Physiotherapists in Somerton 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.

Ligament-Bone and Tendon-Bone Conditions - Bone Formation

The behaviour of the bone around the joint varies in differing arthritic conditions. In rheumatoid arthritis the inflammatory joint condition is linked with loss of bone and this contributes to the damage to the joint and the disability which ensues. However, in ankylosing spondylitis (AS) the inflammation is accompanied by the formation of new bone at the inflamed sites. This new bone forms at each insertion site, growing together in the spine to form bony bridges across the vertebrae, stiffening the spine in a poor position in some cases which can cause significant disability. Since inflammation usually breaks bone down this is difficult to understand.

New bone typically forms at normal ligament or tendon insertions as we get older, but in arthritis the inflammatory phase which erodes bone does settle and then bony spurs can form as the bone laying down phase occurs next in time. In the case of AS, if a bony formation phase follows the inflammatory phase, then suppressing the inflammatory phase with medication might accelerate the bony formation process, increasing the disability. AS patients may continue to fuse their joints even in the presence of new biological treatments but they may be shown to inhibit bone formation at the insertions and thereby reduce disability.