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

Physiotherapy Shoulder Exercises after Breast Cancer Operation

Breast cancer is the commonest cancer in women and in England there are over 36,000 people diagnosed yearly. Treatment is complex but surgery is common to remove the tumour and to remove four or more lymph nodes in the axilla or armpit. This is to work out what stage the cancer is at and prevent it recurring in the axilla. A side effect of this treatment is the development of swelling in the affected arm, known as lymphoedema, which can remain over time and cause physical and psychological problems. Physiotherapists routinely assess and treat patients with cancer, pre or post operatively, to manage the mobility and joint problems which develop after diagnosis and treatment.

Removal of the axillary nodes impacts upon movement of the shoulder as the tissues in the axilla are stretched by raising the arm above the head. A paper in Physiotherapy (December 2008) by Todd and co-workers compared two groups of post operative patients, with one group having unrestricted shoulder movement after 48 hours and the other with this delayed for seven days. The results showed that delaying the movement for seven days avoided the incidence of increased arm lymphoedema, an important consideration as the level of swelling can remain long term.

Losing and Gaining Muscle

Muscle is a dynamic tissue, changing greatly to accommodate to changing requirements. If a person.s leg is immobilised the thickness of the quadriceps muscle decreases by 15-20% in six weeks as the Type 1 muscle fibres reduce their protein production. This is the reason why immobilisation of a fracture or sprain is kept to an absolute minimum as losses of muscle and bone tissue are important, with joint stiffness another potential damaging side effect. Muscle will also respond quickly and strongly to increases in loading, with a maximum weight to be lifted increasing by 100% over a 12 month training period.

Much of the increased strength of muscle is due to hypertrophy of the muscle fibres, although other factors contributing are muscle endurance and learned coordination of the movement. A 30% increase of muscle mass can occur in four days after a muscle is overloaded in a stretched position, indicating the speed by which this part of the musculoskeletal system can adapt to new conditions. Exactly what makes muscles increase in strength is under discussion, but unexpectedly high activity, particularly in eccentric contractions, can cause the exercise induced damage which leads to repair and hypertrophy.