Physiotherapists in South Humberside treat many different conditions including the condition profiled below.

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.

Bone and Ageing

Bone loss occurs much more rapidly than the equivalent process in muscle tissues, with reductions in hormone production and in activity playing a part. After the menopause, the reduction in hormone production in women can result in lowered bone density which is initially termed osteopoenia and then osteoporosis when the bone approaches the levels where it will fracture easily during normal activity. Bone loss affects the trabecular honeycomb bone more than the denser outer cortical bone and also the vertical struts more than the horizontal ones. Once one of the struts is broken it does not repair.

Because they are made up of large amounts of trabecular bones, the spinal bones are often badly affected by osteoporosis, with the process eventually allowing a buckling of the upper and lower surfaces of the vertebrae. The fronts of the vertebrae are more vulnerable to fracture as the trabeculae lose more mass in this area. Physiotherapists teach weight bearing exercises to counteract bone loss and drug therapies can halt breakdown and even increase bone mass. Getting our bone mass up to a high level during younger years so that the steady loss with age does not become important may be the best strategy.

Physiotherapists in South Humberside have contributed some of the many articles on this site such as the one extracted below.

by Jonathan Blood SmythStretching or traction injuries are the most difficult to treat as the status of the nerves is not accurately known, with early surgery potentially preventing normal recovery and delaying surgery perhaps permitting important structures to degenerate. 3-6 weeks after injury is the time surgical intervention would be contemplated if the nerve roots have been avulsed from the spinal cord. If expected recovery from less severe injury is not forthcoming then exploration can occur at 3-6 months from injury. If the nerve has been cut or avulsed then nerve repair or nerve grafting can be performed respectively, with nerve transfers sometimes used to speed recovery.A very difficult part of brachial plexus lesions is the unexpected pain which can develop with time. Even though the nerves have been pulled out from the spinal cord connections, a chronic pain problem can develop in the area the nerves supply normally, which is the arm. As the nerves transmitting impulses to a...

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