Physiotherapists in Worcester 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.

Continuous Passive Motion after Knee Replacement

Total knee replacement is an increasingly common treatment for knee osteoarthritis and large numbers of elderly people undergo this operation every year. Physiotherapy management and treatment of these patients post-operatively is therefore becoming increasingly important if the best functional outcome is to be achieved. Early rehabilitation focuses on improving strength in the quadriceps muscle, restoring range of motion of knee flexion and facilitating gait and activities of daily living. The restoration of knee ranges of movement is one of the key elements on which success is judged and much physiotherapy time is dedicated to this part of the treatment.

A continuous passive motion machine is commonly used to improve knee flexion range of movement, as regular passive movement of a joint has been shown to result in better healing as compared to resting. Research work has shown a minor short term effect of using this treatment technique and it is often reserved for difficult cases such as after manipulation under anaesthetic for a stiff joint. Patients can remain on the machine for long periods but it is important not to forget active practice of the ranges of motion to improve muscle function. Overall continuous passive motion has not been shown to play a significant role in standard knee replacements.