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

Tendon-Bone and Ligament-Bone Conditions . Mechanical Factors

Problems with the junctions between bone and ligaments or tendons can occur because of mechanical rather than inflammatory factors, with overuse injuries, trauma and sport examples of causative factors. MRI scanning may show a pathological change in the insertion or enthesis but the differences between changes caused by inflammation and mechanical factors is not great. It is fairly clear at the Achilles tendon as changes caused by mechanical factors occur two to six centimetres above the insertion while inflammatory changes will occur at the insertion itself. Degenerative changes in the insertions may give similar effects to the changes from inflammation.

Enthesis in osteoarthritis may show the same, if more limited, changes which occur in inflammatory conditions. Modern investigations have improved our knowledge of these conditions, with spinal problems best imaged by magnetic resonance imaging (MRI) and areas of the body which are more easily reached can better be checked out using ultrasound. Swelling of the bony areas around the insertion can be present on scanning, as is soft tissue swelling of the enthesis and its surrounding region. However, a normal MRI and a negative blood test do not exclude an inflammatory arthritis as both tests are not specific enough.

The Curves of the Spine

A quick look at anyone's spine from the side clearly indicates that the spine is not a dead straight structure but has a series of curve. There are four spinal curves, the cervical, thoracic, lumbar and sacral. The neck curve begins to develop when the young child starts to try and lift the head up to look around, while the lumbar curve may be secondary to an upright gait. During walking the curves vary in regular amounts and this may be so that the spine can absorb and release energy, allowing the curves to be increased and decreased rather than the spine just suffers compression. This makes the curve system a form of shock absorber.

During the gait cycles the large muscles of the abdomen and back are working hard to stop large changes in the spinal curves occurring as this would adversely affect stability, and it is these tendons that the energy is stored which would otherwise just be applied to the spine. Walking involves jarring up and down movements which could be harmful if they were transmitted up through the spine and arrived at the head. These forces are lessened by the absorption of forces which the curves provide.