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

Knee Arthritis

The knee is a large synovial joint formed between the large expanded end of the femur (thigh bone) and the top of the tibia or shin bone. The ends of the bones are covered with articular cartilage, a slippery and firm material which allows the almost friction free movement which our joints can provide even if there is a body weight load on them. On an x-ray this shows up as a dark space between the bony surfaces, known as the joint space. In time or after injury this cartilage can change as part of the process of osteoarthritis, although there is a significant genetic component which influences whether we get osteoarthritis or not.

Changes occur both in the cartilage and the bone of the joint during the osteoarthritic process and the process may begin with a softening of the cartilage from its firm, hard surfaces. Next, fissures can develop until the thickness of the cartilage wears down and in severe cases the underlying bone may be exposed, causing a bone on bone crunching and pain. Symptoms of osteoarthritis include pain, loss of joint movement, joint deformity such as knock knee or bow leg and difficulties with gait.

Tendon Bone and Ligament Bone Junctions

Tendons and ligaments have important functions in the body and their ability to perform their functions depends on their connections to the skeleton, on which they exert their forces or their restraining influences. The junction between a tendon or ligament and the bone is called an enthesis and inflammation of that area is known as enthesitis. There is an important group of arthritis conditions where the enthesis is the main site of inflammatory change, as well as normal musculoskeletal problems secondary to injury or degenerative changes. Typical conditions include ankylosing spondylitis, psoriatic arthritis and reactive arthritis.

Entheses vary in their structure: fibrous ones have the ligament or tendon continuing in their normal structure until they contact the bone; fibrocartilaginous ones have a piece of fibrocartilage on the site of attachment and it is this latter group that are mostly of interest in arthritic diseases. The cartilage makes the end of the tendon stiffer and cushions the sudden changes from flexible tendon or ligament material to the hardness of the bone. The management of the stresses which are transmitted through ligaments and tendons to the bone are complex and the body has adapted with a series of anatomical modifications.