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

Clavicle Fractures

The clavicle (collar bone) is commonly fractured in activities which involve the risk of falling on the upper quadrant of the body such as sport, bicycling or simple falls in children and the elderly. The clavicle is a stabilising bone between the scapula and the sternum, holding the arm away from the body during activities and allowing the exertion of force and power. Fracture give acute pain over the bone itself, swelling and bruising and perhaps deformity as the alignment of the bone is disturbed. The fracture may crunch on attempted movement of the arm and be very painful.

To allow healing the arm should be rested for three weeks in a sling to minimise the forces through the clavicle until the fracture begins to unite, during which time the patient should limit arm movement to below shoulder level. Once the pain has reduced after the three week point the arm ranges of movement can be gradually increased. In some cases healing of clavicular fractures can be slow or internal fixation become necessary if they show no signs of uniting after two months or so. Limitation of shoulder movement after fracture is uncommon and physiotherapists typically advise patients on exercises to restore full range.

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.