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

Fracture Treatment

Fractures occur in a huge variety of forms and in a wide variation of severity from the small flake pulled of a bone by a ligament to an open fracture with many pieces. Treatment for a fracture reflects this variety, encompassing a spectrum from a minor reduction in activity to amputation of the body part involved. An important first assessment is to decide whether the fracture is closed or open, meaning whether the skin is intact or there is an open wound leading down to the fracture. Open or compound fractures need thorough cleaning and removal of any dead tissue and treatment with antibiotics to prevent infection.

The next issue to decide is the matter of displacement. Many fractures occur through the body of a bone but the whole bone remains in its original alignment and there is no displacement of one part of the bone compared to another. Healing should occur in as close to the original anatomy as possible so treatment aims to .reduce. a fracture, i.e. to re-establish to original position of the bone by manipulation and then maintaining the position by immobilisation. Fractures are typically placed in Plaster of Paris or other materials to hold the position for a number of weeks.

Degeneration of Intervertebral Discs

The terms degeneration and ageing when applied to intervertebral discs are not exactly the same thing, as degeneration implies damaging changes in disc structure while ageing changes may be incidental. However, degeneration is a lot more common in older rather than younger discs. Degeneration does involve things which ageing does not, such as larger structural changes in the annulus in the endplates. This structural change starts to occur in a person.s twenties and reaches its maximum in middle age. Because disc degeneration occurs more commonly in men and in the lower lumbar spine it is assumed to be related to mechanical stresses.

Changes which occur in the discs are tears in the annular fibres of various patterns, buckling of the inner annular fibres inwards towards the disc centre, greater bulging of the outer disc walls, loss of disc height, defects in the endplates which can include these bulging up into the vertebral body. Blood vessels and nerves can grow inwards along the annular tears as they are no longer opposed by the internal disc pressure. Degeneration may disrupt the disc.s ability to distribute the compression stresses evenly, leading to high levels of stress being applied to areas which are not designed to cope with this.