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

Rehabilitation after Knee Replacement

Rehabilitation after knee replacement starts before the operation as the patient is educated on what to expect and instructed in range of motion and strengthening exercises so the knee is in as good a condition as it can be before the operation. On the first day after operation the physiotherapist will get the patient up, begin their mobilisation, and also start the patient with range of motion exercises and re-establishment of muscle control around the knee. Quadriceps contractions are encouraged many times hourly as the patient must be able to hold the knee stable against the weight of the body if they are to walk safely.

Knee flexion is practised routinely with an eye on the health of the wound which is down over the front of the joint and so stretched by knee bending movements. Analgesia and cold therapy may be required to control pain and swelling and facilitate exercise compliance. An angle of bend of 90 degrees is aimed for over five or six days and eventually the knee may bend to 110 degrees or more, the amount required to ascend stairs normally. On discharge physiotherapy is typically continued with emphasis on quadriceps strength, good range of motion and natural gait.

Disc Prolapses

In a disc prolapse the internal material of the disc becomes displaced in relation to the outer annulus. The annular rings should be around the disc and the water retaining nucleus at the centre of the disc should remain there. In one kind of protrusion the disc bulges the annular fibres outwards but the nuclear material remains inside the disc. If the annular fibres rupture right through their thickness then part of the nucleus can extrude outside the confines of the disc but it still remains in contact with the rest of the nucleus inside the disc.

A third type of disc prolapse can occur where the disc tissue is extruded from the disc but then is separated from the nucleus and exists as an independent fragment outside the disc walls. Disc prolapses or herniations do not seem to be well connected with age or changes of degeneration of the discs even though it is again most common at lower lumbar levels which are subject to both degeneration and stresses more than other spinal regions. Even though disc prolapses are often called .slipped discs., the disc cannot slip as it is tightly bound to the vertebrae above and below.