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

Hip Dislocation

The hip is one of the largest and strongest joints in the body, being a deep ball and socket joint with powerful ligaments holding it all together. This means that dislocation is rare and only occurs in the event of significantly violent events such as motor vehicle crashes. In an accident the thigh may be forced into a position where the hip is levered out of its socket, tearing its surrounding ligaments and remaining out of socket. This causes extreme pain and patients have to be anaesthetised to relocate the joint. Treatment is complicated by the potential threat to the blood supply to the head of the femur.

Dislocation can also occur centrally, where the head of the femur is driven through the socket, fracturing it and ending up inside the pelvis. This injury usually needs internal fixation and significant time non weight bearing until the fractures heal. Normal dislocations are also treated with a period of non weight bearing to ensure the blood supply to the head of the femur, which was disrupted by the dislocation, restores itself. Once weight bearing is allowed the physiotherapist can instruct the patient in normal gait and exercises to restore the strength of the hip muscles.

Lumbar Stenosis

There are many painful syndromes which involve the lumbar spine, with the discs, ligaments, joints, muscles and nerves all implicated in pain production. Older people can present with symptoms which indicate a stenosis of their vertebral canal. The vertebral or spinal canal runs down the back and carries the spinal cord, allowing the nerve roots to exit to the body at each spinal level (each disc level). The spinal canal can be congenitally narrow which increases the chances of developing spinal stenosis with age. As degenerative changes occur in the spinal structures the spinal canal can become narrowed and tight.

The symptoms of spinal stenosis typically do not include back pain but rather leg pain, often bilateral, and worsened by walking but better with sitting. Typically presenting in people of 65 years or older, spinal stenosis can also present as a nerve root irritation of a sciatic type due to stenosis of the exit for the spinal nerve root. Physiotherapy is not usually very useful and little is found on examination apart from a reduction in spinal extension and many people manage their symptoms over time as best they can, although surgical spinal decompression can be very successful in relieving the symptoms.