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

Hand Injuries - Acute Management

Most injuries, apart from the most minor, benefit from being seen and assessed by a doctor as a relatively minor dysfunction in the hand can cause long term functional disability. Initial management of a hand injury should be to control any bleeding by applying gauze or a clean cloth to the wound and putting some pressure on it. In a closed injury (i.e. no wound) then ice can be applied to the damaged area to reduce inflammation and pain. Jewellery such as rings needs to be immediately removed as hand swelling can be very dramatic, rendering easy removal later impossible.

Once in the Emergency Department the doctor will x-ray the hand routinely and may inject the nerve at the wrist level or at the base of one of the fingers to numb the hand or the finger so that they can examine the area without too much pain. Wounds will be cleaned if they are dirty and then closed by stitching or a related method, with antibiotics prescribed to prevent infection developing. Splinting is often used to immobilise the hand in a specific position to prevent further injury or maintain anatomical integrity. A referral to a hand specialist or a plastic surgeon is typically written and pain control medication will be encouraged for a few days.

Simple Neck Exercises . Three

Whilst simple neck exercises are extremely valuable to correct postural abnormalities, lengthen shortened structures and relieve painful neck problems it is important to use the correct technique to get the best from them. Incorrect technique can make the exercises effectively useless or even worsen the problem or cause injury. There are four basic directions of neck exercises: front and back (flexion and extension); side to side (side flexion); rotation; retraction (tucking the head in a bit like a chicken does when it walks). All these movements need to be performed to put the cervical structures through their full movement.

The structures which make up the body do not respond well to fast movement or great forces applied in very short time periods. The aim with simple neck exercises is to get the joints to the extremes of their movement and give a gentle end range stretch to the anatomy. To achieve this the movement needs to be steady and slow, without jerking, and held at the end with a bit of extra effort for a few seconds. It is also useful to do just one movement at a time, the common behaviour of rotating the neck in large circles being both more likely to aggravate the joints and not getting the full movement of any of them.