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

Achilles Tendon Rupture

The Achilles tendon is the largest tendon in the body, a large fibrous structure formed of collagen fibres lined up to form a very strong tendon which has to bear the force of weight bearing activities. The calf muscles are a very important part of propulsion in walking and when we walk, run or jump , very high forces are taken by the Achilles tendon as we perform vigorous movements with the ankle. As we get into our forties the strength of our tendons is declining but we often put the same forces on our body as we did twenty years previously. This can lead to the forces involved exceeding the strength of the tendon and a rupture, either partial or complete, results.

Treatment can be conservative or surgical, in many cases there being no significant clinical difference between the two in terms of outcome. Plaster of Paris used to be used routinely for immobilisation but new bracing systems have now been developed which allow precise control of the angle of the ankle and so the stresses on the tendon. This allows a graded progression of force as the tendon heals. Physiotherapists apply these braces and rehabilitate patients once they are out of the immobilisation.

Lumbar Stenosis

There are many painful syndromes which involve the lumbar spine, with the discs, ligaments, joints, muscles and nerves all implicated in pain production. Older people can present with symptoms which indicate a stenosis of their vertebral canal. The vertebral or spinal canal runs down the back and carries the spinal cord, allowing the nerve roots to exit to the body at each spinal level (each disc level). The spinal canal can be congenitally narrow which increases the chances of developing spinal stenosis with age. As degenerative changes occur in the spinal structures the spinal canal can become narrowed and tight.

The symptoms of spinal stenosis typically do not include back pain but rather leg pain, often bilateral, and worsened by walking but better with sitting. Typically presenting in people of 65 years or older, spinal stenosis can also present as a nerve root irritation of a sciatic type due to stenosis of the exit for the spinal nerve root. Physiotherapy is not usually very useful and little is found on examination apart from a reduction in spinal extension and many people manage their symptoms over time as best they can, although surgical spinal decompression can be very successful in relieving the symptoms.