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

The Facet Joints

The facet joints, also known as the zygapophysial joints, are small synovial joints like the joints of our fingers, but with much flatter surfaces which give the name .facet. to them. They are made up of part of the vertebra above and part below, are lined by articular cartilage and surrounded by a joint capsule lined with synovial membrane. In the lumbar spine the facets joints act to stabilise whilst the area is under compression and to resist excessive movement between the individual vertebrae. This protects the intervertebral discs from damage from inappropriate ranges of movement.

The joint surfaces of the facet joints vary in orientation through the spine, allowing and preventing different movements. In the neck both rotation and flexion/extension is permitted, in the thoracic spine rotation is the dominant movement and in the lumbar spine flexion and extension is permitted and rotation is limited. With disc degeneration in the lumbar spine the loads on the lumbar facet joints can be great and result in osteoarthritic changes in these joints which can be symptomatic and result in low back pain. Facet joint pain occurs in a significant proportion of people with low back pain and can be difficult to manage.

The Rotator Cuff

The rotator cuff muscles of the shoulder function to stabilise the large humeral head on the relatively small shoulder socket or glenoid cavity. The origin of the rotator cuff muscles is the large flat areas of the scapula or shoulder blade, but for the muscles to be able exert their forces the shoulder blade must itself be stabilised. The shoulder blade floats over the thoracic rib cage and is attached by various muscles to the trunk, the rhomboids, trapezius and serratus anterior. If there is a dysfunction in these muscle groups the stability of the scapula will be compromised, making it difficult or impossible for the rotator cuff group to do their work effectively.

The rotator cuff muscle all originate medially to the shoulder, i.e. further in towards the middle of the body. They pass outwards towards the head of the humerus, becoming tendons close to the shoulder itself and then inserting into the greater tuberosity, a bony protrusion on the outside of the head of the humerus. The primary pull of the rotator cuff muscles is in a directly inwardly direction, pulling the humeral head firmly against the glenoid. This counteracts the tendency of the deltoid muscle to pull the humeral head upwards.