Physiotherapists in Gravesend 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.

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.