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

Total Knee Replacement

Joint replacement is one of the most successful medical technical interventions with the highest quality of life improvements of any treatments. The most common reason for having a knee replacement is the occurrence of osteoarthritis, the typical age related joint change which occurs in many millions of people around the world. Osteoarthritis causes joint pain, stiffness, gradually increasing loss of range of movement and difficulties with walking, climbing stairs and rising from sitting. If conservative treatments are not successful and there is significant disability associated with continual pain and difficult sleeping then joint replacement may be considered.

In knee replacement the joint surfaces are replaced by stainless steels components and a plastic liner is inserted between them and on the back of the patella. The operation takes up to two hours and the person is typically seen and mobilised up into standing or walking the next day by the physiotherapist and an assistant. Rehabilitation with the physios is now very important, with exercise practice, gait supervision and functional activities. Length of stay in hospital varies between three and seven days with routine referral to physiotherapy on discharge to work on range of movement and strength.

Disc Nutrition and Posture

The supply of nutritional substances to the inner parts of the discs is in general poor and a lack of this supply is connected with degenerative disc changes. Large differences in the compression forces inside an intervertebral disc can be generated by relatively small changes in posture. These changes have correspondingly large effects on fluid flow out of and into discs and on diffusion of metabolic agents into the disc. The effectiveness of the transport of these materials depends on how far they have to travel from the nearest blood vessel which is usually in the vertebral endplate (top or bottom of the disc).

When bending, the back of the disc walls is stretched and the fronts are compressed, with stretching making the wall thinner and therefore more easily crossed by nutrients. This brings more food supply into the central area of the rear of the disc, the area which receives least nutrition. Compression from movement also squeezes water from the disc and as it returns when the pressure is relieved the incoming water brings nutrients along with it. Changes from a lordosis to a flexed position regularly increase the fluid flow in and out of the disc, encouraging the transport of nutrients.