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

Continuous Passive Motion after Knee Replacement

Total knee replacement is an increasingly common treatment for knee osteoarthritis and large numbers of elderly people undergo this operation every year. Physiotherapy management and treatment of these patients post-operatively is therefore becoming increasingly important if the best functional outcome is to be achieved. Early rehabilitation focuses on improving strength in the quadriceps muscle, restoring range of motion of knee flexion and facilitating gait and activities of daily living. The restoration of knee ranges of movement is one of the key elements on which success is judged and much physiotherapy time is dedicated to this part of the treatment.

A continuous passive motion machine is commonly used to improve knee flexion range of movement, as regular passive movement of a joint has been shown to result in better healing as compared to resting. Research work has shown a minor short term effect of using this treatment technique and it is often reserved for difficult cases such as after manipulation under anaesthetic for a stiff joint. Patients can remain on the machine for long periods but it is important not to forget active practice of the ranges of motion to improve muscle function. Overall continuous passive motion has not been shown to play a significant role in standard knee replacements.

Anterior Cruciate Ligament Injury

The anterior cruciate ligament is one of the four major ligaments of the knee joint and controls the forward and backward movement of the tibia on the femur as well as exerting rotatory control. It is a commonly injured structure especially in contact sports such as football or rugby but also in other activities where momentum is involved such as skiing. Injury usually follows an inward pressure on the knee combined with a rotation with the foot planted on the ground, with the sufferer often feeling or hearing a clear pop in the knee accompanied by significant pain.

Cruciate ligament rupture is almost always followed by the knee swelling up significantly in a few minutes as the injury bleeds into the knee. The acutely painful knee is managed by physiotherapists with ice, compression, bracing and gentle range of movement as soon as practical. Once the knee has settled from its acute stage it can be assessed for competence of the ligament. A cruciate deficient knee is usually unstable on rapid movement and turning and is often listed for reconstructive surgery. Physiotherapists rehabilitate the knee before the surgery to give the patient the best chance of coping with the long period of rehabilitation required post-operatively.