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.

Time and Muscle Degeneration

Ageing is associated with decreases in both muscle bulk and strength, varying with different muscles in the body and with which side is the dominant one. The loss of the capacity of muscle is greater in men than in women and also in people who are less active physically. Hormone changes, reduced rates of protein production and poor dietary intake can all contribute. Physiotherapists can reverse this process by instituting a resisted exercise programme at the higher intensity level. Older people can respond to muscle training although older muscles do react less strongly to stimulation and take longer to recover and strengthen after exercise sessions.

Older muscles also suffer from a variety of other changes: a reduction in the ability to use energy to produce force; an increase in the fibrous tissue content which can increase stiffness. Along with the reduction in the ability to know where the joints are at any one moment the elderly suffer from slower reactions and poorer muscle control, with weaker and more easily tired muscles. This can lead in very elderly people to a loss of independence and increasing frailty. Perhaps because of its good blood supply, muscle is mostly able to regenerate itself and remain strong.