Physiotherapists in West Sussex treat many different conditions including the condition profiled below.

Pacing to Avoid Overdoing Activities in Chronic Pain

Patients with chronic pain very commonly push themselves hard to get things done, to complete the day to day activities they feel they must continue to perform. Unfortunately this almost always leads to a severe worsening of their pain, forcing them to rest in high levels of pain for several days. This pattern is commonly repeated again and again with the consequence that the person.s abilities tend to reduce over time as they become able to do less and less. This is known as the overdoing and under doing cycle, or activity cycling. It is a counterproductive cycle for pain sufferers, who can learn pacing their activities to their advantage.

Pacing changes the way activities are performed from a pain dependent state, where the person does the activity until pain stops them, to a time dependent state. This means they do an activity for a previously specified length of time then stop, not overdoing it at any one time. The person does the activity until they feel their pain worsen, records that time and then takes 20% off that time to give their quota. They are not allowed to go over their quota initially, to gain control of the activity.

Trochanteric Bursitis

Pain on the side of the hip is a common complaint and often diagnosed as trochanteric bursitis, even though this diagnosis may not be verifiable. Lateral hip pain can be referred from the lumbar spine or the hip joint but in many cases the pain is located over the large bony prominence at the side of the hip, the greater trochanter. The tendons of several of the large buttock muscles come round and insert into the greater trochanter. On examination a physiotherapist might find great tenderness over the greater trochanter and over the nearby tendon, with pain on resisted hip abduction which stresses the tendons.

Symptoms are aggravated by walking, running or any activity which demands significant power from the buttock muscles. Initially the pain was thought to be inflammation in one of the lubricating sacs positioned between moving structures, known as bursae. Present ideas indicate that degenerative changes may occur within the tendon structures, causing a tendinosis which can be painful. Treatments can include physiotherapy to teach patients eccentric exercises to stress the tendons and force it to repair, steroid injections into the tendon areas which are painful or in severe cases a surgical release.

Physiotherapists in West Sussex have contributed some of the many articles on this site such as the one extracted below.

The management of dislocated shoulders is a matter of controversy in the orthopaedic field, with the usual management being confined to a sling for between one and six weeks, with or without a strap around the waist to prevent external rotation. The arm is maintained close to the body with the forearm across the belly, a position known as medial rotation and adduction. This avoids the stresses which would be applied to the joint if it were moved to the side or outwards, known as lateral rotation and abduction.Recent studies of dislocation in the scientific literature have shown some clues as to how these injuries should be managed. One study involved MRI scanning to show that the relationship between the rim of the socket and the socket itself is best maintained by placing the arm by the side and rotating it laterally 35 degrees. A cadaveric study of shoulders showed that keeping the arm in slight adduction close to the body allowed a reasonable range of motion without disrupting the c...

more Dislocation of the Shoulder - Part Two