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

Risk Factors for Low Back Pain

Studies of risk factors have not given clear indication of the risk factors for low back pain although about 70% of disc degeneration seems to be connected with genetic factors and around 60% of back pain overall. There is a strong association between genetic factors and osteoarthritis in the small facet joints which lie each side of the spine. General levels of fitness and the strength of back muscles seem to have little relevance as does differences in leg length. One study which was well conducted shows that a high risk of poor lumbar mobility and a long back exists in young people who work in health work and are encountering heavy work for the first time. This may be because taller people are exposed to higher mechanical forces to the longer limb and spinal levers they use when lifting weights.

Of little relevance seem to be height or weight, flexibility of the lumbar spine or straight leg raising, and fitness seems also to be not connected. X-ray and MRI examination findings have no connection to whether a person might suffer low back pain in the future. Overall the highest risk factor for future back pain is having had back pain in the past.

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.