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

The Shoulder

The human shoulder is a design of great functional ability and ingenuity, designed entirely around placing our hands in the places we want them to be. The hand is the tool with which we connect with the world and we need to be able to place it in a great variety of positions so we can manipulate objects. The shoulder contributes to a very large extent to our ability to do this and to achieve this goal it has an extremely large range of motion permitting great flexibility. However, in satisfying the requirement for flexibility it sacrifices stability.

To allow the large range of motion the shoulder is designed with a relatively small socket and a very large ball, the head of the arm bone. The shoulder capsule, the fibrous ligamentous bag which surrounds and supports the joint, is relatively lax and contributes little to stability. The nervous and muscular systems have the job of keeping the large humeral head balanced on the small glenoid cavity (shoulder socket). The large shoulder muscles are more concerned with gross movements of the shoulder, and it is the rotator cuff muscles which perform much of the stabilising work of the joint.

Time and Muscle Degeneration

Ageing is associated with decreases in both muscle bulk and strength, varying with different muscles in the body and with which side is the dominant one. The loss of the capacity of muscle is greater in men than in women and also in people who are less active physically. Hormone changes, reduced rates of protein production and poor dietary intake can all contribute. Physiotherapists can reverse this process by instituting a resisted exercise programme at the higher intensity level. Older people can respond to muscle training although older muscles do react less strongly to stimulation and take longer to recover and strengthen after exercise sessions.

Older muscles also suffer from a variety of other changes: a reduction in the ability to use energy to produce force; an increase in the fibrous tissue content which can increase stiffness. Along with the reduction in the ability to know where the joints are at any one moment the elderly suffer from slower reactions and poorer muscle control, with weaker and more easily tired muscles. This can lead in very elderly people to a loss of independence and increasing frailty. Perhaps because of its good blood supply, muscle is mostly able to regenerate itself and remain strong.