Physiotherapists in Manchester 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.

Muscle Fibre Types

Muscle has three main fibre types which are specialised for different functional abilities. Type 1 muscle fibres, also known as slow twitch fibres, have a good capillary supply and use a mostly aerobic energy system. Type 2 fibres use a non-aerobic energy system more typically and in general the proportion of Type 1 to Type 2 fibres is fixed genetically in an individual. Muscle cells don.t turn over like many other body cells, the muscle continues for the life of the person. Muscles get larger and stronger by the individual muscle cells gaining mass and the number of muscle cells does not change.

Muscles are very adaptive tissues and can respond to altered work demands very much more quickly than other tissues, enabling us to build up the ability to do something new in a short time. The way the muscles are exercised has strong effects on the way muscles adapt to the new stresses. If endurance training is performed, with lower weights and higher repetitions, the largest changes are in the Type 1 slow twitch fibres which exhibit increases in their blood supply and in the enzyme systems which deliver energy. This allows these muscle fibres to contract for longer periods without tiring.