Physiotherapists in Bristol treat many different conditions including the issues profiled below.

Frozen Shoulder

Frozen shoulder is a somewhat mysterious condition which afflicts people mostly in their middle years and can give high levels of pain and disability which can last over several years. Onset of frozen shoulder is typically sudden and may follow a minor shoulder injury or even a tweak on some unaccustomed movement which may not seem relevant. The initial phase is of steadily increasing pain which can be very severe and badly interfere with sleep. During this phase the shoulder is very difficult to move and the patient needs strong analgesia to get some rest and function normally.

Once the acutely painful period has passed the shoulder begins to lose range of movement, particularly lateral rotation, the ability to rotate the upper arm bone outwards. As the pain gradually reduces slowly the stiffness of the shoulder increases until the arm is just very stiff without much in the way of pain. Overall the process can last two years or more until the shoulder loosens up although full range of motion may never be recovered. On examination lateral rotation and elevation will be severely limited and the patient will often lift the whole shoulder girdle in an attempt to raise the arm.

Hypermobility

We are all born with a genetically determined type of fibrous tissue, the collagen material that makes us all or most of our ligaments, tendons, skin and discs. Our collagen varies greatly in the amount of extensibility it allows due partly due to the amount of elastic material included and the length of our tissues. Normal mobility varies from stiff jointed to very mobile and individuals who show very high degrees of flexibility of their joints are termed hypermobile. Hypermobility may be asymptomatic or can cause significant pain problems in other cases. Benign hypermobility syndrome BHS is diagnosed clinically by testing the patient's joint mobility.

The diagnostic tests are: the little finger can be pulled back to 90 degrees to the hand; with the wrist bent the thumb can be pulled back to touch the forearm; the elbows extend back beyond neutral; the knees extend back beyond neutral and the person can bend over with the knees straight and place their palms on the floor. Each joint gets a score of one if positive and this gives a score out of nine. The score indicates the degree of hypermobility the patient is exhibiting and helps decide whether the joint condition is relevant.