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

Lumbar Facet Joint Syndrome

The lumbar spine is a very complex structure made up of a large number of different anatomical structures, many of which can be sources of pain in different situations. One structure which is known to contribute to low back pain is the facet joint, the small synovial joint placed at each side of each disc level. The facet joints are made up of one facet from the vertebra above and one from the vertebra below, with a joint capsule lined with synovial membrane. The joint capsule is well supplied with nerve endings which could transmit pain. In normal backs the facet joints serve to control the movements permitted at the particular part of the spine in which they lie, but do not take large amounts of weight.

With degeneration of the discs the facet joints are pushed together more strongly and forced to take larger amounts of weight, leading to degenerative changes developing within them and then the transmission of pain. The facets are forced to take more weight than they are designed for. Patients with this syndrome particularly dislike extension of the spine which forces the facet joints together and elicits pain. Mobilisations and regular exercises can be helpful from a physio.

Activity and Muscle Strength

When a person starts to train for strength or power they start exerting high forces for short periods of time, i.e. they use heavier weights for smaller numbers of repetitions. This causes large changes in the fast twitch type 2 muscles fibres, increasing their size but not changing their number. This process is known as mechanically induced hypertrophy and results from the muscle cells synthesising increased amounts of muscle proteins to build into larger muscle. Muscles can also add new sections to the areas where they join the tendon if they are subjected to stretching forces.

In contrast, if muscles are inactive they reduce the making of muscle proteins within a few hours and the muscle starts to atrophy, to lose size and strength. In injuries if a muscle is immobilised in a shortened position both its size and its length will be reduced, with non-contracting substances becoming more dominant. This leads to a muscle which is shorter, more stiff and less easily lengthened, a significantly negative outcome in that immobilisation for fractures will have unwanted effects on the local muscular structures. Modern methods concentrate on immobilising a joint only if essential and only for the shortest necessary period.