Physiotherapists in Herefordshire treat many different conditions including the condition profiled below.

Flat Feet

It is common for patients to present with progressive flat foot deformity, also known as pes planus. However, despite it being common there the causes and treatments are still under debate. Adult acquired flat foot is most likely to be caused by an imbalance between the active arch maintenance structures and the passive arch maintenance structures. The foot may have been normal at some stage and something has changed to bring on the process of flattening of the arches. The posterior tibial tendon plays a strong role in actively maintaining the inner arch and a dysfunction or weakness of this structure is thought to be important in flat foot.

However, the ligaments binding the medial arch together and maintaining its structure may also be deficient in some way, leading to flat foot problems. The spring ligament, a strong ligament running between the calcaneus (heel bone) and the navicular, supports the head of the ankle bone (talus) and stops its slipping downwards, thereby maintaining the arch of the foot. Deficiency of this ligament complex is thought to be equally important to problems with the posterior tibial tendon. Treatment typically starts with insoles and modified footwear and progresses to foot surgery.

Overdoing and Avoiding in Chronic Pain

Chronic pain can lead to significant levels of distress and disability as sufferers struggle to maintain their activity levels in the face of high levels of pain. People vary enormously in their responses to a chronic pain problem but the two most obvious approaches are avoiding and overdoing. Avoiding is much less common the person doing less and less with time, avoiding activities as they fear damage to their back. With time this evolves into an almost complete avoidance of activity as the person rests for the majority of the day, with others typically taking over all the domestic tasks and often many of the personal ones too. This leads to high levels of unfitness and deconditioning.

The other approach, more common overall, is to keep pushing on with activities because they have to be done, and then cope with the consequences afterwards. These people feel guilty at not being able to do the things they should and when they wake up to a better day than normal they go for it, doing all the things they have wanted to do until the pain increase stops them and then is much worse for several days, forcing them to rest.

Physiotherapists in Herefordshire have contributed some of the many articles on this site such as the one extracted below.

BBC Health carries an article about a review of six trials covering 1800 patients which concluded that MRI scanning does not help in the management of normal low back pain and should be reserved for specific conditions such as nerve root lesions, infections and tumours. The outcome of low back pain is not improved by the use of scans and there were no differences between the two groups, one group with typical management and the other having an MRI scan at some stage. This was the same for the early outcomes and for up to a year after the onset of acute low back paiMRI scans are commonly requested perhaps because of patient expectations or because the referrer thinks it is a concrete thing to do and might show up the cause of the patient's back pain. Studies have shown that it is very rare for an MRI scan to shows up something important about a person's back problems but it is easier to do this than take the time to communicate the strategy clearly and answer the patient's many problems...

more MRI Scans Dont Help Back Pain