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

Patellar Dislocation

The patella is a small bone embedded in the tendon of the quadriceps muscle which is the main power muscle controlling the knee. The patella has two facets at a slight angle on its under surface which articulate with the femoral condyles, the large rounded ends of the thigh bone at the knee. The outside femoral condyles is slightly larger in a frontwards direction and helps act to hold the patella in place. Due to the angle of the thigh bone coming down from the hip and then joining the tibia which is horizontal there is a bowstring effect as the quadriceps muscle contracts, pulling the kneecap sideways.

If the person rotates their leg with their weight on the foot, the sideways force on the kneecap can be enough to force it outwards over the condyle ridge and off its joint surface completely. This is immediately extremely painful and if the person straightens their knee the patella usually relocates itself automatically. Because the tissues on the inside of the knee have been stretched and torn as the kneecap dislocated the knee is usually kept straight in a splint or plaster for a few weeks to allow this area to tighten up as it heals.

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.