Orthopaedic and Sports

Orthopaedic Physiotherapy specialises in the treatment of patients undergoing planned surgery (elective) or those who are admitted to hospital due to a traumatic accident or incident. Boasting with the latest technology, we are able to provide a wide-range of treatment options for both the professional athlete and the everyday individual alike.

This branch of physical therapy focuses on the problems from the muscular skeletal system (muscles, bones, ligaments or tendons). Physical therapy in this area deals with diagnosing, managing and treating injuries and problems from the muscular and skeletal methods and rehabilitating right after orthopaedic operations, as well.
Orthopaedic therapy workers function particularly in treating postoperative joints, acute injuries due to sporting activities, arthritis and amputations. A major aspect of the role of physiotherapy in this area is to rehabilitate after trauma, most commonly bone fractures and joint dislocations.

Depending on the nature and extent of the damage sustained, some patients will have undergone surgery followed by a period of immobilisation in a cast or splint, whilst others are treated by immobilisation only. This provides a stable environment for optimal healing to occur. However, once healing is complete and the referral to physiotherapy has been made, the challenging process of rehabilitation has to commence! This includes the regaining of normal joint movement, full strength, co-ordination, balance and function.

Our role is also to provide advice and guidance regarding the return to work, driving, and sport and leisure activities.

Elective orthopaedic surgery also often necessitates a physiotherapeutic approach. Many of these are detailed under ‘Post-Surgical Rehabilitation’ and can range from an arthroscopy to a complete joint replacement. For the majority of elective orthopaedic surgical procedures, specific post–operative rehabilitation protocols have been developed by the surgeons and these in turn are implemented under the professional supervision of physiotherapists. In many cases, hands-on treatment is required to ensure that progress keeps pace with the prescribed protocol and that complications are avoided to produce the best outcome possible.

The most common orthopaedic conditions that many patients present to our clinic with include osteopenia, osteoporosis and osteoarthritis. Osteopenia is a condition characterised by less than normal bone density and can increase an individual’s risk of developing osteoporosis. Whilst the role of the physiotherapist in dealing with the consequences of osteoporosis, in terms of the rehabilitation after an osteoporotic fracture may be obvious, our preventative or prophylactic role is of equal if not more importance. It is widely accepted that participation in suitable weight-bearing exercise can reduce the risk of development of osteoporosis, although other factors including normal hormone levels and sufficient calorific intake (especially protein) and adequate levels of calcium and vitamin D are required to achieve adequate peak bone mass.

Physiotherapists are therefore expertly positioned to give advice and education regarding the most appropriate form of weight-bearing exercise to be undertaken for an individual with osteoporosis, taking age, gender, cardiovascular fitness and general physical condition into account.

Other important aspects of physiotherapy intervention in osteoporosis can include pain management if this is a feature and the prevention of falls by implementing balance re-education and strengthening programmes.
Osteoarthritis (OA) or mechanical arthritis is another common orthopaedic condition. It is characterised by the degeneration of joints due to the breakdown of joint cartilage. In the acute phase, physiotherapy treatment is primarily aimed at symptom resolution and minimisation and to restore normal movement, strength and function. The emphasis then switches towards facilitating self-directed management by dispensing practical advice and prescribing appropriate individual home exercise programmes to keep exacerbations of the underlying condition to an absolute minimum.

Some from the techniques and approaches involved in orthopaedic physical therapy to make recovery faster are strength training, hot/cold packs, joint mobilizations and electrical stimulation. An additional procedure recently utilized is sonogram, particularly in remedies like muscle retraining.

Orthopaedic physical therapy is truly essential to restore the patients’ activity, strength and motion right after injuries or surgery. Its importance is two folded. On the 1 hand, orthopaedic patients typically have deficiencies and weaknesses which could be eliminated or at least alleviated via particular targeted workouts and only a specialized physical therapist can show the patient and teach him/her the appropriate workouts designed to restore and enhance functions or, at least minimize the problems.

Knowledge of the type of tissue that is affected is of essential importance for the clinical decision-making process.

Low-intensity ultrasound also speeds up healing of open wounds as well as the recovery of tendons, nerves and bones and promotes healing of acute and subcutaneous inflammations.

Recent research has shown that LIPUS has a positive effect on the recovery of connective tissue in general and on bone tissue in particular. Several RCTs (randomized controlled trials) have shown that low-intensity ultrasound can speed up the consolidation time of fractures of the tibia, radius and scaphoid by about 30% to 38% (compared to treatment with placebo), which results in a significant gain in time.