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

Physiotherapy Shoulder Exercises after Breast Cancer Operation

Breast cancer is the commonest cancer in women and in England there are over 36,000 people diagnosed yearly. Treatment is complex but surgery is common to remove the tumour and to remove four or more lymph nodes in the axilla or armpit. This is to work out what stage the cancer is at and prevent it recurring in the axilla. A side effect of this treatment is the development of swelling in the affected arm, known as lymphoedema, which can remain over time and cause physical and psychological problems. Physiotherapists routinely assess and treat patients with cancer, pre or post operatively, to manage the mobility and joint problems which develop after diagnosis and treatment.

Removal of the axillary nodes impacts upon movement of the shoulder as the tissues in the axilla are stretched by raising the arm above the head. A paper in Physiotherapy (December 2008) by Todd and co-workers compared two groups of post operative patients, with one group having unrestricted shoulder movement after 48 hours and the other with this delayed for seven days. The results showed that delaying the movement for seven days avoided the incidence of increased arm lymphoedema, an important consideration as the level of swelling can remain long term.

Physiotherapy for Fractures of the Humeral Head and Neck

Fractures of the upper part of the upper arm, the neck or head of the humerus, are common in older people who have fallen onto the arm but can occur in younger people who fall hard on the upper arm. The surgeon determines if the fracture is stable and not likely to require intervention. Physiotherapy checks difficulties with the hand, wrist and elbow and gives instruction in maintaining the ranges of motion of these joints. The ranges of the shoulder joint can be maintained in more stable fractures by the performance of pendular exercises, where the patient leans on their good hand and bends over at the waist, allowing the arm to hang forward like a pendulum and to swing back and forward gently as instructed.

At around three weeks from fracture the exercises are progressed to active assisted movements where the other arm is used to bring the arm up into flexion, and usually before six weeks the arm can be raised actively on its own to begin to restore strength into the shoulder muscles. Rotatory movement behind the back and behind the neck are also practiced to restore the vital rotation movements of the shoulder.