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

Activity and Muscle Strength

When a person starts to train for strength or power they start exerting high forces for short periods of time, i.e. they use heavier weights for smaller numbers of repetitions. This causes large changes in the fast twitch type 2 muscles fibres, increasing their size but not changing their number. This process is known as mechanically induced hypertrophy and results from the muscle cells synthesising increased amounts of muscle proteins to build into larger muscle. Muscles can also add new sections to the areas where they join the tendon if they are subjected to stretching forces.

In contrast, if muscles are inactive they reduce the making of muscle proteins within a few hours and the muscle starts to atrophy, to lose size and strength. In injuries if a muscle is immobilised in a shortened position both its size and its length will be reduced, with non-contracting substances becoming more dominant. This leads to a muscle which is shorter, more stiff and less easily lengthened, a significantly negative outcome in that immobilisation for fractures will have unwanted effects on the local muscular structures. Modern methods concentrate on immobilising a joint only if essential and only for the shortest necessary period.

Good and Bad Lumbar Posture

Good and bad lumbar posture has often been decided on grounds that are not sufficiently scientific and future recommendations need to be based on solid research. Early research on the effects of different spinal postures indicated that maintaining a lumbar lordosis reduced the pressures inside the disc nucleus. This seemed fine until it was realised that these pressures were being transferred to the rear disc walls and the facet joints. As the facet joints are known to be frequent causes of low back pain and the nucleus of the disc is not a source of pain the idea that a lordosis is desirable in all circumstances does not stand up to examination.

Overall having some flexion in the spine is better in static positions whilst a slight lordotic posture is better when walking. Too much flexion interferes with the ability of the muscles of the back to protect the spine, so a moderate position should be taken between too much flexion and too much extension. The benefits of slight flexion are mirrored in the typical habits of people in postures, such as crossing the legs or putting a leg up on something at a bar, both actions which increase the flexion of the lumbar spine.