Physiotherapists in Bracknell treat many different conditions including the issues profiled below.

Recovering Strength after Knee Replacement

Recovery from total knee replacement is partly a matter of healing, partly of the patient's determination and partly of physiotherapy management of post-operative rehabilitation. The large number of knee replacements performed each year and the vital functional importance of the knee in normal life make correct rehabilitation extremely important. Typical rehabilitation starts with quadriceps activation, knee flexion exercises and gait practice until the patient is independent with walking, stairs climbing and routine activities of daily living. However, recent research has shown that strengthening up the quadriceps much more thoroughly may be important for normal function and long term ability.

A progressive routine of quadriceps strengthening was applied in one study and the results showed it improved patients almost to the level of an unaffected person of their age. Knee replacement improves an individual's functional ability but their quadriceps typically remains reduced in strength compared to similar healthy older people, limiting overall function. Rehabilitation beyond the initial work to achieve acceptable function is not typically provided. As function comes to a peak about three years after replacement and declines thereafter, getting patients to the highest level of strength and ability is very important to allow them to get the best from their new joint.

Patellofemoral Pain

The patellofemoral joint is a frequent source of pain and disability and a difficult problem to treat successfully. The patella has two large facets on it.s under surface which are angled in respect to each other. They match the groove between the femoral condyles where the patella lies and moves upwards and downwards as the knee bends and straightens. As the quadriceps, the main thigh muscle, contracts to push us up from a chair, go up stairs or walk uphill, the patella acts like a pulley to increase the forces the muscle is able to exert. High levels of force are developed between the patellar and femoral joint surfaces.

The patella surfaces are lined with articular cartilage, a firm and very slippery material which ensures friction free movement of many of our major joints, even under load. With time this can soften and develop small fissures, making the patellar surface sensitive to loads being applied. If there is also a muscle imbalance or other abnormality which allows the patella to track in its groove a little towards the outside, this can also worsen pain. Degenerative changes can progress to osteoarthritis and cause disabling symptoms due to difficulties with stairs and gait.