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

Staying Active after Whiplash

Part of the art of recovering from whiplash injury is to keep as active as possible without aggravating the pain too severely. Resting for a few days in the presence of severe pain is reasonable but longer periods of rest can be counterproductive and disabling. Most activities can be performed without the neck having full movement so the patient should get on and do what they can. Static postures should be avoided for too long and the patient encouraged to change positions and keep moving regularly. The movements should be progressed steadily every day to push the joints a little bit further each time.

When sitting the chair should be the right height and the person get up very regularly to vary the neck position. Office work can be much easier with a well adjusted chair and the computer monitor and keyboard in optimal positions. Driving should be for short periods with regular stops to get out and move around. Pacing general activities by splitting them up into shorter time slots is a very useful strategy, allowing the patient to continue activities or restart them again without causing a significant worsening of pain.

Tendon-Bone and Ligament-Bone Conditions . Mechanical Factors

Problems with the junctions between bone and ligaments or tendons can occur because of mechanical rather than inflammatory factors, with overuse injuries, trauma and sport examples of causative factors. MRI scanning may show a pathological change in the insertion or enthesis but the differences between changes caused by inflammation and mechanical factors is not great. It is fairly clear at the Achilles tendon as changes caused by mechanical factors occur two to six centimetres above the insertion while inflammatory changes will occur at the insertion itself. Degenerative changes in the insertions may give similar effects to the changes from inflammation.

Enthesis in osteoarthritis may show the same, if more limited, changes which occur in inflammatory conditions. Modern investigations have improved our knowledge of these conditions, with spinal problems best imaged by magnetic resonance imaging (MRI) and areas of the body which are more easily reached can better be checked out using ultrasound. Swelling of the bony areas around the insertion can be present on scanning, as is soft tissue swelling of the enthesis and its surrounding region. However, a normal MRI and a negative blood test do not exclude an inflammatory arthritis as both tests are not specific enough.