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

Acute Joint Management

An acute joint is a joint which has suffered an insult, either trauma or arthritic, and has flared up into an inflammatory phase with pain, swelling, loss of range of movement and limited function. Physiotherapists routinely manage acute joints in a variety of situations. The initial management of an acute joint concentrates on controlling the pain and inflammation with analgesics, anti-inflammatories, compression and ice. Reduction in pain and swelling allows the patient to start to get their joint moving so that mechanical stimuli can start to be received by the nervous system. Compression may be a very important treatment as the development of an effusion, fluid within a joint, is known to compromise the muscular control of the joint.

After the initial period the patient is instructed to perform regular contractions of the muscles around the joint to restore control, and to move the joint gradually through a greater and greater range of motion until full range is achieved. Once the ranges of motion are improving and the joint is settling more functional work such as weight bearing or loaded exercises can be started to stress the joint in a graded programme to restore the joint.s full strength and function.

Continuous Passive Motion after Knee Replacement

Total knee replacement is an increasingly common treatment for knee osteoarthritis and large numbers of elderly people undergo this operation every year. Physiotherapy management and treatment of these patients post-operatively is therefore becoming increasingly important if the best functional outcome is to be achieved. Early rehabilitation focuses on improving strength in the quadriceps muscle, restoring range of motion of knee flexion and facilitating gait and activities of daily living. The restoration of knee ranges of movement is one of the key elements on which success is judged and much physiotherapy time is dedicated to this part of the treatment.

A continuous passive motion machine is commonly used to improve knee flexion range of movement, as regular passive movement of a joint has been shown to result in better healing as compared to resting. Research work has shown a minor short term effect of using this treatment technique and it is often reserved for difficult cases such as after manipulation under anaesthetic for a stiff joint. Patients can remain on the machine for long periods but it is important not to forget active practice of the ranges of motion to improve muscle function. Overall continuous passive motion has not been shown to play a significant role in standard knee replacements.