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

Intervertebral Discs and Ageing

Ageing starts early in the discs and proceeds through life. Initially a loss of proteoglycan occurs, and as these chemicals attract and hold water into the centre of the discs, a degree of loss of hydration steadily occurs. The collagenous tissues lose some of their suppleness and resistance, becoming more brittle and more likely to suffer injury. As the discs have no central blood supply and rely on nutrition and oxygen diffusing in, a limitation of this process will accelerate the degenerative process going on in the disc centres. The tops and bottoms of the vertebrae, the endplates, are cartilage but can become calcified, further reducing supplies to the nucleus inside.

The outer part of the disc, the annulus, has layers of collagen material and these thicken and can develop defects. Overall the central disc material becomes drier, fibrosed and stiffer with a smaller volume as it loses water, throwing compressive forces onto the back of the disc annulus. The annulus becomes both stiffer and weaker with age, the increased stiffness perhaps offset by the increase in defects in the disc wall with time. Studies of discs have shown that they do not generally decrease in height with age.

Acute Joint Management

An acute joint is a joint which has suffered an insult, either trauma or arthritic, and has flared up into an inflammatory phase with pain, swelling, loss of range of movement and limited function. Physiotherapists routinely manage acute joints in a variety of situations. The initial management of an acute joint concentrates on controlling the pain and inflammation with analgesics, anti-inflammatories, compression and ice. Reduction in pain and swelling allows the patient to start to get their joint moving so that mechanical stimuli can start to be received by the nervous system. Compression may be a very important treatment as the development of an effusion, fluid within a joint, is known to compromise the muscular control of the joint.

After the initial period the patient is instructed to perform regular contractions of the muscles around the joint to restore control, and to move the joint gradually through a greater and greater range of motion until full range is achieved. Once the ranges of motion are improving and the joint is settling more functional work such as weight bearing or loaded exercises can be started to stress the joint in a graded programme to restore the joint.s full strength and function.