Physiotherapists in Manchester 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.

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.