The Sarah Key Physiotherapy Centre, established in 1987, is the pre-eminent Sydney knee physiotherapy clinic. We specialise in both conservative physical therapy and post-op management of knees, where knee strengthening exercises are an important part of recovery.
To help us help you, we have dedicated management programs for knee arthroscopy recovery and total knee replacement. Patients are taken through by video what to expect - and what they will do after the surgery: from the moment they wake in the Recovery Room, through to a comprehensive rehab program and full recovery.
Watch this enthralling video of Sarah taking you step by step through the way the knee works at all its component parts. Sarah explains all about the knee anatomy and the way this highly efficient joint works, while also explaining the major causes of knee breakdown. Most importantly of all, she shows you the 5 important exercises to keep your knees healthy. You can download Preventing Knee Arthritis here.
At the Sarah Key Physiotherapy Sydney centre all the therapists are highly trained in managing knee problems.
For anyone presenting with knee pain we carefully analyse your gait and observe your general knee function. We look carefully at both legs from the feet up, evaluating leg length, medial and lateral compartment knee joint laxity, the knee locking function, patello-femoral freedom and muscle power. In short, we take your knees very seriously!
We find usually that knees do better with a short course of hands-on mobilising to restore the invisible accessory joint function before we give you the job doing most of treatment yourself at home. All our therapists are well versed in careful knee tinkering to restore vital internal freedoms that make them run smoothly again.
We routinely provide our patients with beautifully hand-made cork wedges that are worn under the heel in the shoe to subtly alter knee alignment and thence the distribution of forces through the joint. This makes a dramatic difference - almost immediately.
In cases of leg length discrepancy, we may supply similar beautifully made shoe raises, worn under the heel of the shorter leg to equalise leg length.
Our management of knee problems includes providing a custom-made regime of exercises, both to mobilse the joints and strengthen the muscles around the knee. If necessary, we also address incipient feet problems that may be causing the knee trouble. We do not supply one-size-fits-all generic exercise sheets, since we know that all knees are different.
With all self-treatment of knee problems, we work intimately with the ‘Knees’ section in Sarah Key’s book ‘The Body in Action’. Here, the common disorders are described in depth and the exercises in their various stages of difficulty are explained.
There have been some recent truly astounding developments stemming from the rheumatology world on cartilage regeneration proving - as we always knew - that indeed cartilage does regenerate.
What's also exciting is that it has been proven that physiological movement - that is, movement within the range of our normal activities of daily living - are positively stimulatory on cartilage growth and regeneration.
This is interesting, particularly for knees, since people with icky knees feel they should protect them at all costs, always shying away from grand-scale postural changes, such as getting up and down from the floor and kneeling or walking on the knees. We now have proof that this is good for them and -within reason - they should do it as much as they can.
Cartilage has a rather sleepy metabolic turnover rate. Cartilage also does not have a blood supply. For this reason, high-pressure joint cartilage contact, alternating with low pressure - such as induced by getting down and up from the floor - squeezes opposing cartilage surfaces together and dints them in imperceptibly.
As the pressure comes off and the dint comes up again, nutritional fluids are sucked up from the cartilage bed at the bony interface. As the pressure comes on again, with the next activity, waste products are also squeezed out. In this way, the cartilaginous buffer covering all bone surfaces of synovial joints is kept in good order.
You will read in my book 'Body in Action' that parallel stimulation is also carried out of the synovial membrane, which lines the joint capsule and secretes the joints' lubricating fluid. Grand scale movement also stimulates synovial fluid release to ease the troubled toil of opposing cartilage surfaces. You can read all about this in the above book and follow the exercise prescribed.
Meanwhile, I urge you to take the time to listen to this 2-part radio program from ABC Radio (Australia) on knees. It is well worth it.
There are some other links to read right here as well:
Let's hope you never need a knee replacement surgery. But if you are thinking about it, have a read here first. Read about Knee Replacement Physiotherapy
Sarah Key is fascinated by Physiotherapy and the potency of therapeutic human touch as a force for good. You can read here her short dissertation on What is Physiotherapy?