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

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.

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.