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

The Structure of Bone

Bone is one of the body.s connective tissue and its cells produce a firm and rigid framework to make the skeleton of the body. It has a good blood supply and is surrounded by nerve endings which are mostly in the soft tissues which enclose the bone. Two types of bone exist, cortical bone which exists in solid masses or sheets and trabecular bone which is a lattice like honeycomb of small bone struts. The mass of bone secreted is five to eight percent water and 60-70 percent Hydroxyapatite, which is composed mostly of calcium and phosphate. The rest of the bone is made up of collagen, a form of fibrous tissue.

The crystals of Hydroxyapatite mean that bone is hard and can withstand compressive stresses while the fibrous tissue reduced the brittleness and resists tension stresses. Bone is laid down in an arrangement of concentric cylinders with a central channel carrying the blood vessels and nerves. The osteocytes or bone maintaining cells lie between the layers of bone. The whole unit of the individual cylinder is known as a Haversian system or an osteon. The periosteum covers the outer surface of the bone, with a tougher outer layer and a cellular inner layer.

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.