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

Physiotherapy for Fractures of the Humeral Head and Neck

Fractures of the upper part of the upper arm, the neck or head of the humerus, are common in older people who have fallen onto the arm but can occur in younger people who fall hard on the upper arm. The surgeon determines if the fracture is stable and not likely to require intervention. Physiotherapy checks difficulties with the hand, wrist and elbow and gives instruction in maintaining the ranges of motion of these joints. The ranges of the shoulder joint can be maintained in more stable fractures by the performance of pendular exercises, where the patient leans on their good hand and bends over at the waist, allowing the arm to hang forward like a pendulum and to swing back and forward gently as instructed.

At around three weeks from fracture the exercises are progressed to active assisted movements where the other arm is used to bring the arm up into flexion, and usually before six weeks the arm can be raised actively on its own to begin to restore strength into the shoulder muscles. Rotatory movement behind the back and behind the neck are also practiced to restore the vital rotation movements of the shoulder.

Physiotherapy and Elderly People

The number of elderly people is increasing strongly in all the industrialised states of the world and the health challenges which come with this are considerable. Physiotherapists have a large role to play both in hospitals once an elderly person is admitted and with elderly people in the community. Once admitted an elderly patient is seen by the physiotherapist if a respiratory, neurological or mobility problem is identified. Physios specialising in elderly care are trained to understand, assess and treat patients who may have a series of co-existing medical conditions as well as difficulties understanding or expressing themselves.

Elderly people are particularly vulnerable to drug reactions, being away from their normal surroundings and being immobilised for any length of time. Complications can quickly occur such as chest infections, pressure sores, confusion and loss of mobility and independence. Physios assess and treat these problems and routinely mobilise patients who have compromised mobility. In the community physiotherapists may visit the elderly in their homes and advise on mobility, safety and functional issues. Physios also take exercise classes in the community for balance and falls prevention, and for bone density to counter the increasing incidence of osteoporosis in elderly women.