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Showing posts from May, 2013

Ehlers–Danlos syndrome (EDS)

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What is it? It is a group of inherited connective tissue disorders, which affects the formation of type I and III collagen. The syndrome is named after Edvard Ehlers from Denmark and Henri-Alexandre Danlos from France as they found that it affected the collagen. What is collagen? Collagen is an important in the skin, joints, muscles, ligaments, blood vessels and visceral organs. It gives these tissues their strength and the collagen in connective tissue helps tissues resist deformation. So what happens to these tissues in Ehlers-Danlos syndrome? Basically the abnormal collagen makes everything more elastic and weaker in structures that have collagen. Obviously this will depend on the type of EDS. Classifications: (These are the main types but there are more than just these) Classical types 1 & 2: Type 1 presents with severe skin involvement, and type 2 with mild to moderate skin involvement. It affects 1 in 20,000 to 50,000 people a...

Thoracic Outlet Syndrome

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Definition: Symptom complex characterized by pain, parasthesia, weakness and discomfort in the upper limb which is aggravated by elevation of the arms or exaggerated movements of the head and neck’ (Lindegren and Oksala 1995) ‘Upper extremity symptoms due to compression of the neurovascular bundle by various structures in the area just above the first rib and behind the clavicle’ (Saunders, Hammond, Rao 2007) Classification of compression: Incidence: Affects 8% of the population Females are more commonly affected than males (between 4:1 and 2:1) Predominantly occurs between the ages of 20 and 40 Rare in children and but when it does occur it presents most commonly as vascular Thoracic outlet syndrome Neurological is more common than vascular Thoracic outlet syndrome: (98% and 2% respectively) How does it occur: Trauma Brought on by a change in activity Repetitive activity or sustained postures Weight gain or increased muscle bulk Arteri...

Sacroiliac (SIJ) Dysfunction

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The SIJ is not a ‘single entity’ It has an integral relationship to whole kinematic chain (affects the whole body). It is responsible for force/load transfer from the lower limb to the spine and from the spine to the lower limb. Functional activities can have an adverse effect on this joint (Vleeming et al 1989) Functional activities such as throwing, bowling, sitting, driving, prolonged vibration of the pelvis, stepping off a height, getting foot caught in stirrup on a horse all have been shown to produce adverse effects in this joint. Joint itself is derived from first three sacral vert. It is L shaped in nature. Has a short vertical and a longer horizontal arm. Movement occurs as glides along these surfaces. The Iliac surface is first to show degeneration by the 3 rd decade and the Sacral surface shows degeneration in the 4th and 5th decades. Sturesson et al (1989 & 1999) demonstrated that mobility is possible & it is essential for shock absorptio...

Patellofemoral pain syndrome: A complex issue.

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Knee pain is rarely caused by isolated events, more commonly they are the consequences of habitual imbalances in the movement system. The one off injury such as the torn anterior cruciate ligament can and does occur, but these are relatively simple as we know what the injury is and what caused it, which makes it easier to treat and prevent re-occurrences. However, physiotherapists are dealing with more complex pain syndromes such as patellofemoral  (knee cap joint) pain, shin splints, and back pain, amongst many others. The issue with these types of conditions is that the cause may be difficult to establish and may be many things. Even more complicated the pain may be coming from another area of the body and not from the site of pain! Equally it may be caused in part by the postures and activities that are performed every day, which could be work related. So the problem then becomes how to you recover and prevent when you are constantly causing the problem every day?...