Tag Archives: knee

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.

PT News

September 26, 2017 Teresa Stockton - Blog, PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. Foot Pain in Dress Shoes
Written by the Therapy Team at the Jackson Clinics Physical Therapy – Northern Virginia

Have you ever had a long anticipated night on the town spoiled by sore feet? The source of your discomfort just might be those pretty shoes you have chosen to wear. Read more

2. Knee Pain… Could it be Patellar Tendinitis?
Written by the Therapy Team at Denali Physical Therapy – Anchorage, AK

What is Patellar Tendinitis?
The patellar tendon is a ligament that connects the shin bone to the patella that helps the muscles extend the knee. Read more

3. ARC Physical Therapy+ Expands with a New Clinic in Urbandale, Iowa
Written by the Therapy Team at ARC Physical Therapy – Urbandale, IA

ARC Physical Therapy+ is pleased to announce the opening of a new clinic in Urbandale, Iowa on September 25^th, 2017. This makes the third ARC Physical Therapy+ clinic in Iowa and the 18^th clinic across Iowa, Missouri and Kansas. Read more

PT News

September 6, 2017 Teresa Stockton - Blog, PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. Does Wearing a New Knee Brace Help?
Written by the Therapy Team at the Jackson Clinics Physical Therapy – Northern Virginia

As the largest joint in the body and because of its exposed position, the knee is especially vulnerable to injury during sports activities. Read more

2. Is Apple Cider Vinegar the Remedy You Need?
Written by the Erin Clason, PT at the Center for Physical Rehabilitation and Therapy – Grand Rapids, MI

Apple cider vinegar (ACV) has been used for centuries as a folk remedy to treat everything from warts and the common cold to acid reflux and arthritis. Read more

3. Therapeutic Ultrasound
Written by Angeline Peterson, PT at Intermountain Physical Therapy and Hand Rehabilitation – Meridian, ID

“Are you checking for a foot baby?” That question is not one you may hear very often and may spark further conversation. Read more

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:

PT News

March 28, 2017 Teresa Stockton - Blog, PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. Exercise after Knee Replacement Surgery
Written by the Therapy Team at Cornerstone Physical Therapy – Gahanna, OH

If you’ve been undergoing treatment for knee arthritis and haven’t gotten any pain relief yet, your doctor may recommend a total knee replacement surgery. Read more

2. Low Back Pain and Sciatica Workshop
Written by the Therapy Team at Oregon Spine & Physical Therapy – Eugene, OR

If you are suffering with chronic back pain or sciatica and you’re looking for some help… why don’t you start by attending one of our Educational Workshops so you can make a better, more educated and more informed decision about your options to ease it. Read more

3. Inflammation and Your Diet
Written by Cheryl Schwieters, Physical Therapist Assistant at the Center for Physical Rehabilitation – Grand Rapids, MI

Throughout the day the body is constantly being bombarded with substances that can trigger inflammation. Read more

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.

Self-Care: Safe Positions & Movement After Knee Surgery

August 11, 2016 Teresa Stockton - Blog, Knee

ACTIVITY GUIDELINES
Recovering from knee surgery does not have to prevent you from moving or taking care of yourself. Listed below are guidelines on how to do some common movements and activities without hindering the healing process.

SLEEP & POSITIONING
• It is very important that when recovering from knee surgery you get enough rest following your surgery. If you cannot get comfortable in your bed, please talk to your therapist.
• Sleep on a bed with a firm mattress. Ideally, the bed should come up to your mid-thigh while you stand.
• Sleep flat on your back and position your leg so your toes and kneecaps point at the ceiling.
• Do not place pillows under your operative leg. If you wish to elevate your leg, support the whole leg with pillows while keeping the knee straight.

Sitting Up In Bed:
• If possible, get out of bed toward non-operated side so that the operated leg is supported as much as possible.

From Sitting on the Side of the Bed to Standing with the Walker:
• Straighten the operated leg in front of you before standing.
• Ensure you have good sitting balance with the walker close in front of you.
• Push up from the bed with both hands and keep weight on the non-operative leg.

From Standing to Getting Into Bed:
• Sit down on the edge of the bed; place at least one hand on the bed as you lower yourself. Remember to keep the operated leg further ahead to avoid straining it.
• Enter your bed leading with the operated side if possible.
• Bring your legs onto the bed while lowering your upper body with your hands then elbows.

BATHING/SHOWERING:
You may shower in a bathtub or shower stall only after your doctor has given their permission.

Getting Into the Tub to Take a Shower:
• Have the tub bench or tub chair placed in the direction facing your shower faucets.
• Using your walker, back up to the bench.
• Reach back with one hand to the bench and sit down with your legs outside of the tub.
• Place one leg at a time into the tub.

Getting Out of the Tub:
• While seated on the tub bench/chair turn your body and place your legs one at a time outside of the tub.
• Push up from the tub bench and stand using both hands on the walker.

TOILET TRANSFERS:
When recovering from knee surgery the low surface may cause excessive painful bending at the knee. If this is the case, your therapist may help you with getting a raised toilet seat or a three-in-one commode that can be used over your toilet.

Getting Up and Down From a Toilet:
• Back up to the toilet.
• Reach back for the armrests/raised toilet seat/seat.
• Slide your operated leg slightly forward and lower yourself slowly onto the toilet.
• To stand, use a grab bar or place your hand at the middle of the center bar of the walker.
• Stand up and get your balance before placing both hands on the walker.

DRESSING:
• Put on your top or shirt as you normally would while seated.
• Do not twist the knee too much when dressing or putting on shoes.
• Your therapist may recommend a sock aid, dressing stick, reacher or long-handled shoe horn to help with dressing.

STAIRS:
You should only try to go up or down stairs when your doctor or therapist says it is okay. Do not try to use stairs while using a walker.
• When going up the steps, first step up with your non-operative leg, followed by the operative leg.
• When going down steps, first step down with your operative leg, followed by the non-operative leg.
• Complete only one step at a time and always have help.

CAR TRANSFERS:
While you are recovering from knee surgery you will need someone to help you with getting in and out of the car for both your safety and comfort. The seat would ideally be at the height of your mid thigh. Avoid cars with low or bucket seats.
• Have someone slide the seat back as far as possible prior to entering the car, preferably on the front passenger side.
• Slightly recline the seat back if possible.