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

Hand Injuries - Diagnosis

The diagnosis of most hand injuries is not difficult as the damage is usually readily apparent to the examiner. There will typically be a history of trauma and this should be carefully attended to as it may give clues to a more complex injury than first appears. Bruising and swelling are very typical signs apparent on initial inspection, with pain a common and often localising feature. There may be an obvious deformity if the joints are dislocated or bones fractures with displacement, the patient will have lost the ability to grip firmly and there may be reduced range of movement in the fingers and thumb.

Examination starts with a visual examination of the hand which guides the doctor as to further required tests and investigations. The doctor will palpate the hand systematically to look for areas of particular pain or abnormal movement which would point to an underlying injury. The ranges of movement of the shoulder, elbow, wrist and hand is assessed and recorded, with the tendon actions tested in turn to search out any tendon involvement. Circulatory function will be checked to exclude blood vessel damage. Investigations will routinely include x-rays to look for fractures, dislocations or embedded objects such as glass.

Achilles Tendon Rupture

The Achilles tendon is the largest tendon in the body, a large fibrous structure formed of collagen fibres lined up to form a very strong tendon which has to bear the force of weight bearing activities. The calf muscles are a very important part of propulsion in walking and when we walk, run or jump , very high forces are taken by the Achilles tendon as we perform vigorous movements with the ankle. As we get into our forties the strength of our tendons is declining but we often put the same forces on our body as we did twenty years previously. This can lead to the forces involved exceeding the strength of the tendon and a rupture, either partial or complete, results.

Treatment can be conservative or surgical, in many cases there being no significant clinical difference between the two in terms of outcome. Plaster of Paris used to be used routinely for immobilisation but new bracing systems have now been developed which allow precise control of the angle of the ankle and so the stresses on the tendon. This allows a graded progression of force as the tendon heals. Physiotherapists apply these braces and rehabilitate patients once they are out of the immobilisation.