Posted on 10/25/2021
Did you know that knee osteoarthritis affects nearly 14 million adults in the United States1 per year? Or that meniscus tears are present in 60-90%1 of those with knee osteoarthritis? With symptoms ranging from knee pain, swelling, stiffness and limited range of motion, medication, injections, surgery and physical therapy are all commonly prescribed to manage knee pain. Medication and injections, however, may simply serve to mask your pain. Surgery can be costly and taxing on your body. Physical therapy, on the other hand, emphasizes a more holistic approach to the body with emphasis on education, pain management and strength and conditioning.
At first glance, it can be frustrating when you are referred to physical therapy for management of knee pain related to structural issues like osteoarthritis or a knee joint tear. Is the physical therapist going to magically reverse your arthritis or heal your meniscus? Shouldn’t you address the structural problem head-on instead of just “strengthening around it?”
Surgery or osteoarthritis physical therapy?
If we dig deeper, a better question to consider might be, “Do I need to change the structure of my knee in order to resume the activities I enjoy?” There are several studies to suggest that abnormal findings on X-rays and MRIs can be common, even in persons without knee pain. In fact, a 2020 study2 of a population with a median age of 44 and no knee pain found that an astounding 97% of knees had abnormalities on MRI. In addition, when comparing physical therapy management to surgical intervention, there are many cases with similar outcomes.
Now, this is not to say that everyone with knee pain should get physical therapy instead of surgery. Sometimes, surgery is exactly what’s needed to improve your overall quality of life. However, including a physical therapist on your health care team – before and after surgery – is beneficial, even without changing the structural abnormalities that are often presumed to be the problem.
If physical therapy isn’t changing the “structural problem,” what exactly is the benefit?
People are more than pictures, and pain is far more complicated than what that picture shows. X-ray and MRI findings can absolutely be helpful in developing a plan of care; however, they are only one piece of the puzzle. While physical therapy is unlikely to result in a change in the X-ray or MRI findings, it can identify and help modify factors contributing to your knee pain and functional limitations.
Focusing on your unique condition, a physical therapist can work with you to determine the following:
- Health and lifestyle factors contributing to your knee pain
- Activity modification so you can safely perform activities of daily living
- Stretches and strategies to improve motion and strength
- Swelling and pain control
- How and when to appropriately get back to activities that cause you pain/discomfort
This combination can help patients to better understand their condition and develop a plan that assists in recovery. Doing all of this may greatly enhance your quality of life and ease the pain and symptoms you are currently experiencing.
Now, if you and your doctor determine that knee surgery is necessary, remember, physical therapy is a vital part of preparing for your procedure and recovering after it. Before surgery, we will work together to get you as healthy and strong as possible, which will enable your post-surgical recovery to be that much more successful and faster. Following surgery, we will focus on helping you to restore your strength, balance and flexibility.
No matter what, physical therapists are committed to helping you be as mobile, independent and pain-free as possible. Our goal is to build a relationship in which you feel comfortable asking us questions, are an active partner in your care and we’re able to work together to ensure the best outcomes possible.
If you have knee pain, contact us today and experience the power of physical therapy.
- Bhushan R. Deshpande, BS, Jeffrey N. Katz, MD, MSc, Daniel H. Solomon, MD, MPH, Edward H. Yelin, PhD, David J. Hunter, MBBS, PhD, Stephen P. Messier, PhD, Lisa G. Suter, MD, and Elena Losina, PhD. The number of persons with symptomatic knee osteoarthritis in the United States: Impact of race/ethnicity, age, sex, and obesity (2017)
- Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol (2020)
By: Patrick Smith, P.T., DPT. Patrick is board-certified clinical specialist in sports physical and orthopedic physical therapy, a fellow of the American Academy of Orthopedic Manual Physical Therapists and a treating physical therapist with NovaCare Rehabilitation in Philadelphia, PA.
Rehab Associates and NovaCare are part of the Select Medical Outpatient Division family of brands.
Posted on 10/18/2021
Technology has brought many wonderful things to our fingertips. However, an undue side effect of all this technology and connectivity is a condition known as tech neck.
If you have a stiff neck, experience headaches or feel frequent muscle tension around your neck and shoulders, your technology-using habits are likely a contributing factor. Physical therapy exercises can help to alleviate your pain.
Many suffer unnecessary pain due to poor posture when using a computer, tablet or smartphone. Poor posture greatly increases the amount of pressure placed on your muscles. Sitting straight up, the weight of your head is 10-12 pounds. Slouching forward with head dropped down, the weight of your head is more like 50-60 pounds to your neck. It’s easy to understand why your muscles are hurting when you imagine them supporting five times more weight for several hours each day.
If you’re suffering from tech neck, the good news is that it’s often reversible and treatable. Here are five strengthening and stretching exercises to combat it:
You may often find yourself sitting slouched forward with your head well in front of your shoulders. This is the starting position for retracting your head.
Pull your chin backward while looking directly forward. You should feel a “double-chin” forming under your jaw. Repeat this forward/backward exercise 10 times once every hour or two while working.
Perform this daily while sitting at your work space.
What about neck exercises for computer or laptop users? Tension in the upper trapezius muscles, which span the back of the neck and shoulders and are responsible for moving the head and shoulder blade, is common. The trap stretch can be performed any time, and you only need 20-30 seconds to help release tension on one side of your neck.
To stretch the right side, place your right hand on your waist or lower back, tilt your head to the left while looking back to the right. Place your left hand on top of your head and gently pull toward the left until you feel a comfortable stretch. Hold this stretch for as long as 60 seconds and repeat on the other side.
Perform this daily while sitting at your work space.
Lean forward in your chair as if you’re smashing a pillow between your belly and thighs. Place your hands with fingers crossed behind your head.
Reach your elbows toward the ceiling while keeping your belly close to your thighs, causing only your upper back to straighten. The thoracic extension reverses the forward bend and slouchy posture so many assume throughout the workday.
Perform this daily while sitting at your work space.
Lie face down on the floor with your arms at your side, hands near the hips.
Keep your neck straight (do not look upward) and simultaneously lift your chin, arms and knees off the ground. Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.
Perform this exercise 2-3 days each week to promote strengthening of the muscles across the back of your neck, shoulders and torso.
Lie face down on the floor with your arms reaching upward and slightly outward from your head.
Keep your neck straight and simultaneously lift your chin, arms and knees off the ground. Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.
This exercise emphasizes the lower trapezius muscle between your shoulder blades due to the overhead arm position. The prone scaption should be performed 2-3 days each week to promote strengthening of the muscles across the back of your neck, shoulders and torso.
Finally, sit up straight. It’s not a complicated tip, but it is easy to forget that we need to maintain good posture when working with technology. Elevate your computer screen so that it is at eye level. If you’re working on a laptop, generally you’ll have to direct your gaze downward while keeping your posture upright, but do your best to comfortably elevate the computer. If you’re on a phone/tablet, simply make an effort to hold the device higher in front of your face.
If you have pain that persists and is impacting your daily activities, contact us today to request an appointment with a licensed physical therapist. A physical therapy plan of care can efficiently and effectively strengthen your body, reduce pain and prevent injury.
By: Joe Zucco, P.T., DPT, FAAOMPT, center manager for Select Physical Therapy in Sarasota, FL.
Select Physical Therapy and Rehab Associates are part of the Select Medical Outpatient Division family of brands.
Posted on 10/1/2021
At Rehab Associates, we believe movement is medicine. So, what moves you? Physical activity is key to good health, vitality, energy, strength and might even make you laugh more.
If pain or a medical condition is holding you back, we’re here to help. Physical therapy is a moving experience.
Physical therapy gets you back to life and the things that are most important to you. Whether it’s running a marathon, playing with the grandkids or simply cooking dinner pain-free, the benefits of physical therapy can change lives for the better.
That’s why we’re excited it is October, one of our favorite months of the year. Why, you may ask? October is National Physical Therapy Month. For 31 days, we get to celebrate all things physical therapy and the many ways our dedicated physical therapists and physical therapist assistants help improve the quality of life.
There is so much to share about the benefits of physical therapy, including the highly-trained clinicians who provide it. Did you know that physical therapy helps people manage pain and chronic conditions? How about the power of physical therapy to help heal from recent injury and reduce the risk of future injury? Or prepare the body for surgery and successful recovery or avoid the need for surgery altogether? Well, physical therapy does all this and more.
Physical therapy is also a safe alternative to taking prescription medication. It treats common aches and strains, sprains and fractures, and helps with many other issues and conditions, including:
- Back sprain/strain
- COVID-19 fatigue and other debilitating illnesses
- Headaches and concussions
- Vertigo, dizziness and balance
- Disc injury and pinched nerves
- Rotator cuff tear, bursitis and frozen shoulder…and more
So, what moves you? That marathon? Those grandkids? That culinary masterpiece? Whatever it is, physical therapy, and our compassionate team of licensed therapists, can help get you moving.
Request an appointment today and see how physical therapy can physically, emotionally and mentally enrich your life.
#ThePowerOfPhysicalTherapy #WhatMovesYou #ChoosePT
Posted on 9/22/2021
Sports and exercise are part of the lives of many young individuals. Typically, people who participate in sports are known to be healthier and less likely to partake in outside negative distractions compared to people who do not play sports. However, for some adolescent girls, when they only focus on the sport and not their bodies, consequences can arise.
Many girls who participate in sports are at risk for an issue called the female athlete triad. This triad consists of three conditions, and the athlete can have one, two or all three. The three conditions include disordered eating, amenorrhea and osteoporosis.
Disordered eating is a term that refers to an individual having unhealthy eating behaviors and worrying about body image. Some of the most common forms of disordered eating include extreme dieting and restrictive eating. On the top end of the spectrum are eating disorders, which involve things such as self-induced vomiting, binge eating and laxative abuse. An individual can have disordered eating and not be diagnosed with an eating disorder. Most girls with disordered eating are trying to lose weight to help them improve their athletic performance. For these specific athletes, this eating pattern can range from not eating enough calories to sustain the amount of activity that they are participating in, to trying to avoid “bad” foods, all the way to eating disorders such as anorexia nervosa and bulimia nervosa.
Amenorrhea is the lack of menstruation, or one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as well as girls who have not started their periods by the age of 15. Intense exercise accompanied with not eating enough calories can lead to a decrease in the hormones needed for menstruation. As a result, a girl’s period may never come, become irregular or stop altogether. Some girls who have been participating in sports since a young age may never get their first period, because they have been training so hard. On the other hand, some girls may have gotten their period, but it disappears as their training intensifies or their eating habits change. On one hand, dysfunction of the menstrual cycle can lead to infertility. And on the other hand, it can lead to unplanned pregnancies in young women recovering from the triad. While the cycle is being restored, an egg may be dropped early and, without contraception, pregnancy can occur.
Osteoporosis is translated as porous bone. It is a disease in which the density and quality of the bone are reduced. For people with osteoporosis, boss loss overtakes the growth of new bone. Consequently, over time the bone becomes more porous and fragile, and the risk of fracture greatly increases. This typically happens silently, and there are usually no symptoms until the first fracture occurs. In girls with the triad, estrogen is typically lower. Low estrogen accompanied with a poor diet, especially low calcium, can lead to osteoporosis. During the teen years, a lot of bone growth is supposed to happen and the peak bone mass should be reached. An athlete with the female athlete triad will have a hard time getting to her peak bone mass, and it can affect her greatly later in life.
Takeaway: Diagnosing and treatment
Girls who have female athlete triad are typically invested in their sports and would do almost anything to be the best athlete possible. Girls in particular sports have more of a risk than others. Sports with a weight class like wrestling, martial arts and rowing, and sports where being thin is more optimal for performing like gymnastics, diving, figure skating, cross country and ballet, have a higher risk. However, the truth is, being very thin, and losing those last few pounds, doesn’t typically improve performance at all.
If a female athlete is suspected to have the triad, a wide-ranging physical examination is needed for diagnosis. A doctor will likely ask questions about her period, diet, exercise habits and overall feelings about her body. From there, blood test will be ordered to check for vitamin deficiencies and to rule out any other reasons for a lack of period and weight loss. A doctor may also order a bone scan to check for osteoporosis, since the athlete will be at a higher risk for bone breaks.
Doctors will not work alone to help treat a girl with female athlete triad. Coaches, athletic trainers, parents, physical therapists, nutritionists and dietitians and mental health specialists all work together and play a role in the recovery of this athlete. They focus on both the physical and emotional issues that the girl is likely facing to help prevent long term issues.
By: Wyneisha Mason, MAT, ATC. ‘Neisha is an athletic trainer with RUSH Physical Therapy in Chicago, Illinois.
RUSH and Rehab Associates are part of the Select Medical Outpatient Division family of brands.