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

Trochanteric Bursitis

Pain on the side of the hip is a common complaint and often diagnosed as trochanteric bursitis, even though this diagnosis may not be verifiable. Lateral hip pain can be referred from the lumbar spine or the hip joint but in many cases the pain is located over the large bony prominence at the side of the hip, the greater trochanter. The tendons of several of the large buttock muscles come round and insert into the greater trochanter. On examination a physiotherapist might find great tenderness over the greater trochanter and over the nearby tendon, with pain on resisted hip abduction which stresses the tendons.

Symptoms are aggravated by walking, running or any activity which demands significant power from the buttock muscles. Initially the pain was thought to be inflammation in one of the lubricating sacs positioned between moving structures, known as bursae. Present ideas indicate that degenerative changes may occur within the tendon structures, causing a tendinosis which can be painful. Treatments can include physiotherapy to teach patients eccentric exercises to stress the tendons and force it to repair, steroid injections into the tendon areas which are painful or in severe cases a surgical release.

Spinal Posture

Spinal posture can mean two main things, one being the shape and orientation of the curves in the spine and two being the angle that the whole spine is aligned to the vertical. The minimum of muscle activity occurs when the trunk is balanced directly above the pelvis and any deviation from this requires muscle activity to increase to maintain position. As the main moving muscles of the spine are orientated lengthways like the spine itself, when they contract they generate significant compression forces through the spine. Contraction of these muscles in easy standing or sitting still generates forces through the lumbar spine that are twice the body weight above the area.

In sitting it makes little difference to the degree of muscle activity whether the lumbar spine is held arched to some degree (lumbar lordosis) or flexed (bent), the key point is whether the spine is vertically aligned or not. So leaning back with a lordosis or forwards with a flexed spine both generate high muscle forces, whilst sitting upright in either posture does not. Sitting positions all flex the lumbar spine, with the lower two lumbar levels being significantly flexed in these postures, even to the maximum of their movement.