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

Patellofemoral Pain

The patellofemoral joint is a frequent source of pain and disability and a difficult problem to treat successfully. The patella has two large facets on it.s under surface which are angled in respect to each other. They match the groove between the femoral condyles where the patella lies and moves upwards and downwards as the knee bends and straightens. As the quadriceps, the main thigh muscle, contracts to push us up from a chair, go up stairs or walk uphill, the patella acts like a pulley to increase the forces the muscle is able to exert. High levels of force are developed between the patellar and femoral joint surfaces.

The patella surfaces are lined with articular cartilage, a firm and very slippery material which ensures friction free movement of many of our major joints, even under load. With time this can soften and develop small fissures, making the patellar surface sensitive to loads being applied. If there is also a muscle imbalance or other abnormality which allows the patella to track in its groove a little towards the outside, this can also worsen pain. Degenerative changes can progress to osteoarthritis and cause disabling symptoms due to difficulties with stairs and gait.

Back Pain - Red Flags for Serious Conditions

Most people with back pain have just that, back pain secondary to injury, time and the mechanical stresses of holding a posture or performing an activity. However, a small proportion of people present with back pain when the underlying reason is a serious pathology of some sort. The signs that indicate that mechanical back pain may not be the reason for the patient's pain are called red flags. Physiotherapists routinely ask the red flag questions to try to exclude the likelihood of a patient having a serious underlying condition which might also be worsened by physio treatment. Examples of red flags for back pain are: age over 55 or under 20 when back pain first presents and significant trauma involved (like a fall).

Other red flags include: significant weight loss; significant night pain; use of steroids; a history of cancer; bladder or bowel disturbance and loss of sensation in the saddle area around the genitals and anus. A degree of judgement is required as the outcome of the questions is rarely clear cut and most red flag situations turn out not to be serious conditions but physios routinely evaluate these to ensure safe treatment and refer questionable cases on for medical evaluation.