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

Supraspinatus Tendinitis

The supraspinatus muscle is one of the rotator cuff muscles of the shoulder and a vital part of a normally functioning shoulder. It originates in the supraspinatus fossa (anatomical depression) at the top of the scapula or shoulder blade and passes outwards towards the head of the humerus. Above the shoulder joint the muscle gradually becomes more tendinous until it passes over the top of the head of humerus and inserts onto the bony area called the greater tuberosity. The muscular action is to move the arm away from the side but a more important action is to hold the humeral head against the glenoid.

Due to the proximity of the tendon to the acromioclavicular joint above it can suffer compression and inflammation from repetitive overactivity, giving a sharp pain on lifting of the arm in many activities. Physiotherapy examination involves testing shoulder abduction with compression and tension stresses to change the impingement and palpation of the supraspinatus insertion on the humeral head whilst the patient's arm is behind their back. Treatment involves limiting aggravating activities, ultrasound to the tendon insertion and strengthening of the remainder of the rotator cuff muscles. Anti-inflammatory medication may also be useful.

Medial Ligament Sprain

The knee is one of the largest joints in the body and is exposed to high levels of force as the large leg muscles move the body around at speed. As it does not having interlocking surfaces to give it stability it must rely on ligaments to perform that job. The medial collateral ligament is a wide band which travels across the inside of the knee from above downwards, preventing the knee joint from opening on the inside and collapsing. If a force is applied strongly to the outside of the knee, in a tackle by someone moving quickly, the knee is pushed hard into a knock knee position and the inside of the joint opens, spraining or rupturing the medial ligament.

Symptoms of a medial ligament sprain are immediate pain, swelling of the knee and if severe a feeling that the knee is unstable. Mild sprains are treated using a knee brace for a week or two and working at regaining joint movement and function as soon as possible. Severe sprains or ruptures may need immobilisation for 4-6 weeks in a plaster of Paris. Careful assessment is important as cartilage injury or anterior cruciate ligament injury can accompany this condition.