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

Fitness

Fitness means different things depending on what we define as the characteristics of being fit, and typically includes a number of physical states and abilities. Aerobic fitness is the ability to maintain an activity (such as jogging) for twenty minutes or more whilst keeping one.s heart rate between 60 and 80% of maximum. We have to be aerobically fit to perform repetitive work moving our bodies about such as in running, swimming or cycling and these activities, along with fast walking, can be used to increase fitness. Muscular fitness is the ability to muscle to exert force against resistance and divides into the abilities of strength and endurance.

Muscular fitness can be trained against resistance in the gym and this kind of training needs to be undertaken to some degree even by those who almost exclusively wish to be fitter in the aerobic sense. It can be argued that two more things need to be added to make ultimate fitness in a person, stretching and core stability. Stretching can be performed after an activity to maintain muscle length but should be avoided before as it may increase the likelihood of injury. Evidence for stretching being therapeutically useful is not very good.

Flat Feet

It is common for patients to present with progressive flat foot deformity, also known as pes planus. However, despite it being common there the causes and treatments are still under debate. Adult acquired flat foot is most likely to be caused by an imbalance between the active arch maintenance structures and the passive arch maintenance structures. The foot may have been normal at some stage and something has changed to bring on the process of flattening of the arches. The posterior tibial tendon plays a strong role in actively maintaining the inner arch and a dysfunction or weakness of this structure is thought to be important in flat foot.

However, the ligaments binding the medial arch together and maintaining its structure may also be deficient in some way, leading to flat foot problems. The spring ligament, a strong ligament running between the calcaneus (heel bone) and the navicular, supports the head of the ankle bone (talus) and stops its slipping downwards, thereby maintaining the arch of the foot. Deficiency of this ligament complex is thought to be equally important to problems with the posterior tibial tendon. Treatment typically starts with insoles and modified footwear and progresses to foot surgery.