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KNEE OSTEOARTHRITIS PHYSICAL THERAPY

September 12, 2013 by admin Leave a Comment

Our knees get a lot of wear and tear, so here are some exercises and information about osteoarthritis in the knee by Ashley Misitzis PT, DPT. If you have any questions, come to San Diego Sports Physical Therapy today for help!

Knee osteoarthritis is one of the leading causes of disability among adults.

Osteoarthritis, known as OA, is characterized by degeneration of cartilage and bone, which cases pain, stiffness, decreased motion and weakness that can lead to difficulty with daily activities. There is no cure for OA, but effective treatment involves managing symptoms and addressing functional limitations. Physical Therapists are licensed health care professionals who are experts in the way the human body moves. Physical therapy uses researched treatment techniques to improve mobility, reduce pain, restore function and prevent disability. Want to improve your health? Learn more about LIVESTRONG.COM’s nutrition and fitness program!

RANGE OF MOTION
According to the CDC, Approximately 80 percent of patients with OA have some degree of movement limitation. Normal knee range of motion is zero to 135 degrees, though there is some variation from person to person.

Your knee must get all the way straight for typical walking mechanics, and must bend normally to allow for sitting and going down stairs. A Physical Therapist will improve your range of motion through direct measures, such as bending and straightening your knee, and will give you home exercises to focus on movement. Indirectly, helping to decrease pain and restore normal joint mechanics also improve your range of motion.

STRENGTHENING
When your joint is damaged, your body needs as much support as it can get from muscle strength. The first step is making sure the muscles directly surrounding the affected knee joint are strong. If you only have arthritis in one knee, then it is also important to strengthen the muscles in the other leg to help support the injured side and to prevent excess force on the healthy knee.

Your hip and ankle strength is also important to provide support to the knee with OA. During your physical therapy evaluation, your physical therapist will determine what muscles need strengthening. The earlier you seek treatment, the less likely you will have muscle strength changes, which improves the outcome.
STRETCHING
Many muscles in the leg cross over the knee joint, so ensuring they are flexible is an important part of the physical therapy process. When pain causes a decrease in your range of motion, it is normal for your body to change how it moves in order to compensate for weak muscles or lessen the pain. This compensation can cause tightness in muscles surrounding the knee including the calves, hamstrings, and quadriceps.

Other muscles may also need stretching depending on what the physical therapist finds during her evaluation.
MANUAL THERAPY
Manual therapy is a physical therapy treatment that involves skilled, specific hands-on techniques that mobilize the joint. These can be used to decrease pain, increase range of motion, lessen soft tissue swelling and improve tissue extensibility. In recent studies, the addition of manual therapy to an exercise-based physical therapy program resulted in dramatically improved function and less pain.
MODALITIES
According to the Arthritis Foundation, both heat and cold treatments are effective for pain management. Heat is best before an activity or in the morning to increase blood flow and decrease stiffness. Use cold treatment after exercise or at the end of each day to lessen swelling and pain. Use each modality for 10 to 15 minutes at a time.

REFERENCES
Centers for Disease Control and Prevention: Osteoarthritis Arthritis Today: Osteoarthritis: Using Heat and Cold for Pain Relief Move Forward PT: Facts Annals of Internal Medicine: Article by Deyle, G. American Academy of Family Physicians: Physical Therapy and Exercise for Osteoarthritis of the Knee
Article reviewed by Helen Holzer Last updated on: Aug 16, 2013

Read more: http://www.livestrong.com/article/178813-knee-osteoarthritis-physical-therapy/#ixzz2e88YONSq

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PHYSICAL THERAPY EXERCISES FOR PLANTAR FASCIITIS

September 10, 2013 by admin Leave a Comment

You’re on your feet all day, so it’s nice to give them a break once in a while. Here are some physical therapy exercises by James Patterson to help rehab your feet. Then come visit us at San Diego Sports Physical Therapy for more exercises.

Plantar fasciitis is a condition where the plantar fascia — a band of tissue running from the heel to the ball of the foot — becomes inflamed through overuse, injury or other trauma. Certain physical therapy exercises may be beneficial in easing the pain associated with plantar fasciitis so you can get back to doing the things you’re used to.
BENEFITS
Physical therapy exercises can prove useful not only for reducing plantar fasciitis pain but also from preventing it from coming back in the future. Stretching helps warm up the tissue as well as encourages blood flow to the area, which can help prevent strains and tears in the tissue.

PLANTAR FASCIA STRETCH
The most simple and common way to exercise the tissue of the plantar fascia in order to prevent or lessen the effects of plantar fasciitis is through a simple stretch. Start by facing a wall or other sturdy object you can brace yourself against. Put both hands on the wall and step forward with your left foot. Keep your right foot back and flat on the ground. Bend your right knee so your leg moves towards the wall, but keep your right foot flat. You will begin to feel a stretch in your right heel. Hold this stretch for 10 to 15 seconds. Switch feet and do the same stretch for your left heel. Stretch each heel two or three times each as part of your physical therapy exercise routine.
BALL ROLL
The ball roll helps soften and relax the plantar fasciitis tissue and can be done while sitting down to the computer or watching TV. Find a small ball the size of a tennis ball. Place it on the floor and put your foot on top of it. Slowly roll the ball along the arch of your foot and your heel. Apply downward pressure on the ball to increase the massage effect on your plantar fasciitis. Perform the ball roll for 30 seconds at a time, stopping in between to let your foot rest.
STAIR DIP
Another effective exercise that helps stretch out the plantar fascia, the stair dip only requires the use of a stair or other elevated surface such as a curb. Stand with one foot on the step and the other in the air. Place your foot so your toes are on the step, with the rest of the foot hanging off the edge. Use your toes to lift your body up so you’re on the tiptoes of your foot. Hold this position for 10 seconds, then lower your body back down so the heel of your foot is slightly below the edge of the step. Hold for another 10 seconds. Repeat three to four times as part of your exercise.
CONSIDERATIONS
If you have a serious injury to your plantar fascia or Achilles tendon, these exercises may cause extreme case. If that is that case, contact your doctor immediately, who may need to examine you for more serious injury that might require further therapy or even surgery.

References
Sports Injury Clinic: Stretching for Plantar Fasciitis
American Academy of Orthopaedic Surgeons: Plantar Fasciitis and Bone Spurs
Family Doctor: Plantar Fasciitis

Filed Under: Uncategorized Tagged With: arch, ball, blood flow, exercis, exercises, feet, flat, floor, foot, health, heel, inflammation, inflammed, leg, management, overuse, pain, physical, physical therapy, plantar, plantar fasciitis, stretch, stretching, tendon, tennis ball, tissue

Heat vs. Ice

August 20, 2013 by admin Leave a Comment

You have an injury, but you’ve heard to both heat and ice it? So which is better? Take a look at this article by Lindsey Balint, PT, DPT, featured on Sports Physical Therapy Institute to find out which will be more beneficial to you!

Ice and heat are common modalities used to help heal orthopedic injuries but how do you decide which is best to use? There are several things to take into consideration when deciding which modality will best help achieve your treatment goals.

Is the injury Acute or Chronic?

Acute: Recent onset of an injury (< 48 hours). During the acute phase of an injury the body's inflammatory response is active and ice is the preferred modality to prevent swelling that can cause pain. During the first 24-48 hours following an injury, the RICE principal should be followed and is described later in this article.
Chronic: Injuries that continue for a long period of time. During the chronic phase of an injury both ice and heat may be used depending on the treatment goals. Typically heat would be used prior to exercising to loosen tissues and prepare for activity. Ice is typically used after exercise to decrease inflammation following the activity.

What is RICE?

RICE is an acronym to help you remember what to do following an acute injury. RICE stands for Rest, Ice, Compression and Elevation.

REST: Immobilize to limit motion, and decrease the amount of weight you put through the injured body part.
ICE: Apply the cold modality of your choice to help reduce swelling, and decrease pain.
COMPRESSION: Apply a compressive bandage to reduce swelling to the area. When applying a compressive bandage it should be snug but not tight. Applying a compressive wrap too tightly can cut off blood supply and cause further damage.
ELEVATION: Raise the injured body part above the level of the heart. This will help the body decrease swelling to the area.

What are the goals of treatment?

Ice Heat

Decrease Swelling/Inflammation X
Decrease Pain X X
Increase Tissue Extensibility X
Decrease Stiffness X
Decrease Muscle Spasm X X
Increase Joint Range of Motion X

Are there any situations in which heat should not be applied?

Over an open wound
Over areas of skin where there is decreased sensation
Areas where circulation is impaired
Over tumors
Acute injuries

Are there any situations in which ice should not be applied?

Over an open wound
If you have hypersensitivity or intolerance to cold
Peripheral Vascular Disease
Over areas of skin where there is decreased sensation
Raynaud's disease

How long should heat or ice be applied to an injury?

Ice and heat can be very helpful in treating orthopedic injuries but overuse of these modalities can be too much of a good thing. Apply heat or ice for only 10-15 minutes at a time to prevent burning or frostbite. If you have any additional questions about when to use heat versus ice, feel free to contact the physical therapists at Sports Physical Therapy for additional information.

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