Syndrome

Physiotherapy is a well-supported first-line treatment for ITB syndrome. Most people respond well to a structured approach.

Hands-on treatment, including soft tissue work, joint mobilisation and dry needling, helps reduce pain early so you can move and load more comfortably.
A running assessment can help identify any issues with strength, mobility and running technique that may be contributing
Load management starts straight away. Rather than stopping completely, we’ll help you modify your running or riding (distance, terrain, intensity) to settle symptoms while keeping you as active as possible.
Strengthening is the key to long-term recovery. We focus on the hips, glutes and legs to improve control of the knee and reduce the load on the outer knee, progressing from basic exercises to more sport-specific work.
Movement and technique retraining looks at the factors driving the problem, such as your running gait, stride and cadence, or your bike setup. Small changes here can make a big difference.
A graded return to running or riding means we build you back up gradually, starting with flat and shorter sessions, so the pain doesn’t return when you increase load.

How Massage & Myotherapy Can Help

People with ITB syndrome often develop tension in the glutes, tensor fasciae latae (TFL), quads and hip muscles. Remedial massage and myotherapy targeting these areas can ease discomfort and help you move more freely.

Trigger point therapy, cupping and soft tissue work to the hip and thigh muscles can complement your rehab program. Our massage and myotherapy team works with your physio so your treatment is coordinated at every stage.

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When to Seek Further Medical Advice

ITB syndrome is not a serious condition and usually responds well to physiotherapy. However, see a doctor or get a prompt assessment if you have:

Significant swelling, locking, or the knee giving way, which may point to an injury inside the joint, such as a meniscus or ligament problem
Pain after a fall, twist or direct knock to the knee
Constant pain that doesn’t change with activity or rest
Night pain, fever, or feeling generally unwell
No improvement after six to eight weeks of consistent, well-structured treatment

If any of these apply, we can often pick them up at your first assessment and refer you to the right health professional.

Prognosis

Most people with ITB syndrome recover well with the right management.

Mild or early cases: often a few weeks of modified training and strengthening
More persistent cases: around six to twelve weeks, sometimes longer if symptoms have been present for a while

The most common reason for symptoms coming back is returning to full training too quickly, before hip strength and running mechanics have been addressed.

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Why Choose Active Balance Physio & Wellness?

Physio-led integrated care

Physio, massage, myo & rehab under one roof

Individualised treatment plans

Friendly, caring team focused on results

Convenient Adelaide location

After-hours appointments available

Frequently Asked Questions

Q: Should I stop running completely?
Usually not. Complete rest may settle the pain, but it often comes back once you return. It’s better to reduce and modify your training to a level that doesn’t flare symptoms while you build strength. Your physio will help you work out what that looks like.

Q: Will foam rolling fix my ITB?
Foam rolling may give short-term relief, but it won’t lengthen or “release” the ITB. It can be part of your routine, but strength work and load management are what bring lasting results.

Q: How is ITB syndrome different from runner’s knee?
ITB syndrome causes pain on the outside of the knee. Runner’s knee, or patellofemoral pain, causes pain around or behind the kneecap. They need different treatment approaches, so an accurate assessment matters.

Q: Do I need a scan?
Usually not. ITB syndrome is diagnosed clinically from your history and a physical assessment. Imaging may be recommended if something else is suspected or you aren’t improving as expected.

Q: Will a cortisone injection help?
A cortisone injection may help in some stubborn cases, but it’s not usually the first option. If used, it should be combined with a rehab program that addresses the underlying cause.

Related articles:

Why "Just Resting" an Injury Usually Isn't Enough

What's actually involved in a running assessment

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Don’t let ITB syndrome cut your runs or rides short. With the right treatment and a structured strengthening program, most people get back to full training without the pain.

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