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

Hand Injuries - Diagnosis

The diagnosis of most hand injuries is not difficult as the damage is usually readily apparent to the examiner. There will typically be a history of trauma and this should be carefully attended to as it may give clues to a more complex injury than first appears. Bruising and swelling are very typical signs apparent on initial inspection, with pain a common and often localising feature. There may be an obvious deformity if the joints are dislocated or bones fractures with displacement, the patient will have lost the ability to grip firmly and there may be reduced range of movement in the fingers and thumb.

Examination starts with a visual examination of the hand which guides the doctor as to further required tests and investigations. The doctor will palpate the hand systematically to look for areas of particular pain or abnormal movement which would point to an underlying injury. The ranges of movement of the shoulder, elbow, wrist and hand is assessed and recorded, with the tendon actions tested in turn to search out any tendon involvement. Circulatory function will be checked to exclude blood vessel damage. Investigations will routinely include x-rays to look for fractures, dislocations or embedded objects such as glass.

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.