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

Achilles Tendon Rupture

The Achilles tendon is the largest tendon in the body, a large fibrous structure formed of collagen fibres lined up to form a very strong tendon which has to bear the force of weight bearing activities. The calf muscles are a very important part of propulsion in walking and when we walk, run or jump , very high forces are taken by the Achilles tendon as we perform vigorous movements with the ankle. As we get into our forties the strength of our tendons is declining but we often put the same forces on our body as we did twenty years previously. This can lead to the forces involved exceeding the strength of the tendon and a rupture, either partial or complete, results.

Treatment can be conservative or surgical, in many cases there being no significant clinical difference between the two in terms of outcome. Plaster of Paris used to be used routinely for immobilisation but new bracing systems have now been developed which allow precise control of the angle of the ankle and so the stresses on the tendon. This allows a graded progression of force as the tendon heals. Physiotherapists apply these braces and rehabilitate patients once they are out of the immobilisation.

Good and Bad Lumbar Posture

Good and bad lumbar posture has often been decided on grounds that are not sufficiently scientific and future recommendations need to be based on solid research. Early research on the effects of different spinal postures indicated that maintaining a lumbar lordosis reduced the pressures inside the disc nucleus. This seemed fine until it was realised that these pressures were being transferred to the rear disc walls and the facet joints. As the facet joints are known to be frequent causes of low back pain and the nucleus of the disc is not a source of pain the idea that a lordosis is desirable in all circumstances does not stand up to examination.

Overall having some flexion in the spine is better in static positions whilst a slight lordotic posture is better when walking. Too much flexion interferes with the ability of the muscles of the back to protect the spine, so a moderate position should be taken between too much flexion and too much extension. The benefits of slight flexion are mirrored in the typical habits of people in postures, such as crossing the legs or putting a leg up on something at a bar, both actions which increase the flexion of the lumbar spine.