Physical Therapy is beneficial for numerous reasons, but MoveForward tells us how it can “Improve Mobility and Motion.” Come visit us at San Diego Sports Physical Therapy to see how physical therapy can benefit you today!

No matter what area of the body ails you – neck, shoulder, back, knee – physical therapists have an established history of helping individuals improve their quality of life.

A physical therapist can help you move freely again without pain and discomfort and feeling renewed and ready to move on. They can even help you prevent an injury altogether.

For instance, a study of 1,435 NCAA Division 1 female soccer players demonstrated that those who participated in a physical therapy program had an overall ACL injury rate 41 percent lower than those who did only a regular warm-up prior to practice.1

Because physical therapists receive specialized education in a variety of sciences – physics, human anatomy, kinesiology (human movement), to name a few – they understand how the body works and how to get you moving again. They know how to manage all four of the body’s major systems – musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary (skin) – to restore and maximize mobility.

Whether you are living with diabetes or recovering from a stroke, a fall, or a sports injury, a physical therapist is a trusted health care professional who will work closely with you to evaluate your condition and develop an effective, personalized plan of care. A physical therapist can help you achieve long-term results for many conditions that limit your ability to move.
Reduce the Risk of Injury

While playing a round of golf or picking up around the house may seem harmless, but these everyday activities can result in injury due to abnormal movement, stress on joints and strain on muscles.

Because physical therapists are experts in knowing how the body works, they are able to design personalized treatment plans to reduce the risk of injury whether in everyday activities or sports.

For example, women perform athletic tasks in a more upright position, putting added stress on parts of the knee such as the ACL, resulting in less controlled rotation of the joint. While men use their hamstring muscles more often, women rely more on their quadriceps, which puts the knee at constant risk. To combat these natural tendencies, your physical therapist may develop a treatment program to improve strength, flexibility, and coordination, as well as to counteract incorrect existing patterns of movement that may be damaging to joints.
Improve Balance and Prevent Falls

Falls among the elderly are prevalent, dangerous, and can diminish their ability to lead an active and independent life. According to the National Aging Council, about one in three seniors above age 65, and nearly one in two seniors over age 80, will fall at least once this year, many times with disastrous consequences. A physical therapist can help you prevent falls by designing an individualized program of exercises and activities with an emphasis on strength, flexibility, and proper gait.

Balance may be improved with exercises that strengthen the ankle, knee, and hip muscles and with exercises that improve the function of the vestibular (balance) system.

Once a physical therapist has reviewed a complete medical history and conducted a thorough examination, he or she will develop a personalized plan of care. This may include a walking regimen with balance components such as changes in surfaces/terrains, distance, and elevations; Tai Chi (which emphasizes balance, weight shifting, coordination, and postural training); and aquatics classes geared toward balance and coordination. The physical therapist also may teach specific strengthening and balance exercises that can be performed at home. If necessary, the physical therapist will refer you to other medical professionals, such as an ophthalmologist or neurologist.
Recover From Stroke

Stroke is the number three cause of death in the U.S,2 and the leading cause of serious long-term disability. If stroke strikes you or a loved one, a physical therapist can help you regain function and cope with physical losses associated with stroke, such as decreased ability to move.

Rehabilitation begins as soon as the stroke survivor is stable, and the health care team works to match patient and family desires with patient abilities. The majority of survivors of stroke will receive physical therapy as part of the rehabilitation process. Your physical therapist will develop an individualized treatment plan which may include prescribing exercise and other activities to improve movement, help facilitate independence, and regain your quality of life after stroke.

Recent advances in neuroscience have had a significant impact on rehabilitation for stroke survivors. As part of research funded by the National Institutes of Health, scientists who are physical therapists are determining how new techniques can help promote motor recovery after a stroke. For example, physical therapists are using methods such as restricting the arm that was less affected by the stroke to encourage more effort from the affected arm. Treadmill training with the use of body-weight support and the assistance of a physical therapist can help people recover walking ability.

If you have problems with movements of the arm or leg that affect your everyday function, a physical therapist can help determine if you are an appropriate candidate for these and other innovative physical therapy interventions.
Live With Diabetes

Diabetes is a growing health issue that affects approximately 24 million adults and children in the United States.3 If you have diabetes, a physical therapist can work with you to design a program that helps control your glucose and fight complications such as loss of movement. While aerobic exercise is often recommended for the treatment of type 2 diabetes, a recent study found that adding high-force strength training to an aerobic program offered significant advantages, helping to improve glucose control, increase strength, and reduce the risk of falls among study participants.

People with diabetes often have reduced muscle mass, and, as a result, mobility. Adding resistance training to a diabetes treatment program leads to improved thigh lean tissue which, in turn, may be an important way to increase resting metabolic rate, protein reserve, exercise tolerance, and functional mobility. As experts in motion, physical therapists are ideally suited to help people with diabetes safely and effectively address their loss of movement.

References

1 American Journal of Sports Medicine August, 2008

2 American Heart Association

3 American Diabetes Association

The knees and hips take a lot of impact on a day to day basis. Take a look at this article by Nelson Marquez, PT, EdD, and come visit San Diego Sports Physical Therapy for your knee and hip pain today!

As a weight-bearing joint, the knee sustains the most overuse injuries, making knee dysfunction the most commonly referred condition to orthopedic physical therapy practices. During the American Physical Therapy Association Annual Conference & Exposition here in June, Christopher Powers, PT, PhD, and Amy Sanderson, PT, OCS, presented biomechanical evidence that supports their assertion that knee injuries are linked to proximal factors that can influence knee loading.

A focus on these factors may hold the key to an effective knee injury rehabilitation program compared to current traditional treatments that do not take into account any proximal muscle weaknesses, they pair said.

Compensation factors

Powers and Sanderson said that hip muscle weakness and impaired trunk proprioception and deficits in trunk control are predictors of knee injuries. They provided a thorough functional biomechanical analysis of the pelvis, hip and knee during walking and running in order to show a link between abnormal hip mechanics and knee injuries.

“The most interesting part of the discussion is the focus on running and its biomechanical demands on the body,” said Shannon Ryals, PTA, academic coordinator for clinical education at Polk State College, Winter Haven, Fla., an attendee at the presentation. “Specifically, the speakers’ analysis of mid-foot strikers versus heel strikers and the shock absorption of each running style provides helpful information that can be used when you work with runners, athletes engaged in sports that require a lot of running, or those who would like to take up running.”

Powers, associate professor at University of Southern California’s Division of Biokinesiology and Physical Therapy, emphasized that during normal gait, there is a pattern of hip flexion, adduction and internal rotation during the loading response phase of walking. However, during higher-demand activities, such as running or jumping, these patterns are increased significantly, causing the knee joint center to move medially relative to the foot, which is in a fixed position on the ground. The inward movement of the knee joint causes the tibia to abduct and the foot to pronate, resulting in what the speakers called dynamic knee valgus.

Excessive knee valgus has been shown to be linked to diminished hip muscle strength, particularly the hip extensors, and overuse of the quadriceps, they said. “These factors contribute to numerous knee injuries, such as anterior cruciate ligament injuries and patellofemoral joint dysfunctions,” Powers said.

Powers pointed out that with a concomitant hip abductor weakness, pelvic stability is compromised. To compensate, patients with hip abductor weakness tend to elevate the contralateral pelvis and lean the trunk towards the stance limb. This tendency is called compensated Trendelenburg gait. It tends to have a negative consequence to the knee, increasing the valgus moment at the joint and tensile strain to the ACL and medial collateral ligament.

The speakers also traced the link between weakness of the gluteus maximus muscle and overuse of the hamstrings and adductor magnus muscles to compensate for the weakness. Biomechanical analysis revealed that such weakness results in increased hip adduction. The speakers also presented an analysis of the overuse of the tensor fascia lata to compensate for the weakness of the gluteus medius, resulting in increased hip internal rotation. Powers mentioned that these combinations of muscle weaknesses and compensations contribute to the medial collapse of the knee during high-demand activities.

Evaluation and treatment implications

The speakers presented evidence that impairments at the hip may adversely affect knee joint mechanics. They proposed that physical therapists conduct dynamic evaluations of patients with various knee conditions, assessing the entire lower chain and paying close attention to both proximal and distal kinetic and kinematic factors that may contribute to patients’ symptoms and dysfunctions. In addition, they proposed that therapists evaluate the conditions under which the symptoms arise. This entails taking into account the influence of speed and fatigue to when symptoms arise or get exaggerated.

As far as clinical implications, two general principles were presented that can be incorporated in the design of a knee injury intervention program: pelvis and trunk stability and dynamic hip joint control.

Powers theorized that improving hip abductor muscle performance will result in optimal alignment of the pelvis during single-limb activities and protect the knee joint from excessive varus moments created by trunk compensations due to hip abductor weakness. He also emphasized that the development of core programs should consider dynamic pelvis stability as an integral aspect of the training protocol. In addition, the gluteus maximus, shown to be well-suited to protect the knee from proximal movement dysfunctions, should also be considered in the training protocol. “Improving its use may serve to unload the knee by decreasing the need for compensatory quadriceps action to absorb impact forces,” Sanderson said.

Ryals said he couldn’t agree more. He said Powers and Sanderson provided newer dimensions on how to assess and manage knee injuries. He said that the general principles that the speakers suggested to incorporate in the treatment of knee injuries is a departure from commonly selected treatments for knee injuries, which consist of heat or cold modalities, vastus medialis oblique retraining and strengthening, as well as knee taping. “It makes knee dysfunction treatments truly evidence-based rather than based on a recipe or a trial-and-error approach and waiting to see what works best,” Ryals said. He also said that he learned that the emphasis on quadriceps strengthening, without addressing hip extensor muscle weakness, may facilitate increased quadriceps overuse that can be detrimental rather than therapeutic for patients with knee problems. •

Nelson Marquez, PT, EdD, is physical therapy editor of Today in PT.