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

Walking with Crutches

In cases of lower limb injury or operation the surgeons may want to restrict weight bearing for a length of time. They instruct that the patient should be .non weight bearing. or .partial weight bearing. for the period specified. To achieve what is required the physiotherapist will instruct the patient in the use of crutches, or in some cases a frame. Initial assessment includes the nature of the condition and the state of the patient's other leg and arms. Arthritic joints in the other limbs may alter what is required in terms of technique or aids, the physiotherapist having to be flexible with what they suggest.

Standing up is performed by pushing up on the armrests of the chair, then the crutches are fitted and placed a short distance in front of the patient so they and the patient make a stable triangle. Initially the crutches are placed forwards and then, if partial weight bearing, the affected leg is placed forwards between the crutches and then the good leg brought up to line. This is a good initial technique to teach as it is straightforward and safe. Patients can progress to a more advanced technique, moving the affected leg at the same time as the crutches.

Bone and Ageing

Bone loss occurs much more rapidly than the equivalent process in muscle tissues, with reductions in hormone production and in activity playing a part. After the menopause, the reduction in hormone production in women can result in lowered bone density which is initially termed osteopoenia and then osteoporosis when the bone approaches the levels where it will fracture easily during normal activity. Bone loss affects the trabecular honeycomb bone more than the denser outer cortical bone and also the vertical struts more than the horizontal ones. Once one of the struts is broken it does not repair.

Because they are made up of large amounts of trabecular bones, the spinal bones are often badly affected by osteoporosis, with the process eventually allowing a buckling of the upper and lower surfaces of the vertebrae. The fronts of the vertebrae are more vulnerable to fracture as the trabeculae lose more mass in this area. Physiotherapists teach weight bearing exercises to counteract bone loss and drug therapies can halt breakdown and even increase bone mass. Getting our bone mass up to a high level during younger years so that the steady loss with age does not become important may be the best strategy.