Knee Pain? Solution: Work your glutes.

Many of us will experience different degrees of knee pain at least once in our lifetime. Factors that can affect the level of knee pain include: faulty movement patterns, muscle force and/or length, posture/alignment and physical activity (occupational, recreational, self-care activities). Many health practitioners choose to treat just the symptoms of knee pain; using modalities such as kineseotape, medication, ultrasound, and inconsistent massage which offer short term relief. To treat the underlying mechanisms of knee dysfunction it is prudent to include: therapeutic exercises to strengthen the glute maximus/medius muscles; self myofascial release with foam roller of quadriceps, hip flexors and gastrocnemius/soleus complex; corrective exercise to improve faulty movement patterns; and manual therapy such as joint mobilization.

After taking a continuing education course on Functional Biomechanics of the Lower Quarter taught by Christopher Powers, PhD, PT and Co-Director of Musculoskeletal Biomechanics Laboratory at U.S.C., I realized the relationship between hip/glute weakness and knee pain. Hip motions that can influence the knee are femoral internal rotation and adduction. These motions if unchecked by strong glute maximus/medius muscles will cause a Genu Valgus (knocked knee) stress on the knee complex. This hip extensor/abductor weakness combined with quadriceps overuse will cause increased patella-femoral joint reaction forces and thus knee pain.

Many personal trainers and even physical therapist would incorrectly treat knee pain with numerous quadriceps strengthening exercises, but this inherently leads to more quadriceps overuse and thus no significant improvement in knee symptoms. Therapeutic exercises to strengthen glute maximus/medius include: bridging, sidelying hip abduction with external rot/extension, quadruped hip motions, single leg stance activities with progression to functional/dynamic movements that require hip/knee stability.

Physical Therapy or Chiropractic, how do you choose?

If you are in pain from a recent injury or chronic condition, how do you decide which healthcare professional will get you the best results and help you manage your symptoms independently. Below are vision and mission statements of both the American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA). Both professions tout: collaborating with other health care practitioners; promoting change in public policy and legislature, giving the most value per health dollars spent on care; and access equity for the consumer.

The APTA Vision Statement however distinguishes itself by establishing what will be the primary guiding system used to achieve results (The Movement System) and focusing on Consumer-centricity (Patient/client/consumer values and goals will be central to all efforts in which the physical therapy profession will engage). The ACA’s mission statement as read below would seem to be more concerned with protecting the chiropractic profession, changing legislature and promoting the growth of chiropractic care. There is little mention of what type of system will be used to achieve optimal outcomes or mention of how a patient’s specific goals will be incorporated into an individualized plan of care.  

ACA’s Mission: The ACA is a professional organization representing Doctors of Chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of Doctors of Chiropractic for the benefit of patients they serve. The purpose of the ACA is to provide leadership in health care and a positive vision for the chiropractic profession and its natural approach to health and wellness. On behalf of the chiropractic profession, we accomplish our mission and purpose by affecting public policy and legislation, by promoting high standards in professional ethics and quality of treatment and by carrying out a dynamic strategic plan to help ensure the professional growth and success of Doctors of Chiropractic. (please go to www.acatoday.org for a complete statement).

Vision Statement for the Physical Therapy Profession: Transforming society by optimizing movement to improve the human experience. Guiding Principles to Achieve the Vision: the following principles are condensed (please go to www.apta.org/Vision/ for a complete statement).

Identity. The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society. Quality.  Collaboration.  Value. Innovation.  Consumer-centricity (as stated above). Access/Equity. Advocacy. 

Lastly, in my over fourteen year experience as a physical therapist I believe the defining difference in ‘Chiro’ and ‘PT’ is that physical therapist from day one of treatment give our patients self-management tools to assist in treating their own symptoms/pain to include extensive home exercise programs. Our primary goal as physical therapist is to assist a patient in restoring, maintaining and enhancing their own health.

For more information or education on physical therapy and rehabilitation please contact:

Greg Sterner, Board Certified Orthopedic Clinical Specialist in Physical Therapy, Owner

San Diego Sports Physical Therapy

2750 Dewey Rd. Ste 101

San Diego, CA 92106

Bone Health

Learn about bone health, what it is, what it is effected by, and how to maintain and promote it. This article gives great insight to the importance of bone health published on moveforwardpt.com, a site created by the American Physical Therapy Association. For more questions call us at 619-756-7500!

 

Physical therapists are experts in improving and restoring mobility and play an important role in ensuring optimal bone health. Healthy bones can help you stay strong and active throughout your life. If good bone health is achieved during childhood and maintained, it can help to avoid bone loss and fracture later in life. For healthy bones, it is important to maintain a physically active lifestyle and eat a balanced diet with plenty of calcium, vitamin D, and perhaps other supplements as needed. Physical therapists can design a unique program for you to help keep your bones healthy.

Osteoporosis is a common bone disease that affects both men and women (mostly women), usually as they age. It is associated with low bone mass and thinning of the bone structure, making bones fragile and more likely to break.

Some people are more at risk for osteoporosis than others. Not all risk factors can be changed, but healthy habits and a proper exercise routine designed by your physical therapist can keep bones healthy and reduce risk. Risk factors* include:

  • Age: More common in older individuals
  • Sex: More common in women
  • Family History: Heredity
  • Race and Ethnicity: Affects all races. In the US, increased risk for Caucasian, Asian, or Latino
  • Weight: Low body weight (small and thin)
  • Diet, especially one low in calcium and vitamin D
  • History of broken bones
  • Menopause
  • Inactive lifestyle
  • Smoking
  • Alcohol abuse
  • Certain medications, diseases, and other medical conditions

Physical therapists can help prevent osteoporosis and treat its effects by designing individualized exercise programs to benefit bone health, improve posture, and enhance core stability and balance. Most of these exercises are simple and can be done at home with no special equipment.

Fight Fracture with Fitness

Inactivity is a major risk factor for osteoporosis. The right exercises and good habits can keep bones strong and prevent or reverse the effects of osteoporosis. Weight-bearing exercise, such as walking, is an important way to build and maintain healthy bones. Muscle strengthening exercises have been found to stimulate bone growth and can help prevent and treat osteoporosis. These types of exercises are best if started early in life and done regularly. However, it is important to remember that you can begin exercising at any age and still reap great benefits.

If you have osteoporosis, are at high risk for a fall or fracture, or have a medical condition, affecting your ability to exercise, do not begin an exercise program without first consulting your physician and a physical therapist.

Avoid exercises and daily activities, which round the spine, such as sit-ups, crunches, bending down to tie your shoes, exercise machines that involve forward bending of the trunk, and movements and sports that round and twist the spine.

Benefits of Good Balance

Preserving balance and stability with exercises can help reduce falls and resulting fractures. Exercises that improve posture, core stability, balance, and coordination, can also protect the spine against compression fractures. An individualized program may include a walking regimen, Tai Chi, and other exercises geared toward conditioning, balance, and coordination.

Bone Health Begins With Good Posture

Physical therapists recommend good posture and safe movements to protect bones from fracture during daily activities. Using proper posture and safe body mechanics during all activities protects the spine against injury. Here are some tips:

  • Keep your back, stomach, and leg muscles strong and flexible.
  • Keep your body in alignment, so it can be more efficient when you move.
  • Do not slouch. When sitting, keep your spine and head straight. Put a small pillow behind your waist to keep your spine in a good position.
  • Use good body positioning at work, home, or during leisure activities.
  • When lifting or bending forward, bend your knees, keep your back straight, bend forward at the hip crease, and lift with your legs. Keep the load close to your body.
  • Ask for help or use an assistive device to lift heavy objects.
  • Maintain a regular physical fitness regimen. Staying active can help to prevent injuries.