Physiotherapists in Nottingham 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.

Physiotherapy and Manipulation

Manipulation is the moving and affecting of bodily tissues by using the hands and encompasses a wide variety of techniques including massage, deep frictions, mobilisation techniques and the forceful treatments commonly referred to as manipulation. Physiotherapists often train to perform manipulations which in this case are sudden, strong movements directed at a joint in an attempt to force it beyond the range of movement it is presently capable of. Mobilisation techniques are gentler and work within the ranges of motion available to the joint, while manipulation aims to restore what movement the joint should have.

Manipulation can be performed in the acute setting such as treating acute wry neck or a sudden onset of severe back pain. Treatment in this case may relocate the structure which is .out of place. or allow a pinched tissue area to be released and so relieve the compression suffered. Manipulation has been shown to reduce the length of time the person suffers the problem but has little effect on the overall outcome in time. More chronic conditions may be helped by manipulation to restore a range of movement which is restricted and the potential cause of pain. Physios are trained to safely and effective manage manipulative techniques.