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

Ligament Bone and Tendon Bone Inflammation . Enthesitis Symptoms

Inflammation of the entheses, the anatomical junctions (insertions) where the bone meets a ligament or a tendon, cause pain in the local areas, persistent stiffness around the joint and swelling of insertions such as where the Achilles tendon attaches to the heel. If there is obvious joint swelling and other relevant symptoms then the diagnosis of an arthritic condition known as a spondyloarthritis is moderately clear. If the extra symptoms are not present the diagnosis is more difficult and patients may be referred for consideration of more localised musculoskeletal conditions such as sports or overuse injuries.

The pain, stiffness and swelling which typically accompany enthesitis commonly occur at the Achilles tendon and patellar tendon insertions but may also be present in the sole of the foot near the heel, in the elbows where tennis elbow typically occurs, around other ligament insertions of the knee and in the spine. Joint swelling which gives an effusion (water in a joint) may occur to confirm the diagnosis. Despite inflammatory changes of an arthritic disease obviously occurring in some patients the blood markers of inflammatory processes may not be raised, making it easy to miss the diagnosis in the absence of confirmatory tests.

Skin Burn after Cryotherapy

Cryotherapy, also called cold therapy or ice therapy, is a common modality of self treatment and routinely used in physiotherapy for acute injuries. However, partial thickness skin burns have been known to occur after cryotherapy and this therapy needs to be carefully managed to prevent doing patients harm. When cold is applied to the skin it responds initially with vasoconstriction, reducing the amount of blood in the area to conserve heat. As the cold persists this is followed by vasodilation as the circulation to the area is increased to bring warmth to the area and prevent tissue damage.

If cold then persists for a long time the circulation may be withdrawn more permanently, allowing an area of skin to be exposed to cold for a time when it has no blood supply to keep it warm and alive. This can result in local death of the skin, an ice burn or frostbite. Physiotherapists are aware of this danger, assess the patient for skin sensibility and apply cold carefully with supervision. The use of cold packs taken from a freezer (at minus 18 degrees) is not safe directly on the skin and a wet towelling material should always be put between the pack and the skin.