Physiotherapists in Kingston Upon Thames treat many different conditions including the issues profiled below.

Bunions

Bunions is the term given to problems which occur with the joint of the big toe as it meets the foot, the first metatarsophalangeal joint or MTP joint. Problems with this joint may be familial with some inherited tendency but can also be do to poor foot use such as ill fitting footwear. Signs may start with an increased prominence at the inner border of the foot as the big toe drifts slightly towards the outside of the foot, eventually leading to rubbing of the prominence on the shoe in walking. Progression may occur as the deformity becomes worse and the joint itself becomes painful, with the big toe compressing the second toe and perhaps overriding or under riding it.

A highly arthritic joint can be very disabling, severely restrict the ability to walk very far and cause huge problems in choosing suitable footwear. Initial physiotherapy treatment can be provision of insoles, mobilisation techniques, gait correction, provision of walking aids and moderation of aggravating activities. More severe problems can be treated by joint injection, shaving of the joint surgically, removal of the joint to leave a fibrous union, fusion of the joint (arthrodesis) or replacement of the joint with a prosthesis.

Hip Dislocation

The hip is one of the largest and strongest joints in the body, being a deep ball and socket joint with powerful ligaments holding it all together. This means that dislocation is rare and only occurs in the event of significantly violent events such as motor vehicle crashes. In an accident the thigh may be forced into a position where the hip is levered out of its socket, tearing its surrounding ligaments and remaining out of socket. This causes extreme pain and patients have to be anaesthetised to relocate the joint. Treatment is complicated by the potential threat to the blood supply to the head of the femur.

Dislocation can also occur centrally, where the head of the femur is driven through the socket, fracturing it and ending up inside the pelvis. This injury usually needs internal fixation and significant time non weight bearing until the fractures heal. Normal dislocations are also treated with a period of non weight bearing to ensure the blood supply to the head of the femur, which was disrupted by the dislocation, restores itself. Once weight bearing is allowed the physiotherapist can instruct the patient in normal gait and exercises to restore the strength of the hip muscles.