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

Knee Osteoarthritis, Stretching and Physiotherapy

Knee osteoarthritis is a common condition with a very large number of sufferers across the world, symptoms including knee pain, swelling, loss of joint movement and limited weight bearing function. Loss of extension of the knee is common and may be related to an increase in the activity of the hamstrings which limits the range of the knee into extension as we walk when a knee is osteoarthritic. Reid and McNair (Physiotherapy, March 2010) looked into this matter in older people as most stretching research has been in younger people. They studied a group of people with osteoarthritis of the knee, giving them three stretches of 60 seconds duration to see if this changed the way the knee behaved.

The two groups who had the stretching showed increased ranges of knee extension, similar in the osteoarthritic and the non-osteoarthritic groups, with some increase in the power available to be exerted. It may be useful to perform hamstring stretches before working on the range and power of the knee and this technique may also have a relevance in knee replacement which is becoming more common as a treatment for end stage osteoarthritis. Limitation of full extension is common after total knee replacement and physios treat it routinely.

Disc Nutrition and Posture

The supply of nutritional substances to the inner parts of the discs is in general poor and a lack of this supply is connected with degenerative disc changes. Large differences in the compression forces inside an intervertebral disc can be generated by relatively small changes in posture. These changes have correspondingly large effects on fluid flow out of and into discs and on diffusion of metabolic agents into the disc. The effectiveness of the transport of these materials depends on how far they have to travel from the nearest blood vessel which is usually in the vertebral endplate (top or bottom of the disc).

When bending, the back of the disc walls is stretched and the fronts are compressed, with stretching making the wall thinner and therefore more easily crossed by nutrients. This brings more food supply into the central area of the rear of the disc, the area which receives least nutrition. Compression from movement also squeezes water from the disc and as it returns when the pressure is relieved the incoming water brings nutrients along with it. Changes from a lordosis to a flexed position regularly increase the fluid flow in and out of the disc, encouraging the transport of nutrients.