Orthopaedics Physiotherapy

Back and Neck Pain

Neck and back pain are among the most common musculoskeletal complaints. Our Physiotherapist will carry out a thorough assessment to screen, diagnose and identify possible contributing factors. Thereafter, an individualized management plan will be discussed with the patient. Physiotherapy interventions may include patient education, therapeutic exercises, manual therapy and electro-physical modalities if necessary to help patients achieve their individual goals. Besides addressing current concerns, patients will also learn exercises and strategies to prevent recurrence of back/neck pain and to self-manage future flare-ups.

Physiotherapy for Osteoarthritis

Osteoarthritis (OA) is a disease of the whole joint, involving alterations in and around the joint (includes: the articular cartilage, subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles). OA is commonly characterized by joint pain and stiffness which may result in physical disability. The most commonly affected joints are the knees, hips and hands.

Risk factors for lower limb OA include age, obesity and previous joint injury. Current best practice guidelines, based on latest research to managing osteoarthritis include education and self-management, weight loss if overweight or obese, and use of walking aids as indicated. Studies show strong evidence that exercise therapy plays an important role in managing long-term OA symptoms. Exercises may help in decreasing pain, improving joint motion, muscle strength and function.

The aim of Physiotherapy is to help guide patients with a personalized and evidence-based management plan and exercise program to achieve preferred level of activity. We currently individualised sessions as well as exercise classes. The goal of the exercise class is to improve patients’ lower limb strength and empower patients with knowledge and ability for self-efficacious active management. Patients will be assessed on their mobility, strength, functional ability and through self-reported questionnaires prior to start of therapy and upon completion of rehabilitation program to ensure goals are met and desired outcomes have been achieved.

Physiotherapy for Knee Arthroplasty

Knee arthroplasty (include total knee replacements) is a surgical procedure to replace parts of the knee joint to relieve pain and disability.

SGH Physiotherapy has a team of physiotherapists which is specialized and well-experienced in the management of knee arthropasty. The aim of physiotherapy is to help guide patients through their journey of recovery after undergoing a knee arthroplasty surgery. This starts with physiotherapy before surgery, immediately after surgery and upon returning home.

Before surgery, patients may undergo physiotherapy to prepare patients for the surgery and to optimize recovery. After surgery, our physiotherapist will attend to the patients at their bedside to start them off with exercises and to get them walking as soon as possible. This will start as early as the same day or next day after surgery. Patients are taught to walk with or without the use of a walking aid depending on their recovery process. Early emphasis is on achieving full extension range and 90 degrees of knee bending to get the best out of their ‘new knee’. Patients will be prescribed with a customized exercise programme to enable their quick return home; and to an independent and active lifestyle.

Upon returning home, patients will be monitored in our outpatient clinic on their knee flexibility, strength and walking ability, to help track with their recovery.

Knee flexibility

Optimal flexibility is important to facilitate movement.
Knee stiffness may affect the ability to climb stairs or bending of the knee.

Knee strength

Adequate knee strength is required to perform daily tasks efficiently.
Strengthening exercises help to improve knee strength if done on a regular basis.

Walking speed

Gives an indicator of one’s overall functional ability.
Without adequate speed,
individuals may face difficulties when crossing roads at traffic light junctions in time.

Patient’s home exercise programme will be progressed according to the individual needs based on the assessments and patient’s goals. It is important for patients to take an active role with the recovery process to help return strength, movement and function to the new knee. Our team of physiotherapists will be able to work with patients to maximize the recovery and to help achieve patient’s goals on their journey after a knee arthroplasty, back to an active lifestyle and improved quality of life.

Sports Injuries Management

Our Sports Physiotherapy team provides individualized Physiotherapy management for a wide variety of sporting injuries sustained by elite athletes or weekend warriors such as

Ligamentous injuries and Meniscus injury to the knee
Patella Tendinopathy - Also known as Jumper's/Runner's Knee
Chrondromalacia Patellar
ITB Friction Syndrome
Ankle sprains
Achilles Tendinopathy
Rotator cuff injury
Bankart lesion
SLAP lesion
Tennis’ elbow
Golfer’s elbow

Management include thorough assessment and intervention to meet rehabilitation goals of returning to desired activities and/or sports. Electro-physical modalities such as ultrasound and interferential therapy may be used for pain relief and to facilitate tissue healing. Neuromuscular electrical stimulation could also be used to re-activate or train muscles inhibited by pain or injury. If required, various taping techniques may be applied to prevent injury and/or enhance sport performance. Muscle strength assessment may be performed using BIODEX machine to better formulate strength and conditioning program as well as to determine fitness to return to activities such as running.

We run Return To Sports classes to help train agility, co-ordination, strength, endurance and confidence. We also provide talks and educational programs on sports injury preventions as well as analysis on sporting techniques to prevent injuries.

We were appointed to provide sports coverage for both local and international events such as the Youth Olympics 2010, Standard Chartered Marathon 2013-2015 and SEA Games 2015.

Upper Limb Physiotherapy

Physiotherapist manage a spectrum of conservative as well as surgical shoulder and elbow conditions and help patients optimize functional recovery. Conditions we manage include:

Frozen shoulder
Rotator cuff pathologies (Tendinopathy & Rotator cuff tears)
Shoulder instability and dislocation/subluxation
Shoulder osteoarthritis
Acromioclavicular joint dislocation/subluxation
Post-surgical care of shoulder debridement and acromioplasty
Post-surgical care of rotator cuff repairs
Post-surgical care of SLAP and Bankart repairs
Post-surgical care of shoulder replacement (Total shoulder arthroplasty; hemiarthroplasty, and reverse shoulder arthroplasty)
Post fracture rehabilitation of the shoulder and elbow
Golfer’s elbow
Tennis’ elbow
Elbow instability

Ergonomics and Management of Work-related Musculoskeletal Injuries

Ergonomics is the science of fitting jobs to people.

The aims of our Ergonomics and Return-To-Work program are to:

Help our patients return to work and to reduce risk of recurrence of work-related injuries.
Help our clients reduce risk factors related to the development of work-related injuries to improve workers’ health, morale, productivity as well as reduce rate of absenteeism, lost work days and medical claims.

Our services may be tailored to your needs or needs of the organization. Cost of our Ergonomics program depends on the range and scope of services which may include:

One-to-one consultation and management of work-related discomforts or injuries as well as recommendations on work postures, workplace ergonomics and exercises to reduce occurrence of aches and pains.
One-hour lunch-time talk on body biomechanics, postural awareness, work-station design, manual handling techniques, stretching and strengthening exercises.
Work-site and job analysis, evaluation, consultation, advice, education and recommendations.

Foot and Ankle Physiotherapy

The Physiotherapy Department provides comprehensive evidence-based assessment, treatment and rehabilitation services for all foot and ankle problems. Physiotherapy assessment includes biomechanics and gait assessment, identifying structural problems in the lower kinetic chain and how they relate to foot/ankle pathology. Our rehabilitation programmes for various foot and ankle, surgical and non-surgical conditions are updated and discussed with our doctors/surgeons.

Physiotherapy interventions may include manual therapy, therapeutic exercises, electro-physical agents, taping, and education on footwear, activity limitations and progressive return to higher level of activity as appropriate to optimize and facilitate recovery as well as prevent recurrence of injury.

Hip Fracture Rehabilitation

Our physiotherapists is part of the multi-disciplinary team involved in the comprehensive care of patients with geriatric hip fractures which can be for surgical or conservative management. We aim to get patients back on their feet as soon as possible to reduce complications associated with prolonged immobility such as deep vein thrombosis (DVT), bed sores, chest infection and physical deconditioning. As most geriatric patients present with pre-existing medical conditions, we will customize rehabilitation plan to improve and optimise physical functional independence and quality of life.

We encourage active caregiver participation in the care process and do caregiver training to facilitate discharge and independent home management. Exercises will be prescribed for progressive improvement of gait and function.