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

Rehabilitation after Knee Replacement

Rehabilitation after knee replacement starts before the operation as the patient is educated on what to expect and instructed in range of motion and strengthening exercises so the knee is in as good a condition as it can be before the operation. On the first day after operation the physiotherapist will get the patient up, begin their mobilisation, and also start the patient with range of motion exercises and re-establishment of muscle control around the knee. Quadriceps contractions are encouraged many times hourly as the patient must be able to hold the knee stable against the weight of the body if they are to walk safely.

Knee flexion is practised routinely with an eye on the health of the wound which is down over the front of the joint and so stretched by knee bending movements. Analgesia and cold therapy may be required to control pain and swelling and facilitate exercise compliance. An angle of bend of 90 degrees is aimed for over five or six days and eventually the knee may bend to 110 degrees or more, the amount required to ascend stairs normally. On discharge physiotherapy is typically continued with emphasis on quadriceps strength, good range of motion and natural gait.

Degeneration of Intervertebral Discs

The terms degeneration and ageing when applied to intervertebral discs are not exactly the same thing, as degeneration implies damaging changes in disc structure while ageing changes may be incidental. However, degeneration is a lot more common in older rather than younger discs. Degeneration does involve things which ageing does not, such as larger structural changes in the annulus in the endplates. This structural change starts to occur in a person.s twenties and reaches its maximum in middle age. Because disc degeneration occurs more commonly in men and in the lower lumbar spine it is assumed to be related to mechanical stresses.

Changes which occur in the discs are tears in the annular fibres of various patterns, buckling of the inner annular fibres inwards towards the disc centre, greater bulging of the outer disc walls, loss of disc height, defects in the endplates which can include these bulging up into the vertebral body. Blood vessels and nerves can grow inwards along the annular tears as they are no longer opposed by the internal disc pressure. Degeneration may disrupt the disc.s ability to distribute the compression stresses evenly, leading to high levels of stress being applied to areas which are not designed to cope with this.