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

Inflammatory Disease of the Entheses

Mechanical factors are thought to be important in inflammatory conditions of the ligament or tendon insertions so addressing these matters may be useful. Physiotherapists can assess the problem and prescribe corrective or cushioning insoles as needed. Local injections of corticosteroids can be useful to treat the pain of enthesitis in a single area. For more widespread inflammation the new biological agents (known as anti-TNF agents) have been shown to be of some use, particularly if the legs are affected as this is so disabling. Typically enthesitis is likely to settle with time so the prognosis is reasonable.

Physiotherapy treatment of this problem includes assessment of joint ranges for restrictions which are developing and the design of an individual exercise regime to maintain the ranges of motion of all the affected joints. Hydrotherapy is a very useful treatment medium for most of the arthritic diseases as it allows the performance of joint movements in a warm and supported environment, minimising the forces on the joints, until the patient is able to progress comfortably to exercises in air. Patient education is important with the physio stressing that the exercise programme, targeted at specific difficulties for each patient, and needs to be maintained daily over the long term.

Hip Dislocation

The hip is one of the largest and strongest joints in the body, being a deep ball and socket joint with powerful ligaments holding it all together. This means that dislocation is rare and only occurs in the event of significantly violent events such as motor vehicle crashes. In an accident the thigh may be forced into a position where the hip is levered out of its socket, tearing its surrounding ligaments and remaining out of socket. This causes extreme pain and patients have to be anaesthetised to relocate the joint. Treatment is complicated by the potential threat to the blood supply to the head of the femur.

Dislocation can also occur centrally, where the head of the femur is driven through the socket, fracturing it and ending up inside the pelvis. This injury usually needs internal fixation and significant time non weight bearing until the fractures heal. Normal dislocations are also treated with a period of non weight bearing to ensure the blood supply to the head of the femur, which was disrupted by the dislocation, restores itself. Once weight bearing is allowed the physiotherapist can instruct the patient in normal gait and exercises to restore the strength of the hip muscles.