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

Knee Arthritis

The knee is a large synovial joint formed between the large expanded end of the femur (thigh bone) and the top of the tibia or shin bone. The ends of the bones are covered with articular cartilage, a slippery and firm material which allows the almost friction free movement which our joints can provide even if there is a body weight load on them. On an x-ray this shows up as a dark space between the bony surfaces, known as the joint space. In time or after injury this cartilage can change as part of the process of osteoarthritis, although there is a significant genetic component which influences whether we get osteoarthritis or not.

Changes occur both in the cartilage and the bone of the joint during the osteoarthritic process and the process may begin with a softening of the cartilage from its firm, hard surfaces. Next, fissures can develop until the thickness of the cartilage wears down and in severe cases the underlying bone may be exposed, causing a bone on bone crunching and pain. Symptoms of osteoarthritis include pain, loss of joint movement, joint deformity such as knock knee or bow leg and difficulties with gait.

Knee Osteoarthritis, Stretching and Physiotherapy

Knee osteoarthritis is a common condition with a very large number of sufferers across the world, symptoms including knee pain, swelling, loss of joint movement and limited weight bearing function. Loss of extension of the knee is common and may be related to an increase in the activity of the hamstrings which limits the range of the knee into extension as we walk when a knee is osteoarthritic. Reid and McNair (Physiotherapy, March 2010) looked into this matter in older people as most stretching research has been in younger people. They studied a group of people with osteoarthritis of the knee, giving them three stretches of 60 seconds duration to see if this changed the way the knee behaved.

The two groups who had the stretching showed increased ranges of knee extension, similar in the osteoarthritic and the non-osteoarthritic groups, with some increase in the power available to be exerted. It may be useful to perform hamstring stretches before working on the range and power of the knee and this technique may also have a relevance in knee replacement which is becoming more common as a treatment for end stage osteoarthritis. Limitation of full extension is common after total knee replacement and physios treat it routinely.