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

Tendon-Bone and Ligament-Bone Conditions . Mechanical Factors

Problems with the junctions between bone and ligaments or tendons can occur because of mechanical rather than inflammatory factors, with overuse injuries, trauma and sport examples of causative factors. MRI scanning may show a pathological change in the insertion or enthesis but the differences between changes caused by inflammation and mechanical factors is not great. It is fairly clear at the Achilles tendon as changes caused by mechanical factors occur two to six centimetres above the insertion while inflammatory changes will occur at the insertion itself. Degenerative changes in the insertions may give similar effects to the changes from inflammation.

Enthesis in osteoarthritis may show the same, if more limited, changes which occur in inflammatory conditions. Modern investigations have improved our knowledge of these conditions, with spinal problems best imaged by magnetic resonance imaging (MRI) and areas of the body which are more easily reached can better be checked out using ultrasound. Swelling of the bony areas around the insertion can be present on scanning, as is soft tissue swelling of the enthesis and its surrounding region. However, a normal MRI and a negative blood test do not exclude an inflammatory arthritis as both tests are not specific enough.

Meniscal Tears

Each knee has a pair of interesting structures inside it known as the menisci, more commonly called the knee cartilages. They are cartilaginous structures a bit like banked tracks and attached to the top of the tibia on each side of the knee. Their upper curves surfaces accommodate the large curved condyles of the end of the femur which otherwise would have to articulate solely with the flat upper tibial surface. The function of the menisci is not entirely clear but they may have to do with distributing synovial fluid around the joint, giving the brain feedback on where exactly the knee is during activities or easing force transmission across the joint as it fills in the gaps between the two joint surfaces.

During movements of the knee the large femoral condyles can pinch the menisci against the tibial surfaces and cause tears in the substance of the meniscus. A small tear from the outside of the structure can cause a flap which is called a .parrot beak. tear. If the tear is horizontal along the plane of the meniscus and does not reach the edge then a flap can be produced which is known as a .bucket handle. tear.