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

Shoulder Dislocation

The shoulder is an anatomically unstable joint as it is optimised for mobility rather than stability, allowing the hand to be placed in the very large number of positions required for optimal function. The shoulder socket (glenoid) is relatively small compared to the very large humeral head, leading to problems for the muscular and neurological systems as they struggle to keep the ball of the humerus centred on the socket during movement. The capsule of the shoulder, the fibrous bag which surrounds the whole shoulder joint, is relatively lax to allow for the large ranges of movement. This means it and its ligaments have little control over the joint and it relies on muscle control.

Dislocation is usually caused by a fall on the arm, especially if the arm in a position of abduction and lateral rotation, the position adopted by the .hands up!. posture. This is the most vulnerable position for the shoulder to dislocate anteriorly, i.e. the ball comes out of joint to the front. Immediate severe pain is the first symptom with the patient holding their arm in a protective position. Medical help is usually required to relocate the joint and there can be damage to the axillary nerve which control the deltoid muscle.

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.