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

Physiotherapy for Femoral Shaft Fractures

Fractures of the femoral shaft in adults are overwhelmingly the result of considerable force such as a road accident or a fall from a height. Due to the force involved and the power of the surrounding muscles the bone ends often overlap, cutting into the soft tissues around them, and there is often a considerable amount of bleeding and pain. Initial treatment consists of pain control, maintaining the patient.s blood volume and applying some traction to the leg to bring the bones out towards their normal positioning. Treatment used to be skeletal traction for up to 12 weeks but this has been superseded by internal fixation with a nail down the femur to stabilise the fracture.

Initial physiotherapy concentrates on restoring the muscle activity to the quadriceps, often inhibited by the pain and direct injury, and regaining range of motion in the knee. Mobilisation with a physiotherapist is performed as soon as comfort allows and the patient is often permitted to partial weight bear with crutches as the fracture is typically stable with the fixation. Further physio treatment includes massage to the fractured area to disperse scar tissue forming in the area which could bind down the muscle and other soft tissues, limiting movement and strength.

Physiotherapy and Falls

Falls are a problem at any age but particularly so in elderly due to the frequency and the severe potential problems which can result. The incidence of fractured neck of femur (fractured hips) in the elderly is considerable and carries significant risk of long term disability or death in people who are already frail and at the edge of independence. Falling is a complex problem which demands a multidisciplinary approach from health professionals to have any chance of success. As we get older our muscular, balance, joint, vision and hearing systems all change for the worse and reduce the speed and amount of information and postural change we are able to understand and accommodate at any time.

Physiotherapists assess and manage falls problems by assessing the medical history and present status of the patient, getting a social history from them and assessing their mental and physical status. The physio checks the patient's ability to see clearly and their awareness of the space around them which is impaired in many medical conditions. The patient is asked to get up and their balance reactions assessed, after which the physio will get them to walk to check for gait abnormalities or balance problems in dynamic activities such as gait.