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

Examination of the Injured Wrist

Initial examination of a person with a wrist injury involves visual inspection of the wrist compare to the other one, as some people have relatively abnormal wrist structure and limited movements. Bruising and swelling may be present as may be one of the typical deformities due to fractures of the distal forearm bones. Palpation of the bony anatomy systematically allows a closer determination of the location of any acute injury such as a fracture. The typical deformity of a Colles fracture is the so-called .dinner fork. deformity where the end of the wrist is angled upwards and the fingers form the prongs of the fork.

In the Smith fracture where the end of the wrist is pushed downwards the deformity is known as a .garden spade. deformity. It is important to examine the remainder of the upper limb including the shoulder, elbow and wrist to exclude other injuries or fractures, with the patient's report of where they have pain a very useful guide. The patency of the arterial systems in the forearm and arm are also assessed as vascular damage can occur from fracture fragments. The three nerves which pass down the arm and supply the feeling and muscles of the hand should also assessed for damage.

Core Stability for Back Pain

Treatments and management techniques for low back pain are very numerous and for most of them the evidence of effectiveness is either nil or not very great. Core stability comes into the category of a treatment which has some evidence for usefulness and for which there is ongoing scientific research. The spinal segments have a stabilising muscular system which keeps them in line with each other and prevent abnormal movement occurring between them which might cause problems. The three main muscle groups involved are the multifidus in the spine, the transversus abdominis in the abdomen and the pelvic floor.

Research has shown that these three groups work in concert and that if a back injury occurs then the multifidus muscles in the spine waste and do not recover spontaneously once the back pain has settled. However, working these core stability muscles at around 30 percent of their maximum capacity can restore the stabilising part of the spinal muscle group. Physiotherapists have researched this method and routinely prescribe core stability exercises for patients, understanding that good scientific evidence for longer term changes in spinal problems is not yet forthcoming. The technique is simple however, easily applied, reasonably logical and has few if any adverse side effects.