Physiotherapists in Glasgow 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.

Supraspinatus Tendonitis of the Shoulder

The shoulder joint is controlled by a group of muscles known as the rotator cuff which originate from the scapula or shoulder blade and travel outwards until they become tendons and insert into the top of the arm bone. The cuff stabilises and holds the large ball of the arm bone in place on the small socket as the shoulder goes through its very large range of motion. Without the rotator cuff the large and powerful deltoid muscle would just pull the shoulder area upwards rather than lift the arm above the head. The supraspinatus muscle is one of the cuff group and its tendon runs just underneath the bony arch above the arm bone to attach to the outside.

If the shoulder is used repetitively for an unaccustomed activity the tendon can impinge on the bony arch above and become inflamed and painful. This is supraspinatus tendonitis, a condition which can be acutely painful or more chronically restricting for the use of the shoulder. Physiotherapy treatment consists of ultrasound or frictions to the tender area and correction of any shoulder muscle imbalances. Further treatment includes corticosteroid injections to reduce the inflammation and if severe enough, investigation to look for rotator cuff tendon tears.