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

Shoulder Dislocation

The shoulder is an anatomically unstable joint as it is optimised for mobility rather than stability, allowing the hand to be placed in the very large number of positions required for optimal function. The shoulder socket (glenoid) is relatively small compared to the very large humeral head, leading to problems for the muscular and neurological systems as they struggle to keep the ball of the humerus centred on the socket during movement. The capsule of the shoulder, the fibrous bag which surrounds the whole shoulder joint, is relatively lax to allow for the large ranges of movement. This means it and its ligaments have little control over the joint and it relies on muscle control.

Dislocation is usually caused by a fall on the arm, especially if the arm in a position of abduction and lateral rotation, the position adopted by the .hands up!. posture. This is the most vulnerable position for the shoulder to dislocate anteriorly, i.e. the ball comes out of joint to the front. Immediate severe pain is the first symptom with the patient holding their arm in a protective position. Medical help is usually required to relocate the joint and there can be damage to the axillary nerve which control the deltoid muscle.

Hand Injuries - Acute Management

Most injuries, apart from the most minor, benefit from being seen and assessed by a doctor as a relatively minor dysfunction in the hand can cause long term functional disability. Initial management of a hand injury should be to control any bleeding by applying gauze or a clean cloth to the wound and putting some pressure on it. In a closed injury (i.e. no wound) then ice can be applied to the damaged area to reduce inflammation and pain. Jewellery such as rings needs to be immediately removed as hand swelling can be very dramatic, rendering easy removal later impossible.

Once in the Emergency Department the doctor will x-ray the hand routinely and may inject the nerve at the wrist level or at the base of one of the fingers to numb the hand or the finger so that they can examine the area without too much pain. Wounds will be cleaned if they are dirty and then closed by stitching or a related method, with antibiotics prescribed to prevent infection developing. Splinting is often used to immobilise the hand in a specific position to prevent further injury or maintain anatomical integrity. A referral to a hand specialist or a plastic surgeon is typically written and pain control medication will be encouraged for a few days.