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

Acute Joint Management

An acute joint is a joint which has suffered an insult, either trauma or arthritic, and has flared up into an inflammatory phase with pain, swelling, loss of range of movement and limited function. Physiotherapists routinely manage acute joints in a variety of situations. The initial management of an acute joint concentrates on controlling the pain and inflammation with analgesics, anti-inflammatories, compression and ice. Reduction in pain and swelling allows the patient to start to get their joint moving so that mechanical stimuli can start to be received by the nervous system. Compression may be a very important treatment as the development of an effusion, fluid within a joint, is known to compromise the muscular control of the joint.

After the initial period the patient is instructed to perform regular contractions of the muscles around the joint to restore control, and to move the joint gradually through a greater and greater range of motion until full range is achieved. Once the ranges of motion are improving and the joint is settling more functional work such as weight bearing or loaded exercises can be started to stress the joint in a graded programme to restore the joint.s full strength and function.

Hypermobility

We are all born with a genetically determined type of fibrous tissue, the collagen material that makes us all or most of our ligaments, tendons, skin and discs. Our collagen varies greatly in the amount of extensibility it allows due partly due to the amount of elastic material included and the length of our tissues. Normal mobility varies from stiff jointed to very mobile and individuals who show very high degrees of flexibility of their joints are termed hypermobile. Hypermobility may be asymptomatic or can cause significant pain problems in other cases. Benign hypermobility syndrome BHS is diagnosed clinically by testing the patient's joint mobility.

The diagnostic tests are: the little finger can be pulled back to 90 degrees to the hand; with the wrist bent the thumb can be pulled back to touch the forearm; the elbows extend back beyond neutral; the knees extend back beyond neutral and the person can bend over with the knees straight and place their palms on the floor. Each joint gets a score of one if positive and this gives a score out of nine. The score indicates the degree of hypermobility the patient is exhibiting and helps decide whether the joint condition is relevant.