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

Hand Injuries - Acute Management

Most injuries, apart from the most minor, benefit from being seen and assessed by a doctor as a relatively minor dysfunction in the hand can cause long term functional disability. Initial management of a hand injury should be to control any bleeding by applying gauze or a clean cloth to the wound and putting some pressure on it. In a closed injury (i.e. no wound) then ice can be applied to the damaged area to reduce inflammation and pain. Jewellery such as rings needs to be immediately removed as hand swelling can be very dramatic, rendering easy removal later impossible.

Once in the Emergency Department the doctor will x-ray the hand routinely and may inject the nerve at the wrist level or at the base of one of the fingers to numb the hand or the finger so that they can examine the area without too much pain. Wounds will be cleaned if they are dirty and then closed by stitching or a related method, with antibiotics prescribed to prevent infection developing. Splinting is often used to immobilise the hand in a specific position to prevent further injury or maintain anatomical integrity. A referral to a hand specialist or a plastic surgeon is typically written and pain control medication will be encouraged for a few days.

Patellar Dislocation

The patella is a small bone embedded in the tendon of the quadriceps muscle which is the main power muscle controlling the knee. The patella has two facets at a slight angle on its under surface which articulate with the femoral condyles, the large rounded ends of the thigh bone at the knee. The outside femoral condyles is slightly larger in a frontwards direction and helps act to hold the patella in place. Due to the angle of the thigh bone coming down from the hip and then joining the tibia which is horizontal there is a bowstring effect as the quadriceps muscle contracts, pulling the kneecap sideways.

If the person rotates their leg with their weight on the foot, the sideways force on the kneecap can be enough to force it outwards over the condyle ridge and off its joint surface completely. This is immediately extremely painful and if the person straightens their knee the patella usually relocates itself automatically. Because the tissues on the inside of the knee have been stretched and torn as the kneecap dislocated the knee is usually kept straight in a splint or plaster for a few weeks to allow this area to tighten up as it heals.