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

Knee Arthritis

The knee is a large synovial joint formed between the large expanded end of the femur (thigh bone) and the top of the tibia or shin bone. The ends of the bones are covered with articular cartilage, a slippery and firm material which allows the almost friction free movement which our joints can provide even if there is a body weight load on them. On an x-ray this shows up as a dark space between the bony surfaces, known as the joint space. In time or after injury this cartilage can change as part of the process of osteoarthritis, although there is a significant genetic component which influences whether we get osteoarthritis or not.

Changes occur both in the cartilage and the bone of the joint during the osteoarthritic process and the process may begin with a softening of the cartilage from its firm, hard surfaces. Next, fissures can develop until the thickness of the cartilage wears down and in severe cases the underlying bone may be exposed, causing a bone on bone crunching and pain. Symptoms of osteoarthritis include pain, loss of joint movement, joint deformity such as knock knee or bow leg and difficulties with gait.

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.