Posture

Posture is the position that the body adopts in a relaxed state and during movement. Most of us do not conform to the postural ideal. Posture is influenced by our genetic make up and the positions we spend most of our time in during the day. Muscles shorten and joints become stiff when not used regularly through their full range. Postural pain can come from overstretched ligaments, tight muscles that develop trigger points (knots), joints that are suddenly asked to move into a position they haven't been in for a while or even nerves that do not have enough room to glide as we move our limbs.

Physiotherapy will identify any postural problems you may have which are contributing to your symptoms and work towards correcting them with you.

Ligament Sprains

Ligaments attach bone to bone across joints and are there to prevent the joint moving beyond a certain point. Sudden force can often overstretch them causing a partial or full tear (rupture). Ligaments contain specialised nerve endings that tell the brain where the joint is at any given time.

Physiotherapy treatment will assist the tissue to heal, strengthen supportive muscles and re-educate the damaged nerves.

Muscle Problems

Muscles are the structures that move the body. They are elastic and are attached to the bones via their tendons. They tend to work in a team with other muscles around the joints. There are several problems that can occur with muscles:

1. Strains

This is a tear in the muscle and can range from a very small tear to a complete rupture.

2. Tight Muscles

Some people naturally have more flexibility in their muscles than others but we can develop tight muscles for a variety of reasons e.g. posture, for example sitting at a desk all day, a sudden growth spurt in a teenager or because a particular muscle is compensating for a weaker one in its 'team' around the joint. Tight muscles often develop trigger points 'knots' which prevent the muscle fully extending. Tight muscles also tear more easily when over stretched.

Physiotherapy will identify the reason why your muscle is tight and come up with the correct treatment in order for you to address the problem.

3. Muscle Imbalance

Muscles work as a team around the joints. The muscles closest to the joint hold it in the correct position (stabilise it) and the longer power muscles produce the movement (mobilise it).

Stabilising muscles often become weak if there has been some joint pain or simply because they are underused either because of the positions we adopt during our work day or the sport we perform. In this situation other mobilising muscles will attempt to stabilise the joint often becoming tight (short) in the process.

Physiotherapy can identify the problem muscles and strengthen the weak links.

Tendinitis/Tendinopathy

Tendinitis literally means inflammation (itis) of the tendon. Tendinopathy is the term more commonly used nowadays as inflammation is only present in the early stages of the condition. We now know that the main problem is an actual weakening of the tendon substance as the normal strong collagen is replaced by a more jelly like material. Tendinopathy is often due to the overuse of the tendon.

Physiotherapy treatment involves reducing the pain and building up the strength of the normal collagen in the tendon as well as building up the strength and flexibility of the muscle in order to reduce the weight load through the affected tendon.

Slipped Discs

Discs are shock absorbing cartilages that sit between the vertebral bones in the spine. They don't actually 'slip' in and out as they are securely attached to the bones on either side, but they 'bulge'. The outer wall of the disc can weaken and overstretch so that when the spine is loaded and compressed e.g. after prolonged sitting or bending, the outer wall bulges (like a weakness in the side wall of a tyre).

The disc itself has pain nerve endings and when stretched can send pain as far down as the knee or elbow joint depending on whether the problem is in the low back or neck. Occasionally the bulge is large enough to irritate one of the spinal nerve roots that runs close to the disc as it leaves the spinal cord. This can produce pain down the leg (sciatica) or arm. If it compresses the nerve this often causes pins and needles and/or some weakness in the muscles that the nerve supplies.

Physiotherapy is aimed at reducing the disc bulge, then restoring full range of movement and strengthening the muscles.

Pins and Needles

Pins and needles can occur when there is some irritation of one of the spinal nerve roots. They may occur in an area of the arm, leg, around the chest wall or even in the face. The nerve root can be irritated by a bulging disc, an osteophyte (extra bone around an arthritic joint) or simply because they do not have enough space to glide because they are surrounded by stiff, tight spinal joints.

Physiotherapy will identify the cause of your pins and needles. Treatment will be focused on reducing the cause of the irritation.

Osteoarthritis/Spondylosis

Often called Spondylosis in the spine and 'wear and tear' of the joints by the medical profession. Many of us have osteoarthritis without any symptoms at all but it can trigger inflammation of the ligamentous tissues that surround the affected joints and cause pain. As this inflammation settles down the previously inflamed tissues tighten up and can then restrict movement at the joint causing problems with movement and pain when the tight tissues are overstretched. The pain also tends to inhibit the muscles around the joint making them weaker and unable to fully support the affected joints.

Physiotherapy can not change the 'wear and tear' in the joints but can have a big effect on the tight soft tissues, muscle strength and pain.

Bursitis

Bursa are small sacs of synovial fluid which prevent muscles and tendons from rubbing on bone. Bursitis is when a bursa becomes inflamed; this is usually caused by compression or repetitive action.

Physiotherapy will assist in reducing the inflammation.

Cartilage Tears

There are specialised cartilages in the knee and wrist joints which can occasionally tear due to trauma or overuse.

A physiotherapy assessment will identify and diagnose the problem. It can often treat the symptoms and refer you on for an Orthopaedic opinion if surgery is required.

Fractures

A fracture is a broken bone, usually the result of a trauma but can occur occasionally from overuse. The fracture is usually immobilised in a splint for a period of time. The joints enclosed in the splint can become very stiff and the muscles that surround the fracture can become weak.

Physiotherapy can help restore movement to the affected joints and strengthens the surrounding muscles.

Biomechanical Problems

The term biomechanics actually means the way the body moves. It looks at how one body part moves in relation to those above and below it. Our biomechanics is affected by our body structure. It is also influenced by the postures we adopt during our daily lives and the sports we perform. Very few of us are biomechanically perfect but problems often reveal themselves when we suddenly challenge our body e.g. training for the Great North Run. The increased intensity of work for the body and the repetitive nature of the training can cause a variety of symptoms to occur e.g. knee pain, achilles tendinopathy.

A physiotherapy assessment will identify any biomechanical problems you may have. If there are any specific foot problems that can not be addressed with physiotherapy treatment we will refer you to a podiatrist.