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

Hand Injuries - Diagnosis

The diagnosis of most hand injuries is not difficult as the damage is usually readily apparent to the examiner. There will typically be a history of trauma and this should be carefully attended to as it may give clues to a more complex injury than first appears. Bruising and swelling are very typical signs apparent on initial inspection, with pain a common and often localising feature. There may be an obvious deformity if the joints are dislocated or bones fractures with displacement, the patient will have lost the ability to grip firmly and there may be reduced range of movement in the fingers and thumb.

Examination starts with a visual examination of the hand which guides the doctor as to further required tests and investigations. The doctor will palpate the hand systematically to look for areas of particular pain or abnormal movement which would point to an underlying injury. The ranges of movement of the shoulder, elbow, wrist and hand is assessed and recorded, with the tendon actions tested in turn to search out any tendon involvement. Circulatory function will be checked to exclude blood vessel damage. Investigations will routinely include x-rays to look for fractures, dislocations or embedded objects such as glass.

Trochanteric Bursitis

Pain on the side of the hip is a common complaint and often diagnosed as trochanteric bursitis, even though this diagnosis may not be verifiable. Lateral hip pain can be referred from the lumbar spine or the hip joint but in many cases the pain is located over the large bony prominence at the side of the hip, the greater trochanter. The tendons of several of the large buttock muscles come round and insert into the greater trochanter. On examination a physiotherapist might find great tenderness over the greater trochanter and over the nearby tendon, with pain on resisted hip abduction which stresses the tendons.

Symptoms are aggravated by walking, running or any activity which demands significant power from the buttock muscles. Initially the pain was thought to be inflammation in one of the lubricating sacs positioned between moving structures, known as bursae. Present ideas indicate that degenerative changes may occur within the tendon structures, causing a tendinosis which can be painful. Treatments can include physiotherapy to teach patients eccentric exercises to stress the tendons and force it to repair, steroid injections into the tendon areas which are painful or in severe cases a surgical release.