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

Hand Injuries - Diagnosis

The diagnosis of most hand injuries is not difficult as the damage is usually readily apparent to the examiner. There will typically be a history of trauma and this should be carefully attended to as it may give clues to a more complex injury than first appears. Bruising and swelling are very typical signs apparent on initial inspection, with pain a common and often localising feature. There may be an obvious deformity if the joints are dislocated or bones fractures with displacement, the patient will have lost the ability to grip firmly and there may be reduced range of movement in the fingers and thumb.

Examination starts with a visual examination of the hand which guides the doctor as to further required tests and investigations. The doctor will palpate the hand systematically to look for areas of particular pain or abnormal movement which would point to an underlying injury. The ranges of movement of the shoulder, elbow, wrist and hand is assessed and recorded, with the tendon actions tested in turn to search out any tendon involvement. Circulatory function will be checked to exclude blood vessel damage. Investigations will routinely include x-rays to look for fractures, dislocations or embedded objects such as glass.

Anterior Cruciate Ligament Injury

The anterior cruciate ligament is one of the four major ligaments of the knee joint and controls the forward and backward movement of the tibia on the femur as well as exerting rotatory control. It is a commonly injured structure especially in contact sports such as football or rugby but also in other activities where momentum is involved such as skiing. Injury usually follows an inward pressure on the knee combined with a rotation with the foot planted on the ground, with the sufferer often feeling or hearing a clear pop in the knee accompanied by significant pain.

Cruciate ligament rupture is almost always followed by the knee swelling up significantly in a few minutes as the injury bleeds into the knee. The acutely painful knee is managed by physiotherapists with ice, compression, bracing and gentle range of movement as soon as practical. Once the knee has settled from its acute stage it can be assessed for competence of the ligament. A cruciate deficient knee is usually unstable on rapid movement and turning and is often listed for reconstructive surgery. Physiotherapists rehabilitate the knee before the surgery to give the patient the best chance of coping with the long period of rehabilitation required post-operatively.