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

Patellofemoral Pain

The patellofemoral joint is a frequent source of pain and disability and a difficult problem to treat successfully. The patella has two large facets on it.s under surface which are angled in respect to each other. They match the groove between the femoral condyles where the patella lies and moves upwards and downwards as the knee bends and straightens. As the quadriceps, the main thigh muscle, contracts to push us up from a chair, go up stairs or walk uphill, the patella acts like a pulley to increase the forces the muscle is able to exert. High levels of force are developed between the patellar and femoral joint surfaces.

The patella surfaces are lined with articular cartilage, a firm and very slippery material which ensures friction free movement of many of our major joints, even under load. With time this can soften and develop small fissures, making the patellar surface sensitive to loads being applied. If there is also a muscle imbalance or other abnormality which allows the patella to track in its groove a little towards the outside, this can also worsen pain. Degenerative changes can progress to osteoarthritis and cause disabling symptoms due to difficulties with stairs and gait.

The Rotator Cuff

The rotator cuff muscles of the shoulder function to stabilise the large humeral head on the relatively small shoulder socket or glenoid cavity. The origin of the rotator cuff muscles is the large flat areas of the scapula or shoulder blade, but for the muscles to be able exert their forces the shoulder blade must itself be stabilised. The shoulder blade floats over the thoracic rib cage and is attached by various muscles to the trunk, the rhomboids, trapezius and serratus anterior. If there is a dysfunction in these muscle groups the stability of the scapula will be compromised, making it difficult or impossible for the rotator cuff group to do their work effectively.

The rotator cuff muscle all originate medially to the shoulder, i.e. further in towards the middle of the body. They pass outwards towards the head of the humerus, becoming tendons close to the shoulder itself and then inserting into the greater tuberosity, a bony protrusion on the outside of the head of the humerus. The primary pull of the rotator cuff muscles is in a directly inwardly direction, pulling the humeral head firmly against the glenoid. This counteracts the tendency of the deltoid muscle to pull the humeral head upwards.