Physiotherapists in Preston 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.

Spinal Posture

Spinal posture can mean two main things, one being the shape and orientation of the curves in the spine and two being the angle that the whole spine is aligned to the vertical. The minimum of muscle activity occurs when the trunk is balanced directly above the pelvis and any deviation from this requires muscle activity to increase to maintain position. As the main moving muscles of the spine are orientated lengthways like the spine itself, when they contract they generate significant compression forces through the spine. Contraction of these muscles in easy standing or sitting still generates forces through the lumbar spine that are twice the body weight above the area.

In sitting it makes little difference to the degree of muscle activity whether the lumbar spine is held arched to some degree (lumbar lordosis) or flexed (bent), the key point is whether the spine is vertically aligned or not. So leaning back with a lordosis or forwards with a flexed spine both generate high muscle forces, whilst sitting upright in either posture does not. Sitting positions all flex the lumbar spine, with the lower two lumbar levels being significantly flexed in these postures, even to the maximum of their movement.