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

Hip Dislocation

The hip is one of the largest and strongest joints in the body, being a deep ball and socket joint with powerful ligaments holding it all together. This means that dislocation is rare and only occurs in the event of significantly violent events such as motor vehicle crashes. In an accident the thigh may be forced into a position where the hip is levered out of its socket, tearing its surrounding ligaments and remaining out of socket. This causes extreme pain and patients have to be anaesthetised to relocate the joint. Treatment is complicated by the potential threat to the blood supply to the head of the femur.

Dislocation can also occur centrally, where the head of the femur is driven through the socket, fracturing it and ending up inside the pelvis. This injury usually needs internal fixation and significant time non weight bearing until the fractures heal. Normal dislocations are also treated with a period of non weight bearing to ensure the blood supply to the head of the femur, which was disrupted by the dislocation, restores itself. Once weight bearing is allowed the physiotherapist can instruct the patient in normal gait and exercises to restore the strength of the hip muscles.

Lumbar Facet Joint Syndrome

The lumbar spine is a very complex structure made up of a large number of different anatomical structures, many of which can be sources of pain in different situations. One structure which is known to contribute to low back pain is the facet joint, the small synovial joint placed at each side of each disc level. The facet joints are made up of one facet from the vertebra above and one from the vertebra below, with a joint capsule lined with synovial membrane. The joint capsule is well supplied with nerve endings which could transmit pain. In normal backs the facet joints serve to control the movements permitted at the particular part of the spine in which they lie, but do not take large amounts of weight.

With degeneration of the discs the facet joints are pushed together more strongly and forced to take larger amounts of weight, leading to degenerative changes developing within them and then the transmission of pain. The facets are forced to take more weight than they are designed for. Patients with this syndrome particularly dislike extension of the spine which forces the facet joints together and elicits pain. Mobilisations and regular exercises can be helpful from a physio.