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

Frozen Shoulder

Frozen shoulder is a troublesome and enigmatic condition which affects mostly middle aged people and causes significant pain and disability. As our shoulders age they become more vulnerable to injury or damage and in some cases this develops into the pain condition known as frozen shoulder. A sudden movement or small tweak of the shoulder may result in the area becoming more and more painful until the pain is very severe and interrupting sleep. This is the pain stage of frozen shoulder which is followed by the painful and stiff phase where the pain eases to some extent and the shoulder becomes restricted in movement.

Later in the process the pain recedes and the shoulder remains with just the joint stiffness so the person cannot lift their arm up far. The process may take two years or so to go through and the person may not regain their full shoulder movement. In the painful period physiotherapy is aimed at relieving the pain by gentle mobilisations and exercise and progressed to working at the joint stiffness as the pain recedes. Later physiotherapy involves stronger mobilisation techniques and stretching to ease out the strong soft tissue restrictions which have developed.

Ligament-Bone and Tendon-Bone Conditions - Bone Formation

The behaviour of the bone around the joint varies in differing arthritic conditions. In rheumatoid arthritis the inflammatory joint condition is linked with loss of bone and this contributes to the damage to the joint and the disability which ensues. However, in ankylosing spondylitis (AS) the inflammation is accompanied by the formation of new bone at the inflamed sites. This new bone forms at each insertion site, growing together in the spine to form bony bridges across the vertebrae, stiffening the spine in a poor position in some cases which can cause significant disability. Since inflammation usually breaks bone down this is difficult to understand.

New bone typically forms at normal ligament or tendon insertions as we get older, but in arthritis the inflammatory phase which erodes bone does settle and then bony spurs can form as the bone laying down phase occurs next in time. In the case of AS, if a bony formation phase follows the inflammatory phase, then suppressing the inflammatory phase with medication might accelerate the bony formation process, increasing the disability. AS patients may continue to fuse their joints even in the presence of new biological treatments but they may be shown to inhibit bone formation at the insertions and thereby reduce disability.