San Diego Sports Physical Therapy

Knee Pain? Solution: Work your glutes.

March 3, 2015 by admin Leave a Comment

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.

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Myths Regarding What Physical Therapy Is All About

February 24, 2015 by admin Leave a Comment

With the high demand for quality physical therapy services there still remains many questions and myths to when physical therapy is warranted and how it is delivered to a sometimes misinformed public. A recent survey conducted by the American Physical Therapy Association (APTA) revealed common misnomers adults have regarding physical therapy:

Physical Therapy is painful
Physical Therapy is only for injuries or accidents
A Physician referral or prescription is required to see a Physical Therapist
Physical Therapy is not covered by health insurance
Any healthcare professional can perform physical therapy
Physical Therapy can be done entirely by the patient (with or without surgical intervention)
Surgery is the only option

Other findings of the survey include:

71% of people who have never visited a Physical Therapist think physical therapy is painful. That percentage significantly decreased among patients who had visited a physical therapist within the past year.
19% of consumers think physical therapy is only for rehabilitation, despite 81% recognizing physical therapist diverse skills
Although the survey found 42% of consumers are aware physical therapy can be performed only by a licensed Physical Therapist, 37% still believe other healthcare professionals can provide physical therapy. The remaining 21% were unsure. (This is scary as some other healthcare professional and even personal trainers tout themselves as performing rehabilitation and restorative therapy).
79% of people who recently have seen a Physical Therapist believe physical therapy can be a viable alternative to surgery.

For information on what quality Physical Therapy is 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

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How to Avoid Overtraining Injuries

January 27, 2015 by admin Leave a Comment

Overtraining is a common concern, and something that we should all be aware of (both physical therapists and clients). Learn more about overtraining injuries, how to prevent them, and get the right guidance for training from this article published on MoveForwardPT.com, an informational site created by the American Physical Therapy Association. For more questions please call at 619-756-7500.

Overtraining is a concern for all people pursuing fitness – from recreational or elite athletes to people who exercise to lose weight and stay in shape. Overtraining injuries are musculoskeletal injuries that occur due to more activity or exercise than your body is used to, and may happen to anyone who increases intensity or changes type of activity. Overtraining syndrome includes overtraining injuries, but also encompasses general fatigue and other symptoms.

Signs and Symptoms

If you experience any of the following after working hard to meet advanced fitness goals, overtraining may be a cause.

Physiological: increased resting heart rate, increased blood pressure
Physical: decreased appetite, upset stomach, insatiable thirst, sleep disturbances, increased frequency of sickness and infections, general feeling of increased difficulty and fatigue throughout the day, abnormal muscle soreness, pain occurs that is different than typical muscle soreness
Behavioral: personality changes, decreased motivation, altered concentration, lowered self-esteem, decreased ability to cope with stress
Performance: Increased heart rate during activity, decreased strength or endurance, impaired movement and coordination, multiple technical errors.

Avoiding Overtraining Injuries

No matter the activity (running, swimming, weight lifting, etc), when working to improve your fitness you need to push yourself in order to see results. But pushing yourself too hard can result in injuries that are detrimental to your fitness goals. Here are some tips to avoid overtraining injuries:

Don’t increase exercise difficulty level too quickly. Exercise needs to be progressed steadily at a gradual pace. Following a structured plan that increases your activity incrementally and safely can help you stay healthy and pain free. For example:

For running, increasing difficulty may include increasing speed, running up or downhill, increasing duration, and use of intervals, where you alternate intensity over time.
For resistance training, increasing difficulty may include increased weight, repetitions, sets, and decreasing the amount of time to perform the same amount of exercise.

Pay attention to your body.Your body is smart. If it feels like you are developing signs of overtraining, then take a break, lessen your activity, or rest.

Ease into it. Particularly if you are new to fitness or altering your exercise activities, take it slow. Don’t expect to make up for several months of inactivity with a few weeks of exercise. Aim for long-term consistency, not overnight success. People who try to do too much too soon often end up injured or frustrated and give up on their fitness goals altogether.

Avoiding Overtraining Syndrome

Overtraining syndrome occurs when an active individual or athlete increases activity faster than the body can adapt or is unable to recover from a sustained high level of activity. Your body then lets you know that you’ve done too much too fast through a variety of physical responses.

There are several signs and symptoms that may indicate overtraining syndrome but are also symptoms of other problems

Every active individual is unique. Your pain may be due to overtraining, but it also may be due to other health issues. For example, heart rate changes, general fatigue, and other systemic symptoms may be due to a more concerning condition. Physical therapists are educated to evaluate and treat a variety of conditions. If you have any of the above signs a physical therapist can help to determine the seriousness of the signs and what your next course of action for your health.

Here are some tips to avoid overtraining syndrome:

Take a break. If you have a scheduled rest day in your plan, use it, you’ve earned it! Your bones, joints, and muscles need rest days to stay healthy.

Get rest. Recent studies are supporting the important role of sleep in the health of active people and athletes. This is when our bodies’ build and repair and our immune system recovers.

Eat well. Proper nutrition is essential to the health of your body. Do not severely restrict calories when exercising. Make sure to eat proper nutrients, including plenty of lean meats, fruits and vegetables.

How will a physical therapist help me meet my fitness goals?

Physical therapists are movement experts, and work with people of all ages and levels of activity. During a visit, a physical therapist can:

Check your flexibility, strength, and endurance of muscles to support your desired level of activity.
Ensure that symptoms are due to overuse or overtraining and not something more serious.
Identify training errors to ensure a safe fitness plan, no matter your previous level of activity.
Correct biomechanical problems in form with your chosen activity to avoid overuse of a susceptible body part.
Provide appropriate training plan to minimize risk of injury and help you safely meet your fitness goals.

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