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

Physiotherapy for Fractures of the Humeral Head and Neck

Fractures of the upper part of the upper arm, the neck or head of the humerus, are common in older people who have fallen onto the arm but can occur in younger people who fall hard on the upper arm. The surgeon determines if the fracture is stable and not likely to require intervention. Physiotherapy checks difficulties with the hand, wrist and elbow and gives instruction in maintaining the ranges of motion of these joints. The ranges of the shoulder joint can be maintained in more stable fractures by the performance of pendular exercises, where the patient leans on their good hand and bends over at the waist, allowing the arm to hang forward like a pendulum and to swing back and forward gently as instructed.

At around three weeks from fracture the exercises are progressed to active assisted movements where the other arm is used to bring the arm up into flexion, and usually before six weeks the arm can be raised actively on its own to begin to restore strength into the shoulder muscles. Rotatory movement behind the back and behind the neck are also practiced to restore the vital rotation movements of the shoulder.

The Acromioclavicular Joint

Just above the shoulder joint proper lies a small joint between the acromion part of the scapula and the outward end of the collar bone or clavicle, the acromioclavicular joint. It is usually not troublesome and functions like the suspension strut in a car, keeping the moving parts away from the centre of the body. For the arm to able to exert power the shoulder girdle has got to stay where it is when the strength is applied and the clavicle does this by bracing the chest and shoulder apart, forming joints at the chest end and at the shoulder end.

This is a butt joint linked by strong ligaments and is meant to transmit force and not to move significantly. Acromioclavicular joint injuries are typically sustained by falling directly on the shoulder or other part of the arm, forcing the acromion upwards against the stabilised clavicle. This disrupts the joint and is immediately acutely painful with the patient avoiding anything to do with pushing anything. Minor injuries give pain and heal well, whilst more major injuries can cause a deformity as the two parts of the joint no longer sit next to each other. This gives a non functioning joint which can be a chronic problem.