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

Radial Head Fractures

The radial head is a small, rounded structure on the outside of the forearm near the elbow, with a structure a bit like a cotton reel. It is held within a ligament which surrounds it like a cuff and articulates with the elbow and the ulna next to it. The radial head allows the forearm to rotate as it spins within its ligamentous circle, permitting what is known as pronation (turning the palm downwards) and supination (turning the palm upwards). These movements are very important for arm function, palm downwards allowing writing and reaching to pick up objects and palm upwards allowing the acceptance of change in monetary transactions.

Most radial head fractures are undisplaced, with pain as the major symptom and typically caused by a fall on the arm. If the fracture is in place within its ligamentous restriction the treatment is a sling for comfort and mobilisation of the elbow under physiotherapy supervision. Flexion and extension of the elbow and pronation and supination of the forearm are practiced within pain limits to restore the ranges of movement as soon as possible. More vigorous work should be restricted until after the healing period of six weeks for the bone.

Inflammatory Disease of the Entheses

Mechanical factors are thought to be important in inflammatory conditions of the ligament or tendon insertions so addressing these matters may be useful. Physiotherapists can assess the problem and prescribe corrective or cushioning insoles as needed. Local injections of corticosteroids can be useful to treat the pain of enthesitis in a single area. For more widespread inflammation the new biological agents (known as anti-TNF agents) have been shown to be of some use, particularly if the legs are affected as this is so disabling. Typically enthesitis is likely to settle with time so the prognosis is reasonable.

Physiotherapy treatment of this problem includes assessment of joint ranges for restrictions which are developing and the design of an individual exercise regime to maintain the ranges of motion of all the affected joints. Hydrotherapy is a very useful treatment medium for most of the arthritic diseases as it allows the performance of joint movements in a warm and supported environment, minimising the forces on the joints, until the patient is able to progress comfortably to exercises in air. Patient education is important with the physio stressing that the exercise programme, targeted at specific difficulties for each patient, and needs to be maintained daily over the long term.