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

The Rotator Cuff

The rotator cuff muscles of the shoulder function to stabilise the large humeral head on the relatively small shoulder socket or glenoid cavity. The origin of the rotator cuff muscles is the large flat areas of the scapula or shoulder blade, but for the muscles to be able exert their forces the shoulder blade must itself be stabilised. The shoulder blade floats over the thoracic rib cage and is attached by various muscles to the trunk, the rhomboids, trapezius and serratus anterior. If there is a dysfunction in these muscle groups the stability of the scapula will be compromised, making it difficult or impossible for the rotator cuff group to do their work effectively.

The rotator cuff muscle all originate medially to the shoulder, i.e. further in towards the middle of the body. They pass outwards towards the head of the humerus, becoming tendons close to the shoulder itself and then inserting into the greater tuberosity, a bony protrusion on the outside of the head of the humerus. The primary pull of the rotator cuff muscles is in a directly inwardly direction, pulling the humeral head firmly against the glenoid. This counteracts the tendency of the deltoid muscle to pull the humeral head upwards.

Bone Metabolism

Bone, like muscle, is an adaptive tissue and bony mass and its structure changes to resist the forces which are applied to it in activity. Changes in the bone require that a large number of cells which are quite far apart join in to perform a particular activity and they do this by chemical messengers but also by long outgrowths from their cells connecting with others. How fast bones can strengthen or become weaker is not clear, although experiments have shown that a bone can increase its mineral content by 40% in six weeks if it is frequently loaded. A loss of 10-15% of bone mass can be expected if a bone is kept unloaded for eight weeks.

Cortical bone may be 35% greater in mass in the playing arm of a professional male tennis player and bone can react even more strongly as its density is very high in expert weight lifters. Sclerosis, an increase in density of vertebrae adjacent to discs which are suffering degeneration, is less beneficial a process and may impede nutritional transport through the bone. Osteophytes, bony outgrowths, may be an attempt to stabilise a joint but can also get in the way and cause nerve impingement.