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

Supraspinatus Tendonitis of the Shoulder

The shoulder joint is controlled by a group of muscles known as the rotator cuff which originate from the scapula or shoulder blade and travel outwards until they become tendons and insert into the top of the arm bone. The cuff stabilises and holds the large ball of the arm bone in place on the small socket as the shoulder goes through its very large range of motion. Without the rotator cuff the large and powerful deltoid muscle would just pull the shoulder area upwards rather than lift the arm above the head. The supraspinatus muscle is one of the cuff group and its tendon runs just underneath the bony arch above the arm bone to attach to the outside.

If the shoulder is used repetitively for an unaccustomed activity the tendon can impinge on the bony arch above and become inflamed and painful. This is supraspinatus tendonitis, a condition which can be acutely painful or more chronically restricting for the use of the shoulder. Physiotherapy treatment consists of ultrasound or frictions to the tender area and correction of any shoulder muscle imbalances. Further treatment includes corticosteroid injections to reduce the inflammation and if severe enough, investigation to look for rotator cuff tendon tears.

Severe Arm Pain and Physiotherapy

Neck pain is very common but, like sciatica in the leg, severe arm pain is uncommon but distressing for the sufferer. Nerve root conditions are caused typically by compression or inflammation from a disc protrusion near to the nerve exit in the spinal column or by bony encroachment on the same areas in older people. Patients complain of severe pain in the arm, often worse below the elbow and into the hand, with a surging quality which is very unpleasant. Typically patients are not able to sleep with this so appear tired and miserable due to the loss of sleep and constant severe pain.

Physiotherapy management starts with a careful assessment of the neck and arm but this may be severely limited by the severity of the pain and the irritability, the ease by which the condition can be stirred up by minimal input. Initial treatment is aimed at pain relief with analgesia, restriction of aggravating activities and a collar at night to restrict neck movements. Once the pain begins to settle the patient is encouraged to start gentle exercises or the physiotherapist performs mobilisation techniques to put mechanical stresses through the joint to start the process of restoring the area's capacity to cope with stress.