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

Total Knee Replacement

Joint replacement is one of the most successful medical technical interventions with the highest quality of life improvements of any treatments. The most common reason for having a knee replacement is the occurrence of osteoarthritis, the typical age related joint change which occurs in many millions of people around the world. Osteoarthritis causes joint pain, stiffness, gradually increasing loss of range of movement and difficulties with walking, climbing stairs and rising from sitting. If conservative treatments are not successful and there is significant disability associated with continual pain and difficult sleeping then joint replacement may be considered.

In knee replacement the joint surfaces are replaced by stainless steels components and a plastic liner is inserted between them and on the back of the patella. The operation takes up to two hours and the person is typically seen and mobilised up into standing or walking the next day by the physiotherapist and an assistant. Rehabilitation with the physios is now very important, with exercise practice, gait supervision and functional activities. Length of stay in hospital varies between three and seven days with routine referral to physiotherapy on discharge to work on range of movement and strength.

Time and Muscle Degeneration

Ageing is associated with decreases in both muscle bulk and strength, varying with different muscles in the body and with which side is the dominant one. The loss of the capacity of muscle is greater in men than in women and also in people who are less active physically. Hormone changes, reduced rates of protein production and poor dietary intake can all contribute. Physiotherapists can reverse this process by instituting a resisted exercise programme at the higher intensity level. Older people can respond to muscle training although older muscles do react less strongly to stimulation and take longer to recover and strengthen after exercise sessions.

Older muscles also suffer from a variety of other changes: a reduction in the ability to use energy to produce force; an increase in the fibrous tissue content which can increase stiffness. Along with the reduction in the ability to know where the joints are at any one moment the elderly suffer from slower reactions and poorer muscle control, with weaker and more easily tired muscles. This can lead in very elderly people to a loss of independence and increasing frailty. Perhaps because of its good blood supply, muscle is mostly able to regenerate itself and remain strong.