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

The Acromioclavicular Joint

Just above the shoulder joint proper lies a small joint between the acromion part of the scapula and the outward end of the collar bone or clavicle, the acromioclavicular joint. It is usually not troublesome and functions like the suspension strut in a car, keeping the moving parts away from the centre of the body. For the arm to able to exert power the shoulder girdle has got to stay where it is when the strength is applied and the clavicle does this by bracing the chest and shoulder apart, forming joints at the chest end and at the shoulder end.

This is a butt joint linked by strong ligaments and is meant to transmit force and not to move significantly. Acromioclavicular joint injuries are typically sustained by falling directly on the shoulder or other part of the arm, forcing the acromion upwards against the stabilised clavicle. This disrupts the joint and is immediately acutely painful with the patient avoiding anything to do with pushing anything. Minor injuries give pain and heal well, whilst more major injuries can cause a deformity as the two parts of the joint no longer sit next to each other. This gives a non functioning joint which can be a chronic problem.

The Upper Neck

The upper neck or cervical spine is specialised in its anatomy and function as it has to bear the weight of the head and allow the head to be moved into any position for our sensory organs to receive the information they need. The two upper vertebrae, the atlas and the axis, have a specialised anatomical structure which is designed to satisfy the needs of head positioning in many functions. The upper vertebra, the atlas, has no body and is a bony ring with large facet joints to articulate with the facet joints of the lowest part of the skull, the occiput.

The second vertebra, the axis, has .captured. the body part of the vertebra above and has a upwardly protruding pin called the dens (latin for tooth) which forms a joint with part of the atlas above and also with a ligament which runs round it. The integrity of this joint is very important and if the dens is fractured or the ligament becomes slack then there can be a risk of damage to the spinal cord with death or quadriplegia. For this reason in any patient who may have suffered head or neck trauma the dens is x-rayed and checked carefully.