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

Activity and Muscle Strength

When a person starts to train for strength or power they start exerting high forces for short periods of time, i.e. they use heavier weights for smaller numbers of repetitions. This causes large changes in the fast twitch type 2 muscles fibres, increasing their size but not changing their number. This process is known as mechanically induced hypertrophy and results from the muscle cells synthesising increased amounts of muscle proteins to build into larger muscle. Muscles can also add new sections to the areas where they join the tendon if they are subjected to stretching forces.

In contrast, if muscles are inactive they reduce the making of muscle proteins within a few hours and the muscle starts to atrophy, to lose size and strength. In injuries if a muscle is immobilised in a shortened position both its size and its length will be reduced, with non-contracting substances becoming more dominant. This leads to a muscle which is shorter, more stiff and less easily lengthened, a significantly negative outcome in that immobilisation for fractures will have unwanted effects on the local muscular structures. Modern methods concentrate on immobilising a joint only if essential and only for the shortest necessary period.

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.