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

Recovering Strength after Knee Replacement

Recovery from total knee replacement is partly a matter of healing, partly of the patient's determination and partly of physiotherapy management of post-operative rehabilitation. The large number of knee replacements performed each year and the vital functional importance of the knee in normal life make correct rehabilitation extremely important. Typical rehabilitation starts with quadriceps activation, knee flexion exercises and gait practice until the patient is independent with walking, stairs climbing and routine activities of daily living. However, recent research has shown that strengthening up the quadriceps much more thoroughly may be important for normal function and long term ability.

A progressive routine of quadriceps strengthening was applied in one study and the results showed it improved patients almost to the level of an unaffected person of their age. Knee replacement improves an individual's functional ability but their quadriceps typically remains reduced in strength compared to similar healthy older people, limiting overall function. Rehabilitation beyond the initial work to achieve acceptable function is not typically provided. As function comes to a peak about three years after replacement and declines thereafter, getting patients to the highest level of strength and ability is very important to allow them to get the best from their new joint.

Hypermobility

We are all born with a genetically determined type of fibrous tissue, the collagen material that makes us all or most of our ligaments, tendons, skin and discs. Our collagen varies greatly in the amount of extensibility it allows due partly due to the amount of elastic material included and the length of our tissues. Normal mobility varies from stiff jointed to very mobile and individuals who show very high degrees of flexibility of their joints are termed hypermobile. Hypermobility may be asymptomatic or can cause significant pain problems in other cases. Benign hypermobility syndrome BHS is diagnosed clinically by testing the patient's joint mobility.

The diagnostic tests are: the little finger can be pulled back to 90 degrees to the hand; with the wrist bent the thumb can be pulled back to touch the forearm; the elbows extend back beyond neutral; the knees extend back beyond neutral and the person can bend over with the knees straight and place their palms on the floor. Each joint gets a score of one if positive and this gives a score out of nine. The score indicates the degree of hypermobility the patient is exhibiting and helps decide whether the joint condition is relevant.