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

Losing and Gaining Muscle

Muscle is a dynamic tissue, changing greatly to accommodate to changing requirements. If a person.s leg is immobilised the thickness of the quadriceps muscle decreases by 15-20% in six weeks as the Type 1 muscle fibres reduce their protein production. This is the reason why immobilisation of a fracture or sprain is kept to an absolute minimum as losses of muscle and bone tissue are important, with joint stiffness another potential damaging side effect. Muscle will also respond quickly and strongly to increases in loading, with a maximum weight to be lifted increasing by 100% over a 12 month training period.

Much of the increased strength of muscle is due to hypertrophy of the muscle fibres, although other factors contributing are muscle endurance and learned coordination of the movement. A 30% increase of muscle mass can occur in four days after a muscle is overloaded in a stretched position, indicating the speed by which this part of the musculoskeletal system can adapt to new conditions. Exactly what makes muscles increase in strength is under discussion, but unexpectedly high activity, particularly in eccentric contractions, can cause the exercise induced damage which leads to repair and hypertrophy.

Stretching and Tightness

We all have a genetically determined stretchiness or tightness to our connective tissues, the skin, tendons, ligaments and discs which are made up of collagen. It is partly the make up of collagen and partly the length of our tendons and ligaments which determine how bendy or tight we are. Mostly the length of our soft tissues is not very important as we are able to function normally with what we have got, but in some cases such as injury or pain conditions the tightness or laxness of our tissues can become an issue. In low back and neck pain syndromes certain structures can become tight and others slack, leading to imbalances in the muscular and joint systems.

Physiotherapists use stretching routinely to correct these imbalances and teach their patients very specific and controlled programmes. For stretching to be effective the action must be taken to the point of tightness, pushed a little further into the resistance and held for 15 seconds or more steadily. Bouncing should be avoided as this does not stretch well and can cause injury. Stretching should feel uncomfortable in the target tissues but not greatly painful and any discomfort should settle quickly once the stretch is removed.