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

Recovering Strength after Knee Replacement

Recovery from total knee replacement is partly a matter of healing, partly of the patient's determination and partly of physiotherapy management of post-operative rehabilitation. The large number of knee replacements performed each year and the vital functional importance of the knee in normal life make correct rehabilitation extremely important. Typical rehabilitation starts with quadriceps activation, knee flexion exercises and gait practice until the patient is independent with walking, stairs climbing and routine activities of daily living. However, recent research has shown that strengthening up the quadriceps much more thoroughly may be important for normal function and long term ability.

A progressive routine of quadriceps strengthening was applied in one study and the results showed it improved patients almost to the level of an unaffected person of their age. Knee replacement improves an individual's functional ability but their quadriceps typically remains reduced in strength compared to similar healthy older people, limiting overall function. Rehabilitation beyond the initial work to achieve acceptable function is not typically provided. As function comes to a peak about three years after replacement and declines thereafter, getting patients to the highest level of strength and ability is very important to allow them to get the best from their new joint.

Pain Behaviours

When we hurt ourselves it is usual for us to give some indication of the fact that we are injured and these behaviours we exhibit are caused pain behaviours. Typical pain behaviours are non-verbal such as groaning or moaning, grimacing, holding the painful part, lying down, seeking a space away from people or taking painkillers. These behaviours are normal and are a form of communication, letting other people know we have a problem so that they can help us if we require some assistance to manage our injury. These behaviours allow others to assist us more quickly than if we had to think about it and ask them, which would be difficult immediately after a painful injury.

However, such pain behaviours can become chronic, a sort of ingrained habit, and people may use them to communicate daily to people around them about how they are doing that day. This type of communication, being non-verbal, can be misconstrued as it is not clear what is being communicated, leading to incorrect guesses and unwanted actions. Non-assertive communication can be very irritating for those around the person as it is never clear what they want and when something is done it is wrong.