Category Archives: Hip

PT News February 2023

March 1, 2023 Teresa Stockton - Blog, Hip, PT News, Sports and Fitness

This time in PT News we recap what our clinics have been posting throughout February 2023. We are excited to bring you current physical therapy-based posts featuring published articles from PTandMe partnering clinics!

1. Hip Pain: Causes, Symptoms & Treatment

Written by Sport & Spine Physical Therapy with locations throughout Greater Wausau, WI

WHAT IS HIP PAIN? Hip pain can be caused by a variety of factors, ranging from injuries and overuse to medical conditions such as arthritis or hip dysplasia. Here are some common causes and potential solutions for hip pain: Read more

2. Improve Your Golf Game with a TPI Golf Screening

Written by Carolina Physical Therapy and Sports Medicine an outpatient physical therapy practice with locations in Columbia, Charleston, Sumter, and Rock Hill, SC.

Are you interested in improving your golf game? Maybe adding some yards to your drive or irons? Or want to move better? Titleist Performance Institute (TPI) Certified Professionals can help with all of this and more! TPI Professionals are trained in identifying movement restrictions and compensations related to the golf swing. Read more

3. Athletic Training vs. Physical Therapy

Written by ARCH Physical Therapy, an outpatient physical therapy clinic in Lansing, MI.

Have you ever wondered about the difference between an athletic trainer and a physical therapist? While they may seem similar on the surface, the two careers are quite different from each other. Read on to learn more about the two professions! Read more

We hope you enjoyed our picks for the PT News February 2023 edition.

Find these locations and others to start feeling better today!

Stretches for Sciatica Pain Relief

October 19, 2022 Teresa Stockton - Back, Blog, Hip

What is Sciatica and the Sciatic Nerve?

The sciatic nerve is the longest and thickest nerve in the body.
It starts with five nerves in the lower back that come together and form one nerve that runs through the buttocks and down the leg. When there is inflammation of the sciatic nerve it is called sciatica. It can cause a burning or shooting pain in the buttocks or a pain that goes all the way down the leg and usually occurs only on one side.

Common Signs and Symptoms

Pain in the back of the thigh, usually traveling below the knee; may be worse with bending, sneezing, coughing, straining, or prolonged sitting
Numbness or weakness affecting the thigh, lower leg, ankle, or foot
Occasionally, pain in the back or buttocks

Common Causes of Sciatica

Inflammation of the sciatic nerve because of irritation from a variety of sources, which include:

Trauma
A ruptured disk
Arthritic spurs of the spine
Spondylolisthesis (slippage of the vertebrae)
Pressure from muscles of the pelvis (hamstring, piriformis)
Prolonged sitting on a wallet

5 Simple Stretches to Relieve Sciatica Pain:

Pigeon Pose (Reclining)

This is a great pose for opening the hips and stretching the back (this is also used in yoga).
1. Begin by lying on your back. Bring one of your legs upward, to a right angle. Lock both of your hands behind your thigh.
2. Bring up your other leg, placing the ankle on top of the opposite knee.
3. Hold the position. This helps stretch the piriformis muscle, which is often a cause of sciatic pain.
4. Switch legs and repeat the exercise.

Pigeon Pose (Sitting in Chair)

This exercise is recommended if you can easily perform the pigeon pose. Try it out!
1. Sit on a stool or chair, with your legs directly in front of you.
2. Bend your right leg. Put the ankle on top of your left knee.
3. Lean forward, pushing your upper body towards your thighs.
4. Hold this position for 15-30 seconds to stretch out the muscle in the lower back and glutes.
5. Repeat on the other side.

Knees To Opposite Shoulder

This stretch offers sciatica pain relief by stretching and loosening both the piriformis and gluteal muscles.
1. Begin by lying on your back, and extending your legs.
2. Bend your right leg gently, clasping your opposite hand around the knee.
3. Pull the right leg across your body towards the opposite shoulder, holding it for up to 30 seconds. Pull only hard enough to feel a stretch – if you feel pain, reduce the force you’re using.
4. Push your knee down, returning to the starting position.
5. Repeat for a total of 3 reps, alternating each leg.

Sitting Spinal Stretch

This stretch helps relieve back pain and decompress the spine. It’s quite simple!
1. Sit on the ground in a neutral position, with your legs stretched outward.
2. Bend your right knee until you put your foot flat on the floor, past your opposite knee.
3. Place your left elbow on the right knee. Gently turn your body toward the right, flexing the spine.
4. Hold the position for 3 seconds and repeat for 3 reps on either side.

Standing Hamstring Stretch

This stretch helps relieve hamstring tightness caused by sciatica.
1. Find a flat, elevated surface such as a bench or a chair that’s at (or below) hip level. Place your right foot on this surface.
2. Keep your leg and toes straight. Bend your body forward, towards your foot, like you’re trying to touch your toes. The deeper you bend, the more intense the stretch.
3. Push the hip of your raised leg downward. Hold for 30 seconds and repeat on the opposite side.

There is no one-size-fits-all exercise for sciatic nerve pain. Never force yourself through an exercise that doesn’t feel right. Instead, focus on finding the ones that work for you! As you improve, you may be able to do some movements that didn’t work at first. Anyone experiencing pain for more than a month could benefit from seeing a physical therapist. Physical therapy and exercise help strengthen and mobilize tissues in the lower back, pelvis, abdomen, buttocks, and thighs. Commitment and frequency are important attributes of a successful treatment outcome when using physical therapy and exercise for sciatica.

Resources

Special thanks to North Lake Physical Therapy in Portland, OR for posing for our stretches!

https://www.healthline.com/health/back-pain/sciatic-stretches#What-is-the-sciatic-nerve?
https://www.webmd.com/pain-management/sciatica-exercises-pain-relief
https://www.movementforlife.com/articles/physical-therapy-sciatica-5-stretches-pain-relief
https://www.suburbanortho.com/wp-content/uploads/2017/03/Sciatica.pdf

Winter Is A Great Time To Take Care Of Injuries

December 16, 2020 Teresa Stockton - Back, Blog, Hip, Knee, Shoulder

As Mother Nature keeps bringing on the winter wind, now is the time to think about spring and summer! Waiting to take care of these injuries when the first fair day arrives can be too late. No one wants to lose weeks to months of fun in the sun because of a lengthy rehabilitation. By taking care of these injuries now, you can have plenty of time to enjoy your favorite activities in the best kind of weather.

BACK INJURIES
From picking up leaves in the fall to shoveling snow, low back injuries are common this time of year. While a simple backache may dissipate in a day or two after shoveling out after a winter storm, if it lingers longer than a week, chances are it’s not going away on its own. Waiting until the first round of golf to find out that you can’t complete the backswing due to low back pain not only severely hinders the golf game, but can also severely hinder the recovery. The more chronic the pain is, the longer it takes to eliminate the pain once treatment is started. Pain management becomes more complex; muscle strength atrophies; and bad spinal mechanics become a difficult habit to break. Fortunately, from a simple muscle strain to a herniated disc, all low back injuries have the opportunity to be conservatively managed quickly if treatment is sought out quickly.

JOINT REPLACEMENTS
Fear of slipping and falling is often the biggest rationale people wait to have their much-needed joint replacement surgeries. While a legitimate concern, the process of recovery and length of time for recovery is often overlooked by patients. For a typical total hip replacement, it can take 12 weeks or more to feel “normal” again. For a total knee replacement, that timeline can extend to six months. By waiting until spring to have the surgery, patients forego their fun-in-the-sun for recovery and rehabilitation. However, if that same surgery were elected to be performed in the late fall or winter, then plenty of warm weather is still left in the year to enjoy the capabilities of the new joint. To address the fear of falling, simple precautions can easily be taken to minimize the risk of slip and fall in the snow following the surgery. As an added benefit, patients in the winter often experience less swelling than those in the summer, as a result of the reduced humidity.

ROTATOR CUFF REPAIRS
Similar to joint replacement surgery, shoulder surgeries are often avoided in the winter due to the fear of falling. However, again, similar to joint replacement surgeries, the length of time for recovery from this surgery is grossly underestimated. Returning to swing a golf club, throwing a ball, or even swimming laps in a pool will take a
minimum of 12 weeks of physical therapy. While a neighborhood teenager may need to be hired to shovel the snow, the winter hibernation season is an idea for resting and mending from a rotator cuff repair surgery. After completing a comprehensive rehabilitation program with your physical therapist, you will be ready to tee off with your regular golf league and enjoy your planned summer vacation without restrictions.

SPORTS EVALUATIONS AND CONDITIONING
Winter is not only the time to remedy nagging injuries, but it’s the perfect time to prepare for the athletic season ahead. Whether you are a runner, a golfer, or an over-40 league softball player, preparing for the upcoming outdoor activities can help prevent future nagging injuries. The “off-season” is the best time to undergo performance and biomechanical evaluations with a physical therapist trained in motion analysis. From this evaluation, deficiencies can be addressed and a plan for improvement implemented. Furthermore, winter is a perfect time to re-strengthen after the holidays and to condition yourself into the shape you need to be in in order to enjoy those outdoor activities and minimize the concern for strains and sprains. In just a few simple visits to physical therapy, conditioning tips and technique changes can help make the warm weather even more rewarding and enjoyable.

The winter is long and it would be unfortunate to miss enjoying any of the warm, sunny weather heading our way in a few months. Addressing lingering winter injuries now will help ensure a fun spring and summer without restrictions. Always discuss your medical options with your doctor first. Then, call your physical therapist to help accelerate your recovery and be a picture of health.

How To Safely Get In and Out of a Chair After Surgery

February 5, 2020 Teresa Stockton - Aging, Blog, Hip, Knee

After going through total replacement surgery, it can be difficult to move around. Shortly after discharge, but before outpatient physical therapy begins, most patients will be seen by a home health nurse or physical therapist. Their visits with you will focus on making sure the wound heals properly and that you are able to perform essential functions around the home. This can include bathing, getting in and out of bed, and even walking up and down the stairs. In this article, we want to focus on how you can safely get in and out of a chair after surgery.

One of the easiest things you can do is to choose to sit in chairs that are at an appropriate height for you. Your thighs should be parallel to the ground and your hips should NOT be lower than your knees. Avoid low chairs and overstuffed sofas and couches as much as possible. The ultimate goal is to be able to go from sitting to standing, vice-versa with even weight distribution on both legs.

How to sit down in a chair after surgery

Back up with your walker until you feel the chair with your legs
Slide your surgical leg forward. Reach back for the arm-rests one hand at a time.
Lower yourself using your arms and your nonsurgical leg.
Scoot back into the chair using your arms to assist.

How to get up from a chair after surgery

Avoid low chairs and chairs without armrests in your immediate post-operative phase.
Scoot to the edge of the chair keeping your surgical leg in front of you.
Push up using your arms and nonsurgical leg until you are standing. Do not pull up using the walker.
Reach out and take hold of your walker.
Make sure your balance is secure before you take your first step.

Whether you are working to safely get in and out of a chair after surgery, make sure you DO NOT pull up from the walker or sit down holding onto the walker.

The tips above will work in most cases, but not all. It is important to follow the advice and restrictions given to you by your health care provider. In our next post about how to safely manage movement after a hip or knee replacement, we will be covering the proper steps for getting in and out of chairs and the bed. We wish you all the best in recovery. If you are looking for an outpatient physical therapy clinic please stop by the Find a PT page.

How to Manage Movement after a Total Hip or Knee Replacement

December 11, 2019 Teresa Stockton - Aging, Blog, Hip, Knee

After going through total replacement surgery, it can be difficult to move around. Shortly after discharge, but before outpatient physical therapy begins, most patients will be seen by a home health nurse or physical therapist. Their visits with you will focus on making sure the wound heals properly and that you are able to perform essential functions around the home. This can include bathing, getting in and out of bed, and even walking up and down the stairs. In this upcoming series of blog posts, we will be showing you how to safely manage movement after a hip or knee replacement. We would like to begin by preparing your home before you go into surgery. We call it our pre-op prep!

Simple things you can do to make your home safer and more comfortable as you heal from a joint replacement.

Keep a cordless phone near you or carry your cell phone in your pocket.
Move furniture to keep a clear wide path to your kitchen, bathroom, and bedroom.
Remove throw rugs that may cause you to slip or trip. Tape down any loose edges of large area rugs that cannot be removed. Make sure extension cords are out of traffic areas or tape them down if needed.
Wear rubber-soled shoes to prevent slipping.
Keep commonly used items in your home at waist level within easy reach. This will prevent you from bending over to reach items. Use a reacher to grab objects and avoid excessive bending at the hip.
Make sure there is adequate lighting in the house. Add night lights in hallways, bedrooms, and bathrooms.
It may be helpful to have a temporary living space on the same floor if your bedroom/bathroom is located on the second floor of your home. Walking up/downstairs will be more difficult immediately following surgery and could increase your risk of falls.
Arrange for someone to collect your mail and take care of pets or loved ones if necessary.
Prepare frozen meals in advance to assist you with cooking.
Stock up on groceries, toiletries, and any medications you might need.
Purchase a shower chair or a tub bench will make bathing much easier. Do not take soak baths until your physician allows you to do so.
Install an elevated toilet seat. This will be helpful with toilet transfers and with following post-surgical precautions or guidelines.
Purchase assistive devices for dressing such as a reacher, extended shoehorn and/or sock aid may be necessary during your post-operative recovery.

After surgery, your health care provider will show you how to use a walker. Use your walker for as long as directed by your surgeon. This is important since the walker relieves some of the weight off of the leg and can protect it, even when just taking a few short steps.

Steps to take while using your walker on a level surface

Advance the walker
Step up to the walker with your surgical leg
Next, step forward with your nonsurgical leg
Make sure all four legs of the walker are in firm contact with the floor or ground.

How to use your walker while going upstairs

Place your walker sideways with the opening toward you.
Firmly grasp the stair rail with one hand and the walker with your other hand.
The walker’s legs should be against the stair riser with all four legs in contact with the stairs. (2 legs on the top step, 2 legs on the lower step)
Step up with your nonsurgical leg.
Follow with your surgical leg to the same step.

How to use your walker while going downstairs

Place your walker sideways with the opening toward you.
Firmly grasp the stair rail with one hand and the walker with your other hand.
The walker’s legs should be against the stair riser with all four legs in contact with the stairs. (2 legs on the top step, 2 legs on the lower step)
Step down with your surgical leg. Follow with your nonsurgical leg to the same step.

What is Causing Your Hip Pain?

July 7, 2017 Teresa Stockton - Blog, Hip

The hip is a large weight bearing ball and socket joint. We use our hips to help move our legs, and for the most part it’s stable and doesn’t give us a whole lot of trouble. That’s not the case for everyone however. Let’s take a look at hip pain and what the main culprits are.

The Most Common Types of Hip Pain
The most common type of hip pain is arthritis which literally means” swelling of the joint”. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are 3 types of arthritis that may ultimately require surgical intervention such as a hip replacement. Other traumatic injuries, birth deformity or childhood hip disease can also cause hip joint damage.

Osteoarthritis is caused by wear and tear of the joint and is typically seen in people 50 years or older. The articular cartilage becomes soft and wears down causing pain, loss of range of motion, and swelling.

Rheumatoid Arthritis is an autoimmune disease whereby your body’s immune system attacks your joints causing pain and swelling.

Traumatic Arthritis can occur following a severe hip injury or fracture. In this case, the trauma causes cartilage damage which can lead to hip pain and stiffness over time. Avascular Necrosis is a condition following a traumatic injury to the hip whereby the blood supply to the femoral head is compromised resulting in pain and damage to the articular cartilage.

For more information on hip pain or what to expect from hip replacement recovery check the articles below:

This article about hip pain was provided by PTandMe physical therapy partner: STAR Physical Therapy. More information about STAR Physical Therapy and their 65 locations throughout TN can be found on their website at www.STARpt.com

Can Your Feet Cause Pain in Your Knee, Hip or Back?

February 23, 2017 Teresa Stockton - Back, Blog, Foot, Hip, Knee

Can your feet cause pain in other areas of the body? Yes it can. The foot is an arch and arches decrease compressive forces by distributing them across the span of the arch. Engineers use arches in building and bridges to hold up greater weight across longer spans. The human foot has 3 arches that all work together to distribute the forces our bodies put on it. This allows us to walk, run and jump.

We start running into problems when the arch is either too flat or too high – causing the forces put through the foot to be abnormally distributed, resulting in strain.

Flat feet limit the range of motion of our ankle, causing our hips to rotate inward and move towards the center of our body.
High arches do the opposite to our hip joints.
These changes cause strain to our ankle, knee and hip joints, and our back.

People can be unaware that their feet cause pain throughout the body because they were born with flat feet or high arches and they do not know what “normal” feels like. As physical therapists we have treated many children who didn’t realize that their feet are not supposed to be sore. But instead of seeing them for prescribed foot pain, they come for pain in their joints or back.

Orthotics were developed to correct or adapt to changes in the foot. Orthotics should be fitted by a healthcare professional trained in assessing the foot and gait. Standing on a pressure plate in the store is not good enough. Why? If your foot hurts are you going to stand on it normally? Probably not. This results in an abnormal reading.

An orthotic by itself is not the best treatment. A physical therapist will assess your function, strength, flexibility and range of motion. Patients will present with other problems as the result of abnormal arches. Treatment with orthotics combined with strengthening and stretching exercises, balance training, functional training and manual therapy is necessary to restore full function.

Postoperative Physical Therapy

November 17, 2016 Teresa Stockton - Aging, Blog, Hip, Knee

Postoperative physical therapy after a Total Hip Replacement is essential to your recovery. Your physical therapist will follow your physician’s protocol and will focus on range of motion exercises, progressive strengthening exercises, gait training, balance training, and activity specific training to meet your specific needs. Modalities such as ice and e-stim may be used to help reduce discomfort and swelling. It is very important to complete your home exercise program as directed by your physical therapist and physician.

RANGE OF MOTION EXERCISES
Swelling and pain can make you move your knee less. Your physical therapist can teach you safe and effective exercises to restore the range of motion to your knee so that you can perform your daily activities.

STRENGTHENING EXERCISES
Weakness of the muscles of the thigh and lower leg is typical after surgery. Your physical therapist can determine the best strengthening exercises for you with the goal of no longer needing a cane or walker to walk.

BALANCE TRAINING
Specialized training exercises can help your muscles “learn” to adapt to changes in your world such as uneven or rocky ground. When you are able to put your full weight on your knee without pain, your physical therapist may add agility exercises so that you can safely and quickly change directions or make quick stops or starts. They may use a balance board that will challenge your balance and knee control. These exercises will be safe and fun.

GAIT TRAINING
Your physical therapist will work with you in retraining your gait following your surgery using appropriate assistive devices such as a walker or cane. They will make sure that you will be able to safely and confidently go up and down stairs, negotiate curbs, and inclines, etc.

ACTIVITY SPECIFIC TRAINING
Depending on the requirements or your job or the type of recreational activities you enjoy, your physical therapist will tailor your program so that you can meet your specific demands.

This article about postoperative physical therapy was written by STAR Physical Therapy, an outpatient physical therapy group with over sixty locations in Tennessee. Established in 1997 with one clinic and one mission – to serve. Today, they have grown to offer that direct service in more than 60 clinics, and while they’ve grown, one thing that has not changed is their commitment to you, their communities, and their employees. For more information click here.