Posts Tagged ‘Physiotherapy’

Joint Examination and Physiotherapy

Our ability to participate in functional activities is greatly dependent on the state of our body joints, from the knees and hips which bear weight and allow walking to the jaw joints which aid speaking and eating. Our joints are exceptionally well designed to allow us to move about and accomplish tasks and mostly they do their jobs quietly and very well. Illness, injury or disease can damage the joints, causing pain and stiffness and limiting functional activity. Physiotherapy examination of the joints is a core skill, demanding a logical approach, the finding of pathological signs and the formation of a treatment plan.

Joints, the junctions between two bones, can have weight carrying, force transmission or movement properties depending on their design and position in the body. An example of a movement joint is the shoulder with its great range, the acromio-clavicular joint is a force transmission joint allowing arm function and the back and hips are weight bearing joints with some movement function. The most obvious of our joints are all synovial joints, a particular and very important joint type. The bone ends are coated with articular cartilage which reduces friction, the joint fluid is secreted by the synovial joint lining membrane and the joint capsule, formed by the ligaments, holds the joint protected against mechanical forces.

Physiotherapy examination of a joint starts with observating how the person uses the joint as they move into the consultation room and sit down. They may hold the joint protectively in a low-risk position, move carefully and guardedly to avoid stressing the joint or splint the joint in some way. The physio takes a history then looks at the joint, noting any deformity, warmth, swelling or effusion, all signs of inflammation. A cool, non-swollen joint in a good position may still have a problem but it is not acute and will need to be searched for. A hot joint with tight swelling will need immediate treatment with the acute injury protocols.

After the visual examination the physiotherapist will palpate the joint and surrounding structures, which means exploring or stressing an area logically with the fingers or hand, an important physio skill to clarify the diagnosis. The physio will palpate around the joint margins, the joint line itself, the tendon insertions and the ligaments surrounding the joint. Effusion, which means the presence of synovial fluid in a joint, can be felt by the resistance it gives if it is tight, by its thickness and plasticity if it is sticky and by the way it can be moved around the joint if it watery.

Once the joint has been assessed visually, which takes a very short time, the physiotherapist will move on to palpation of the joint structures which will help identify which parts of the joint are affected. Palpation involves systematically feeling and stressing structures in an anatomical area to pin down faulty structures more closely. Palpation of the joint involves testing the joint line, the insertions of the tendons and ligaments, along the ligaments themselves and around the joint margins. Fluid in the joint is called an effusion and can be thick and sticky, very tight and firm if there is a lot, or movable if the fluid is thin

The physiotherapist will assess the active range of the joint movement which is what the patient can manage independently, noting the ranges as a proportion of normal and why the joint could not achieve full range, e.g. pain or muscle weakness. The physio will then move the patients joint passively without the patients effort to see if the joint ranges are different. If the physio can move the joint through its full normal range but the patient cannot do this, then either pain or muscle weakness is the likely cause. If neither the physio nor the patient can get the joint to full range, pain or joint stiffness may be the problem.

Ligaments are very important for normal function of a joint and the physiotherapist will routinely test their integrity, stressing them strongly by manual testing. The ligaments of major joints are very strong and testing a normal ligament should show no effect but it can uncover an absent, painful or stretched ligament by its effect on joint stability. Physios use the Oxford 0-5 scale to grade muscle strength, allowing for anxiety or pain which might interfere with a patients effort. Proprioception and joint sensibility may also be tested to ascertain if good feedback from the joint to the brain is present, this being important in normal movement planning.

Be the first to comment - What do you think?  Posted by admin - December 13, 2017 at 4:30 am

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Physiotherapy And Cardiac Surgery

One may feel fatigued and sore after cardiac surgery; it is only natural.  On the other hand, it seems altogether strange to think of embarking on a course of physiotherapy afterwards instead of just resting.  Yet, that is just what is recommended.

Types of cardiac surgery include bypass surgeries, angioplasty, stents, heart valve replacements, and even heart transplants.  Patients having all of these surgeries can benefit from physiotherapy.  Patients who have other cardiac problems can use the help too; they include victims of heart attacks, heart failure, peripheral artery disease, chest pain, and cardiomyopathy.

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Be the first to comment - What do you think?  Posted by admin - December 11, 2017 at 4:27 pm

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Unique and New physiotherapy unit – “BIO-MAG”

“BIO-MAG” – physiotherapy equipment for therapy and bioresonance antiparazitarnoy adjustments, unique in its functionality, compactness and convenience.

The device bioresonance therapy “BIO-MAG” is the latest development of Russian scientists, for a wide range of users (from doctors to ordinary housewife), referring to its integrated multi-effects, on the one hand, and a simple and intuitive interface, compactness and usability on the other. Read more…

Be the first to comment - What do you think?  Posted by admin - December 10, 2017 at 4:34 pm

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Wrist Fracture – Try Physiotherapy

Every winter the weather gets cold and icy at some time and we realise that the time has come when we are less safe out and about, that season when people start to slip and fall. Falls on an outstretched hand (FOOSH) are a very common injury and often cause a fracture of the end of the forearm bones, a fracture routinely known as a wrist or colles fracture. The fracture can be insignificant or very major requiring screws and plates to realign and fix it in position. Physiotherapists assess and plan rehabilitation of the wrist, hand and forearm.

The wrist is the most commonly damaged part of the arm and three quarters of wrist injuries consists of radius and ulna fractures. Minor injuries may have just a crack and remain in position and as injuries become more serious they involve larger numbers of fragments and more marked displacement. As the person falls on the hand the results depend to some degree on age: children develop a greenstick fracture (a kink in the bone), adolescents separate the growth plate from the bone and adults fracture the radius and ulna in the last inch near the wrist. Read more…

Be the first to comment - What do you think?  Posted by admin - December 7, 2017 at 4:28 pm

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Physical Therapy Treatments – How Physiotherapy is Used in the Treatment of Down Syndrome

When we speak of physiotherapy as a treatment for children suffering from Down syndrome, it must be kept in mind that Down syndrome is a condition that can never be completely treated. Physiotherapy is used not so much to treat the syndrome as to alleviate the complications peculiar to children afflicted by Down syndrome.

Treatment in the early stages of a child with Down syndrome concentrates on addressing four problems common in this phase. The first among these is hypotonia. Children with Down syndrome do not have muscle tone, meaning their muscles are slack and lack control. Hypotonia requires immediate attention since if left untreated it hampers a child ability to develop sufficient motor skills or balance. Read more…

Be the first to comment - What do you think?  Posted by admin - December 6, 2017 at 4:28 am

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Physiotherapy Can Help Cervical Nerve Root Neck Pain

Cervical radiculopathy is a pain syndrome involving one of the cervical nerve roots, with the C7 root (60%) and the C6 root (25%) being the most commonly involved. In younger persons this is due a direct injury which compromises the nerve exit or due to an acute disc prolapse. In older age groups this syndrome can also occur, but in this case is due to narrowing of the nerve exit by arthritic joints and ligament enlargement, disc bulging and bony outgrowths. Cervical nerve root pain referred to physiotherapists for the management of neck pain and arm pain.

The regular lifting of weights over 12 kilograms (25 pounds), operating or driving machinery which vibrates and cigarette smoking are all risk factors for cervical radiculopathy. This kind of neck and arm pain is much less common than the lumbar syndrome of back and leg pain (sciatica). The discs between the cervical vertebrae allow loads to be transmitted down the spine and damp down unwanted shocks. The joint, disc, bone and ligamentous structures form exit spaces for the nerves on the sides of the vertebrae, with up to a third of their space taken up by the nerve. This space can be compromised if degenerative changes occur nearby, leading to nerve compression symptoms.

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Be the first to comment - What do you think?  Posted by admin - December 3, 2017 at 4:31 pm

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Physiotherapy and the Management of Knee Replacement

Major joint replacement is one of the success stories of the late twentieth century, providing the greatest changes in quality of life measurements of all medical treatments or operations. Total knee replacement has now developed from a less predictable operation to a routine procedure with good long-term results for severely osteoarthritic joints. Populations in developed countries are rapidly getting older and total knee replacement is set to overtake total hip replacement as the most performed joint replacement.

Osteoarthritis is a degenerative joint condition which is more common the older a person becomes, and is the most prevalent joint condition in human populations. The most affected joints vary, with some people having spinal and finger changes whilst other suffer OA of the major joints such as the hips and the knees. Major joint disease is more disabling as it tends to compromise normal mobility and so reduce independence. The patient can suffer from loss of knee movement, reduction of knee power, grating and crunching of the joint and pain, for which weight loss, muscle strengthening, painkilling medication and physiotherapy can be useful. If normal therapies are not successful then knee replacement is the remaining option. Read more…

Be the first to comment - What do you think?  Posted by admin - December 2, 2017 at 4:34 am

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Shoulder Rotator Cuff Disease

The rotator cuff is a musculotendinous cuff which surrounds the humeral head and through which the shoulder stabilising and movement muscles exert their forces onto the shoulder. The cuff enables us to put our shoulder through a very large range of motion, the greatest range of any joint in the body, for the purpose of putting our hands in functional positions. The shoulder’s function is to allow our hands to be put in useful positions within our visual field so we can perform the intricate activities that define being human to a degree.

As the muscles approach their insertions on the humeral head they become more and more fibrous until they become wholly tendinous. Many bodily tendons are cylindrical and long but the shoulder tendons are flatter structures which coalesce over the top of the humeral head. The rotator cuff has a relatively poor blood supply and little or no ability to heal and with time and physical stresses tears appear which are often painful but not always so. Rotator cuff tears are a major part of a shoulder surgeon’s work and rotator cuff surgery is common, complex and demands detailed physiotherapy follow up for successful outcomes.

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Be the first to comment - What do you think?  Posted by admin - November 28, 2017 at 4:32 am

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Physiotherapy and Stretching

The limitations in flexibility which people exhibit are of interest to a large group of professions from medicine to physiotherapy, osteopathy and chiropractic. Yoga and other eastern traditions have employed stretching techniques called asanas for thousands of years although this was not their primary purpose. The eastern martial arts, such as karate, judo and taekwondo, also emphasise flexibility in the performance of these comprehensive martial ways of living. Flexibility is not precisely defined but in anatomical terms it mostly refers to the ability of joints to go through a particular range of motion.

Ballistic versus Static Stretching

Stretching, when you get down to details, has a lot of controversial and uncertain matters which are unresolved. The pros and cons of static and ballistic stretching is one discussion point. Static stretching is Read more…

Be the first to comment - What do you think?  Posted by admin - November 26, 2017 at 4:29 am

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Physiotherapy Can Help Cervical Nerve Root Neck Pain

Cervical radiculopathy is a pain syndrome involving one of the cervical nerve roots, with the C7 root (60%) and the C6 root (25%) being the most commonly involved. In younger persons this is due a direct injury which compromises the nerve exit or due to an acute disc prolapse. In older age groups this syndrome can also occur, but in this case is due to narrowing of the nerve exit by arthritic joints and ligament enlargement, disc bulging and bony outgrowths. Cervical nerve root pain referred to physiotherapists for the management of neck pain and arm pain.

The regular lifting of weights over 12 kilograms (25 pounds), operating or driving machinery which vibrates and cigarette smoking are all risk factors for cervical radiculopathy. This kind of neck and arm pain is much less common than the lumbar syndrome of back and leg pain (sciatica). The discs between the cervical vertebrae allow loads to be transmitted down the spine and damp down unwanted shocks. The joint, disc, bone and ligamentous structures form exit spaces for the nerves on the sides of the vertebrae, with up to a third of their space taken up by the nerve. This space can be compromised if degenerative changes occur nearby, leading to nerve compression symptoms. Read more…

Be the first to comment - What do you think?  Posted by admin - November 24, 2017 at 4:28 pm

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