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

Bone and Ageing

Bone loss occurs much more rapidly than the equivalent process in muscle tissues, with reductions in hormone production and in activity playing a part. After the menopause, the reduction in hormone production in women can result in lowered bone density which is initially termed osteopoenia and then osteoporosis when the bone approaches the levels where it will fracture easily during normal activity. Bone loss affects the trabecular honeycomb bone more than the denser outer cortical bone and also the vertical struts more than the horizontal ones. Once one of the struts is broken it does not repair.

Because they are made up of large amounts of trabecular bones, the spinal bones are often badly affected by osteoporosis, with the process eventually allowing a buckling of the upper and lower surfaces of the vertebrae. The fronts of the vertebrae are more vulnerable to fracture as the trabeculae lose more mass in this area. Physiotherapists teach weight bearing exercises to counteract bone loss and drug therapies can halt breakdown and even increase bone mass. Getting our bone mass up to a high level during younger years so that the steady loss with age does not become important may be the best strategy.

Examination of the Injured Wrist

Initial examination of a person with a wrist injury involves visual inspection of the wrist compare to the other one, as some people have relatively abnormal wrist structure and limited movements. Bruising and swelling may be present as may be one of the typical deformities due to fractures of the distal forearm bones. Palpation of the bony anatomy systematically allows a closer determination of the location of any acute injury such as a fracture. The typical deformity of a Colles fracture is the so-called .dinner fork. deformity where the end of the wrist is angled upwards and the fingers form the prongs of the fork.

In the Smith fracture where the end of the wrist is pushed downwards the deformity is known as a .garden spade. deformity. It is important to examine the remainder of the upper limb including the shoulder, elbow and wrist to exclude other injuries or fractures, with the patient's report of where they have pain a very useful guide. The patency of the arterial systems in the forearm and arm are also assessed as vascular damage can occur from fracture fragments. The three nerves which pass down the arm and supply the feeling and muscles of the hand should also assessed for damage.