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

Physiotherapy for Osteoporosis

Osteoporosis is an increasingly common condition, mostly but not exclusively occurring in women after the menopause when hormonal changes mean the bone density drops steadily with time. Those women who have good bone density to start with and whose density does not drop at a high rate may never reach the risky category. If osteoporosis is present then the incidence of fractures is higher, with vertebral body fractures and fractured neck of femur being the most common, both requiring intervention and causing distress and expense. Physiotherapists are involved in the assessment and management of people with low bone density.

Physios assess patients for their lifestyle, refer them for dietary advice if appropriate, generally advise on management, warn against inappropriate functional activities and prescribe exercise routines to maintain independence and maximise bone health. Physios may advise that lumbar flexion to pick up weights is inappropriate as the front aspects of the vertebral bodies are vulnerable in this activity to crush fractures. General and weight bearing exercises are taught as weight bearing stimulates bone maintenance and growth due to the jarring involved. Swimming and cycling are good aerobic exercise methods but do not have the bone stimulating effect of walking or doing exercises in a gym.

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.