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

Supraspinatus Tendinitis

The supraspinatus muscle is one of the rotator cuff muscles of the shoulder and a vital part of a normally functioning shoulder. It originates in the supraspinatus fossa (anatomical depression) at the top of the scapula or shoulder blade and passes outwards towards the head of the humerus. Above the shoulder joint the muscle gradually becomes more tendinous until it passes over the top of the head of humerus and inserts onto the bony area called the greater tuberosity. The muscular action is to move the arm away from the side but a more important action is to hold the humeral head against the glenoid.

Due to the proximity of the tendon to the acromioclavicular joint above it can suffer compression and inflammation from repetitive overactivity, giving a sharp pain on lifting of the arm in many activities. Physiotherapy examination involves testing shoulder abduction with compression and tension stresses to change the impingement and palpation of the supraspinatus insertion on the humeral head whilst the patient's arm is behind their back. Treatment involves limiting aggravating activities, ultrasound to the tendon insertion and strengthening of the remainder of the rotator cuff muscles. Anti-inflammatory medication may also be useful.

The Acromioclavicular Joint

Just above the shoulder joint proper lies a small joint between the acromion part of the scapula and the outward end of the collar bone or clavicle, the acromioclavicular joint. It is usually not troublesome and functions like the suspension strut in a car, keeping the moving parts away from the centre of the body. For the arm to able to exert power the shoulder girdle has got to stay where it is when the strength is applied and the clavicle does this by bracing the chest and shoulder apart, forming joints at the chest end and at the shoulder end.

This is a butt joint linked by strong ligaments and is meant to transmit force and not to move significantly. Acromioclavicular joint injuries are typically sustained by falling directly on the shoulder or other part of the arm, forcing the acromion upwards against the stabilised clavicle. This disrupts the joint and is immediately acutely painful with the patient avoiding anything to do with pushing anything. Minor injuries give pain and heal well, whilst more major injuries can cause a deformity as the two parts of the joint no longer sit next to each other. This gives a non functioning joint which can be a chronic problem.