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

Recovering Strength after Knee Replacement

Recovery from total knee replacement is partly a matter of healing, partly of the patient's determination and partly of physiotherapy management of post-operative rehabilitation. The large number of knee replacements performed each year and the vital functional importance of the knee in normal life make correct rehabilitation extremely important. Typical rehabilitation starts with quadriceps activation, knee flexion exercises and gait practice until the patient is independent with walking, stairs climbing and routine activities of daily living. However, recent research has shown that strengthening up the quadriceps much more thoroughly may be important for normal function and long term ability.

A progressive routine of quadriceps strengthening was applied in one study and the results showed it improved patients almost to the level of an unaffected person of their age. Knee replacement improves an individual's functional ability but their quadriceps typically remains reduced in strength compared to similar healthy older people, limiting overall function. Rehabilitation beyond the initial work to achieve acceptable function is not typically provided. As function comes to a peak about three years after replacement and declines thereafter, getting patients to the highest level of strength and ability is very important to allow them to get the best from their new joint.

Bunions

Bunions is the term given to problems which occur with the joint of the big toe as it meets the foot, the first metatarsophalangeal joint or MTP joint. Problems with this joint may be familial with some inherited tendency but can also be do to poor foot use such as ill fitting footwear. Signs may start with an increased prominence at the inner border of the foot as the big toe drifts slightly towards the outside of the foot, eventually leading to rubbing of the prominence on the shoe in walking. Progression may occur as the deformity becomes worse and the joint itself becomes painful, with the big toe compressing the second toe and perhaps overriding or under riding it.

A highly arthritic joint can be very disabling, severely restrict the ability to walk very far and cause huge problems in choosing suitable footwear. Initial physiotherapy treatment can be provision of insoles, mobilisation techniques, gait correction, provision of walking aids and moderation of aggravating activities. More severe problems can be treated by joint injection, shaving of the joint surgically, removal of the joint to leave a fibrous union, fusion of the joint (arthrodesis) or replacement of the joint with a prosthesis.