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

The Shoulder

The human shoulder is a design of great functional ability and ingenuity, designed entirely around placing our hands in the places we want them to be. The hand is the tool with which we connect with the world and we need to be able to place it in a great variety of positions so we can manipulate objects. The shoulder contributes to a very large extent to our ability to do this and to achieve this goal it has an extremely large range of motion permitting great flexibility. However, in satisfying the requirement for flexibility it sacrifices stability.

To allow the large range of motion the shoulder is designed with a relatively small socket and a very large ball, the head of the arm bone. The shoulder capsule, the fibrous ligamentous bag which surrounds and supports the joint, is relatively lax and contributes little to stability. The nervous and muscular systems have the job of keeping the large humeral head balanced on the small glenoid cavity (shoulder socket). The large shoulder muscles are more concerned with gross movements of the shoulder, and it is the rotator cuff muscles which perform much of the stabilising work of the joint.

Spinal Posture

Spinal posture can mean two main things, one being the shape and orientation of the curves in the spine and two being the angle that the whole spine is aligned to the vertical. The minimum of muscle activity occurs when the trunk is balanced directly above the pelvis and any deviation from this requires muscle activity to increase to maintain position. As the main moving muscles of the spine are orientated lengthways like the spine itself, when they contract they generate significant compression forces through the spine. Contraction of these muscles in easy standing or sitting still generates forces through the lumbar spine that are twice the body weight above the area.

In sitting it makes little difference to the degree of muscle activity whether the lumbar spine is held arched to some degree (lumbar lordosis) or flexed (bent), the key point is whether the spine is vertically aligned or not. So leaning back with a lordosis or forwards with a flexed spine both generate high muscle forces, whilst sitting upright in either posture does not. Sitting positions all flex the lumbar spine, with the lower two lumbar levels being significantly flexed in these postures, even to the maximum of their movement.