PHYSIOTHERAPY

Physiotherapy plays a vital part in the treatment of upper limb
conditions. The majority of common problems, such as Frozen Shoulder
and Rotator Cuff Tendinopathy, can be treated successfully without
surgery in most patients. Physiotherapy has moved away from the old-
fashioned ‘hands-on’ techniques, such has massage and
electrotherapy, as these have been found to give very short-term
benefit without long term gain. Modern Physiotherapy involves the
prescription of tailored exercise regimes for the patient’s
individual problem and research would suggest that for many upper
limb conditions this strategy is as good as or better than surgery.
Of course, this does not work for all patients and not all conditions
but physiotherapy support is also imperative after all upper limb
surgeries and fractures to aid patients recover their arm movement,
function and strength.

Rotator Cuff Tendinopathy:

This is the most common cause of shoulder pain. The shoulder tendons can become
painful after an injury or simply as a result of the tendons weakening as part of the
normal aging process. It is common for people over the age of 60 to even develop
tendon tears without injury that may or may not be painful. Physiotherapy can help to
strengthen weak painful tendons or strengthen surrounding muscles to compensate for
torn tendons. Many Studies have found that teaching patients how to strengthen their
shoulders and self-manage the problem resulted in better long term outcomes than
traditional forms of Physiotherapy.

Frozen Shoulder:

This is a very painful condition that usually affects people of middle age. The cause is
unknown but it is more common in women and in the diabetic population. Typically
patients complain of pain in the upper arm, rather than over the shoulder itself, and it
usually feels worst at night. As time goes by the shoulder becomes less mobile having
an impact in day-to-day function. Physiotherapy, usually in combination with a
steroid injection, can help reduce pain and restore shoulder movement.

Shoulder Instability:

The shoulder joint is very mobile but can be prone to instability when the ball of the
joint slips partly or fully out of the socket. This is usually caused by injuries in young
sporty adults but can sometimes happen without injury in people who are hypermobile
(double-jointed). The muscles around the shoulder play an important role in
maintaining stability so need be retrained after episodes of shoulder instability.

Post-operative Physiotherapy:

The Physiotherapist sees the patient before they are discharged to instruct them on
how long to wear a sling and which gentle exercises to do in the early stages. The
post-operative instructions vary depending on the type of surgery performed..