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

Intervertebral Discs and Ageing

Ageing starts early in the discs and proceeds through life. Initially a loss of proteoglycan occurs, and as these chemicals attract and hold water into the centre of the discs, a degree of loss of hydration steadily occurs. The collagenous tissues lose some of their suppleness and resistance, becoming more brittle and more likely to suffer injury. As the discs have no central blood supply and rely on nutrition and oxygen diffusing in, a limitation of this process will accelerate the degenerative process going on in the disc centres. The tops and bottoms of the vertebrae, the endplates, are cartilage but can become calcified, further reducing supplies to the nucleus inside.

The outer part of the disc, the annulus, has layers of collagen material and these thicken and can develop defects. Overall the central disc material becomes drier, fibrosed and stiffer with a smaller volume as it loses water, throwing compressive forces onto the back of the disc annulus. The annulus becomes both stiffer and weaker with age, the increased stiffness perhaps offset by the increase in defects in the disc wall with time. Studies of discs have shown that they do not generally decrease in height with age.

Rehabilitation after Hip Replacement

Hip replacement is aimed at restoring the ability of a person with an arthritic hip to walk, rise from chairs, manage stairs and crouch. Pre-assessment starts the process with education of the patient about what they should expect so they can cooperate with the process. Exercises are taught to maintain the ranges of motion and keep up muscle strength around the joint. Gait correction is given and a walking aid provided as appropriate. The day after the operation the physiotherapist and an assistant will get the patient up into standing and walking. Gentle range of movement exercises to encourage hip flexion and the ability to move the leg in the bed is encouraged.

Once the patient is able to get up with assistance they are taught to get out of the bed independently and perform as natural as possible a gait pattern, within the weight bearing instructions of the surgeon and physiotherapist. Patients are encouraged to walk longer distances steadily to build up their stamina and taught to manage a set of stairs safely. If there is evidence of muscle weakness around the hip then exercises may be prescribed, but much of the necessary muscle power around the hip will be restored by normal activity.