Physiotherapists in Lee On The Solent treat many different conditions including the issues profiled below.

Supraspinatus Tendinitis

The supraspinatus muscle is one of the rotator cuff muscles of the shoulder and a vital part of a normally functioning shoulder. It originates in the supraspinatus fossa (anatomical depression) at the top of the scapula or shoulder blade and passes outwards towards the head of the humerus. Above the shoulder joint the muscle gradually becomes more tendinous until it passes over the top of the head of humerus and inserts onto the bony area called the greater tuberosity. The muscular action is to move the arm away from the side but a more important action is to hold the humeral head against the glenoid.

Due to the proximity of the tendon to the acromioclavicular joint above it can suffer compression and inflammation from repetitive overactivity, giving a sharp pain on lifting of the arm in many activities. Physiotherapy examination involves testing shoulder abduction with compression and tension stresses to change the impingement and palpation of the supraspinatus insertion on the humeral head whilst the patient's arm is behind their back. Treatment involves limiting aggravating activities, ultrasound to the tendon insertion and strengthening of the remainder of the rotator cuff muscles. Anti-inflammatory medication may also be useful.

Tendon Bone and Ligament Bone Junctions

Tendons and ligaments have important functions in the body and their ability to perform their functions depends on their connections to the skeleton, on which they exert their forces or their restraining influences. The junction between a tendon or ligament and the bone is called an enthesis and inflammation of that area is known as enthesitis. There is an important group of arthritis conditions where the enthesis is the main site of inflammatory change, as well as normal musculoskeletal problems secondary to injury or degenerative changes. Typical conditions include ankylosing spondylitis, psoriatic arthritis and reactive arthritis.

Entheses vary in their structure: fibrous ones have the ligament or tendon continuing in their normal structure until they contact the bone; fibrocartilaginous ones have a piece of fibrocartilage on the site of attachment and it is this latter group that are mostly of interest in arthritic diseases. The cartilage makes the end of the tendon stiffer and cushions the sudden changes from flexible tendon or ligament material to the hardness of the bone. The management of the stresses which are transmitted through ligaments and tendons to the bone are complex and the body has adapted with a series of anatomical modifications.