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

The Rotator Cuff

The rotator cuff muscles of the shoulder function to stabilise the large humeral head on the relatively small shoulder socket or glenoid cavity. The origin of the rotator cuff muscles is the large flat areas of the scapula or shoulder blade, but for the muscles to be able exert their forces the shoulder blade must itself be stabilised. The shoulder blade floats over the thoracic rib cage and is attached by various muscles to the trunk, the rhomboids, trapezius and serratus anterior. If there is a dysfunction in these muscle groups the stability of the scapula will be compromised, making it difficult or impossible for the rotator cuff group to do their work effectively.

The rotator cuff muscle all originate medially to the shoulder, i.e. further in towards the middle of the body. They pass outwards towards the head of the humerus, becoming tendons close to the shoulder itself and then inserting into the greater tuberosity, a bony protrusion on the outside of the head of the humerus. The primary pull of the rotator cuff muscles is in a directly inwardly direction, pulling the humeral head firmly against the glenoid. This counteracts the tendency of the deltoid muscle to pull the humeral head upwards.

Ligament-Bone and Tendon-Bone Conditions - Bone Formation

The behaviour of the bone around the joint varies in differing arthritic conditions. In rheumatoid arthritis the inflammatory joint condition is linked with loss of bone and this contributes to the damage to the joint and the disability which ensues. However, in ankylosing spondylitis (AS) the inflammation is accompanied by the formation of new bone at the inflamed sites. This new bone forms at each insertion site, growing together in the spine to form bony bridges across the vertebrae, stiffening the spine in a poor position in some cases which can cause significant disability. Since inflammation usually breaks bone down this is difficult to understand.

New bone typically forms at normal ligament or tendon insertions as we get older, but in arthritis the inflammatory phase which erodes bone does settle and then bony spurs can form as the bone laying down phase occurs next in time. In the case of AS, if a bony formation phase follows the inflammatory phase, then suppressing the inflammatory phase with medication might accelerate the bony formation process, increasing the disability. AS patients may continue to fuse their joints even in the presence of new biological treatments but they may be shown to inhibit bone formation at the insertions and thereby reduce disability.