Physiotherapists in Southampton 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 Treatment used to be skeletal traction for up to 12 weeks but this has been superseded by internal fixation with a nail down the femur to stabilise the fracture.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.

Flat Feet

It is common for patients to present with progressive flat foot deformity, also known as pes planus. However, despite it being common there the causes and treatments are still under debate. Adult acquired flat foot is most likely to be caused by an imbalance between the active arch maintenance structures and the passive arch maintenance structures. The foot may have been normal at some stage and something has changed to bring on the process of flattening of the arches. The posterior tibial tendon plays a strong role in actively maintaining the inner arch and a dysfunction or weakness of this structure is thought to be important in flat foot.

However, the ligaments binding the medial arch together and maintaining its structure may also be deficient in some way, leading to flat foot problems. The spring ligament, a strong ligament running between the calcaneus (heel bone) and the navicular, supports the head of the ankle bone (talus) and stops its slipping downwards, thereby maintaining the arch of the foot. Deficiency of this ligament complex is thought to be equally important to problems with the posterior tibial tendon. Treatment typically starts with insoles and modified footwear and progresses to foot surgery.