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

Patellar Dislocation

The patella is a small bone embedded in the tendon of the quadriceps muscle which is the main power muscle controlling the knee. The patella has two facets at a slight angle on its under surface which articulate with the femoral condyles, the large rounded ends of the thigh bone at the knee. The outside femoral condyles is slightly larger in a frontwards direction and helps act to hold the patella in place. Due to the angle of the thigh bone coming down from the hip and then joining the tibia which is horizontal there is a bowstring effect as the quadriceps muscle contracts, pulling the kneecap sideways.

If the person rotates their leg with their weight on the foot, the sideways force on the kneecap can be enough to force it outwards over the condyle ridge and off its joint surface completely. This is immediately extremely painful and if the person straightens their knee the patella usually relocates itself automatically. Because the tissues on the inside of the knee have been stretched and torn as the kneecap dislocated the knee is usually kept straight in a splint or plaster for a few weeks to allow this area to tighten up as it heals.

Common Causes of Disc Prolapse

Spinal surgeons know that most disc herniations they are required to operate on are mostly made up of nucleus pulposus and rarely consist of much of the annulus fibrosis, which never occurs alone in a prolapse. Typical actions which risk prolapse are lifting and carrying, imposing flexion, side bending and compression loads on the lumbar spine at the same time. Combinations of these forces are what make a prolapse more likely, such as falling on the bottom whilst the legs are straight out in front, combining compression and bending. Other combinations could include tripping and so bending forward whilst carrying, reaching forward to catch a heavy object or lifting something heavy after a period when the spine has been in flexion.

If the upper body is pulled forwards suddenly and a force applied this is the most risky posture as the back muscles are contracting most strongly to resist the forward movement at that time and so increasing the compression through the spine. Due to fact that the discs are tighter and more swollen with water in the morning, it seems that disc prolapse may be more likely to occur at this time. Repeated bending in heavy jobs could also cause prolapse with time.