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

Shoulder Dislocation

The shoulder is an anatomically unstable joint as it is optimised for mobility rather than stability, allowing the hand to be placed in the very large number of positions required for optimal function. The shoulder socket (glenoid) is relatively small compared to the very large humeral head, leading to problems for the muscular and neurological systems as they struggle to keep the ball of the humerus centred on the socket during movement. The capsule of the shoulder, the fibrous bag which surrounds the whole shoulder joint, is relatively lax to allow for the large ranges of movement. This means it and its ligaments have little control over the joint and it relies on muscle control.

Dislocation is usually caused by a fall on the arm, especially if the arm in a position of abduction and lateral rotation, the position adopted by the .hands up!. posture. This is the most vulnerable position for the shoulder to dislocate anteriorly, i.e. the ball comes out of joint to the front. Immediate severe pain is the first symptom with the patient holding their arm in a protective position. Medical help is usually required to relocate the joint and there can be damage to the axillary nerve which control the deltoid muscle.

The Facet Joints

The facet joints, also known as the zygapophysial joints, are small synovial joints like the joints of our fingers, but with much flatter surfaces which give the name .facet. to them. They are made up of part of the vertebra above and part below, are lined by articular cartilage and surrounded by a joint capsule lined with synovial membrane. In the lumbar spine the facets joints act to stabilise whilst the area is under compression and to resist excessive movement between the individual vertebrae. This protects the intervertebral discs from damage from inappropriate ranges of movement.

The joint surfaces of the facet joints vary in orientation through the spine, allowing and preventing different movements. In the neck both rotation and flexion/extension is permitted, in the thoracic spine rotation is the dominant movement and in the lumbar spine flexion and extension is permitted and rotation is limited. With disc degeneration in the lumbar spine the loads on the lumbar facet joints can be great and result in osteoarthritic changes in these joints which can be symptomatic and result in low back pain. Facet joint pain occurs in a significant proportion of people with low back pain and can be difficult to manage.