Category Archives: Knee

How to Remain Active with a Knee Injury

January 9, 2019 Teresa Stockton - Blog, Knee

In the U.S., ACL and other knee injuries are one of the most common orthopedic and sports-related injuries. For athletes, physically-active folks, and health-conscious individuals, suffering a knee injury can be particularly difficult as they find themselves suddenly immobilized, with minds craving for exercise. Fortunately, as with any injury, there is always something that can be done. As your knees heal, you need only to modify and adapt your training regimen and lifestyle so that you don’t lose the hard-earned strength, stamina, and sport-specific fitness that you’ve so far acquired.

Consider the following 3 tips on how to remain active with a knee injury and keep yourself in the proverbial game.

Tips to Remain Active

1. Find the Right Exercise Regimen

Knee or ACL injuries are particularly problematic as most endurance exercises, and many strength training activities, require activity and flexion in the knees. Thankfully, an injured knee should not keep you bedridden and away from any physical activity. There are still many other activities that you can do to stay active and physically fit, and even recuperate faster.

You do have to be smart about choosing the exercises and always (always!) consult your doctor, physical therapist, or other medical professional. Depending on the severity and extent of your injury, they may recommend a variety of exercises and activities and keep you from exacerbating your condition.

Knee-Friendly Cardio

It’s difficult to think of cardio exercises that do not require flexion and extension of your knees. You may have to wait until you’ve fully recovered to run, jog, or hike again. Nevertheless, you still have many other options for cardio that do not require one knee (or two). Ask your doctor about kayaking, one-legged cycling, rowing, or using an arm ergometer (the handcycle machine).

You could even try swimming, which is a favorite of many with joint or muscle issues! Of course, you’ll need some support or a buoy to keep you from kicking with your legs. Check your local swimming pool if hydrotherapy classes are available. As soon as you are able and approved by your physical therapist, return to doing regular walks, but keep them light and short.

Keep Flexibility and Strengthen Other Muscle Groups

Along with cardio, remember to keep your flexibility and strength up as well. Although you should expect some muscle loss in and around your problem knee, you can still train your other muscle groups.

Again, consult your doctor or a physical therapist before attempting any strength training methods. Depending on your condition, your PT may recommend assisted bench presses for your chest and arm muscles, Lat pulldowns or seated cable rows for your back, presses for your shoulders, as well as appropriate core exercises for your abs and obliques. You may also inquire of their recommended repetition and load for each exercise.

With strength training also comes the importance of flexibility exercises. These activities will keep you nimble, lower risk of injury, and make for more efficient muscles.

Always Warm Up thoroughly

Whatever physical activity you end up doing, never forget to warm up. The proper warm-up techniques deter injury and prepare you both physically and mentally.

2. Wear the right gear

You’ll also need to pay closer attention to your exercise gear whenever you’re physically active. Although you won’t be training your knee directly, a good supportive shoe that absorbs impacts will be invaluable to your recovery.

Another crucial accessory for staying active with an injured knee is a good compression knee brace. Look for the best compression knee brace you can get and find the one that suits your particular injury best. Compression knee brace gives added support to the knees, reduces swelling, relieves pain, increases blood circulation, and aids in the healing process.

You could also give resistance bands a try, particularly when your weight training or stretching. These will help reduce any pressure on your knees.

3. Focus on other healthy habits

An active mind will motivate you to stay physically active as well. Of course, you won’t get as much exercise as before, at least not until you fully recover. Thus, in the meantime, you can set your mind to other healthy activities. For example, now would be a great time to improve your diet and sleep routine. Find a good diet that will help you maintain and keep the weight off (or lose, depending on your doctor’s orders.

Getting better quality sleep is paramount regardless if you’re injured or not. In fact, it’s as important as exercise and diet for a healthy and active lifestyle.

Final Thoughts

No one wants to lose all the progress and fitness gains they’ve made when they’re injured. And with the right mindset and determination, you won’t have to. Find the right exercise, equip yourself with the right gear, and focus on other healthy habits. Give some time to healing and rehabilitation. You’ll be jumping again before you know it. Never let an injury discourage or demotivate you from reaching your health or fitness goals.

About The Author
Aaron Burns is the Owner and freelance writer for Apex Health & Care. A site dedicated to informing and educating people about the right products to support their injuries. Aaron discovered his passion for health and fitness at the young age of 9, after spraining his ankle during a weekly soccer match. He was forced to wear custom orthotics (thanks, flat feet!) and ankle braces to avoid re-injuring his ankle. This childhood experience spurred his passion for writing content surrounding the themes of health, fitness and nutrition. He hopes to aid people of all ages in their endeavor of remaining happy, healthy and mobile as they grow older.

How Physical Therapy Helps Knee Rehabilitation

January 3, 2018 Teresa Stockton - Blog, Knee

Physical therapists can provide more than pre/post surgical knee rehabilitation for patients experiencing knee pain.

What Causes Knee Pain?
The knee is a relatively simple joint required to do a complicated job…to provide flexible mobility while bearing considerable weight. While walking down the street, our knees bear three to five times our body weight. When the knee is overstressed in sports or in everyday activities, these structures can break down — and a knee injury occurs.

Common Knee Problems Seen by Our Physical Therapists:

Strain / Sprain
Arthritis Pain
Muscle Weakness
Ligament Sprains
ACL Tears
Tendinitis (ie: Patellar, Pes Anserinus)
Chondromalacia Patella
Patellofemoral Syndrome / Knee Pain
Pre / Post Operative Therapy

How Physical Therapy Provides Knee Rehabilitation
Rehabilitation acutely after knee surgery or a knee injury primarily centers around decreasing swelling in the knee joint. Even a small amount of fluid inhibits the quadriceps muscle on the front of knee by slowing the signal for movement traveling from the brain to the muscle. Manual techniques to decrease muscle spasm and improve length tension relationships of soft tissue are also incorporated. Gradually, exercises to increase strength, range of motion and functional mobility are introduced.

Treatments Offered Include:

Comprehensive evaluation with an emphasis on determining the source of the problem
Individualized and specific exercise programs
Manual therapy (hands-on treatment)
Modalities as needed
Work and sport specific simulations
Progressive home program to help restore independence and self-management

Knee Rehabilitation Goals:

Reduce Pain
Improve Mobility
Movement Awareness/Gait Training
Functional Strength
Patient Education

For more information on knee injuries visit our PT & Me Knee Injury Center page by clicking here.

The PT & Me Injury Center goes over diagnoses on how physical therapists treat specific injuries.

To find or search for a local participating PT & Me physical therapy clinic in your local area please click here.

Common Causes of Knee Injuries

November 15, 2017 Teresa Stockton - Blog, Knee

While most of us take our knees for granted, injuries can occur quite easily and for a variety of reasons. Only when you suffer a knee injury, do you realize how much we rely on these joints on a day to day basis. Knee injuries cause discomfort and pain, but that’s not all. They can also be extremely debilitating and in serious cases, result in dramatically reduced mobility. So let’s take a look at some of the most common causes of knee injuries, and what to do in case you experience one.

What Are the Most Common Knee Injury Causes?

Well, there are a number of them – some more serious than others. Let’s take a look at some of the most common ones!

Fractures: Fractures are very common knee injuries and can affect the patella, which is the most commonly fractured bone around the knee. Fractures can also affect the ends of the tibia and femur in the area where they come together to form the knee joint. Incidents such as serious falls and road traffic accidents are common causes of fractures. And sometimes even the best knee brace for running or other sports won’t be able to prevent a fracture.
Dislocated knee: Knee dislocation is another common knee issue and it occurs when the knee bone is either partially or totally out of place. This could include the patella slipping or the femur and tibia sustaining injury that forces them out of alignment. Various different sports activities as well as falls and other high impact trauma can cause this injury.
Torn ligament: Tearing of the anterior cruciate ligament is also a common type of knee injury. This is more common among those that take part in athletics and sporting activities. Some of the common causes of this injury include a rapid change in direction when running or incorrectly landing from a jump. In many cases, this sort of injury also comes with additional injuries to the cartilage.
Torn tendons: This type of injury is more common among older people, particularly those who are active runners or do any sports that require a lot of running. The tendons of the patella can become stretched and then torn during this type of activity. Direct force to the front of the knees, falls, and incorrect landing following a jump are all common causes of a torn tendons.

There are many different causes of knee injuries, but usually they involve some sort of high impact trauma. This is why these types of injuries are often sustained by athletes as well as people who are keen on physical activities. Falls, incorrect landings following a jump, and the twisting of the knee can all cause various different knee injuries.

The knees are among the most easily injured joints in the human body, and also one of the most common reasons for people seeing their doctor. So in the event of a knee injury, no matter what the cause, it is important to seek medical advice because a knee injury can escalate from simple twisting of the knee to a dislocation or worse pretty quickly. Because the treatment for a knee injury varies based on the severity as well as the type and cause of the problem, ranging from medication and physical therapy to even surgery, consulting a medical professional is the first step to treating your knee successfully.

More information about common knee injuries can be found in the PTandMe injury center.

Physical Therapy Following a Total Knee Replacement

October 12, 2017 Teresa Stockton - Blog, Knee

There are over 600,000 total knee replacements done each year in the U.S. As the workforce ages and as obesity levels continue to rise, this number is expected to increase.

Candidates for a knee replacement include patients experiencing difficulty doing simple daily activities, including walking or going down steps, and where conventional treatments are no longer helping. Common causes that lead to a replacement include pain with simple ADL’s (activities of daily living), pain at rest, chronic swelling, inflammation not improving with medication, knee deformity, knee stiffness, or trauma to the joint. When you are scheduled for a total knee replacement, ask to see your physical therapist for a pre¬surgical exercise and stretching program. This will help your knee recover its range of motion and strength.

Surgery consists of resurfacing the knee’s damaged and worn joint surfaces with artificial parts made of metal or plastic. Most patients are in the hospital for an average of 3¬5 days. And more than 90 percent of people report significant decrease in pain and improvement in ability to perform ADL’s within one month after surgery. Currently, many knee replacements are lasting 20 years or more with appropriate activity modification. One of the most important factors in success after a total knee replacement is follow up with physical therapy and a lifelong exercise program. Physical therapy typically starts during the hospital stay with the goals being to get the individual up and walking decreasing swelling in the knee and increasing knee ROM (range of motion). Upon hospital discharge, patients either go home and receive home physical therapy for one to two weeks, or to an extended care facility to continue their therapy.

Typically, patients need outpatient physical therapy after therapy at home, which usually begins two to four weeks after surgery. Outpatient physical therapy is recommended for three times a week for up to three months. Therapy goals initially are to reduce swelling and pain, and improve knee range of motion in both directions. To achieve these goals, treatment may consist of soft tissue massage to increase circulation and decrease swelling, stretching to improve flexibility, patellar mobilization, range of motion exercises, and modalities such as ice and electrical stimulation to help decrease pain and swelling. Physical therapy will progress to lower extremity strengthening exercises, balance activities, and fine tuning the gait pattern. Various activities and techniques will be used to improve strength, balance, and gait. As patients reach the end of their course of physical therapy, a personalized home exercise program is developed with the focus on independence with all ADL’s and returning to activities such as walking, swimming, dancing, golf, and biking. It is important for patients to stay active and maintain strength, flexibility, and endurance.

PREHAB Move to Improve Your Goals: Total Knee Replacement

August 8, 2017 Teresa Stockton - Aging, Blog, Knee

PREHAB Home Preparation
Before total knee replacement surgery there are a few simple things you can do in your home to make it safer and more comfortable during recovery.

Consider keeping 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 sole 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 knee.
Make sure there is adequate lighting in the house. Add night lights in hallways, bedrooms, and bathrooms.
It may be helpful to have temporary living space on the same floor if your bedroom/bathroom is located on the second floor of your home. Walking up/down stairs will be more difficult immediately following surgery and could increase your risk for 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 needed medications you might need.
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.
An elevated toilet seat will be helpful with toilet transfers and with following post surgical precautions or guidelines.
Assistive devices for dressing such as a reacher, extended shoe horn and / or sock aid may be necessary during your post operative recovery.

While it’s important to prepare your home before surgery, PREHAB should also include physical therapy. Physical therapists will work with patients to create an exercise program before surgery that can help improve performance and decrease recovery times after a total knee replacement. Talk to a PT near you and learn about the benefits of PREHAB before total joint replacements.

Total Knee Replacement Prehab: Move to Improve Your Outcomes

April 20, 2017 Teresa Stockton - Aging, Blog, Knee

Many people with arthritis favor their joints over time in an effort to relieve pain and thus become weaker in their leg muscles or lose range of motion. However, the better shape you are in before surgery the better your results will be after surgery so it is important to strengthen your leg muscles and work on your range of motion. Before surgery your physical therapist will teach you appropriate exercises to help improve strength, range of motion, and balance. They will also teach you how to walk with an appropriate assistive device such as a walker or cane in the immediate post operative recovery period. Finally, they will discuss precautions and advise you in a few short term home adaptations such as removing loose rugs to help make your recovery easier and safer.

Prehab Goals
• Develop an exercise program with your PT to help you
• Improve strength
• Improve range of motion
• Improve balance
• Gait training — Review walking with an appropriate assistive device such as a walker or cane in the immediate post operative recovery period
• Discuss precautions and review a few short term home adaptations that can help make your recovery easier and safer

Pre Surgery Exercise Plan
Make every effort to begin these exercises as early as possible before your surgery. Only do what you are able to do without increasing your pain. It is important for you not to exacerbate your pain prior to surgery. Ice packs for 15 minutes following your exercises may be helpful to reduce any soreness in your knee.

This information was written by STAR Physical Therapy, an outpatient physical therapy group with 60 locations in Tennessee, offering more than 15 comprehensive specialty services. STAR Physical Therapy was established in 1997 with one clinic and one mission – to serve. Today, they’ve grown to offer that direct service in more than 60 clinics. 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.

More about knee replacements and physical therapy can be found here:

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.

Common Ice Hockey Injuries

January 31, 2017 Teresa Stockton - Blog, Knee, Sports and Fitness

Ice hockey is one of the most popular sports played in North America. Physical therapy can provide specific treatment to a number of specific ice hockey injuries. Here are a few injuries that can happen during a hockey game or practice:

Common Ice Hockey Injuries

BACK INJURIES
Hockey players are at risk for low-back injuries due to the flexed (forward) posture of skating and the frequent hyperextension (backward) stress. Low-back pain and/or a pulled muscle are the most common injuries. Stretching of the hip flexors along with strengthening of the back and abdominal muscles will help avoid these injuries.

HIP INJURIES
The hip joint and groin muscle are susceptible to injury due to the mechanisms of the skating stride. Some of the most common soft tissue injuries in hockey players include a groin strain and a hip flexor strain. Off-season strengthening and dedicated stretching before and after practice are important to prevent these injuries. In addition, a direct blow to the outside of the hip can cause a hip pointer or trochanteric bursitis. Hockey pants with reinforced padding over these areas may help protect them.

KNEE INJURIES
The medial collateral ligament is the most susceptible to a sprain because of the leg position – pushing off the inside edge of the skate blade – and contact to the outside of the knee. Anterior cruciate ligament (ACL) disruption and meniscus tears (torn cartilage) can also occur but are less common in hockey that in other sports such as football, soccer and basketball.

SHOULDER INJURIES
The most common shoulder injuries in hockey are a shoulder separation and a broken collarbone. These injuries occur from direct contact of the shoulder with another player, the boards or the ice. Treatment can include a sling, rest and in serious cases surgery.

ELBOW INJURIES
The point of the elbow is a frequent area of contact, which can result in the development of bursitis. Thick and scarred bursal tissue (which feels like bone chips, but isn’t) can be a source of recurrent inflammation. The best prevention method is wearing elbow pads that will fit well and have an opening for the elbow, soft padding and a plastic outer shell.

WRIST INJURIES
A fall on the outstretched arm or contact with the boards that forces the wrist up or down, may cause a fracture. Players should try bracing themselves against the boards using their forearms instead of their hands.

Trigger Point Dry Needling

December 6, 2016 Teresa Stockton - Back, Blog, Foot, Knee, Manual Therapy, Shoulder

Dry needling uses small, thin needles to stimulate underlying myofascial trigger points, muscular and connective tissues for the management of many orthopedic conditions, both acute and chronic. By inserting a needle into the dysfunctional tissue, it often leads to a contraction of the muscle which then stimulates a relaxation. This leads to a reduction of pain, improvements in flexibility and a restoration of normalized movement when combined with corrective exercises.

WHAT IS A MYOFASCIAL TRIGGER POINT?
A myofascial trigger point is a hyperirritable spot within a taut band of skeletal muscle that produces local or referred pain. The trigger point can lead to increased pain, decreased flexibility and decreased muscle function if not treated. Trigger point dry needling is a safe, effective and efficient treatment technique to release these painful spots.

WHAT TYPE OF PROBLEMS CAN BE TREATED?
Muscle dysfunction can be the primary or secondary contributing factor to many neuromusculoskeletal conditions.

WHAT YOU NEED TO KNOW:
• Dry needling must be specifically prescribed by a physician.
• Dry needling is not covered by insurance, it is a cash based modality.

This information was written by The Jackson Clinics, a locally owned physical therapy practice in multiple locations throughout Northern Virginia. They specialize in outpatient orthopedics and sports rehabilitation. Their therapists and assistants possess advanced clinical skills in spinal disorders, sacroiliac joint dysfunction and peripheral joint problems, including rotator cuff injuries, knee injuries and foot and ankle pain. They also also have specialty programs in breast cancer rehab, vestibular rehab, pediatrics, post-cancer rehab, aquatic therapy and women’s health. For more information click here.

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.