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

Time and Muscle Degeneration

Ageing is associated with decreases in both muscle bulk and strength, varying with different muscles in the body and with which side is the dominant one. The loss of the capacity of muscle is greater in men than in women and also in people who are less active physically. Hormone changes, reduced rates of protein production and poor dietary intake can all contribute. Physiotherapists can reverse this process by instituting a resisted exercise programme at the higher intensity level. Older people can respond to muscle training although older muscles do react less strongly to stimulation and take longer to recover and strengthen after exercise sessions.

Older muscles also suffer from a variety of other changes: a reduction in the ability to use energy to produce force; an increase in the fibrous tissue content which can increase stiffness. Along with the reduction in the ability to know where the joints are at any one moment the elderly suffer from slower reactions and poorer muscle control, with weaker and more easily tired muscles. This can lead in very elderly people to a loss of independence and increasing frailty. Perhaps because of its good blood supply, muscle is mostly able to regenerate itself and remain strong.

Total Shoulder Replacement

Shoulder replacement is less commonly performed than replacement of the hip or knee but remains a very useful treatment for a variety of shoulder conditions. Osteoarthritis is much less common in the shoulder than in the knee or hip so replacement is more frequently performed for arthritic diseases such as rheumatoid arthritis and for painful conditions secondary to trauma such as fractures or rotator cuff dysfunction. Replacing the shoulder is a different matter from the main weight bearing joints of the lower limbs which can be thought of as .hard tissue joints.

The shoulder is more of a .soft tissue joint. in that the orientation and sufficiency of the soft tissues are what allows the joint to function properly. Typically the socket is replaced by a plastic socket component and the humeral head by a metal component which has a stem down the humeral shaft. The correct positioning of the humeral head in relation to the soft tissues such as the rotator cuff tendons is vital as if this is not correct then the joint surfaces may be fine but the shoulder will not function correctly. Patients are routinely referred to physiotherapy, initially for range of motion and later for strengthening and functional work.