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

Examination of the Injured Wrist

Initial examination of a person with a wrist injury involves visual inspection of the wrist compare to the other one, as some people have relatively abnormal wrist structure and limited movements. Bruising and swelling may be present as may be one of the typical deformities due to fractures of the distal forearm bones. Palpation of the bony anatomy systematically allows a closer determination of the location of any acute injury such as a fracture. The typical deformity of a Colles fracture is the so-called .dinner fork. deformity where the end of the wrist is angled upwards and the fingers form the prongs of the fork.

In the Smith fracture where the end of the wrist is pushed downwards the deformity is known as a .garden spade. deformity. It is important to examine the remainder of the upper limb including the shoulder, elbow and wrist to exclude other injuries or fractures, with the patient's report of where they have pain a very useful guide. The patency of the arterial systems in the forearm and arm are also assessed as vascular damage can occur from fracture fragments. The three nerves which pass down the arm and supply the feeling and muscles of the hand should also assessed for damage.

Sciatica - Physiotherapy Examination

Sciatica is also known as nerve root pain, nerve root irritation, nerve root entrapment and slipped disc pain in the leg. True sciatica occurs when one of the nerve roots exiting the spinal canal is compromised, usually by a disc protrusion. The pain is typically severe, radiates down the leg beyond the knee, is worse in the lower leg or foot, has a surging quality and is worse with sitting or bending and better lying down. Physiotherapy examination starts with a history of the pain location and aggravating or easing factors and what were the precipitating factors for the pain problem.

The physio will examine the patient carefully as it is easy to aggravate the pain. Muscle power (as able), sensibility and reflexes will be tested to check the conduction of the nerve root involved and this should fit in with the area of pain reported. With the patient lying supine the affected leg will be raised with the leg straight to stretch the nerve and evaluate any changes in the pain reported. This neural tension test must provoke the typical pain to be positive. Palpation of the patient's spine may be performed in prone to evaluate the mobility or stiffness of the spinal segments.