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

Patellofemoral Pain

The patellofemoral joint is a frequent source of pain and disability and a difficult problem to treat successfully. The patella has two large facets on it.s under surface which are angled in respect to each other. They match the groove between the femoral condyles where the patella lies and moves upwards and downwards as the knee bends and straightens. As the quadriceps, the main thigh muscle, contracts to push us up from a chair, go up stairs or walk uphill, the patella acts like a pulley to increase the forces the muscle is able to exert. High levels of force are developed between the patellar and femoral joint surfaces.

The patella surfaces are lined with articular cartilage, a firm and very slippery material which ensures friction free movement of many of our major joints, even under load. With time this can soften and develop small fissures, making the patellar surface sensitive to loads being applied. If there is also a muscle imbalance or other abnormality which allows the patella to track in its groove a little towards the outside, this can also worsen pain. Degenerative changes can progress to osteoarthritis and cause disabling symptoms due to difficulties with stairs and gait.

Muscle

Human muscle is classified into three types, smooth, striated and cardiac. Striated or skeletal muscle is the type we think about when we consider muscle, allowing us to contract with force, maintain posture and produce movement. Muscle is well supplied with blood and also with nerve endings which are able to continuously monitor the stresses and strains through the tissue. Pain nerve endings are present mainly in the fibrous sheaths which surround the muscle. The muscle is structured in bundles of fibres, each surrounded by a fibrous sheath which join together at the ends into tendinous tissue on its way to attachment to bone.

Muscle fibres can be orientated in various directions which gives the muscles different abilities as contractile structures. If the fibres are arranged longitudinally along the muscle it tends to be longer and to be able to contract more in length terms, while muscles in different configurations such as the fibres on a feather can generate higher degrees of force. Higher forces may be required in muscles which have to work against gravity and move the weight of the body. Muscles have three different types of fibres, named Type 1, 2A and 2B, with different functions.