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

Good and Bad Lumbar Posture

Good and bad lumbar posture has often been decided on grounds that are not sufficiently scientific and future recommendations need to be based on solid research. Early research on the effects of different spinal postures indicated that maintaining a lumbar lordosis reduced the pressures inside the disc nucleus. This seemed fine until it was realised that these pressures were being transferred to the rear disc walls and the facet joints. As the facet joints are known to be frequent causes of low back pain and the nucleus of the disc is not a source of pain the idea that a lordosis is desirable in all circumstances does not stand up to examination.

Overall having some flexion in the spine is better in static positions whilst a slight lordotic posture is better when walking. Too much flexion interferes with the ability of the muscles of the back to protect the spine, so a moderate position should be taken between too much flexion and too much extension. The benefits of slight flexion are mirrored in the typical habits of people in postures, such as crossing the legs or putting a leg up on something at a bar, both actions which increase the flexion of the lumbar spine.

Walking with Crutches

In cases of lower limb injury or operation the surgeons may want to restrict weight bearing for a length of time. They instruct that the patient should be .non weight bearing. or .partial weight bearing. for the period specified. To achieve what is required the physiotherapist will instruct the patient in the use of crutches, or in some cases a frame. Initial assessment includes the nature of the condition and the state of the patient's other leg and arms. Arthritic joints in the other limbs may alter what is required in terms of technique or aids, the physiotherapist having to be flexible with what they suggest.

Standing up is performed by pushing up on the armrests of the chair, then the crutches are fitted and placed a short distance in front of the patient so they and the patient make a stable triangle. Initially the crutches are placed forwards and then, if partial weight bearing, the affected leg is placed forwards between the crutches and then the good leg brought up to line. This is a good initial technique to teach as it is straightforward and safe. Patients can progress to a more advanced technique, moving the affected leg at the same time as the crutches.