Knee

This joint is made of your femur, tibia and patella. Its main movements are flexion and extension, but it does rotate slightly when your knee is in flexion.  Due to its main movements being flexion and extension it is classified as a hinge joint.

It is stabilised by ligaments and muscles passing across the joint, which can be injured when high levels of force is subjected to the knee. Other soft tissue structures that are important to the knee are the mensci that sit between the femur and tibia as shock-absorbers.

All of these can be effectively treated with Physiotherapy with or without surgery.

Anterior Cruciate Ligament Reconstruction is sometimes required when you rupture you anterior cruciate ligament (ACL), which typically happens after high impact sideways stress on the knee or where the foot is planted and the knee is slightly bent forward and rotated across the midline of the body during sporting activities.

Your surgeon will probably send you for Physiotherapy prior to the surgery to ensure you have full range of movement, reduce swelling and optimise muscle strength.  You will require Physiotherapy after the surgery to assist with reducing swelling around the knee, regaining full range of movement and full muscle strength to ensure you can return to normal activities of living and your sporting activity with confidence and help reduce the risk of re-rupture after ACL reconstruction.

Total knee replacement, Unilateral knee replacement and patello-femoral joint replacement are usually performed if you have grade 3-4 arthritic changes in your knee either between your tibia and femur or femur and patella.  This can cause severe pain, stiffness and reduced mobility.

It can be helpful to see your Physiotherapist prior to the operation to improve your range of movement and muscle strength and is vital after the surgery to continue with Physiotherapy to  improve your range of movement, muscle strength and regaining a normal walking pattern.  This will be achieved with mobilisation, soft tissue massage, swelling management, gait re-education and exercise programme on land and in the water.

Knee osteotomy is used to offload the arthritic part of your knee either by closed or open wedge osteotomy on your tibia or femur.  Your surgeon may choose this procedure if you are still quite young or you are wanting to return to certain sporting activities which would wear out a prothesis quickly.

You will require Physiotherapy after your procedure to regain range of movement,muscle strength and normal walking pattern, manage swelling and pain.  This can be achieved with mobilisation, hydrotherapy, gait re-education and exercise programme.

Knee arthroscopy is a surgical procedure in which your surgeon is able to look at and examine the inside of a joint using a camera or ‘scope’.  This is usually performed due to findings on your MRI scan which shows cartilage damage and/or bony changes.  These changes maybe on your tibia, femur or patella.

Your surgeon will recommend Physiotherapy after the procedure to manage post operative swelling and stiffness, but also to reduce the risk of further damage to the knee and re-educate your knee to function correctly in conjunction with the rest of your body.  This will enable you to return to your normal and sporting activities, but also reduces the requirement for a more invasive knee surgery at all or at a young age.  Your physiotherapist will tailor your programme to your symptoms which could include taping, bespoke exercise programme, gait re-education when walking and/or running.

Treatments include:

  • Tailored exercise programmes
  • Acupuncture
  • Pilates
  • Trigger point release
  • SNAGs, NAGs and MWMs
  • Hydrotherapy
  • Postural re-education
  • Gait re-education
  • Manual therapy
  • Soft tissue release