Functional Body

Spine

 

The spine is separated into 4 areas:

Cervical spine (neck)                                   

Thoracic spine (mid back)

Lumbar spine (lower back)

Sacrum (part of the pelvis)

 

Cervical spine constitutes the first seven vertebrae which enable the head and neck to move in conjunction with each other or independently upon each other. They, like all other vertebrae, are also the pivot around which the soft tissues that attach and surround them, such as muscles, ligaments, discs, nerves and fibrous capsule control movement.

 

Thoracic spine. The primary role for the 12 thoracic vertebrae as a group is rotation of the upper body to the right and left, as well as contributing to the global movements of the spine in all directions. Bigger in size to their cervical counter parts  they nevertheless provide the same functions including; protection for the neural structures, muscle attachment to engineer movement, weight bearing and transfer and absorption of impact.

 

Lumbar spine is the 5 remaining non fused vertebrae which perform the same roles as the rest of the vertebrae of the spine. However the differences in design demonstrate the differences in responsibility. Larger in size than the other vertebrae to accommodate the increased weight bearing and transference there is also enlarged bony prominences primarily to enable the attachment of the larger muscle groups.

 

Sacrum combines with the innominate bones to create the pelvis. These four vertebrae are fused and therefore do not allow independent movement however as a group are involved in the movement of the spine, through flexion and extension, on the innominate bones. 

 

Common complaints include, stiffness, pain, referred pain, loss of function and movement and change in sensation. These symptoms can be individual in presentation or a combination of many and can significantly vary in presentation, severity and irritability in each individual.

Physiotherapy can help in diagnosing as well as treating conditions through a variety of interventions that include:

 

·        Mobilisation and manipulation

·        Nerve impingement release techniques

·        Muscle strengthening and stabilising

·        Posture and positioning advice

·        Soft tissue release and massage

·        Pain relief

Shoulder

 

The shoulder is a highly mobile multi-functional joint comprised of the glenohumeral joint, scapula and clavicle. 

There are many differing types of injuries and conditions that can affect the shoulder meaning a loss of function or movement. The most common include:

 

Impingement - Where some of the soft tissues are painfully trapped between the bony surfaces

Dislocation - Where the soft tissues can no longer hold the joint in place due to trauma or excessive force

Instability - Where the stability of the joint is compromised because of lax ligaments and / or poor muscular control.

Frozen shoulder - Where the capsule surrounding the joint becomes inflamed thereby restricting movement.

 

Physiotherapy will help restore correct movement and function to full range, using techniques such as:

Mobilisation

Soft tissue techniques

Motor control activation and recruitment

Muscle group facilitation and strengthening

Elbow

 

There is only two way movement available at the elbow joint, flexion and extension. Flexion is where the forearm (radius and ulna) moves towards the upper arm (humerus) and extension vice versa. This hinge joint allows us the function of a powerful yet stable structure used to some degree in a majority of all upper limb activities.

 

Although bony injuries and joint dislocation can occur the most common injuries surround the soft tissues including:

 

Tennis elbow

Golfers elbow

Ligament sprain

Bursitis

 

The other movement recognised at the lower arm is turning of the forearm or pronation and supination. These movements although appearing to occur at the elbow actually occur at the articulations between the two forearm bones (radius and ulna). At either end of these two bones a rotation allows the arm to face upward (supination) and downward (pronation). As such these bones and joints are susceptible to injury and overuse just as any other structure.

 

Common conditions around the wrist include:

Carpal tunnel syndrome

Repetitive strain injury (R.S.I.)

Radius, Ulna or hand bone fracture

Hip

 

As the most stable joint of the human body, the primary role of the hip is to support the weight of the body and enable the transfer of movement forces from the trunk and upper limbs. Nevertheless there is a large degree of movement necessary at this joint and this occurs at the ball and socket joint between the head of the femur and the pelvis. Both of these functions allow us to perform dynamic movements whilst withstanding the exertion of outside forces.

Injury to the hip has direct influences over the levels of mobility of an individual. Fracture or dislocation can cause total immobilisation where lesser restrictive injuries with still impact upon the gait pattern. If these are not identified and treated accordingly they can cause compensatory mechanisms elsewhere around the body both upper and lower limb. However the most common complaints include:

 

Fracture neck of femur: Where the bone that allows movement and weight transfer between the femur and pelvis is fractured

 

Hip Replacement: When the bones that make the hip joint have been damaged or degenerated beyond repair a new hip joint is surgically introduced 

 

Physiotherapy will help restore correct movement and function to full range using techniques such as:

  • Mobilisations

  • Soft tissue techniques

  • Motor control activation and recruitment

  • Muscle group facilitation and strengthening

Knee

 

A complicated joint of the lower limb, the knee is the pivotal hinge between the large upper bone (Femur) and lower bone (Tibia). Functionally it is vital in any role of the lower limbs and integral in the process of weight transference that enables our bipedal movement. However it is this responsibility of weight bearing that directly places it at great risk of degeneration and injury.

 

The patella (kneecap) is located at the front of this joint and is an unusual bone in that is it encased in muscle tissue. As the movement of extension is performed at the knee joint, the patella enables the muscle tendon greater leverage thereby allowing a strong powerful movement.

 

Due to the continuing supportive role of weight bearing and transference through movement the knee is susceptible to degeneration and injury such as:

Osteoarthritis

Ligament rupture/sprain

Meniscal tear

Bursitis

Muscle strain

Dislocation

Ankle & Foot

 

The true articulation of the ankle joint is where the bones of the lower leg move on the foot, to enable flexion and extension movements. These are the only two movements available at this joint, other movements such as turning the foot are often misconstrued as ankle movements but actually occur at the foot joints.

 

To enable a stable structure that allows us to weight bear often through dynamic movements such as walking, running or jumping the ankle and foot joints have a bony design structure that provides a compact solid base. On top of this there are also many strong fibrous ligaments interconnecting the bones that prevent excessive movement thereby contributing to the stability.

 

A common injury to the ankle is a sprained ligament and most common ligament sprained is the one on the outer surface of the foot. However the ankle, foot and their structures are susceptible to any injury that is associated with all of the joints of the lower limb which include:

 

Muscle strains

Arthritic changes

Gait abnormailties

Joint dysfunction

Dislocation

Fractures

 

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Explore Movement - Physiotherapy @ Castle Clinic

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