Deciphering Knee Pain

As a physical therapist, our job is to figure out what is causing your pain/problem and then determine/teach you how to fix it. Low back pain and knee pain are probably the two most common diagnoses we receive. Neck pain and shoulder pain are next on the list. We combine information such as the cause of the injury, the description of the pain, and the results from our examination to come up with a plan. Today we are going to focus on some factors to help diagnosis pain in the knee. Read more to learn about knee anatomy and what causes knee pain at different locations throughout the knee!

Read More

Muscle Imbalances: Hip Flexors and Glutes

A couple months ago I did a post about quad and hamstring muscle imbalances. Today, I am going to do the second post on muscle imbalances focusing on the hip flexors and glutes. The hip flexors lay in the front of the hip and act to bring your leg closer to your trunk. The glutes (or hip extensors) lay in the back of the hip and act to bring your leg away from you. Most people have tight and short hip flexors, but long and weak glutes. This is similar to the quads (dominant) and hamstring (weak). This is primarily due to the fact that most people spend a majority of their time sitting and do not move enough in the right ways.   

An imbalance between the hip flexors and glutes can cause a multitude of injuries including low back pain, hip pain, knee pain, ITB syndrome, and muscle strains. The body is a chain, so a problem in the hips can affect both the joints above and below it. Weak hips means an unstable base for the knees and spine. One of the most common problems with tight hips flexors is low back pain because some of the hip flexors originate from the low back as you can see in the picture below. The tight muscle pulls on the spine and can result in pain. 

Read More

Ice vs. Heat: Which should you use and when?

As a physical therapist, I usually try to address the cause of the pain someone is having. Knee pain usually means hip and glute strengthening is needed. Shoulder pain often originates from poor shoulder mechanics, shoulder blade weaknesses, and postural deficits. However, the immediate pain a person is experiencing also needs to be addressed. We cannot work on strength and muscle imbalances until the person has pain free motion and is able to perform the recommended exercises. I believe gentle movement is one of the best ways to work towards pain free mobility, but sometimes we need a targeted treatment directly over the painful area especially if the injury just happened. One of the easiest ways to do this is by applying ice or heat. Both ice and heat decrease pain, but the reasons for choosing one over the other are quite different and very important.

Here is a breakdown if the two: 

Read More

Active Warm Up

Before exercising, we should always warm up. Most people do this naturally by starting their walk or jog a little slower or perhaps doing a couple quick stretches before beginning their game. However, the best way to warm-up is to do some dynamic exercises. Starting with a slower speed of walking or jogging does not incorporate all your muscle groups, and static stretching is not good if your muscles are cold because they can tear more easily. A dynamic warm-up includes a variety of movements to get your blood flowing and loosen up your muscles before you begin your activity.    

Below is my active warm-up that I do before EVERY run, no excuses. Whether it's a 5k race or marathon, easy run or recovery run, speed workout or long run - you will find me doing this active warm-up. It is also great for other sports including soccer, tennis, and even strength training. For swimming, I like to do a modified version mostly just involving arm swings and shoulder/neck rolls, but I still do something dynamic before jumping in the pool. 

Read More

Core Strength and Stability for a Healthy Back

Low back pain is the #1 cause of disability and the most common diagnosis treated by physical therapists. We see it every day both inside and outside of work. Most people in their lives experience low back pain, and most people have reoccurring low back pain. In many cases, the pain comes and goes on its own. However, there are several steps you can take to speed up the healing process and minimize repeat injuries. Core strength and stability is the #1 way to conservatively treat and prevent low back pain. Simply staying active and moving is #2. Other management strategies include utilizing proper lifting techniques (lift by bending your knees not your back and keep objects close to your body), maintaining upright posture (sit and stand as tall as you can), and keeping your weight in an appropriate range (a bulging belly increases stress to the low back). 

Low back pain can be caused by arthritis, muscle strains, degenerative disc disease (when the discs between our vertebrae flatten), herniated discs (when the discs tear and leak outside their normal space), spinal stenosis (narrowing of the space around the spinal cord), or fractures. Other factors leading to low back pain can include prolonged sitting, too much exertion, weight gain, deconditioning and lack of exercise, or new/unusual activities. Any and all of these causes can be treated with core strengthening and stabilization!

Your core involves the muscles between the bottom of your ribs and your hips. The most important of these is the lower abdominals, which lay directly over the low back. When your lower abdominals are strong, they provide a stable support structure for the low back. The lower abdominals minimize abnormal forces and shear that break down the low back and lead to pain.

Below are my top core strengthening/stabilization exercises and progressions.

Read More

Muscle Imbalances: Quads and Hamstrings

Muscle imbalances are a common cause of injuries and easily preventable. Similar to needing a balance between stress and relaxation, we need a balance between the muscle groups throughout our body in order to function at our maximal capacity and avoid problems. Each sport requires certain muscles to dominate more than others, but everyone still requires a balance amongst all our muscles for them to perform optimally and together as a unit. When we move, no muscle works independently all by itself. Our muscles will also compensate when another isn't working properly. Here we will focus on an important muscle pair in the legs: the hamstrings and quads. 

Read More