Physiotherapists in Kingston Upon Thames treat many different conditions including the issues profiled below.

Supraspinatus Tendinitis

The supraspinatus muscle is one of the rotator cuff muscles of the shoulder and a vital part of a normally functioning shoulder. It originates in the supraspinatus fossa (anatomical depression) at the top of the scapula or shoulder blade and passes outwards towards the head of the humerus. Above the shoulder joint the muscle gradually becomes more tendinous until it passes over the top of the head of humerus and inserts onto the bony area called the greater tuberosity. The muscular action is to move the arm away from the side but a more important action is to hold the humeral head against the glenoid.

Due to the proximity of the tendon to the acromioclavicular joint above it can suffer compression and inflammation from repetitive overactivity, giving a sharp pain on lifting of the arm in many activities. Physiotherapy examination involves testing shoulder abduction with compression and tension stresses to change the impingement and palpation of the supraspinatus insertion on the humeral head whilst the patient's arm is behind their back. Treatment involves limiting aggravating activities, ultrasound to the tendon insertion and strengthening of the remainder of the rotator cuff muscles. Anti-inflammatory medication may also be useful.

Physiotherapy and Manipulation

Manipulation is the moving and affecting of bodily tissues by using the hands and encompasses a wide variety of techniques including massage, deep frictions, mobilisation techniques and the forceful treatments commonly referred to as manipulation. Physiotherapists often train to perform manipulations which in this case are sudden, strong movements directed at a joint in an attempt to force it beyond the range of movement it is presently capable of. Mobilisation techniques are gentler and work within the ranges of motion available to the joint, while manipulation aims to restore what movement the joint should have.

Manipulation can be performed in the acute setting such as treating acute wry neck or a sudden onset of severe back pain. Treatment in this case may relocate the structure which is .out of place. or allow a pinched tissue area to be released and so relieve the compression suffered. Manipulation has been shown to reduce the length of time the person suffers the problem but has little effect on the overall outcome in time. More chronic conditions may be helped by manipulation to restore a range of movement which is restricted and the potential cause of pain. Physios are trained to safely and effective manage manipulative techniques.