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

Recovering Strength after Knee Replacement

Recovery from total knee replacement is partly a matter of healing, partly of the patient's determination and partly of physiotherapy management of post-operative rehabilitation. The large number of knee replacements performed each year and the vital functional importance of the knee in normal life make correct rehabilitation extremely important. Typical rehabilitation starts with quadriceps activation, knee flexion exercises and gait practice until the patient is independent with walking, stairs climbing and routine activities of daily living. However, recent research has shown that strengthening up the quadriceps much more thoroughly may be important for normal function and long term ability.

A progressive routine of quadriceps strengthening was applied in one study and the results showed it improved patients almost to the level of an unaffected person of their age. Knee replacement improves an individual's functional ability but their quadriceps typically remains reduced in strength compared to similar healthy older people, limiting overall function. Rehabilitation beyond the initial work to achieve acceptable function is not typically provided. As function comes to a peak about three years after replacement and declines thereafter, getting patients to the highest level of strength and ability is very important to allow them to get the best from their new joint.

Common Causes of Disc Prolapse

Spinal surgeons know that most disc herniations they are required to operate on are mostly made up of nucleus pulposus and rarely consist of much of the annulus fibrosis, which never occurs alone in a prolapse. Typical actions which risk prolapse are lifting and carrying, imposing flexion, side bending and compression loads on the lumbar spine at the same time. Combinations of these forces are what make a prolapse more likely, such as falling on the bottom whilst the legs are straight out in front, combining compression and bending. Other combinations could include tripping and so bending forward whilst carrying, reaching forward to catch a heavy object or lifting something heavy after a period when the spine has been in flexion.

If the upper body is pulled forwards suddenly and a force applied this is the most risky posture as the back muscles are contracting most strongly to resist the forward movement at that time and so increasing the compression through the spine. Due to fact that the discs are tighter and more swollen with water in the morning, it seems that disc prolapse may be more likely to occur at this time. Repeated bending in heavy jobs could also cause prolapse with time.