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

Tendon Bone and Ligament Bone Junctions

Tendons and ligaments have important functions in the body and their ability to perform their functions depends on their connections to the skeleton, on which they exert their forces or their restraining influences. The junction between a tendon or ligament and the bone is called an enthesis and inflammation of that area is known as enthesitis. There is an important group of arthritis conditions where the enthesis is the main site of inflammatory change, as well as normal musculoskeletal problems secondary to injury or degenerative changes. Typical conditions include ankylosing spondylitis, psoriatic arthritis and reactive arthritis.

Entheses vary in their structure: fibrous ones have the ligament or tendon continuing in their normal structure until they contact the bone; fibrocartilaginous ones have a piece of fibrocartilage on the site of attachment and it is this latter group that are mostly of interest in arthritic diseases. The cartilage makes the end of the tendon stiffer and cushions the sudden changes from flexible tendon or ligament material to the hardness of the bone. The management of the stresses which are transmitted through ligaments and tendons to the bone are complex and the body has adapted with a series of anatomical modifications.

Forward Bending Actions Which Can Injure The Spine

In normal circumstances people bend their lumbar spines by 80-100% of the available movement when they bend over to the floor to pick things up. Adding an awkward movement such as to one side increases the stretch on the facet joint of the other side. This indicates that it is easy to get to the maximum bend limit of the lower spine by doing something easy like reaching down to the feet to put on shoes. Long periods of remaining flexed, such as sitting for a long car journey, forces the ligaments to relax, decreasing the protective muscular mechanisms and increasing the chances of suffering a disc prolapse.

If the muscles get tired by repetitive actions of lifting or bending over then their protective care of the spine is also diminished. In the anatomical examination of spines after death there has been shown to be a 20% incidence of rupture of the ligaments which connect the spines of the individual vertebrae at the back. As these ligaments are fully stretched when the spine is fully bent it is likely that bending injuries due to too much flexion of the spine are very common as people are suddenly forced into bend by an accidental movement.