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

Total Knee Replacement

Joint replacement is one of the most successful medical technical interventions with the highest quality of life improvements of any treatments. The most common reason for having a knee replacement is the occurrence of osteoarthritis, the typical age related joint change which occurs in many millions of people around the world. Osteoarthritis causes joint pain, stiffness, gradually increasing loss of range of movement and difficulties with walking, climbing stairs and rising from sitting. If conservative treatments are not successful and there is significant disability associated with continual pain and difficult sleeping then joint replacement may be considered.

In knee replacement the joint surfaces are replaced by stainless steels components and a plastic liner is inserted between them and on the back of the patella. The operation takes up to two hours and the person is typically seen and mobilised up into standing or walking the next day by the physiotherapist and an assistant. Rehabilitation with the physios is now very important, with exercise practice, gait supervision and functional activities. Length of stay in hospital varies between three and seven days with routine referral to physiotherapy on discharge to work on range of movement and strength.

Disc Prolapses

In a disc prolapse the internal material of the disc becomes displaced in relation to the outer annulus. The annular rings should be around the disc and the water retaining nucleus at the centre of the disc should remain there. In one kind of protrusion the disc bulges the annular fibres outwards but the nuclear material remains inside the disc. If the annular fibres rupture right through their thickness then part of the nucleus can extrude outside the confines of the disc but it still remains in contact with the rest of the nucleus inside the disc.

A third type of disc prolapse can occur where the disc tissue is extruded from the disc but then is separated from the nucleus and exists as an independent fragment outside the disc walls. Disc prolapses or herniations do not seem to be well connected with age or changes of degeneration of the discs even though it is again most common at lower lumbar levels which are subject to both degeneration and stresses more than other spinal regions. Even though disc prolapses are often called .slipped discs., the disc cannot slip as it is tightly bound to the vertebrae above and below.