Physiotherapists in Blackheath 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.

Anterior Cruciate Ligament Injury

The anterior cruciate ligament is one of the four major ligaments of the knee joint and controls the forward and backward movement of the tibia on the femur as well as exerting rotatory control. It is a commonly injured structure especially in contact sports such as football or rugby but also in other activities where momentum is involved such as skiing. Injury usually follows an inward pressure on the knee combined with a rotation with the foot planted on the ground, with the sufferer often feeling or hearing a clear pop in the knee accompanied by significant pain.

Cruciate ligament rupture is almost always followed by the knee swelling up significantly in a few minutes as the injury bleeds into the knee. The acutely painful knee is managed by physiotherapists with ice, compression, bracing and gentle range of movement as soon as practical. Once the knee has settled from its acute stage it can be assessed for competence of the ligament. A cruciate deficient knee is usually unstable on rapid movement and turning and is often listed for reconstructive surgery. Physiotherapists rehabilitate the knee before the surgery to give the patient the best chance of coping with the long period of rehabilitation required post-operatively.