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

Simple Neck and Shoulder Girdle Exercises

Slow performance of the exercises is important, taking up to five seconds to get to the end of each individual direction of movement. The neck should be moved in each of the standard directions which are: turning the head left and right; side flexing left and right (ear down to same shoulder with face facing forward); bending head forward and back; tucking the head in (a bit like a chicken). It is important to do each movement separately so the maximum range is obtained as the ends of the movement are where the value is in exercising.

Shoulder movements are useful as they may be stiff or the shoulder girdle may not be moving well, and shoulder movements stress the neck to some extent. Shrugging shoulders and rolling them backwards are an example of this movements as are circling of the arms either backwards or forwards. Once the movements are easy then some auto-resisted neck strengthening can be performed with the neck being held in place as one of the hands tries to push it out of position. Holding this for about ten seconds forces the muscles to work hard to maintain the neck position.

Internal Fixation for Fractures

Many fractures can be managed by immobilisation if not displaced or can be repositioned and maintained in position by a plaster cast. Some fractures cannot be maintained in position, slip out of position once re-positioned or cannot be immobilised because of the length of time required or the awkwardness of the anatomical location. In these cases internal fixation with plates, screws, wires or nails is considered. Internal fixation requires an operation which carries the usual risks including infection so is only performed when required from a clinical standpoint.

Fracture alignment is important to maintain the relative position of the nearby joints so that excessive forces are not thrown onto one part of a joint or another. Wrist fractures which do not remain in a good position can be plated then immobilised until healed. Fractures with many pieces may need re-assembling and maintaining in position by metalwork. Femoral shaft fractures cannot be immobilised except by traction and with the healing period being 12 weeks the decision is usually to place a nail down the femur and get the patient up and out of hospital in a few days. Complex fixation may be used to restore the structure of a badly damaged bone in some cases.