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

Physiotherapy and Manipulation

Manipulation is the moving and affecting of bodily tissues by using the hands and encompasses a wide variety of techniques including massage, deep frictions, mobilisation techniques and the forceful treatments commonly referred to as manipulation. Physiotherapists often train to perform manipulations which in this case are sudden, strong movements directed at a joint in an attempt to force it beyond the range of movement it is presently capable of. Mobilisation techniques are gentler and work within the ranges of motion available to the joint, while manipulation aims to restore what movement the joint should have.

Manipulation can be performed in the acute setting such as treating acute wry neck or a sudden onset of severe back pain. Treatment in this case may relocate the structure which is .out of place. or allow a pinched tissue area to be released and so relieve the compression suffered. Manipulation has been shown to reduce the length of time the person suffers the problem but has little effect on the overall outcome in time. More chronic conditions may be helped by manipulation to restore a range of movement which is restricted and the potential cause of pain. Physios are trained to safely and effective manage manipulative techniques.

Joint Position Sense (JPS)

Joint position sense, also called proprioception, is the ability of the brain to sense the positions of the joints and segments of the body and the degree of muscle contraction being exerted at any point in time. It is a precise sense and we rely on it to move about accurately, with loss of the JPS causing us significant difficulties. The brain relies on the incoming information from the muscles, ligaments and joints to understand where the body is and thereby to plan what the next movement requires in terms of direction and muscle activity.

Loss of any degree of proprioception causes the person significant problems with understanding where they are and how to perform the next movement safely and successfully. It is much more disabling than a loss of muscle power alone and requires that they pay much more visual attention to their position and the outcomes of each new attempted movement. Physiotherapists work routinely with people with proprioceptive loss to restore this sense after operation or stroke. Gym exercises prescribed by physios include standing on a wobble board and performing activities such as bouncing and catching a ball against a wall. Restoration of JPS is vital before return to sport.