Physiotherapists in Halifax 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.

Losing and Gaining Muscle

Muscle is a dynamic tissue, changing greatly to accommodate to changing requirements. If a person.s leg is immobilised the thickness of the quadriceps muscle decreases by 15-20% in six weeks as the Type 1 muscle fibres reduce their protein production. This is the reason why immobilisation of a fracture or sprain is kept to an absolute minimum as losses of muscle and bone tissue are important, with joint stiffness another potential damaging side effect. Muscle will also respond quickly and strongly to increases in loading, with a maximum weight to be lifted increasing by 100% over a 12 month training period.

Much of the increased strength of muscle is due to hypertrophy of the muscle fibres, although other factors contributing are muscle endurance and learned coordination of the movement. A 30% increase of muscle mass can occur in four days after a muscle is overloaded in a stretched position, indicating the speed by which this part of the musculoskeletal system can adapt to new conditions. Exactly what makes muscles increase in strength is under discussion, but unexpectedly high activity, particularly in eccentric contractions, can cause the exercise induced damage which leads to repair and hypertrophy.