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

Falls and Healthy Bones

Falling in adults is an important matter with involvement of around 30% of people over sixty-five years old and half of those over eighty-five years. There are significant risks to falling for elderly people, with many much older people dying and or suffering loss of mobility or other problems. Ninety percent of hip fractures are caused by falling and this comes with a very high cost both personally and financially. Only twenty percent of people who fracture their hip recover well enough to attain their previous level of functional abilities which includes walking. There may be many reasons for a person falling and the evidence for the many interventions proposed being effective is not very good.

Physiotherapists prescribe exercise programmes as part of their main arsenal of skills, with good evidence that well designed programmes which include training balance and strength can be effective at reducing falls in the community. Patient access to assessment and treatment by a physiotherapist is however variable in the UK, with hip fracture patients likely to receive this (due to admission to hospital) but patients with non-hip fractures are much less likely to receive this even when admitted. Physios have a much greater role in this matter which they have not taken up.

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.