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

Physiotherapy for Femoral Shaft Fractures

Fractures of the femoral shaft in adults are overwhelmingly the result of considerable force such as a road accident or a fall from a height. Due to the force involved and the power of the surrounding muscles the bone ends often overlap, cutting into the soft tissues around them, and there is often a considerable amount of bleeding and pain. Initial treatment consists of pain control, maintaining the patient.s blood volume and applying some traction to the leg to bring the bones out towards their normal positioning. Treatment used to be skeletal traction for up to 12 weeks but this has been superseded by internal fixation with a nail down the femur to stabilise the fracture.

Initial physiotherapy concentrates on restoring the muscle activity to the quadriceps, often inhibited by the pain and direct injury, and regaining range of motion in the knee. Mobilisation with a physiotherapist is performed as soon as comfort allows and the patient is often permitted to partial weight bear with crutches as the fracture is typically stable with the fixation. Further physio treatment includes massage to the fractured area to disperse scar tissue forming in the area which could bind down the muscle and other soft tissues, limiting movement and strength.

Lumbar Posture and Muscles

The abdominal and back muscles are affected in three main ways by changes in the posture of the spine: how long the muscles are; what angle they pull against the spine; how powerful they can be due to their changing leverage. Muscle length is important is the application of power and they develop most tension when they are stretches to about 10% above their normal resting length. If the muscle is shortened by contraction then the available strength of contraction is reduced. The fibrous elements in a muscle have their tension increased a lot by stretching, storing energy which can be released as part of enhanced contraction.

In normal standing the back muscles are shortened slightly so they develop more power when the spine is flexed, i.e. bent over to some degree. This means it may be best to bend the back somewhat to lift a heavy weight as this allows increased muscle power to be generated. Stretching of the passive fibrous structures and back muscles whilst lifting can be coupled with a lack of high tension forces on the ligaments and discs by flexing the spine at the time to most of its range.