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

Damage To The Spine By Bending Forward

Injuries sustained in bending occur when the forces involved exceed the coping capacity of the tissues of the spinal structures. The movements of the lumbar spinal bones in a living person undergoing a rapid forward bend are controlled mostly by the strength and length of the disc and ligamentous tissues. Initial damage occurs to the more superficial ligaments which connect the spines of the individual vertebrae posteriorly and if some side bending or twisting motion is added then the capsules of the facet joints can be stretched to their limits. The rear part of the disc wall may act like a ligament in extreme bend, restricting further bending.

In slower bending where a position is held for a time the resistance of the spinal tissues to bending decreases, allowing greater movements between the vertebrae and a slow change in the internal disc alignment. Due to the mechanical properties of the tissues quick movements have an increased likelihood of damaging the ligaments and discs, while holding the spine in flexion for some time may both reduce the protection activity of the back muscles and the ability of the ligaments to protect the lumbar segments as they move.

Ligament-Bone and Tendon-Bone Conditions - Bone Formation

The behaviour of the bone around the joint varies in differing arthritic conditions. In rheumatoid arthritis the inflammatory joint condition is linked with loss of bone and this contributes to the damage to the joint and the disability which ensues. However, in ankylosing spondylitis (AS) the inflammation is accompanied by the formation of new bone at the inflamed sites. This new bone forms at each insertion site, growing together in the spine to form bony bridges across the vertebrae, stiffening the spine in a poor position in some cases which can cause significant disability. Since inflammation usually breaks bone down this is difficult to understand.

New bone typically forms at normal ligament or tendon insertions as we get older, but in arthritis the inflammatory phase which erodes bone does settle and then bony spurs can form as the bone laying down phase occurs next in time. In the case of AS, if a bony formation phase follows the inflammatory phase, then suppressing the inflammatory phase with medication might accelerate the bony formation process, increasing the disability. AS patients may continue to fuse their joints even in the presence of new biological treatments but they may be shown to inhibit bone formation at the insertions and thereby reduce disability.