Treatments

When you consult a physiotherapist, you get a detailed examination and assessment which is individually tailored to your needs. Your physiotherapist will listen carefully to the type of problem you describe and analyse what structures could be affected and how they should be examined.

The conclusions from this session form a plan of treatment and can be used to predict how much treatment you might need and how much improvement you can expect to achieve.

For more information choose from Professional Treatments or Common Conditions below.

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Professional Treatments

Woman's Health

Woman’s Health


 

A4 Toosie womens health 2016


 
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Tv Hip

What is Tv Hip?

This is a condition that has been seen over the years particularly in women, and it can lead to leg pain, knee pain, back pain and even ankle and foot problems.

It’s common in women of all ages and all ability levels, certainly runners can have problems with it, so can cyclists and people who go to the gym. But also everyday folk, anyone who comes home after a long day at work and finally gets a chance to sit down and watch a bit of telly or relax with a good book. If you identify it early you can nip it in the bud and save a lot of joint problems from developing later on.
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Physiotherapy

Physiotherapy

Functional movement is a central element in what it means to be healthy. Physiotherapists work in partnership with their patients to develop, maintain and restore maximum movement and functional ability throughout life. Movement and function can be threatened by aging, injury, disease or environmental factors. Whatever the problem, our role is to take a detailed history and conduct an accurate physical examination with a view to formulating a plan of treatment and predicting specific outcomes.Call and speak to one of the physiotherapy staff if you are unsure about whether physiotherapy can help you, we will be happy to take your call.

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Manipulative Therapy

Manipulative therapy

Manipulative therapy is the term used to describe thrust techniques, also recognisable as a short swift click to the joint when it has become restricted in terms of range of movement. The formal definition is a high velocity, short amplitude thrust. The classic application of such a technique is in a simple locked apophyseal joint where resistance limits the range of movement. In this situation an expertly applied manipualtive thrust technique restores the range of movement dramatically.
These techniques are taught to a high standard at post graduate level and at the same time physiotherapists learn anatomy and physiology, biomechanics and pathology in a lot more depth so that their clinical reasoning skills become more precise. Manipulative thrust techniques are just one aspect of treatment and would commonly be applied sparingly and alongside other modalities such as soft tissue massage, mobilisation and exercise therapy. The aim is to restore the function rapidly and effectively

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Geko

Geko


Richmond Physiotherapy are delighted to have been selected by firstkind to trial the geko in patients with musculo-skeletal conditions. We have been looking at the application of the geko for a broad spectrum of conditions over the last two months and it has been really popular with patients; it is easy to use and anecdotally we have found it effective in promoting the rapid resolution of soft tissue swelling in a range of conditions including ligament sprains, muscle tears and OA knees.

View the link: http://gekodevices.com/en-uk/physio-registration/registration/

For more information. View The geko™ Brochure (PDF)

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Podiatry

Podiatry

Amanda Walker of The Gait Lab can take your appointment their office number is 0870 6093612 – www.thegaitlab.co.uk

Deep Tissue Massage

Deep Tissue massage

Deep Tissue massage is designed to relieve severe tension in the muscle and the connective tissue or fascia. This type of massage focuses on the muscles located below the surface of the top muscles. Deep tissue massage is often recommended for individuals who experience consistent pain, are involved in heavy physical activity, such as athletes, and patients who have sustained physical injury.
Massage uses five styles of long, flowing strokes to massage. The five basic strokes are effleurage (light touch), petrissage (kneading), tapotement (rhythmic tapping), friction (compression), and vibration. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks. It has also been shown to be helpful in individuals with poor circulation.

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Sports Massage

Sports Massage

Sports Massage is the management, manipulation and rehabilitation of soft tissues of the body including muscles, ligaments and tendons.

Improve circulation & lymphatic flow
Assist in the removal of metabolic waste
Sedate or stimulate nerve endings
Increase or decrease muscle tone
Increase or decrease muscle length
Remodel scar tissue when required
Assist in mental preparation for sporting participation

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Manual Lymphatic Drainage

Manual Lymphatic Drainage (MLD)

MLD is a very specialised type of massage that plays an important role in the treatment of lymphoedema. The aim of the massage is to stimulate movement of the the excess fluid away from the swollen area so that it can drain away normally.
This is achieved through gentle rhythmic movements of the skin which stimulate the contraction of the lymphatic vessels (the lymphatic system is an important component of the body’s immune system and is supports the blood system). This results in the removal of metabolic waste products and excess fluid from the body’s tissues which then enter the lymphatic system. The fluid, now known as lymph, passes through a series of lymph nodes where it is cleansed of dead cells, bacteria and other waste products (=detox). The clean lymph then returns back into the blood stream.

Benefits of MLD …

• is used in the treatment of both primary and secondary lymphoedema
• is a key element in the treatment of venous oedema
• may be used pre and post surgery to aid healing (e.g. orthopaedic surgery, cosmetic surgery)
• speeds up the healing of sports injuries
• reduces acne due to detoxification
• alleviates fluid congestion such as tired puffy eyes and fluid retention due to pre menstrual syndrome (swollen ankles, bloating)
• promotes the healing of wounds and burns and can improve the appearance and texture of old scars
• helps reduce headaches, migraine and sinusitis
• increases bowel/bladder movements by improving elimination
• improves some digestive disorders
• reduces ME symptoms
• reduces stress
• stimulates the immune system
• induces deep sleep and relaxation
• increases the overall sense of well-being

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Pilates
Pilates is a physical fitness system developed in the early 20th century by Joseph Pilates in Germany. Pilates called his method Contrology (from control and Greek -λογία, -logia), because he believed his method uses the mind to control the muscles. The Pilates approach focuses on the core postural muscles which help keep the body balanced and which are essential to providing support for the spine.

In particular, Pilates exercises teach awareness of breath and alignment of the spine, and aim to strengthen the deep torso muscles.

The exercises are based around eight key principles : control, concentration, centering, breathing, precision and flowing movement. This is a holistic approach working closely with the mind-body connection promoting better posture, balance, core strength, increased lung capacity, circulation, better body awareness and correct spinal alignment.

Our classes are small, usually four – six people and this means that you get really good supervision while you follow the exercises so you know you’re getting it right; or you can try one to one sessions and see if that works better for you. Physiotherapy and Pilates work well together because the principle is the same : getting optimal function and maintaining it.

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Women’s Health

Women’s Health

This concerns physical problems related to pregnancy and gynaecological associated conditions. There are other physical discomforts not directly related to pregnancy that women are affected by, which can be helped by physiotherapy. We also offer a range of services for women during pregnancy such as appropriate exercise.

Read More about What is Women’s Health Physiotherapy?

After discovering I had a prolapse, the consultant I saw suggested I see Toosie at Richmond Physiotherapy. Well, I had no idea what a womens health physio was or quite what they did as women don’t openly talk about the problems associated with a dysfunctional pelvic floor. I have to admit to dreading the first appointment as we ladies really don’t like ‘those’ examinations and I was feeling generally quite down about my situation. Toosie somehow managed to normalise the whole situation and I went from crying at our first session to having a great laugh with her and later joining her Pilates class to further reinforce the exercises she had taught me. My symptoms are much improved and I feel more confident about my condition. I wish such advice had been more available when I had my babies and would advise anyone post pregnancy to see a womens’ health specialist like Toosie. Obviously no-one else will be as good!!!!!!!!!!!!!:):):)

LB, Richmond
Acupuncture
Acupuncture is one of the many skills used within physiotherapy as an integrated approach to the management of pain, inflammation and as a means of enhancing the body’s own healing chemicals in order to aid recovery and enhance rehabilitation. Acupuncture is used by Physiotherapists, against a background of sound research and evidence, as a means of enhancing pain modulation via the stimulation of the brain and spinal cord to generate pain relieving chemicals, such as endorphins; melatonin to promote sleep and serotonin to promote well being. These assist the body’s healing process and offer pain relief as a precursor for other manual or exercise therapy.

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Common Conditions

Ankle

Ankle

One of the commonest injuries at the ankle is a sprain of the ligament (running from bone to bone) on the outer aspect, from the base of the fibula to the calcaneum. Easily done, by missing your footing, or slipping, the foot turns in and the lower leg doesn’t. The fibres of the ligament are over-stretched to varying degrees depending on the force involved. There will be an inflammatory response at the time of injury. Inflammation is the body’s defence response to injury, what you see is redness and swelling, what you feel is tenderness to the touch and pain on movement. A normal healthy inflammatory response is, if anything, rather overdone, so it is important to reduce swelling which in turn reduces pain and support the injured tissues, enough to make movement more comfortable and allow the ligament to repair (the inflammatory exudate contains fibroblasts, cells responsible for tissue repair). As the ligament heals it is important to keep the fibres approximated so that the ligament heals at the the appropriate length – not too long or the ankle will be unstable after repair, not too short or the ankle will lack its normal flexibility. The ankle ligament contains loads of proprioceptors: nerve endings sensitive to position which feed up to the brain and inform balance reactions in the leg muscles. It is important to retrain these balance reactions after ankle injury, otherwise the ankle performs poorly on uneven ground or in complex rapid movements and the ligament will be vulnerable to reinjury.

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Spinal problems

Spinal problems

Low back pain is a big problem in the western world in terms of loss of working days and health service bills. If you have back pain, however severe it may be, other people can’t see it. Time and again patients with back pain will say to me: “I had no idea it could be this bad.” If you’ve had a severe bout of back pain, you will know only too well how disabling it feels, as if even the slightest movement is going to make it so much worse. Your body seems to be telling you to stay absolutely still. Yet we know from many research papers that the sooner you get moving the better it will be for your back.

Of course it is important to get your back thoroughly examined and in a tiny percentage of cases surgery will be required but the vast majority of patients with back pain will benefit from appropriate manipulation and exercise.

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Elbow
Tennis elbow is a common injury. It tends to be precipitated by a period of repetitive use, for example in tennis this could be an unusually long session, or a lesson concentrating on a particular stroke. It can also be caused by a change in pattern of use, for instance a different racquet (wider grip. different weight, head size) or a completely revised stroke.

Lots of people get tennis elbow without ever having played tennis! It has become a common term for elbow pains associated with difficulty in gripping.

Pain can arise from irritation of a number of structures around the elbow joint : inflammation can occur around the tendon(s) at the point of attachment to the bone, or at the junction between tendon and muscle fibre; the mobility of the elbow joint can deteriorate, particularly the articulation between the head of the radius and the humerus. There can be restriction of the passage of nerve fibres, particularly the radial nerve, through the soft tissues around the elbow.

Research has shown that in the majority of cases there will be some degree of dysfunction in the neck, contributing to elbow pain, particularly if the condition has been persistent.

All of these structures need to be accurately examined and treated to resolve tennis elbow. If you have had tennis elbow for any length of time you will probably hear about all sorts of different treatment approaches which may or may not have worked; this is because it is a condition which can have a number of differing underlying causes.

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Headaches

Headaches

There are many reasons why head pain occurs. If you suffer from headaches you might like to check with your doctor before consulting a physiotherapist. If you choose to go straight to a physiotherapist for assessment then you can be reassured that we will take a detailed history and perform a careful examination.

Tension headaches, as they are called, can arise from irritation of the structures between the base of the skull, and the top two vertebrae: the atlas and the axis.

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Hip

Hip

Hip pain often arises from reduced mobility in the hip joint. This joint is extremely mobile but sedentary western living makes hardly any use of the available range. The ball and socket mechanism of the hip joint needs to be lubricated across the entire surface to ensure nutrition of the cartilage. Otherwise the cartilage surface tends to deteriorate. Without use the muscles, ligaments and tendons around the hip become distorted and weak. It’s a good example of the “use it or lose it” adage.

Where the hip is the primary source of pain, restoration of movement and muscle power is essential to reduce pain and improve function. Not all hip pain comes from the hip though ! Sometimes there will be pain around the hip, even including tenderness in the muscles, yet it is the lower back ( lumbar spine) that is at fault, giving rise to “referred” pain into the hip.

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Knee & Kneecaps

Knee & Kneecaps

The knee can be described as a hinge joint, its main movements being flexion and extension (i.e bending and straightening). It is vulnerable to torsion which can damage a) the ligaments (running from bone to bone) either on the inner or outer aspect of the knee b) the cartilages (washer type structures inside the knee) c) the cruciate ligaments inside the knee – these are designed to hold the knee steady from front to back – so they are more likely to become injured when the knee is “sheared”.

Some sports are particularly tough on knees, football for instance. Knees that have taken a lot of trauma over the years will tend to get arthritic. This means that the actual cartilage surface on the femur and the tibia gets ragged and irregular. Normal cartilage surfaces slide on each other incredibly smoothly, like ice on ice. When this surface deteriorates, movement of the knees can be more restricted, certainly more noisy, but not necessarily painful. The mechanism of injury often suggests the structures most likely to be damaged. The physiotherapist can then confirm the problem by careful (and gentle) testing in the clinic. It is common practice to use expensive scanning procedures for many injuries these days, but a good physiotherapist can often identify the injury in the clinic by examination.

Kneecaps

A common cause of pain around the knee, not only for sporty types, is retro patellar pain, (pain behind the kneecap). The kneecap is actually enclosed within the tendon of the quadriceps muscle (four muscles on the front of the thigh) The balance between the muscles needs to be just right so that the knee cap sits centrally over the knee. If the balance goes off then the muscles tend to pull the kneecap sideways (usually towards the outer aspect) on the knee. This causes friction between the back of the kneecap and the front of the femur, leading to inflammation.

Alternatively the knee can hyper extend (when standing with the knees locked straight, they don’t just straighten, they go past straight and bow backwards) this can cause the kneecap to rub excessively against the knee joint, setting up a low grade inflammation which will become painful.

Typically the pain is more noticeable when sitting for a long time, (for instance, in the car or at the cinema), or when the knee works under load – e.g down or upstairs. For some, kneeling is impossible. Physiotherapy assessment will include muscle testing, measuring the “lie” of the patella, working out how to correct the position and retrain the muscles to restore balance.

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Shoulders
The shoulder or gleno humeral joint is an intricate arrangement – loads of movement is available in just about every direction, but stability is limited, so this has to be provided by the muscles and ligaments surrounding it. The head of the humerus (the long bone of the upper arm ) moves on the glenoid, a slightly convex surface on the outer aspect of the shoulder blade. The collar bone also connects up with a part of the shoulder blade called the acromion. The muscles surrounding the joint, running between the humerus and shoulder blade are known as the rotator cuff.

Shoulders dislocate relatively easily, once the dislocation is treated it is important to get all the muscles back in good working order. Shoulders can become painful and restricted seemingly out of the blue, and the term frozen shoulder is quite often used.

Shoulder problems need really careful examination, they can be very difficult to diagnose because the whole mechanism is so intricate. Not only that, a significant number of pain patterns will appear to be arising from the shoulder when in fact the problem lies in the neck and the pain is actually referred to the shoulder, shoulder blade or down the arm.

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Wrist & Hand

Wrist & Hand

Common problems around the wrist and hand can arise from repetitive activities such as using a keyboard. Factors which can contribute include unusually prolonged periods of time using the keyboard, or using the keyboard in an awkward position ( too high, too low, at an awkward angle etc) or switching from one type of use to another – (keyboard to mouse, scrollin g etc)

Pain can arise from local inflammation in the tendons and / or small joints of the hands and wrist. There may also be irritation of the nerves supplying the hands/ wrist/ forearms.

Careful examination will identify the source of symptoms. Treatment can include improving the mobility of the soft tissues: muscles, tendons,ligaments; the joints of the hand and wrist. The use of low dose pulsed ultrasound will reduce inflammation. Clearly it is often worth reviewing the working environment to prevent recurrence of this sort of problem.

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