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

Disc Nutrition and Posture

The supply of nutritional substances to the inner parts of the discs is in general poor and a lack of this supply is connected with degenerative disc changes. Large differences in the compression forces inside an intervertebral disc can be generated by relatively small changes in posture. These changes have correspondingly large effects on fluid flow out of and into discs and on diffusion of metabolic agents into the disc. The effectiveness of the transport of these materials depends on how far they have to travel from the nearest blood vessel which is usually in the vertebral endplate (top or bottom of the disc).

When bending, the back of the disc walls is stretched and the fronts are compressed, with stretching making the wall thinner and therefore more easily crossed by nutrients. This brings more food supply into the central area of the rear of the disc, the area which receives least nutrition. Compression from movement also squeezes water from the disc and as it returns when the pressure is relieved the incoming water brings nutrients along with it. Changes from a lordosis to a flexed position regularly increase the fluid flow in and out of the disc, encouraging the transport of nutrients.

Simple Neck and Shoulder Girdle Exercises

Slow performance of the exercises is important, taking up to five seconds to get to the end of each individual direction of movement. The neck should be moved in each of the standard directions which are: turning the head left and right; side flexing left and right (ear down to same shoulder with face facing forward); bending head forward and back; tucking the head in (a bit like a chicken). It is important to do each movement separately so the maximum range is obtained as the ends of the movement are where the value is in exercising.

Shoulder movements are useful as they may be stiff or the shoulder girdle may not be moving well, and shoulder movements stress the neck to some extent. Shrugging shoulders and rolling them backwards are an example of this movements as are circling of the arms either backwards or forwards. Once the movements are easy then some auto-resisted neck strengthening can be performed with the neck being held in place as one of the hands tries to push it out of position. Holding this for about ten seconds forces the muscles to work hard to maintain the neck position.