Upper_limb | Physiotherapy in Edinburgh

Jill Kerr Physiotherapy Ltd, based in Morningside, Edinburgh, Specialises in all Musculoskeletal Injuries & Pathologies such as Sports Injuries, lower back and neck pain, ligament sprains, muscle sprains, tendon pathology and joint arthritis. Our Physiotherapists also specialise in the rehabilitation of clients recovering from broken bones (fractures), peripheral joint replacement as well as helping clients with persistent (chronic) pain.

The musculoskeletal system will be examined using a detailed clinical assessment and the diagnosis explained, then each client will be given Physiotherapy/rehabilitation appropriate to their specific injury and lifestyle.

If you are unsure whether Physiotherapy is suitable for your problem, then please contact our team. Our Physiotherapists offer Telephone, Virtual and Face to Face Consultations.

Below is a list of just some of the common conditions our Specialists Physiotherapists can assist you with:

Shoulder:

Rotator Cuff Injuries in Shoulder

The rotator cuff tendons in the shoulder control the position of the head of the humerus and are important in the control of movement in the shoulder. These tendons work collectively as a cuff and individually are known as< Supraspinatus/ Infraspinatus/ Teres Minor/Subscapularis.

The tendons are susceptible to several different pathologies including acute/chronic calcific tendinopathy, acute or degenerative tendon tears, and most commonly a Reactive Tendinopathy.

The pain from any of these problems is felt on the upper arm and the history and examination will help guide your Physiotherapist to the most likely diagnosis for your pain. Your Physiotherapist can explain your probable diagnosis and help you understand why your shoulder is painful and what you can do to help. The main function of tendons is to transmit load from tendon to the bone and therefore a loading programme is likely to be an essential part of your rehabilitation.

Frozen Shoulder (Adhesive Capsulitis)

Frozen Shoulder also known as Adhesive Capsulitis is a common presentation our Physiotherapists treat in clinic. It is common in middle stage of life and can come on either as a result of mild trauma such as a fall or pull on the shoulder, or for no known cause. There can be a link with an underactive thyroid or diabetes- and your Physiotherapist may ask you to get contact your GP to test for these conditions. This is an irritation of the shoulder joint capsule and there is inflammation and then adhesions making the shoulder progressively more stiff and painful. The good news is the majority will return to full function but the timescale for this can vary.

Pain is felt in the upper arm and clients notice a worsening stiffness/mobility in the arm along with an increasing pain down the arm and disturbed sleep. Your Physiotherapist will be able to ascertain the stage your Adhesive Capsulitis is in and explain the options for treatment which could include Physiotherapy and stretches, A joint injection or a distension Arthrogram. Your treatment will aim to reduce the inflammation and increase your range of movement. As your movement returns to normal so will your function.

Subacromial Pain Syndrome (SAPS)

Subacromial pain syndrome is an umbrella term to highlight pain within the subacromial area. There are many anatomical structures in this compact space between the underside of the acromion (the flat bone at top of the shoulder) and the head of the humerus. These structures include the subacromial bursa, the rotator cuff, the long head of biceps tendon, and the glenoid labrum.

Overhead activities can predispose clients to SAPS and onset can often be gradual- your diagnosis may include involvement of more than one of the anatomical structures mentioned above. Your Physiotherapist will ask questions and carry out clinical examination to ascertain the cause and structures involved in your pain. Clients typically complain of catching pain either superficially or deep in the shoulder joint. Your age and mode of onset will also help to build the clinical picture. Different structures are more likely to be affected at different ages and stages of life.

Interestingly rounded shoulders can reduce the subacromial space to make us more likely to have pain in this region.

Acromioclavicular joint sprain/ OA (AC joint)

A typical fall onto the tip of the shoulder or onto an outstretched arm can sprain the ligaments supporting this small joint in the epaulette area of the top of the shoulder. The pain is local to the tip of the shoulder and depending on the severity of the injury the time to recovery will vary from 3-12 weeks. The injury will be graded from 1-5 by your Physiotherapist. You may notice a visible bump at the end of your collar bone. Early physiotherapy intervention will facilitate the healing process and return to normal activity levels. Movement of the shoulder will feel restricted in all directions.

If there has been no trauma and you feel pain in this area- this joint is subject to wear and tear (OA/ Degenerative changes), especially if there has been previous trauma to this area. An x-ray would be able to confirm if there are any degenerative changes to the joint. Your Physiotherapist will be able to assist you with pain in this area.

Shoulder dislocation/fracture

If you have had a fall and either fractured or dislocated your shoulder been x-rayed and seen by an Orthopaedic Specialist- our Physiotherapists can assist you with the rehabilitation of your shoulder to regain full shoulder movement and strength. We would normally see you at either 2 or 6 weeks depending on the Orthopaedic recommendation. Both these injuries can be painful when you start to move the shoulder when they have been in a sling as the soft tissues will also have tightened up- your Physiotherapist will explain and will reassure you of the normal processes of healing and rehabilitation.

Elbow:

Tennis Elbow

Tennis elbow is the most common condition we see at the elbow in clinic. Sometimes known as lateral epicondylitis/reactive extensor tendon tendinopathy - Tennis elbow is due to an overuse of the wrist extensor tendons that originate on the outside of the elbow. This means a lot of gripping and lifting actions at the hand and wrist which overloads the tendon at the origin at the elbow. Many different activities can spark tennis elbow and interestingly these days it is less likely to be tennis but more decorating, gardening and an increase in gripping actions of the hand. As with all tendons transmit load and a loading programme is an essential part of the treatment programme.

Soft tissue mobilisation, acupuncture, and taping can help with pain relief and allowing the progression of loading. Being in the know of what to do and what to avoid when you have tennis elbow can make a huge difference to daily function.

Wrist:

Dequervain’s Tenosynovitis

Dequervain’s tenosynovitis involves the thumb tendons that extend/abduct and move the thumb in the direction of the thumb nail and out to the side, and pain is felt at the base of the thumb close to the wrist joint. It is prevalent in new mums and those working in a occupation or hobby involving using the thumb a lot, e.g. texting, gaming. There can be crepitus and occasionally swelling between the tendons and their covering the tendon sheaths. Local tenderness will be felt.

Soft tissue treatments, taping, a loading programme and/or injection therapy are options for this lesion, but your Physiotherapist must address the contributing factors of why it has become painful.

Carpal Tunnel Syndrome

Carpal tunnel syndrome presents with painful pins and needles in the thumb, index, middle and half the ring finger. The median nerve is compressed in the hand. It is a presentation which can either be associated with some systemic illness which results in swelling in the hands such as under active thyroid, can be common during pregnancy and sometimes a result of compression from heavy manual work.

Carpal tunnel can be difficult to differentiate from problems with the neck. Your Physiotherapist has tests that differentiate where the problem is originating from and has various solutions to tackle the problem depending on the source of the problem.

For more information about the injuries & pathologies we treat and the treatments we offer, or to book an appointment please call 0131 447 9990 or email us at info@jillkerrphysiotherapy.co.uk