Physiotherapists in Herne Hill 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.

Physiotherapy Mobilisation Techniques

Physiotherapists use a large number of treatment techniques to manage the variety of conditions their patients present with. Joint problems make up a large proportion of a physio.s caseload and to treat these a number of treatment approaches have been developed which go under the general umbrella of mobilisation techniques. Joint mobilisations are a technique of stressing the joint manually by moving it through a proportion of its range and with a specific amount of force. Manipulation, meaning work done with the hands, includes the more vigorous manoeuvres which are commonly referred to as manipulation.

Initially a physiotherapist will fully assess the joint for the type of problem which is present such as primarily pain, pain and stiffness or primarily stiffness with little pain. Mobilisations for pain will be gentle and rhythmic to avoid aggravating an already irritable joint. If the pain is less severe and there is some stiffness the joint can be pushed a little harder. If stiffness is the main problem in the absence of pain then the joint may tolerate being pushed repeatedly to the end of its available movement in an attempt to increase its range of motion. Training is required to assess and treat a joint safely and effectively.