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

Hammer toes

Hammer toes are a common deformity of the foot and often associated with more profound changes in the foot such as pes cavus where the inside foot arch is exaggerated. The small intrinsic foot muscles, which allow the toes to be kept straight as they grip the ground, weaken and the extensor muscles then pull the near part of the toe upwards. This makes the near joints of the toes bend up leading to a clawing of the toes. The extensor tendons can then shorten, leading to a permanent deformity where the person cannot get the toes flat down onto the ground any more.

There are a series of consequences from this deformity. The toes curl up and thereby take up much more room at the end of the shoe, causing the tops of the joints to suffer pressure against the shoe and develop sore areas or calluses. A more spacious toe box in the shoes can relieve this. The metatarsal heads suffer increased pressure from weight bearing and also develop calluses under the ball of the foot where the loading is greatest. In time these changes can lead to foot pain and require stretches or surgical correction.

Disc Nutrition and Posture

The supply of nutritional substances to the inner parts of the discs is in general poor and a lack of this supply is connected with degenerative disc changes. Large differences in the compression forces inside an intervertebral disc can be generated by relatively small changes in posture. These changes have correspondingly large effects on fluid flow out of and into discs and on diffusion of metabolic agents into the disc. The effectiveness of the transport of these materials depends on how far they have to travel from the nearest blood vessel which is usually in the vertebral endplate (top or bottom of the disc).

When bending, the back of the disc walls is stretched and the fronts are compressed, with stretching making the wall thinner and therefore more easily crossed by nutrients. This brings more food supply into the central area of the rear of the disc, the area which receives least nutrition. Compression from movement also squeezes water from the disc and as it returns when the pressure is relieved the incoming water brings nutrients along with it. Changes from a lordosis to a flexed position regularly increase the fluid flow in and out of the disc, encouraging the transport of nutrients.