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

Stretching and Tightness

We all have a genetically determined stretchiness or tightness to our connective tissues, the skin, tendons, ligaments and discs which are made up of collagen. It is partly the make up of collagen and partly the length of our tendons and ligaments which determine how bendy or tight we are. Mostly the length of our soft tissues is not very important as we are able to function normally with what we have got, but in some cases such as injury or pain conditions the tightness or laxness of our tissues can become an issue. In low back and neck pain syndromes certain structures can become tight and others slack, leading to imbalances in the muscular and joint systems.

Physiotherapists use stretching routinely to correct these imbalances and teach their patients very specific and controlled programmes. For stretching to be effective the action must be taken to the point of tightness, pushed a little further into the resistance and held for 15 seconds or more steadily. Bouncing should be avoided as this does not stretch well and can cause injury. Stretching should feel uncomfortable in the target tissues but not greatly painful and any discomfort should settle quickly once the stretch is removed.

Tendon-Bone and Ligament-Bone Conditions . Mechanical Factors

Problems with the junctions between bone and ligaments or tendons can occur because of mechanical rather than inflammatory factors, with overuse injuries, trauma and sport examples of causative factors. MRI scanning may show a pathological change in the insertion or enthesis but the differences between changes caused by inflammation and mechanical factors is not great. It is fairly clear at the Achilles tendon as changes caused by mechanical factors occur two to six centimetres above the insertion while inflammatory changes will occur at the insertion itself. Degenerative changes in the insertions may give similar effects to the changes from inflammation.

Enthesis in osteoarthritis may show the same, if more limited, changes which occur in inflammatory conditions. Modern investigations have improved our knowledge of these conditions, with spinal problems best imaged by magnetic resonance imaging (MRI) and areas of the body which are more easily reached can better be checked out using ultrasound. Swelling of the bony areas around the insertion can be present on scanning, as is soft tissue swelling of the enthesis and its surrounding region. However, a normal MRI and a negative blood test do not exclude an inflammatory arthritis as both tests are not specific enough.