That feeling of your knee “giving out” or throbbing with pain are two very common patient complaints. Your knees work hard, so it’s no surprise either or both react to the workload. There are a myriad  of reasons for knee pain and many ways physical therapy (PT) can help improve or resolve it.

Types of Pain

There are three main categories of pain. Acute pain is the severe pain right after an injury. Sub-acute pain can kick in a few weeks after the injury and can last up to six months. Chronic pain is discomfort that lasts past the six-month mark.

Recommended Treatment Response

During the acute period, lean into the RICE treatment, which means rest, ice, compression, and elevation. The goal is to give your knee a chance to heal before asking it to perform movements and carry weight. 

During the sub-acute pain period, introduce gentle movement to improve mobility. 

Along the way, keep in touch with your medical professionals, who will evaluate your range of motion and pain levels, among other things. They may request imaging if there is concern over damage to muscles, ligaments, tendons, or bones. Chronic pain often persists even after the core issue has been addressed, but if you haven’t already, now is the time for a thorough evaluation and assessment from your medical professional. 

At any point along the way, your physician may recommend physical therapy to help improve mobility and rebuild strength. 

Types of Knee Injuries

From cartilage wearing down to ligament tears, the knees can suffer a host of injuries such as:

• ACL tear
• PCL injury
• MCL damage
• Osteoarthrosis
• Patellar instability
• Patellofemoral stress syndrome (PFSS)
• Iliotibial band (ITB) stress
• Hamstring strain
• Baker’s cyst
• Bursitis
• Sprains and strains

Symptoms to Watch for

In addition to pain, there are other indicators of knee injury or instability to pay attention to. Seek medical advice if you have symptoms such as locking, catching, or clicking when you bend your knee, a popping sensation when you twist or bend the knee, or an inability to straighten the knee completely.

What to Expect From Your PT Appointment

Your physical therapist will ask a range of questions regarding the initial injury, how long it’s been bothering you, if you’ve had similar issues in the past, what seems to help or exacerbate the problem, and what diagnosis and treatment you’ve already received.

He or she will then test your gait, range of motion, strength, balance, and physical structures of the knee. They will complete a comprehensive assessment of your entire lower extremity from your hips to your feet.

PT Strengthening and Exercise 

Although the movements may seem small, physical therapy exercises target the problem area, slowly strengthening muscles and increasing mobility. Your PT will work you through a variety of exercises at your appointment and send additional activities home with you. They may also offer pain-relieving therapies like electric stimulation, kinesiology taping, heat and ice application, soft tissue massage, or bracing.

Your PT can walk you through proper technique for strengthening, mobility, and balance exercises so you can improve without causing further injury. 

This might include exercises like:

• Straight leg raises to the front, side, or back
• Exercises to strengthen your hips
• Stretches for targeted muscles in the lower extremities
• Knee lifts
• Hip rotations
• Mini-squats with or without aids
• Hip flexion, extension or abduction exercises
• Hamstring curls
• Hip bridge
• Step exercises

Working with your physical therapist regarding knee pain and instability can not only improve your current pain level and mobility issues, but can help you maintain the strength and control to avoid strains and injuries in the future. Once your knee instability and pain have improved and you get the green light from your doctor or PT, try low impact activities like yoga, swimming, walking, and tai chi to keep the progress going.

To get started, give Encore a call today to see how we can help with your knee pain and instability. 

Sources:

https://www.healthline.com/health/types-of-pain

https://www.webmd.com/pain-management/knee-pain/injury-knee-pain-16/slideshow-knee-exercises

If you’ve had a nagging pain in your shoulder or can’t quite reach the top shelf lately, you may be suffering from frozen shoulder.

What is Frozen Shoulder?

Adhesive capsulitis, commonly known as frozen shoulder, is a common ailment. As the name implies, frozen shoulder presents with extreme stiffness and limited range of motion in the shoulder joint. Typically the stiffness begins gradually and then becomes more severe. During this early freezing stage, patients experience pain and their range of motion becomes more restrictive. 

In the next stage, called the frozen stage, the range of motion becomes so limited that patients may not be able to lift their arm above their head. Typically pain begins to decrease at this point, even though the range of motion becomes worse. Finally, the thawing stage will see some improvement in range of motion as the shoulder starts to relax again.

Moving through the stages is a long process. The freezing stage can last months and the frozen and thawing stages can take one to three years to completely get back to normal.

Causes

There is no single direct cause for frozen shoulder, but according to the Mayo Clinic, it is more common in diabetics, those with thyroid issues, and patients recovering from ailments that limit movement of the arm. It can also stem from a mild injury caused by something as simple as throwing a ball or catching your arm on a wall while walking. Adhesive capsulitis is more common in women than men and most commonly affects patients between the ages of 40 and 60.

Diagnosis

Your doctor can typically diagnose adhesive capsulitis with a physical exam. However, he or she may order imaging tests just to make sure there isn’t something else going on. During your exam, your doctor will ask you to move your arm in different directions to evaluate your range of motion and level of pain. He or she will likely also provide counterpressure, asking you to push against their hands in different directions. This helps identify whether the problem lies in a muscle, tendon, or ligament rather than the shoulder joint. It helps eliminate other common shoulder injuries like a torn rotator cuff.

Treatment

Your doctor may tell you to take a consistent dose of ibuprofen to help with inflammation and pain. Ice and heat can help at home too. Your doctor may also suggest a cortisone shot, which is administered into the shoulder joint capsule.

Movement

Part of the reason your doctor may recommend physical therapy is to keep your shoulder from freezing up in the first place. Doctors commonly recommend range-of-motion exercises that can help keep frozen shoulder from settling in, but if it’s already limiting you, movement is still the best treatment. 

Physical Therapy

Improving your range of motion can begin during any stage of frozen shoulder. Your physical therapist will walk you through exercises like the following to improve your range of motion. He or she may also use heat to relax the muscles before stretching and other techniques to help with pain, inflammation, and limited movement. 

Wall Walk

Standing a comfortable distance from a wall, place both hands on the wall in front of you. Use your fingers to walk up the wall as far as you can without serious pain.

Shoulder Rotation

Stabilize yourself while leaning forward 90 degrees, allowing your arms to hang naturally. Your shoulder may not allow your arm to hang straight. Regardless, move your hand in a circular motion, increasing the size of the circle as your range of motion improves. 

Door Stretch

Start facing the side of a doorway with your elbow bent at 90 degrees and the hand of your affected shoulder pressing against the inside or outside of the door jamb. Then rotate your body away from your arm for a gentle stretch.

Crossover Stretch

Sitting upright or laying on your back, use your unaffected arm to pull your affected arm across your chest. Hold for 10-15 seconds for a deep stretch and release slowly.

 

If you’re experiencing frozen shoulder, give Encore Physical Therapy a call to see how we can help.  

Sources:

Mayo Clinic, Frozen Shoulder, https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684

Ortho Infor, Frozen Shoulder, https://orthoinfo.aaos.org/en/diseases–conditions/frozen-shoulder/

 

Neck pain is a common complaint. If it makes it difficult to get out of bed in the morning, perform everyday tasks during your day, or keeps you from activities you love, it might be time to seek medical care for that pain in your neck.

Causes for Neck Pain

Tension, misalignment, stress, muscle strain, injury, joint issues, and nerve damage are just a few possible causes for neck pain. Although there are some serious illnesses that cause neck pain, the overwhelming majority of cases stem from poor body mechanics or posture. That means the way we sit and move. 

When you meet with your physical therapist (PT), be sure to discuss your hobbies, work practices, and sleep situation to provide insight on where the problems lie. With this information and an examination, your PT can suggest anything from the right kind of keyboard to a shoe lift.

Home Care for Neck Pain

When your neck feels tight, practice basic stretches such as looking slowly to the left and then to the right. With your head back at center, tip one ear towards your shoulder and repeat on the other side. Be gentle with yourself. The goal is to stretch tight muscles, not to cause more injury. 

You can also take anti-inflammatory medications for a few days and practice a schedule of ice and heat. You could even look into seeing a massage therapist to help relieve tight and stiff muscles.

Most of the time, neck pain is nothing to worry about, but see a doctor if you experience severe pain, you can’t get any relief after several days, the pain radiates down your arms or legs, or you also have a headache, numbness, or weakness in your extremities.

Benefits of Physical Therapy for Neck Pain

When you find it difficult to look over your shoulder while driving, raise your eyes to the sky, or have a nagging pain that you can’t seem to resolve, physical therapy can likely help. 

While strengthening muscles and improving your range of motion are certainly benefits, there may be other perks you haven’t thought about.

For example, PT can help decrease the intensity, frequency, and duration of headaches. As a result of fewer headaches and reduced neck pain, you may also be able to decrease medication use. Overall, if you can get that pain in the neck under control, you’ll experience a better quality of life. 

PT Techniques to Relieve Neck Pain

Whether you’ve decided to begin PT or are still wondering how it can benefit you, understanding what a typical appointment might look like is a good place to start in your journey. Note that every case is different, so a personalized plan will follow your initial evaluation, but the techniques below are generally helpful for many types of neck pain.

Manual Therapy

Stiff muscles and alignment issues both contribute to neck pain and headaches. An experienced physical therapist can use manual therapy techniques to alleviate stiffness, increase mobility, decrease muscle tension and spasms, and improve muscle performance.

Exercise

Although you may feel like movement is the antithesis for your painful problem, research has shown benefits of exercise as a treatment for neck and other types of pain. Your PT will evaluate your abilities and design a treatment plan that fits within your capabilities. These stretches and exercises will help build strength, range of motion, stability, and endurance, which will result in less pain and inflammation.

Education

A big part of helping yourself is understanding what is going on beneath the surface. Your PT can provide images and materials in order to gain a better image of what the joints and muscles are battling. Depending on your diagnosis, education around stress relief, understanding triggers, or proper posture can also help.

The bottom line is that you likely don’t have to live with that pain in the neck. Give Encore Physical Therapy a call to see how we can help.

 

There are nearly as many reasons to go to physical therapy as there are treatments once you get there, so it’s not surprising you may be wondering what to expect from the process. After all, there’s no, What to Expect When You’re Going to PT book that’s handed out when your doctor recommends making an appointment. So here’s a bit of information to give you a better idea of what that first appointment and the follow up visits will entail.

The First Appointment

Your mind might be swirling with questions, so this article about your first appointment is a good place to start. It covers what to bring with you, what to wear, and how long you can expect the appointment to take.

Sharing Information

In order for your physical therapist to provide the best treatments, try to provide a complete picture of your situation. Be sure to mention prior and current injuries and provide a comprehensive medical history. Share your hopes for treatment, whether that be as focused as strengthening your calves or as general as overall improved balance and stability. 

You might be surprised by the conditions physical therapy can treat, so although you come in for something like recovery after surgery, with effective communication you might also find yourself treating incontinence.

Who Will I Work With?

The Encore team works together with the same goal–to provide professional and effective treatment with a focus on the needs of the patient. For your initial visit, you’ll meet with one of our skilled physical therapists for a complete evaluation. This is the time to ask questions and provide as much information as you can about your condition and your goals. 

Many patients are surprised to see a new face when they arrive for their second visit. That’s because our qualified Physical Therapist Assistants (PTA) commonly meet with patients after the initial visit. The PTA will walk you through warm ups, stretches, exercises, and other movements that increase flexibility, strength, balance, and range of motion. For reduction of pain and inflammation, your PTA may also hook you up with heat, ice, ultrasonic treatment, and manual (hands on) therapy.

Your PT and PTA regularly share information and work together on your treatment plan so there’s no need to explain everything twice. Your PT will monitor your progress through conversations with the PTA and by meeting with you periodically throughout your treatment.

How Long Will it Take?

Near the end of your initial appointment, your PT will outline a plan for additional appointments, often starting at 2-3 times each week and slowly reducing in frequency as you improve. This can come as a shock if you’ve expected to have the issue resolved in a session or two, but be aware the number of appointments depends on several factors including insurance, budget, your schedule, and your area of concern. Typically you will make appointments for the first few weeks and reevaluate the frequency as you progress.

Depending on what you’re dealing with, PT can help in a few visits or can be ongoing for months.

What Can I Expect From Treatments?

Patients have all kinds of perceived notions about what physical therapy looks like. Regardless of the image you have in mind, it’s probably not that. The first rule is physical therapy should never hurt. You may have some discomfort during certain movements, but pain is a boundary to pay attention to. 

The goal of PT is to reduce or eliminate that pain by correcting the core issue. Typically that revolves around strengthening and improving flexibility. This is not an exercise class. Don’t expect to break a sweat or break records for an upcoming spin class. Most PT is centered around minute movements–with surprising results. You may feel like you’re doing basically nothing, yet soon you’ll see how those micromovements lead to improvement.

Anticipate Homework

Much of the work you do will be in between appointments. After each appointment, your PT or PTA will provide you with written or printed sheets outlining exercises to work on at home. The more closely you follow your homework plan, the more improvement you will see. During your next appointment your PT will ask how the homework is going, evaluate your progress, and suggest new work-at-home activities to continue your improvements.

Be Open to Suggestions

You might remember the childhood song, “The Skeleton Dance,” with lyrics like, “The foot bone’s connected to the leg bone.” Even though you seek treatment for pain in one area, the core of the problem may lie elsewhere. So don’t be surprised if treatment for lower back pain involves stretching your calves or relaxing your hips. Similarly, even though you might feel like the exercises aren’t challenging enough, trust your PT to keep you at the right level of progress. Feel free to communicate concerns, but give the process a chance and be patient as you work together to achieve your goals.