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

Forward Bending Actions Which Can Injure The Spine

In normal circumstances people bend their lumbar spines by 80-100% of the available movement when they bend over to the floor to pick things up. Adding an awkward movement such as to one side increases the stretch on the facet joint of the other side. This indicates that it is easy to get to the maximum bend limit of the lower spine by doing something easy like reaching down to the feet to put on shoes. Long periods of remaining flexed, such as sitting for a long car journey, forces the ligaments to relax, decreasing the protective muscular mechanisms and increasing the chances of suffering a disc prolapse.

If the muscles get tired by repetitive actions of lifting or bending over then their protective care of the spine is also diminished. In the anatomical examination of spines after death there has been shown to be a 20% incidence of rupture of the ligaments which connect the spines of the individual vertebrae at the back. As these ligaments are fully stretched when the spine is fully bent it is likely that bending injuries due to too much flexion of the spine are very common as people are suddenly forced into bend by an accidental movement.

Pes Cavus

This condition is also known as high instep or high arch and is a type of foot anatomy where the medial longitudinal arch (arch on the inner side of the foot) is significantly greater than normal. This is the opposite foot deformity to flat foot and may be without symptoms. However the limiting of weight bearing stresses to the heel and the metatarsal heads may put excessive stresses on the ball of the foot, causing calluses to form and a painful front foot problem. This can also go with hammer toes where the toes are flexed up in a clawed manner and take no part in contacting the ground in gait.

Pes cavus may cause difficulties in selecting suitable footwear as the height of the foot in the midfoot region is so much greater than normal, and some people may need insoles to support the arch and allow effective and painless walking. Pes cavus can be hereditary or can be secondary to a neurological or neuromuscular condition. Treatment is usually conservative such as physiotherapy for strengthening and stretching and the provision of custom insoles as surgery to treat foot pain of this cause is unpredictable in outcome.