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

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.

Tennis Elbow

Tennis elbow is a troublesome pain condition affecting the outer part of the forearm around the elbow. It is common is people who do repetitive forearm activities in work or hobbies and while it mostly occurs in people who do not play tennis, it can occur in tennis players too. In the acute stage tennis elbow can be very disabling as it interferes significantly with the function of the arm and hand and can produce high levels of pain. A more gradual onset of pain over the outer part of the elbow may be more common, with difficulty gripping and holding objects or performing repeated actions.

Physiotherapy examination consists of palpating the musculotendinous junction of the extensor muscles of the forearm for tenderness and pain, testing resisted forearm extension and the ability to grip strongly. An abnormality of the tendon, a tendinosis, is thought to contribute to the pain of this condition. Physiotherapy treatment consists of reducing the stresses by activity modification and use of an epicondylitis brace, ultrasound, deep frictions and eccentric exercises to the forearm extensors. Local injections of corticosteroid or even a surgical tendon release can be used in difficult cases.