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

Ligament Bone and Tendon Bone Inflammation . Enthesitis Symptoms

Inflammation of the entheses, the anatomical junctions (insertions) where the bone meets a ligament or a tendon, cause pain in the local areas, persistent stiffness around the joint and swelling of insertions such as where the Achilles tendon attaches to the heel. If there is obvious joint swelling and other relevant symptoms then the diagnosis of an arthritic condition known as a spondyloarthritis is moderately clear. If the extra symptoms are not present the diagnosis is more difficult and patients may be referred for consideration of more localised musculoskeletal conditions such as sports or overuse injuries.

The pain, stiffness and swelling which typically accompany enthesitis commonly occur at the Achilles tendon and patellar tendon insertions but may also be present in the sole of the foot near the heel, in the elbows where tennis elbow typically occurs, around other ligament insertions of the knee and in the spine. Joint swelling which gives an effusion (water in a joint) may occur to confirm the diagnosis. Despite inflammatory changes of an arthritic disease obviously occurring in some patients the blood markers of inflammatory processes may not be raised, making it easy to miss the diagnosis in the absence of confirmatory tests.

Continuous Passive Motion after Knee Replacement

Total knee replacement is an increasingly common treatment for knee osteoarthritis and large numbers of elderly people undergo this operation every year. Physiotherapy management and treatment of these patients post-operatively is therefore becoming increasingly important if the best functional outcome is to be achieved. Early rehabilitation focuses on improving strength in the quadriceps muscle, restoring range of motion of knee flexion and facilitating gait and activities of daily living. The restoration of knee ranges of movement is one of the key elements on which success is judged and much physiotherapy time is dedicated to this part of the treatment.

A continuous passive motion machine is commonly used to improve knee flexion range of movement, as regular passive movement of a joint has been shown to result in better healing as compared to resting. Research work has shown a minor short term effect of using this treatment technique and it is often reserved for difficult cases such as after manipulation under anaesthetic for a stiff joint. Patients can remain on the machine for long periods but it is important not to forget active practice of the ranges of motion to improve muscle function. Overall continuous passive motion has not been shown to play a significant role in standard knee replacements.