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Hands and fingers Carpal tunnel syndrome Carpal tunnel syndrome occurs when pressure build-up within the carpal tunnel causes nerve compression. When the compression is sufficiently high, it causes changes in nerve function, which causes numbness / tingling, pain in the hand and fingers and, consequently, muscle weakness. In most situations, numbness / tingling affects the thumb, forefinger, middle and part of the ring. The signs usually appear at night, but can appear during daily activities, such as driving or reading a newspaper. Patients notice that they have reduced grip strength and may drop objects from their hands. In the most severe cases, tenderness may be completely absent and the muscles at the base of the thumb atrophied (atrophy of the tenar eminence). The cause is usually unknown. Fluid retention during pregnancy can in some cases cause edema in the canal, which usually disappears after delivery. Some diseases such as hypothyroidism, rheumatoid arthritis, diabetes and kidney failure can be associated with this syndrome. Stenosing tenosynovitis (trigger finger) Stenosing tenosynovitis, commonly known as a trigger finger, involves the tendons and pulleys of the flexor tendons of the fingers. The tendons work like long cords from the muscles in the forearm and through a tunnel, with a bone base and fibrous tissue ceiling, until they reach the fingers. Inside the tunnel the tendons are wrapped in a film that allows easy sliding inside the sheath and pulleys. The trigger finger occurs when the tendon develops a lump or edema of the surrounding film. When the tendon swells, it increases in volume, and has to rub at the entrance to the tunnel (flexor tendon sheath), which causes pain, bouncing and a feeling of being trapped in the finger. When the tendon touches the sheath, there is more inflammation and more edema. This causes a vicious cycle between the trigger, inflammation and edema, which in some cases leads to a blockage, and it is not possible to bend or stretch the involved finger. The causes for the appearance of the trigger finger are not fully understood. Trauma to the palm can irritate the flexor tendons. Some diseases such as rheumatoid arthritis, gout and diabetes are associated with the appearance of a trigger finger. The trigger finger may start as a slight discomfort felt at the base of the finger. Thickening can be felt in this area. When the finger starts to become blocked and cause the shoulder or trigger, the problem may appear in the interphalangeal joint near the finger. Dupuytren's disease Dupuytren's disease is a benign pathology that is characterized by a fibrotic thickening of the palmar and digital fascia of the hand. Initially, it presents as a palpable palpable mass (Dupuytren's nodule) that can progress to contracture in flexion of the hand joints. It occurs most frequently on the 4th and 5th fingers. The decrease in range of motion affects the patient's daily activities. The pre-tendon nodules that form in the palmar flexion folds may be painless or moderately painful. As they grow, Dupuytren's nodules develop cords that extend distally and proximally and that, once thickened, shorten and lead to contracture. Quervain's tenosynovitis Tenosynovitis, tendonitis, or De Quervain's syndrome is an inflammation that affects the tendons of the wrist leading to the thumb, namely the tendons of the long abductor and short extensor of the thumb, in the area where they cross a thick fibrous sheath, which constitutes the first wrist extensor compartment. Although the causes of De Quervain's tenosynovitis are unknown, in most cases it is associated with overuse, either at home or at work, or with rheumatoid arthritis. Any activity that involves repetitive movement of the wrist and hand such as gardening, playing golf or tennis or picking up a baby, for example, can trigger and / or aggravate the symptoms. Prolonged vicious positions or situations of overload can also be at its origin. In addition, there are physiological conditions that predispose to the development of this pathology, such as pregnancy, the puerperium or in patients who have had a previous wrist fracture. The main symptom of De Quervain's tendonitis is pain in the outer edge of the wrist. The pain can start suddenly or insidiously and initially appears at the base of the thumb, in the area that corresponds to the first extensor compartment. Often the pain radiates towards the thumb or forearm, and it is sometimes difficult for the patient to locate a specific point of pain. De Quervain's tendonitis is curable with appropriate treatment, which consists of eliminating inflammation of the affected tendons, thus providing pain relief and recovery of mobility and function. Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment

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Knee Knee pain is one of the most common pain in the human body. It affects both the elderly, generally having a degenerative origin, and young individuals as a rule due to traumatic injuries or problems with the alignment of the patella (so-called rotulian syndromes). Generally, knee pain (whether mild or severe) has pathological significance, that is, there is a pathology or disease that is at the origin of it. Constant knee pain is an indication (or symptom) that something is not right. In other situations, knee pain can be caused only by a specific situation of overload of effort, such as that which occurs in a longer walk, or in climbing slopes, or carrying excessive weights or even in more intense sports training. In these cases, a period of rest or sports break may be sufficient to resolve the condition. Gonarthrosis (Knee Arthrosis) Which is? Chronic and degenerative disease associated with pain and loss of knee function. Greater vigilance is needed when associated with other risk factors such as diabetes or cardiovascular disease. What are the causes? Gradual degradation of knee cartilage, reduced viscosity and elasticity of synovial fluid. This degradation ends up fragmenting the cartilage and the protective space between the knee bones decreases, which causes greater friction and the formation of painful bone formations known as parrot beaks. What are the symptoms? - Knee pain and inflammation - Joint stiffness and swelling - Severe pain and swelling in the morning, or at rest, or after intense physical activity - Sensation of blockage or sagging during movements due to the interference of cartilage fragments in joint movements Previous cruciate ligament injury The previous cruciate ligament (ACL) has the function of being one of the main stabilizers of the knee joint. The central cruciate ligament of the knee forms with the posterior cruciate ligament. Both cruciate ligaments contribute, not only to the antero-posterior stability, but also to the rotational stability of this joint. The previous cruciate ligament rupture is one of the most frequent injuries in sportsmen. This previous cruciate ligament injury is often referred to as "tearing of the knee ligament". A non-athlete can also “break the ligament” when performing everyday tasks, as a result of a twisting mechanism and slight knee flexion. It affects women very often, due to the specificities of their knee anatomy, hormonal differences and muscle development, namely hamstrings. In the rupture of the previous cruciate ligament, the symptoms are very characteristic . When the athlete undergoes a rupture of the previous cruciate ligament, he usually refers to a snap and acute knee pain. A hematic joint effusion quickly sets in, and the patient finds it difficult to walk without the support of Canadians for a few days. After the acute phase, one of the main symptoms of ACL rupture is instability, with the feeling that the “knee fails”. The patient feels insecure when going up and down stairs or slopes, as well as playing sports. Physiotherapy in the rupture of the ACL is essential for a full recovery. Some patients are asymptomatic (without symptoms) after undergoing physical therapy, thus dispensing with any surgical intervention. Meniscus injury The meniscus is a fibrocartilaginous structure , triangular in shape, which is located inside the knee joint covering the periphery of the tibial plates. Its anatomy is specially adapted to the function it performs: dampening shocks and transmitting loads. The rupture of the meniscus occurs very frequently during sports, due to sprains of the knee that cause twisting movements and consequent meniscal injury. Injury to the meniscus or meniscal injury in the sportsman results in reduced performance and, in certain sports such as football, more or less prolonged stops in his practice. Therefore, the importance of timely diagnosis and treatment of all meniscal injuries should be stressed. In the rupture or injury of the meniscus, the main signs and symptoms are the presence of knee pain , usually located in the joint interline, accompanied by a progressive installation effusion due to inflammation of the synovial adjacent to the meniscus. In the injury of the internal or external meniscus in a basket wing, the symptoms are sometimes very disabling, resulting in a deficit of passive extension of the knee, the so-called knee block. Physiotherapy allows a faster recovery and resumption of sports activity, usually without major limitations. It is based on anti-inflammatory therapies in the initial phase, followed by mandatory muscle strengthening and proprioceptive training. Rotulian syndrome Rotulian syndromes (what patients call a misaligned kneecap or kneecap out of place) are also a cause of knee pain. In extreme situations, routine instability can result in dislocation of the kneecap. Rotulian syndromes usually affect young adults, requiring an adequate study of femuro-patellar relationships. Strengthening and rebalancing the quadriceps muscle , namely the vast internal oblique, are decisive in reducing external hyperpressure of the kneecap, but the realignment surgery of the extensor apparatus may be necessary to reduce anterior knee pain and prevent progression to kneecap arthrosis. Knee tendonitis Tendonitis of the knee usually causes pain in the insertion area of the inflamed tendon. They are located, most frequently, in the lower pole of the patella, quadriceps insertion and in the tendons of the goose leg. They usually force the patient to take ice, anti-inflammatories and rest for very variable periods, but they generally have a good prognosis. Knee bursitis Knee bursitis occurs due to inflammation of the bursae or synovial pouches that exist around the knee. They usually result from long periods of placing the knees on the floor, as in certain professions or activities (housekeepers, religious, floor settler, etc ...) especially in the pre-patellar zone or pre-tibial tuberosity. Chondromalacia Which is? Chronic and degenerative disease that cause abnormal softening and degradation of cartilage, also known as "runner's knee". What are the causes? Very associated with overuse of the knee (running or jumping sports), muscle weakness, traumatic injuries or surgery. What are the symptoms? - Excessive knee pain (running or jumping sports), muscle weakness, traumatic injuries or surgery. - Pain around the kneecap with greater intensity when descending or climbing stairs - Pain when kneeling, or crouching, or with the knee bent for a long period of time Total knee arthroplasty (TKA) Knee arthroplasty (TKA) is the knee surgery generally used to treat knee arthrosis. The operation consists of replacing the affected joint with a metal and polyethylene implant, the so-called knee prosthesis. This is fixed to the bone using a special cement. Knee arthrosis results from a degenerative process due to wear on the knee cartilage that occurs naturally with the evolution of age, or secondarily originated by excess weight, deviation in the knee axis or trauma with a fracture or injury to the cruciate ligaments. TKA is in the treatment of gonarthrosis , an alternative to the already outdated, knee arthrodesis. It is the knee surgery that has undergone the most evolution in recent years, thanks to progress in implants and better knowledge of knee biomechanics. It allows, in most cases of knee arthrosis, a marked reduction in pain and a marked improvement in the patient's quality of life. Surgery to place a prosthesis on the knee is essential to cancel knee pain in stages of more advanced arthrosis. The success rate of this intervention is very high (more than 90% of patients preserve their prosthesis for up to 20 years). TKA usually requires a hospital stay of only 3 or 4 days, during which the rehabilitation process begins. The recovery of the operated knee begins the day after knee replacement surgery with active mobilization and lift supported by Canadians. The TKA presents rapid rehabilitation allowing the patient to leave the hospital with great autonomy and safety while walking. When technically knee prostheses are well implanted and also well rehabilitated, the probability of obtaining a normal joint after TKA is high. In this sense, after discharge, the patient must immediately start an adequate rehabilitation protocol in order to achieve a full recovery. Objectives of a rehabilitation program: Improving mobility and joint movement Pain relief General physical reconditioning Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment

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35 YEARS TAKING CARE OF YOU PHYSIOTHERAPY CLINIC Portimão, Algarve Agreement with National Health Service Learn More SERVICES MEDICAL APPOINTMENT Physical Medicine and Rehabilitation (Physiatry) consultation to assess problems: orthopaedic rheumatological neurological pediatric Schedule an Appointment PHYSIOTHERAPY Improved joint range of motion Muscle strengthening Learn More MASSAGE/MANUAL MEDICINE Pain and contracture relief Learn More SHOCK WAVES Plantar fasciitis and calcaneal spur Medial and lateral epicondylitis (elbow) Calcific tendinopathy of the rotator cuff (shoulder) Learn More INVASIVE TECHNIQUES ECOGUIDED Intra- and Peri-Articular Infiltrations: Tendonitis, Bursitis, Joint effusion, Tendon and muscle sprains/tears Pain relief in arthritis/cartilage wear and tear Learn More All Services OFERTA DE EMPREGO Venha trabalhar connosco! Vagas AGREEMENTS

Gout Gout is an inflammatory rheumatic disease resulting from the deposition of sodium monoate crystals (a form of accumulation of uric acid). It is more prevalent in men and very rare in women before menopause. The drop results from the deposition of sodium monoate crystals (a form of accumulation of uric acid) in the joints, but also in other locations. This phenomenon occurs when the levels of uric acid in the blood are chronically high. Other risk factors to consider are: genetic, dietary factors (ingestion of alcohol or purine-rich foods such as shellfish, meat and viscera), co-morbidities (including metabolic syndrome, obesity, hypertension, diabetes, psoriasis...) and the use of some drugs. The drop initially evolves with an acute and intermittent phase, i.e., with crises of joint inflammation (arthritis) interspersed with asymptomatic periods. The crisis periods may be triggered by external factors, such as local trauma, drugs and intake of purine-rich foods and alcoholic beverages. Usually in the early stages of the disease only one joint is affected, the most typical location being in the lower limbs, particularly the 1st toe (podagra), ankles and knees. The joints of the upper limbs (hands, wrists and elbows) may be affected more rarely and later. During the crisis, patients may also report general (systemic) inflammatory symptoms such as fever. Seizures can be self-limited (regression in 1 to 2 weeks), but the start of appropriate therapy aims to shorten their duration. With progression to chronicity, seizures tend to reach more joints and be more frequent and prolonged, with shorter asymptomatic periods (until symptom-free periods no longer exist). In order to prevent gout crises and their potential consequences, it is essential to educate and raise awareness among patients about changing lifestyles and adherence to hypouricemiant treatments. Regular exercise, a regular diet and compliance with chronic medication are the means to avoid the long-term consequences of gout. Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation General physical reconditioning Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment

Ortopédicas PATHOLOGIES Orthopedic / Rheumatological Spine Shoulder Elbow Hand and fingers Hip knee Ankle Foot and toes Osteoarthritis Rheumatoid arthritis Spondyloarthritis Fibromyalgia Gout Systemic lupus erythematosus Osteoporosis ... Neurological Stroke Trauma Brain Injury Spinal cord injury Multiple sclerosis Parkinson's disease ... Pain Medicine Neuropathic pain Spinal Pain Musculoskeletal Pain Headache Tumor Pain ... Âncora 1 Âncora 1

Electrotherapie Electrical Stimulation It is a stimulation through the skin, which consists of the application of an electrical current provided by an external, portable and small electrical device or device, which emits high frequency and low intensity pulses through skin electrodes, or vice versa, depending on the type of pain, to the selected painful surface or to the nerves. These small electrical impulses "deceive" the transmission of pain. This type of stimulation is practically free of adverse effects. TENS (Transcutaneous electrical nerve stimulation) stimulation is perceived by the patient as a more pleasant sensation than the pain he suffers. The so-called "Neuromuscular Electrical Stimulation" (NMES) refers to the use of equipment that generate electrical current for motor stimulation, i.e., generate muscle contraction. Ultrasound When the ultrasound penetrates the body, the effect of the vibrations mobilizes the internal particles and stimulates the reabsorption of the inflammatory fluid. Ultrasound also allows the transmission of energy to tissues producing heat. Another effect is the increased permeability of the cell membrane, which allows the entry of nutrients and the elimination of cellular waste. SERVICES

Vertebral Column Backache, commonly known as spinal pain, is a quite frequent complaint and one of the main reasons for absenteeism from work in our country. More than 80% of the population suffers from backache, at least once in their lives, especially between the ages of 40 and 60, mainly as a result of excessive effort, forced postures, repeated movements, etc. Fortunately, it is possible to take measures to prevent most back pain and undergo specific treatments to improve the quality of life. The causes are very varied and, consequently, the respective medical approach. Among the most common are mechanical as well as inflammatory pains. Both have their own specificities (they affect sleep, the ability to work as well as interfere with social life). Cervical Pain Cervical pain is the pain that we feel in the upper region of the spine, sometimes located on the shoulders / neck, and may radiate to the head (headache). It is a pain often associated with posture, and for this reason, often observed in young people in the active phase. Cervical pain can be caused by vertebral pathology and / or intervertebral discs, or it can simply be a muscle problem. When this pain radiates to the upper limbs, it is called cervicobrachialgia, usually associated with a compression of the spinal nerve. In these cases, there may be a sensation of tingling or loss of sensation, as well as, in more serious cases, loss of strength in the upper limbs. Thoracic Pain The dorsal pain or dorsalgia, is located in the middle region of the back and may irradiate the lumbar or cervical spine. It can also cause a fracture or collapse of the vertebral body, appearing after a fall or in people with decreased bone mineral density (osteoporosis). Lumbar Pain It is the pathology that we treat most frequently in our clinic, and is one of the most frequent causes of absenteeism at work. Lumbar pain has many causes, the most frequent being herniated discs, joint/facet wear or narrowing of the lumbar spinal canal. When this pain extends to the lower extremities, we speak of lumbociatalgia, also commonly known as sciatica pain. Sacroiliac joint Pain We talk about sacroiliac pain and localized pain in the buttocks. This pain is usually caused by the involvement of the sacroiliac joints (union between the sacrum and both iliac bones). Patients who suffer from this pathology usually also report discomfort in the groin area, or in the lower extremities. It is a pain that interferes with long positions maintained, such as sitting. Sacroiliac joint Pain Dor ciática Estenose do canal lombar Hérnia discal Herniated disc Disc hernias result from the fact that intervertebral discs, like all tissues in the body, are subject to aging phenomena, losing their elasticity and the ability to absorb the physical forces acting on them. The first signs of degeneration are the loss of water and consequent dehydration of the nucleus of the intervertebral disc. Later, disc protrusions may appear in the epidural canal, fissures of the fibrous ring with loss of disc content, or real ruptures or herniated discs. The mechanical pressure of the disc on the adjacent spinal nerves can cause pain along the upper or lower limbs, depending on whether the injury is cervical or lumbar. Sometimes the contents of the disc can trigger an inflammatory process in the spinal nerves causing irritation and pain. Sciatica Sciatica pain corresponds to the presence of pain, tingling, weakness or numbness that originate in the lower back, go down the gluteal region to the posterior portion of the loss, following the path of the sciatic nerve. Sciatica is more common in middle age, rarely occurring before age 20. In general, the evolution is favorable but in about 30% of the cases the symptoms last 1 year or more. Most cases result from a herniated intervertebral disc that compresses a nerve root. Other possible causes are tightening of the canal surrounding the spinal cord, tumors or cysts that compress nerve roots. About 80 to 90% of sciatica cases resolve without surgery and about half of the attacks last less than six weeks. Lumbar canal stenosis Pain due to lumbar canal stenosis often appears along the lower limbs during walking. It results from degenerative changes in the intervertebral discs, the articular facets, the yellow ligament, or the narrowing of the vertebral cane. The pain or discomfort disappears at rest, although it causes a significant limitation of the patient's autonomy; in advanced stages it can prevent walking completely. Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation Stabilization of spine static and dynamics General physical reconditioning Improvement of gait, balance and coordination Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment

Feet and fingers Morton's neuroma It is an inflammation and thickening of one of the nerves that are responsible for innervating the toes. It occurs most often between the 3rd and 4th fingers, usually as a result of repeated trauma, irritation or excessive pressure. The incidence is higher in women. Symptoms - There may be swelling of the painful site - Burning pain that can radiate to the other fingers; the pain can worsen with physical activity, tight shoes or with high heels - numbness and / or discomfort. Plantar fasciitis Plantar fasciitis is a very common problem of pain in the sole of the foot, which manifests itself in both sportspeople and sedentary people. It affects the so-called plantar fascia: a strip of elastic tissue that extends from the heel to the toes. When this area becomes inflamed, there is a sharp, piercing pain that can limit daily activity. Neuroma de Morton Fasceíte plantar Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation General physical reconditioning Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment

Ankle Ankle Sprain An ankle sprain is a ligament injury (of the ligaments) that usually occurs after a sprained ankle. Ankle ligaments are elastic structures that allow the joint to be kept in its correct position. The ligaments, which constitute the lateral stabilizers of the ankle, are mainly responsible for the stability of the joint, namely, in movements at the ends of the joint amplitudes. Under normal conditions, ligaments, as elastic structures that they are, stretch (stretch) to their limit, then return to their initial position. Sprain occurs when the ligament is forced beyond its normal capacity. Examples of abnormal movements are twisting of the foot (twisting the foot), rotations and rolling of the foot. This movement can cause the ligaments to stretch (distend or stretch beyond normal, creating problems in their function) or even, in the most severe cases, to rupture (tear). In most sprains, foot pain, which can be mild to very intense, is immediately felt at the site of the sprain. Often, the ankle starts to “swell” (edema) immediately and local ecchymosis (black ankle) and some joint effusion (fluid in the ankle) may appear. The ankle area is usually sensitive to touch and the pain increases with movement. In more severe sprains, you can hear and / or feel something “tearing” along with a click. The pain is immediate and strong after the sprain, you will not be able to walk or even exert force on the foot (put your foot on the floor or “step on”). Thus, the greater the pain and the edema (swelling), the more severe the injury and consequently the longer the rehabilitation phase. The extent of the edema (swelling) and the intensity of the pain in the foot vary in proportion to the severity of the sprain. The recovery time to heal a sprain can range from weeks to months and depends on the severity of the injury and the treatment instituted. See more information on treatment. In sports that require sudden movements and extremes of amplitude (football, futsal, basketball, handball, athletics, etc.), sprains can occur more easily. However, sprains can also occur accidentally in day-to-day life, when the person places “badly on the ground”, etc. The use of inappropriate footwear, such as high heels, very wide shoes, among others, can be a risk factor for the occurrence of sprains. Imbalances are one of the risk factors for ankle sprain. Those who have “weak muscles” and exercise or do physical activity without prior adaptation training are more likely to develop sprains. Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation General physical reconditioning Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment