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

Recovering Strength after Knee Replacement

Recovery from total knee replacement is partly a matter of healing, partly of the patient's determination and partly of physiotherapy management of post-operative rehabilitation. The large number of knee replacements performed each year and the vital functional importance of the knee in normal life make correct rehabilitation extremely important. Typical rehabilitation starts with quadriceps activation, knee flexion exercises and gait practice until the patient is independent with walking, stairs climbing and routine activities of daily living. However, recent research has shown that strengthening up the quadriceps much more thoroughly may be important for normal function and long term ability.

A progressive routine of quadriceps strengthening was applied in one study and the results showed it improved patients almost to the level of an unaffected person of their age. Knee replacement improves an individual's functional ability but their quadriceps typically remains reduced in strength compared to similar healthy older people, limiting overall function. Rehabilitation beyond the initial work to achieve acceptable function is not typically provided. As function comes to a peak about three years after replacement and declines thereafter, getting patients to the highest level of strength and ability is very important to allow them to get the best from their new joint.

Lumbar Facet Joint Syndrome

The lumbar spine is a very complex structure made up of a large number of different anatomical structures, many of which can be sources of pain in different situations. One structure which is known to contribute to low back pain is the facet joint, the small synovial joint placed at each side of each disc level. The facet joints are made up of one facet from the vertebra above and one from the vertebra below, with a joint capsule lined with synovial membrane. The joint capsule is well supplied with nerve endings which could transmit pain. In normal backs the facet joints serve to control the movements permitted at the particular part of the spine in which they lie, but do not take large amounts of weight.

With degeneration of the discs the facet joints are pushed together more strongly and forced to take larger amounts of weight, leading to degenerative changes developing within them and then the transmission of pain. The facets are forced to take more weight than they are designed for. Patients with this syndrome particularly dislike extension of the spine which forces the facet joints together and elicits pain. Mobilisations and regular exercises can be helpful from a physio.