Physiotherapists in Upper Holloway 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 Treatment used to be skeletal traction for up to 12 weeks but this has been superseded by internal fixation with a nail down the femur to stabilise the fracture.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.

Whiplash Syndrome

Whiplash syndrome is typically the result of low velocity car crashes. Usually affecting the neck, whiplash can also affect the lumbar spine as it is almost fully flexed in sitting, allowing the spine to be over flexed by even a small further movement. Most tissues in the neck can be injured in a rear shunt collision but the evidence points to facet joint injury as being the most likely cause of chronic pain and disability. Any warning about the impact can result in the individual tightening up the stabilising muscles around the spine but also increases the forces compressing the spine at the same time. This could allow the discs and vertebrae themselves to be damaged in a compressive injury.

If there is no warning of the accident then there will be no protective muscle contractions to prevent spinal injury, with the posterior ligaments taking stress as the head is bent forward and the posterior bony elements impinging as the head is bent back. The exact position of the head at the moment of impact is also important as if it is rotated then the structures can suffer a rotational injury which could involve the facet joints.