Does your Growing Athlete have Knee Pain?

Patellar Femoral Pain Syndrome, otherwise known as PFPS, is common in adolescent athletes especially those who participate in sports year-round. This diagnosis presents itself with generic soreness in and around the front of the knee and/or kneecap. Since most athletes in their teens have growth spurts, their bones grow faster than their muscles. This causes an imbalance with the forces around the knee causing abnormal motion of the kneecap. Typically, this will cause pain with prolonged standing, negotiating stairs and athletic activity in general.

Physical therapy is one of the few avenues available to reduce the pain and accelerate a return to sports with full function. The typical plan of care is as follows:

  1. REDUCE SWELLING: Modalities, such as ice, heat or electric stim can help
  2. INCREASE FLEXIBILITY:  Chances are good that the ligaments surrounding the knee (IT Band, lateral retinaculum) haven’t kept up with the bone growth and are therefore very tight.  As a result, the patella moves laterally (to the outside) when running or walking, creating extra friction, and often pain.  Stretching the tight ligaments allows the knee cap to return to its normal tracking pattern and will reduce pain.
  3. STRENGTHEN WEAK MUSCLES:  As the therapist works to stretch tight ligaments, the patient must also strengthen key muscle groups, such as quadriceps, hamstrings, gluteus medius, gluteus maximus. These muscles help to stabilize the joint which provide increased endurance with sport-related activities and also help to keep the patella moving smoothly.
  4. ADD PLYOMETRICS:  As pain and swelling is alleviated, it is time to introduce a plyometric program, such as agility or sport-specific training.  This is the final step with therapy to help the athlete ease their transition back to his/her sport. This last step challenges the athlete with higher functional tasks in order to simulate game or field conditions. Quick steps, lateral jumps, and ladder drills are just a few of the techniques that a therapist may use to help move a young adult toward reentry to their sport or activity.

Don’t wait and deal with pain! Come in and see a physical therapist today.

Sleeping Away your Pain

We know your type, you go above and beyond to advance, progress, and accomplish. You are up at dawn and burn the midnight oil to get ahead. And when an injury presents itself, you work with your physical therapist to recover, whether it be attending every visit in the clinic or doing your home exercise program ten times per day!  However, something you may not have considered, is how sleep deprivation can play into your recovery.

Sleep deprivation is widespread. The CDC considers it a public health problem. It is estimated that up to 90% of sleep pathologies are undiagnosed! Think you sleep well and long enough already due to tracking your sleep? Don’t be too sure. In trials of over 80 sleep tracking devices (think Fitbit) worn by consumers, only one withstood a clinical trial. Most of the devices overestimated sleep duration and quality and underestimated awakenings at night.

Sleep helps you recover. A recent article in Physical Therapy, a professional PT research journal, reviewed the correlation of quality sleep to injury rehabilitation. Not only does sleep increase cognitive function as we’ve heard so often, but it also facilitates increased immune function and tissue healing as well as decreased perception of pain.  Imagine, get your 8 hours of solid shut-eye each night and feel no pain (well, OK maybe just less pain)

We can help maximize your comfort to get more sleep! Our professionals know how to make you more comfortable at night. While we are not sleep specialists, we do know how to position you for maximum comfort in that recliner after shoulder surgery or baby that back to get as much deep sleep as possible.

Daily exercise aids sleep as well. This article reminds us that regular moderate exercise has a positive benefit on sleep quality as well. A physical therapist can recommend specific exercises which will be safe to perform, even if you have some limitations. A HARTZ PT, we also provide our signature Medically Adapted Gym and our Better Bones, Better Balance Class designed to help you achieve your goals.  Improved sleep may be a side benefit of trying out these programs.

Sleeping is crucial to your recovery and quality of life. So next time you find yourself skimping on sleep, do yourself a flavor and get a little shut eye. It might help you more than you realize.

Works Cited: F.Al-dughmi, Catherine, et al. “Sleep Health Promotion: Practical Information for Physical Therapists .” OUP Academic, Oxford University Press, 18 May 2017, academic.oup.com/ptj/article/97/8/826/3831304.

5 Easy Tips for Pain-Free Gardening

For most of us, spring and summer is the time of year when the weeds in our yard start calling!  When the weeds go crazy, we might feel overwhelmed and want to do it all in one weekend, however, as I’m sure you have figured out, this is not a great idea.  Overdoing it can often mean an increase in aches and pains, especially back pain.

Whether you are planning on weeding the flower beds, mulching, pruning, planting, or all of the above, there are a few steps you can take to help prevent residual soreness the following few days.

GET THE GEAR:  Before working in the yard, it is important to have to proper gear: hat, suntan lotion, sunglasses, and a water bottle.  You’ve all heard it before, staying hydrated and protected from the sun is a must!

WARM-UP:  Get those muscles warmed and loose by going for a short 5-10 minute walk.  In addition, it is a good idea to perform some dynamic stretches, such a walking lunges with a torso twist, skipping or high knee walking.  Yard work is hard work and skipping a warm-up will put excess strain on your muscles and joints, increasing your chance of an injury.

TAKE BREAKS: Don’t get so caught up in the work, that you forget to take frequent breaks. They don’t have to be long, but it is important to take time to stretch and get a drink of water.

CHECK YOUR FORM: Whether it’s bending over weeding, shoveling or spreading mulch or pushing a lawn mower, all of these jobs put extra strain on your back. By altering your form while you do some of these activities, you can decrease your chances of having back pain.  Here are some suggestions:

Weeding:
– Good idea: Kneel on a soft mat to save your back and knees.
– Better idea: Sit on a stool and rest your elbows on your knees
– Change positions frequently to avoid overuse

Trimming the Hedges:
– Keep your back straight
– Utilize small strokes to prevent strain in neck and shoulders
– Rest every 5-7 minutes to give you back a rest… it will thank you later.

Wheel barrel:
– Bend your knees to lift, NOT your back
– Try not to twist while holding the handles. Wheel barrels can easily be unbalanced…if it starts to go, you do not want to be pulled down with it.
– Push, do not pull.

Shoveling:
– Keep feet firmly planted on the ground
– Keep hips forward, facing where you are shoveling to prevent twisting of the back
– If you are moving dirt from one place to another, pick up your feet and turn your entire body to face the side you will be placing the dirt. This may seem unnatural and may take a little longer, however you could be saving your back from days of soreness.

Lifting :
– As temping as it is to get it all in one load, save your back and take two trips with smaller loads.
– Make sure to keep the load close to your body.

COOL DOWN/STRETCHINGOnce you’ve had your fill, it is a good idea to take a few moments to cool down and stretch.  Often your body might tell you what body part could use a good stretch, but if you are looking for a few suggestions, we’ve got you covered:

Yard work can be fun, especially when you get the whole family involved, but taking a few steps to lesson injury risk can go a long way to keeping the garden weed-free all summer long!

Osteoporosis- Tips to Keep those Bones Strong

What is contentious, funny, serious, can be picked, has its own song named after it, and is only appreciated when broken? The answer: a 206 piece puzzle you carry around with you every day. Not only does it keep you from falling into a soft puddle of ooze on the floor, your bones also help form blood cells (red and white), store and release minerals, hold (and hide!) some triglycerides, and protect your brain and spine. When it comes to your bone health, osteoporosis is a chief concern to wrecking your source of stability. Here are key lifestyle changes that will reduce your risk for fractures, as well as a quick peek at the disease process itself.

What is osteoporosis? It all relates back to that mineral holding and releasing property mentioned earlier. If your body keeps stealing your bone minerals for other functions, the skeleton loses its density, causing bones to become more brittle, thereby increasing likelihood of fracture.

So where does this come from and who does it affect? Women are the strong favorites for osteoporosis, as well as the elderly. Other risk factors include: Family history, European or Asian descent, sedentary lifestyles, smoking, low calcium/Vitamin D intake, more than 2 drinks imbibed daily, as well as certain prescription medications which increase your risk.  Granted, some of these risk factors can’t be helped. Changing your family history or age is truly impossible, despite our best efforts!  However WE CAN focus on changing some lifestyle factors affecting the disease.

Medication may feel like the easy way out of bone compromise. There are generally two types of drugs: Antiresorptive drugs which slow down bone loss, and bone-building drugs, which promote increased bone mass. However some of these drugs can increase your risk of cancer, heart disease, and other side effects, warranting a discussion with your doctor before utilizing such medication.

A more natural option is focusing on mineral intake. Calcium and vitamin D are crucial in building bone mass. Calcium alone is difficult for the body to utilize without vitamin D. Once again speaking with a doctor or nutritionist is important in setting dietary goals and intake levels. Other dietary changes can include reducing alcohol consumption and ceasing smoking.

Finally, low impact exercises can be very beneficial in building bone mass. Walking, hiking, dancing, lifting weights, and biking are all excellent option to improve bone mass. However in cases of severe osteoporosis, low impact exercise, such as swimming, may be a better starting point. Talk to us, your local movement experts, for recommendations for a good exercise plan tailor-made to keep you happy and growing stronger! Here at HARTZ PT, we offer a Medically Adapted Gym (MAG) which is designed to customize your fitness goals with a supervising exercise physiologist.  Our Better Bones, Better Balance Class is also designed to keep you on your feet and reduce injury and the fear of falling, allowing you to move with confidence.

No matter where you are in your bone health journey, let us help you stay healthy or improve your health with our exceptional therapy services, tailored gym work-outs, or focused balance classes. Remember, you have a lot of bones to keep in working order!

Tips for Traveling after a Joint Replacement

The surgery is done and now is the time to get back to your life.  A joint replacement of any kind is not an easy surgery from which to recover. It takes time!  When the time comes to travel again via car or plane, here are some tips to help make the trip more enjoyable.

4-6 weeks post-surgery:  The majority of surgeons will recommend that you wait a minimum of 6 weeks post-surgery before traveling, however some say you can travel as soon as you are comfortable sitting down, but a minimum of 4 weeks.  This decision depends largely on the length of time you will be traveling, and what mode of transportation you will be utilizing.

Pick your Seat: If you are traveling by air, it is best to select what seat you have on the airplane.  Upgrading to first class is the best solution, but many times not financially possible.  The row of seats behind the partition (between first class and economy) tend to have a little more leg room.  Emergency exit rows also have a little more leg room but since you are traveling after a major operation you might not have the ability to move fast enough to perform the duties required in those rows in case of an actual emergency.  It would also be best to obtain an aisle seat if the other options listed are not possible.

Frequent Breaks: Sitting for long periods of time is very common when traveling. The affected extremity tends to grow tight and stiffen up.  If possible, while on the plane, attempt to get up every 15-20 minutes.  If your travels by plane take you across the country, try to split the trip up and make a stop along the way (at least one layover) to give yourself the opportunity to get off the plane and walk around until your next flight is called.

Security Woes: Going through security at the airport is challenging for anyone. Getting through security after a joint replacement may require a little more preparation. Some physician’s offices may give you a letter stating you have had a joint replacement surgery.  You should also inform the TSA agent upon your arrival at the security checkpoint, that you have received a joint replacement very recently.  You should be prepared to go through extra screening.  Wear loose fitting clothing in the case that you are asked to show your surgical incision.  The more prepared you are, the smoother the process.

Car travel does not have security component, but you still want to plan your trip with frequent stops to give yourself time to get up and walk around. This will help avoid stiffness and tightness at the surgical location and surrounding extremity.  Some knee replacement patients prefer to sit in the back seat to keep their leg elevated across the seat, while others prefer the passenger seat pushed back all the way leaving as much leg room under the dash as possible.

Traveling after a joint replacement is possible, it just takes a little more planning.  It is always a good idea to consult your surgeon or physical therapist prior to your trip for additional recommendations specific to your state of recovery.