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

Rehabilitation after Knee Replacement

Rehabilitation after knee replacement starts before the operation as the patient is educated on what to expect and instructed in range of motion and strengthening exercises so the knee is in as good a condition as it can be before the operation. On the first day after operation the physiotherapist will get the patient up, begin their mobilisation, and also start the patient with range of motion exercises and re-establishment of muscle control around the knee. Quadriceps contractions are encouraged many times hourly as the patient must be able to hold the knee stable against the weight of the body if they are to walk safely.

Knee flexion is practised routinely with an eye on the health of the wound which is down over the front of the joint and so stretched by knee bending movements. Analgesia and cold therapy may be required to control pain and swelling and facilitate exercise compliance. An angle of bend of 90 degrees is aimed for over five or six days and eventually the knee may bend to 110 degrees or more, the amount required to ascend stairs normally. On discharge physiotherapy is typically continued with emphasis on quadriceps strength, good range of motion and natural gait.

Intervertebral Discs and Ageing

Ageing starts early in the discs and proceeds through life. Initially a loss of proteoglycan occurs, and as these chemicals attract and hold water into the centre of the discs, a degree of loss of hydration steadily occurs. The collagenous tissues lose some of their suppleness and resistance, becoming more brittle and more likely to suffer injury. As the discs have no central blood supply and rely on nutrition and oxygen diffusing in, a limitation of this process will accelerate the degenerative process going on in the disc centres. The tops and bottoms of the vertebrae, the endplates, are cartilage but can become calcified, further reducing supplies to the nucleus inside.

The outer part of the disc, the annulus, has layers of collagen material and these thicken and can develop defects. Overall the central disc material becomes drier, fibrosed and stiffer with a smaller volume as it loses water, throwing compressive forces onto the back of the disc annulus. The annulus becomes both stiffer and weaker with age, the increased stiffness perhaps offset by the increase in defects in the disc wall with time. Studies of discs have shown that they do not generally decrease in height with age.