Joint injuries

Joint injuries are among the most common problems experienced by physiotherapy patients. These injuries may result from trauma to the body part or from wear and tear to the joint as in the case of carpal tunnel or arthritis. Patients may also seek physiotherapy following surgical procedures. Hip, knee, elbow, shoulder, wrist and hand surgery are among the most common. Before beginning treatment, we will perform a subjective assessment of the patient through interview, review of the patient's records and doctor's referral. An objective assessment follows to assess the extent of the patient's deficits and to formulate treatment goals.

Once the assessment is over, you should ask questions and voice concerns. A good physiotherapist will be able to alleviate any fears you may have and restore your confidence in the therapeutic process. Then we will formulate goals for post discharge together. These goals should be measurable and functional. Work hardening programs and functional capacity evaluations may be undertaken if you plan to return to work.

In the case of a hip injury or injury of the lower extremity, treatment will focus on ambulation, balance and coordination while following the necessary precautions. We will teach you how to use an assistive device such as a walker, cane or crutches. Strength training will also be undertaken as healing progresses. You will be trained in stair climbing and using the stationary bike to regain range of motion. Before the you are discharged you will be taught how to transfer in and out of a car, go up and down a curb and a ramp. Pain is also addressed during therapy sessions and different modalities - heat, ice, ultrasound and E-stim to name a few - will be employed. Education on pain management at home will be provided.

Activities of daily living (ADL) are also a crucial part of the therapy program as you return to your prior level of functioning. A hip, knee or shoulder patient may be taught the use of adaptive equipment to help with his bathing and dressing activities. The goal here is not to make you dependent on the device but to help you become independent while coping with the injury. Recovery for a hip patient is around six weeks, while knee patients may require about ten weeks. Independent activities of daily living (IADL) like car transfers and driving are part of the program in most clinics.

Wrist and hand patients need about six weeks for recovery, but their treatment may center mainly on fine motor activities. Since the hand is such a complicated structure, physiotherapists are specially trained in this area. Range of motion, strength and fine motor tasks form the basis of therapy as well as splinting in some cases. By discharge you should feel confident to resume your prior activities.