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

Rehabilitation after Knee Replacement

Rehabilitation after knee replacement starts before the operation as the patient is educated on what to expect and instructed in range of motion and strengthening exercises so the knee is in as good a condition as it can be before the operation. On the first day after operation the physiotherapist will get the patient up, begin their mobilisation, and also start the patient with range of motion exercises and re-establishment of muscle control around the knee. Quadriceps contractions are encouraged many times hourly as the patient must be able to hold the knee stable against the weight of the body if they are to walk safely.

Knee flexion is practised routinely with an eye on the health of the wound which is down over the front of the joint and so stretched by knee bending movements. Analgesia and cold therapy may be required to control pain and swelling and facilitate exercise compliance. An angle of bend of 90 degrees is aimed for over five or six days and eventually the knee may bend to 110 degrees or more, the amount required to ascend stairs normally. On discharge physiotherapy is typically continued with emphasis on quadriceps strength, good range of motion and natural gait.

Stress and Neck Pain

Neck pain causes problems in life, reducing our ability to do things, interrupting comfortable postures and interfering with our concentration. This causes stress and anxiety , a very typical response, and which can increase muscle tension and increase pain. The tension caused by stresses can increase the contraction levels in neck muscles and this spasm contributes towards muscle pain in all the overactive muscles. Figuring out what the stresses are and taking action to reduce them at this stage is very important and may help recovery. Mindfulness, controlled breathing and relaxation techniques may all be useful.

Mindfulness is a technique of placing yourself in the here and now with yourself and not judging yourself and the situation you are in, you just accept and experience it. Relaxation techniques are often practised lying down with a pillow under the knees to relax the low back area. Contracting each set of muscles from the feet up and then letting them go will provide a relaxation, with a guide from a relaxation CD or tape a useful adjunct. Controlled breathing by allowing the abdomen to rise as the diaphragm is used to inhale air in a slow rhythm can also be very relaxing.