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

Inflammatory Disease of the Entheses

Mechanical factors are thought to be important in inflammatory conditions of the ligament or tendon insertions so addressing these matters may be useful. Physiotherapists can assess the problem and prescribe corrective or cushioning insoles as needed. Local injections of corticosteroids can be useful to treat the pain of enthesitis in a single area. For more widespread inflammation the new biological agents (known as anti-TNF agents) have been shown to be of some use, particularly if the legs are affected as this is so disabling. Typically enthesitis is likely to settle with time so the prognosis is reasonable.

Physiotherapy treatment of this problem includes assessment of joint ranges for restrictions which are developing and the design of an individual exercise regime to maintain the ranges of motion of all the affected joints. Hydrotherapy is a very useful treatment medium for most of the arthritic diseases as it allows the performance of joint movements in a warm and supported environment, minimising the forces on the joints, until the patient is able to progress comfortably to exercises in air. Patient education is important with the physio stressing that the exercise programme, targeted at specific difficulties for each patient, and needs to be maintained daily over the long term.

Knee Ligament Injuries

Knee injuries are extremely common and a routine part of sporting activities of many kinds, especially in younger people. The knee is a large hinge type of joint connected by powerful ligaments but because of the joint.s position in the middle of a long lever (the leg) it is vulnerable to high levels of force during movement. Physiotherapists routinely diagnose and treat ligamentous injuries and rehabilitate patients back to their functional goal. A common injury is a strain of the medial collateral ligament when a force is applied to the outside of the knee when the foot is on the ground, pushing the knee inwards and opening out the joint on the inside.

Typically the knee will swell over the next 12 hours or so and be painful over the inside of the joint, sometimes making it difficult to walk easily. Treatment is to immobilise the knee in a brace or plaster of Paris for a shorter or longer period of time, then get the knee moving so that it does not lose range of movement. The ligament is under tension when the knee is straight so the physio will concentrate on restoring the ability of the muscles to fully extend the knee.