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

The Sacro-Iliac Joint

The sacro-iliac joints are a pair of large irregular joints at the base of the spine which connect the sacrum, the triangular bone below the lumbar vertebrae, with the ilium, the large wings of the pelvis. It is a synovial joint like the fingers or knees but has very limited movement and functions to transfer the weight of the upper body from the spine to the hips. The sacro-iliac joint has very strong ligaments which travel the very short distances between the two highly irregular joint surfaces. There are no muscles which can act to produce real movements of the joint as other joints move and it functions as the weight transmitting and stress relieving pelvic joint.

The sacro-iliac joints are designed to absorb the torsional stresses which occur in the pelvis during gait and do have small degree of movement to help them manage this function. The irregular joint surfaces with its depressions and prominences allow the sacrum to lock between the iliac bones so that it cannot be driven downwards by the weight of the body. The irregular joint surfaces also prevent the sacrum being rotated inappropriately, with its strong ligaments being responsible for absorbing pelvis stresses during walking.

Pes Cavus

This condition is also known as high instep or high arch and is a type of foot anatomy where the medial longitudinal arch (arch on the inner side of the foot) is significantly greater than normal. This is the opposite foot deformity to flat foot and may be without symptoms. However the limiting of weight bearing stresses to the heel and the metatarsal heads may put excessive stresses on the ball of the foot, causing calluses to form and a painful front foot problem. This can also go with hammer toes where the toes are flexed up in a clawed manner and take no part in contacting the ground in gait.

Pes cavus may cause difficulties in selecting suitable footwear as the height of the foot in the midfoot region is so much greater than normal, and some people may need insoles to support the arch and allow effective and painless walking. Pes cavus can be hereditary or can be secondary to a neurological or neuromuscular condition. Treatment is usually conservative such as physiotherapy for strengthening and stretching and the provision of custom insoles as surgery to treat foot pain of this cause is unpredictable in outcome.