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

Flat Feet

It is common for patients to present with progressive flat foot deformity, also known as pes planus. However, despite it being common there the causes and treatments are still under debate. Adult acquired flat foot is most likely to be caused by an imbalance between the active arch maintenance structures and the passive arch maintenance structures. The foot may have been normal at some stage and something has changed to bring on the process of flattening of the arches. The posterior tibial tendon plays a strong role in actively maintaining the inner arch and a dysfunction or weakness of this structure is thought to be important in flat foot.

However, the ligaments binding the medial arch together and maintaining its structure may also be deficient in some way, leading to flat foot problems. The spring ligament, a strong ligament running between the calcaneus (heel bone) and the navicular, supports the head of the ankle bone (talus) and stops its slipping downwards, thereby maintaining the arch of the foot. Deficiency of this ligament complex is thought to be equally important to problems with the posterior tibial tendon. Treatment typically starts with insoles and modified footwear and progresses to foot surgery.

Pacing to Avoid Overdoing Activities in Chronic Pain

Patients with chronic pain very commonly push themselves hard to get things done, to complete the day to day activities they feel they must continue to perform. Unfortunately this almost always leads to a severe worsening of their pain, forcing them to rest in high levels of pain for several days. This pattern is commonly repeated again and again with the consequence that the person.s abilities tend to reduce over time as they become able to do less and less. This is known as the overdoing and under doing cycle, or activity cycling. It is a counterproductive cycle for pain sufferers, who can learn pacing their activities to their advantage.

Pacing changes the way activities are performed from a pain dependent state, where the person does the activity until pain stops them, to a time dependent state. This means they do an activity for a previously specified length of time then stop, not overdoing it at any one time. The person does the activity until they feel their pain worsen, records that time and then takes 20% off that time to give their quota. They are not allowed to go over their quota initially, to gain control of the activity.