Physical and Occupational Therapy for Arthritis

Physical and Occupational Therapy for Arthritis

Arthritis treatment may include physical therapy and/or occupational therapy.

People with arthritis often have stiff joints -- largely because they avoid movements that can increase pain. By not moving arthritic joints, however, the stiffness and pain only get worse. Therefore, people with arthritis often benefit from physical therapy. A physical therapist can teach you how to work out stiffness without further damaging your joint. Physical therapy also is useful after an injury, such as from a fall, and after joint surgery, especially for artificial joint replacement.

Occupational therapy can teach you how to reduce strain on your joints during daily activities. Occupational therapists can show you how to modify your home and workplace environments to reduce motions that may aggravate arthritis. They also may provide splints for your hands or wrists, and recommend assistive devices to aid in tasks such as driving, bathing, dressing, housekeeping, and certain work activities.

What Is the Goal of Physical Therapy?

The goal of physical therapy is to get a person back to the point where he or she can perform normal, everyday activities without difficulty.

Preserving good range of motion is key to maintain the ability to perform daily activities. Therefore, increasing the range of motion of a joint is the primary focus of physical therapy. Building strength in the involved muscles surrounding the joint also is extremely important, since stronger muscles can better stabilize a weakened joint.

Physical therapists provide exercises designed to preserve the strength and use of your joints. They can show you the best way to move from one position to another and can also teach you how to use walking aids such as crutches, a walker or a cane, if necessary.

What Are Some Benefits of Occupational and Physical Therapy?

If you have arthritis, there are many benefits to participating in a physical and occupational therapy program, including:

·         You gain education about your type of arthritis, so that you can be well informed.

·         If you are overweight, a dietary plan can be created to reduce the stress of excess weight on supporting joints of the back, legs, and feet. As yet, no specific diet -- other than a diet designed for weight loss -- has proved helpful for arthritis.

·         You gain foot-care advice, including choice of well-fitting shoes with shock-absorbing outer soles and sculptured (orthotic) insoles molded exactly to the contour of each foot.

·         You will learn therapeutic methods to relieve discomfort and improve performance through various physical techniques and activity modifications.

What Techniques Will I Learn?

You'll learn several techniques, including:

·         Rest. Bed rest helps reduce both joint inflammation and pain, and is especially useful when multiple joints are affected and fatigue is a major problem. Individual joint rest is most helpful when arthritis involves one or only a few joints. Custom splints can be made to rest and support inflamed joints and a soft collar can support the neck while you are sitting or standing.

·         Thermal modalities. Applying ice packs or heating pads, as well as deep heat provided by ultrasound and hot packs, can help relieve local pain. Heat also relaxes muscle spasm around inflamed joints. Heating joints and muscles with a warm bath or shower before exercising may help you exercise more easily.

·         Exercise . Exercise is an important part of arthritis treatment that is most effective when done properly every day. Your doctor and therapist will prescribe a program for you that may vary as your needs change.

What Therapy Is Offered for People Recovering From Joint Replacement?

Preoperative programs of education and exercise, started before joint replacement surgery, are continued at home. They may be changed in the hospital after surgery to fit new needs during the rehabilitation period. These exercises may be added to your usual exercise regimen, and you may find your ability to exercise has improved after surgery.

What Joint Protection Techniques Are Offered?

There are ways to reduce the stress on joints affected by arthritis while participating in daily activities. Some of these include:

·         Controlling your weight to avoid putting extra stress on weight-bearing joints such as the back, hips, knees, and feet.

·         Being aware of body position, using good posture to protect your back and the joints of your legs and feet. When possible, sit down to do a job instead of standing. Change position often since staying in one position for a long time tends to increase stiffness and pain.

·         Conserving energy by allowing for rest periods, both during the workday and during an activity.

·         Respecting pain. It is your body's way of telling you something is wrong. Don't try an activity that puts strain on joints that are already painful or stiff.

An occupational therapist can show you ways to do everyday tasks without worsening pain or causing joint damage. Some joint protection techniques include:

·         Using proper body mechanics for getting in and out of a car, chair or tub, as well as for lifting objects.

·         Using your strongest joints and muscles to reduce the stress on smaller joints. For example, carrying a purse or briefcase with a shoulder strap rather than with your hand.

·         Distributing pressure to minimize stress on any one joint. Lifting dishes with both palms rather than with your fingers and carrying heavy loads in your arms instead of with your hands.

·         If your hands are affected by arthritis, avoid tight gripping, pinching, squeezing, and twisting. Ways to accomplish the same tasks with alternate methods or tools can usually be found.

What Are Assistive Devices for Arthritis?

If you have arthritis, many assistive devices have been developed to make activities easier and less stressful for the joints and muscles. Your therapist can suggest devices that will be helpful for tasks you may find difficult at home or at work.

A few examples of helpful devices include a bath stool for use in the shower or tub, grab bars around the toilet or tub, and long-handled shoehorns or sock grippers. Your therapist can show you catalogs that have a wide variety of assistive devices

Call us today to schedule an appointment if you or someone you love suffers from arthritis pain and are looking for relief!  
1-386-898-0443

Physical Therapy and the Camaraderie of Healing

I found this wonderful article written by an author about her experiences as a physical therapy patient.  It really speaks to the bond and relationship patients and Physical Therapists develop during the course of treatment... 

Physical Therapy and the Camaraderie of Healing

Brian Stauffer

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ClosI first had physical therapy at 27, after I slipped on an icy Montreal sidewalk and tore the ligaments in my left ankle. I had it again at 42 and 43, after surgery on my right and left knees, and most recently I’ve had it on both shoulders.

My orthopedist likes to say surgery is half the battle. If so, it’s the easy half.

The slow and repetitive work of physical therapy often starts the next day, and for an injury like a tear in an anterior cruciate ligament, it can take up to six months. Before you’ve done it, it’s hard to imagine anything is going to take so long and hurt so much.

Part of the challenge is the nature of arthroscopic surgery, whose multiple incisions are often so tiny they barely leave a trace. I’ve had torn meniscus (cartilage) removed from both my knees, and I have to look really hard to find my scars. Removal of bone spurs from my shoulder through four incisions left my skin almost smooth. Surely this is a good thing.

But those minuscule entry points make it difficult to comprehend what has been done in there. After only 45 minutes under general anesthetic and with no huge incision or bloody wound, why am I in so much pain? And why do I have to keep doing these silly exercises?

Surgeons have little time, and sometimes less appetite, to discuss the minutiae of a procedure’s aftereffects. Often it’s the physical therapists who patiently explain what the physician did and why we now have to relinquish huge chunks of our time to rehabilitation.

Physical therapy, or P.T., demands the month-after-month tedium of spending hours in a room filled with strangers stretching colored rubber bands or spinning their arms in circles.

The rituals are oddly and intimately public. Patients of every age, race and income level share a large, sunny room. We do our leg-raises side by side on wide beds. We wait in line for the pulley, the elliptical and the arm bike. We learn a new language and its tools: the strap, the stick, shrugs and pinches.

Everyone ends up in P.T. — lithe teenage athletes, construction workers and police officers with job-related strains, C.E.O.’s with skiing injuries, older people with replaced knees and hips. I’ve commiserated there with an Episcopal minister, an Ivy League economics professor and a firefighter.

The rituals become routine, starting with a heating pad and nerve stimulation, ending with the soothing benediction of a black rubber ice pack. We learn to bend our lives around the inexorable, unfashionable truth — healing takes work and it takes time.

Camaraderie grows as patients compare notes on the frustration of needing help for tasks as simple as pulling up your trousers or opening a can of soup. Women commiserate with the new knowledge that a bra strap can pinch a healing shoulder like steel cable. Struggling to complete even the simplest of tasks in a room full of fellow adults is humbling. When I see someone’s jaw clench with effort, I remember that lifting a one-pound weight can be tough.

I never expected to forge a multiyear relationship with my physical therapists, but I have. I like Helen and Matt and Stephanie and Richard. Really. I just hope I never see them again.

I don’t envy them their job, stretching and shaking and manipulating our joints to loosen them and keep them flexible. It has left me gasping in pain, sometimes even tears. I can’t imagine having to intentionally inflict pain, but that, one quickly learns, is an inevitable part of healing.

It must be difficult for our physical therapists to cheer us on for what are, in other circumstances, a toddler’s proud achievements — when we have regained the ability to tie our shoelaces or walk steadily across a room or throw a ball.

There is an upside. Because we see them so frequently for months, we get to know our physical therapists, and they us, in ways we’ll never know our doctors. We learn where they live and go on vacation, who has a new puppy, whose husband changed careers.

It’s not an intimacy we would choose. But, shoved out of our private, busy lives, whether reluctantly or gratefully, we fall into their strong, skilled, waiting hands.

Caitlin Kelly is the author of “Blown Away: American Women and Guns.”

New Study Proves PT is the Best Choice in Tendon Injuries....

For Tendon Pain, Think Beyond the Needle

By JANE E. BRODY Published: February 28, 2011

Two time-honored remedies for injured tendons seem to be falling on their faces in well-designed clinical trials.

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The first, corticosteroid injections into the injured tendon, has been shown to provide only short-term relief, sometimes with poorer long-term results than doing nothing at all.

The second, resting the injured joint, is supposed to prevent matters from getting worse. But it may also fail to make them any better.

Rather, working the joint in a way that doesn’t aggravate the injury but strengthens supporting tissues and stimulates blood flow to the painful area may promote healing faster than “a tincture of time.”
And researchers (supported by my own experience with an injured tendon, as well as that of a friend) suggest that some counterintuitive remedies may work just as well or better.

A review of 41 “high-quality” studies involving 2,672 patients, published in November in The Lancet, revealed only short-lived benefit from corticosteroid injections. For the very common problem of tennis elbow, injections of platelet-rich plasma derived from patients’ own blood had better long-term results.
Still, the authors, from the University of Queensland and Griffith University in Australia, emphasized the need for more and better clinical research to determine which among the many suggested remedies works best for treating different tendons.

My own problem was precipitated one autumn by eight days of pulling a heavy suitcase through six airports. My shoulder hurt nearly all the time (not a happy circumstance for a daily swimmer), and trying to retrieve something even slightly behind me produced a stabbing pain. Diagnosis: tendinitis and arthritis. Treatment: rest and physical therapy.

Two months of physical therapy did help somewhat, as did avoiding motions that caused acute pain. The therapist had some useful tips on adjusting my swimming stroke to minimize stress on the tendon while the injury gradually began to heal.

The following spring, although I still had some pain and feared a relapse, I attacked my garden with a vengeance. Much to my surprise, I was able to do heavy-duty digging and lugging without shoulder pain.
Could the intense workout and perhaps the increased blood flow to my shoulder have enhanced my recovery? A friend, Richard Erde, had an instructive experience.

An avid tennis player at 70, he began having twinges in his right shoulder while playing. Soon, simple motions like slipping out of a shirt sleeve caused serious pain. The diagnosis, based on a physical exam, was injury of the tendon that attaches the biceps muscle of his upper arm to the bones of the shoulder’s rotator cuff.
He was advised to see a rheumatologist, who declined to do a corticosteroid injection and instead recommended physical therapy and rest.

“I stopped playing tennis for a month, and it didn’t help at all,” Mr. Erde told me. “The physical therapist found I had very poor range of motion and had me do a variety of exercises, which improved my flexibility and reduced the pain somewhat.” After two months, he stopped the therapy.

Then several weeks ago, after watching the Australian Open, he thought he should do more to strengthen his arm and shoulder muscles and decided to try playing tennis more vigorously. “The pain started to drop off dramatically,” he said, “and in just 10 days the pain had eased more than 90 percent.”

A Frustrating Injury

Tendinopathies, as these injuries are called, are particularly vexing orthopedic problems that remain poorly understood despite their frequency. “Tendinitis” is a misnomer: rarely are there signs of inflammation, which no doubt accounts for the lack of lasting improvement with steroid shots and anti-inflammatory drugs. They may relieve pain temporarily, but don’t cure the problem.

The underlying pathology of tendinopathies is still a mystery. Even when patients recover, their tendons may continue to look awful, say therapists who do imaging studies. Without a better understanding of the actual causes of tendon pain, it’s hard to develop rational treatments, and even the best specialists may be reduced to trial and error. What works best for one tendon — or one patient — may do little or nothing for another.

Most tendinopathies are precipitated by overuse and commonly afflict overzealous athletes, amateur and professional alike. With or without treatment, they usually take a long time to heal — many months, even a year or more. They can be frustrating and often costly, especially for professional athletes and physically active people like me and Mr. Erde.

In a commentary accompanying the Lancet report, Alexander Scott and Karim M. Khan of the University of British Columbia noted that although “corticosteroid injection does not impair recovery of shoulder tendinopathy, patients should be advised that evidence for even short-term benefits at the shoulder is limited.” Like the Australian reviewers, the commentators concluded that “specific exercise therapy might produce more cures at 6 and 12 months than one or more corticosteroid injections.”

Treatments to Try

Now the question is: What kind of physical therapy gives the best results? Most therapists prescribe eccentric exercises, which involve muscle contractions as the muscle fibers lengthen (for example, when a hand-held weight is lowered from the waist to the thigh). Eccentric exercises must be performed in a controlled manner; uncontrolled eccentric contractions are a common cause of injuries like groin pulls or hamstring strains.

Marilyn Moffat, professor of physical therapy at New York University and president of the World Confederation for Physical Therapy, prefers “very protective” isometric exercises, at least at the outset of treatment until the tendon injury begins to heal. These exercises involve no movement at all, allowing muscles to contract without producing pain. For example, in treating shoulder tendinopathy, she said in an interview, the patient would push the fists against a wall with upper arms against the body and elbows bent at 90 degrees.

In another exercise, the patient sits holding one end of a dense elastic Thera-Band in each hand and, with thumbs up, upper arms at the sides and elbows bent at 90 degrees, tries to pull the hands apart.
“The stronger the shoulder muscles are when the tendinopathy calms down, the better shape the shoulder is in to take over movement without further injury,” Dr. Moffat said. “You don’t want the muscles to weaken, which is what happens when you rest and do nothing. That leaves you vulnerable to further injury.”

(article originally appeared in the NY Times.  http://www.nytimes.com/2011/03/01/health/01brody.html?_r=1&ref=physicaltherapy)

Teaching our Children the True Meaning of Christmas...very inspirational

Instead of our usual blog, and in consideration of the wonderful season that is now upon us, I've decided to make this week's entry be more about teaching the true meaning of Christmas.  I found this story online and I hope you enjoy it as much as I did.  It really helps put the season into perspective and gives us the opportunity to teach our own children about the true meaning of Christmas while they are still young.  Enjoy!

Teach the children...

Late one Christmas Eve, I sank back, tired but content, into my easy chair. The kids were in bed, the gifts were wrapped, the milk and cookies waited by the fireplace for Santa. As I sat back admiring the tree with its decorations, I couldn't help feeling that something important was missing. It wasn't long before the tiny twinkling tree lights lulled me to sleep.

I don't know how long I slept, but all of a sudden I knew that I wasn't alone. I opened my eyes, and you can imagine my surprise when I saw Santa Claus himself standing next to my Christmas tree. He was dressed all in fur from his head to his foot just as the poem described him, but he was not the "jolly old elf" of Christmas legend. The man who stood before me looked sad and disappointed, and there were tears in his eyes.

"Santa, what's wrong?" I asked, "Why are you crying?"

"It's the children," Santa replied sadly.

"But Santa, the children love you," I said.

"Oh, I know they love me, and they love the gifts I bring them," Santa said, "but the children of today seem to have somehow missed out on the true spirit of Christmas. It's not their fault. It's just that the adults, many of them not having been taught themselves, have forgotten to teach the children."

"Teach them what?" I asked.

Santa's kind old face became soft, more gentle. His eyes began to shine with something more than tears. He spoke softly. "Teach the children the true meaning of Christmas. Teach them that the part of Christmas we can see, hear, and touch is much more than meets the eye. Teach them the symbolism behind the customs and traditions of Christmas which we now observe. Teach them what it is they truly represent."

Santa reached into his bag and pulled out a tiny Christmas tree and set it on my mantle. "Teach them about the Christmas tree. Green is the second color of Christmas. The stately evergreen, with its unchanging color, represents the hope of eternal life in Jesus. Its needles point heavenward as a reminder that mankind's thoughts should turn heavenward as well."

Santa reached into his bag again and pulled out a shiny star and placed it at the top of the small tree. "The star was the heavenly sign of promise. God promised a Savior for the world and the star was the sign of the fulfillment of that promise on the night that Jesus Christ was born. Teach the children that God always fulfills His promises, and that wise men still seek Him."

"Red," said Santa, "is the first color of Christmas." He pulled forth a red ornament for the tiny tree. "Red is deep, intense, vivid. It is the color of the life-giving blood that flows through our veins. It is the symbol of God's greatest gift. Teach the children that Christ gave His life and shed His blood for them that they might have eternal life. When they see the color red, it should remind them of that most wonderful Gift."

Santa found a silver bell in his pack and placed it on the tree. "Just as lost sheep are guided to safety by the sound of the bell, it continues to ring today for all to be guided to the fold. Teach the children to follow the true Shepherd, who gave His life for the sheep."

Santa placed a candle on the mantle and lit it. The soft glow from its one tiny flame brightened the room. "The glow of the candle represents how people can show their thanks for the gift of God's Son that Christmas Eve long ago. Teach the children to follow in Christ's foot steps... to go about doing good. Teach them to let their light so shine before people that all may see it and glorify God. This is what is symbolized when the twinkling lights shine on the tree like hundreds of bright, shining candles, each of them representing one of God's precious children, their light shining for all to see."

Again Santa reached into his bag and this time he brought forth a tiny red and white striped cane. As he hung it on the tree he spoke softly. "The candy cane is a stick of hard white candy: white to symbolize the virgin birth and sinless nature of Jesus, and hard to symbolize the Solid Rock the foundation of the church, and the firmness of God's promises. The candy cane is in the form of a 'J' to represent the precious name of Jesus, who came to earth. It also represents the Good Shepherd's crook, which He uses to reach down into the ditches of the world to lift out the fallen lambs who, like all sheep, have gone astray. The original candy cane had three small red stripes, which are the stripes of the scourging Jesus received by which we are healed, and a large red stripe that represents the shed blood of Jesus, so that we can have the promise of eternal life."

"Teach these things to the children."

Santa brought out a beautiful wreath made of fresh, fragrant greenery tied with a bright red bow. "The bow reminds us of the bond of perfection, which is love. The wreath embodies all the good things about Christmas for those with eyes to see and hearts to understand. It contains the colors of red and green and the heaven-turned needles of the evergreen. The bow tells the story of good will towards all and its color reminds us of Christ's sacrifice. Even its very shape is symbolic, representing eternity and the eternal nature of Christ's love. It is a circle, without beginning and without end. These are the things you must teach the children."

I asked, "But where does that leave you, Santa?"

The tears gone now from his eyes, a smile broke over Santa's face. "Why bless you, my dear," he laughed, "I'm only a symbol myself. I represent the spirit of family fun and the joy of giving and receiving. If the children are taught these other things, there is no danger that I'll ever be forgotten."

"I think I'm beginning to understand."

"That's why I came," said Santa. "You're an adult. If you don't teach the children these things, then who will?"

(author unknown)

Carpal Tunnel Syndrome and How Our Certified Hand Therapists Can Help You!

What is it?

• Carpal tunnel syndrome is the effect of pressure on the median nerve, one of the main nerves of the hand. It can result in a variety of problems, including pain, tingling, numbness, swelling, weakness or clumsiness of the thumb, index, middle and ring fingers.

What caused it?

• Carpal tunnel syndrome develops in people who have a tendency toward swelling or inflammation in their hands.
• Like a telephone cable, the median nerve is a connection between the fingers and the spinal cord. It passes a through a protective conduit (tunnel) deep in the wrist (carpus), along with the nine tendons which bend the fingers. The nerve and each of the tendons are each nearly as wide as a pencil. The tunnel is only a little over an inch wide - just big enough to hold the nerve and tendons. When the tendons are irritated, the lining around the tendons (synovium) swells up and puts pressure on the nerve. This pressure cuts off the blood supply to the nerve.
• Tendon swelling (tendinitis) results from a person's own tendency to collect fluid around their tendons and joints. This may be aggravated by repetitive or strenuous activities.
• Swelling from adjacent problems, such as trigger finger, basal joint arthritis, rheumatoid arthritis or effects of a wrist fracture may aggravate or bring on carpal tunnel syndrome.
• Early on, symptoms occur during sleeping hours. This is because the swelling is relieved by normal use of the hand which pumps extra fluid out of the carpal tunnel. The fluid pressure builds up only when the hand is at rest - especially during sleep. Bending the wrist may also increase pressure on the nerve.
• In more advanced cases, symptoms occur during waking hours. At this stage, scar tissue may form around the nerve from repeated episodes of pressure. Nerve damage is suspected when any symptoms occur regularly during the day.

What can you do to help?

• As many as two out of three people with mild carpal tunnel syndrome will have some improvement with Stretching Exercises designed to relieve pressure within the carpal tunnel as outlined here.
• "Over the counter" non-steroidal anti-inflammatory medication (NSAID), such as aspirin, ibuprofen, naprosyn, or ketoprofen. Check with your pharmacist regarding possible side effects and drug interactions.
• Take Vitamin B6 100 mg daily (not more) - controversial, but can't hurt, and might help. If you are pregnant or receiving vitamin therapy already, first check with your doctor.
• A splint or brace which supports the wrist, to use while sleeping.
• Wait and watch.

What can a therapist do to help?

• Provide a hand splints to support the wrist.
• Help identify aggravating activities and suggest alternative postures.

What can a doctor do to help?

• Confirm that this actually is the problem. This may require special nerve tests done by a neurologist.
• Prescribe stronger NSAID medication or cortisone-type medication.
• Prescribe hand therapy and/or a custom prescription splint.
• The most effective treatment without surgery is a cortisone shot into the carpal tunnel. Depending on several factors, these measures can provide provide long-term relief in 5 to 60 per cent of patients. Conservative treatment is usually not recommended for patients who have evidence of nerve damage.
• Surgery for carpal tunnel syndrome is intended to provide more space for the nerve and tendons, so that swelling will not put dangerous amounts of pressure on the nerve. It is usually done through an incision on the palm or the front of the wrist. An incision is made to open the carpal tunnel. The tunnel opens up.  It heals with more space inside for the nerve and tendons - like letting out a pair of pants.
• Carpal tunnel syndrome associated with other medical conditions, such as rheumatoid arthritis, may require a more extensive cleaning out of the tissue around the tendons, referred to as a synovectomy.

There are many different techniques used for the surgery - whether it involves a cut in the palm, the wrist, smaller or longer cuts or different instruments, the one thing in common is that the thick layer of ligament in front of the nerve is cut.

After surgery, the healing edges of the ligament beneath the skin are usually tender for at least four to six weeks after the procedure. Temporary tenderness on each side of the palm where the ligament is attached to the bones on each side of the palm these bones is common after surgery and is called "pillar pain". This generally resolves gradually. Hand therapy is often helpful during recovery.

How successful is treatment?

• Swelling, stiffness, aches and pains in the hand may well be due to other problems, and may persist to some extent following any form of treatment.
• Nerve damage existing before treatment may lead to incomplete recovery.
• With this in mind, the great majority of patients are improved with appropriate treatment. Most reports indicate that if carpal tunnel syndrome is the only problem, over 95% of patients have a satisfactory outcome from surgery.

What happens if you have no treatment?

• It depends most importantly on whether or not the problem actually is carpal tunnel syndrome and whether or not there are other medical conditions contributing to the overall picture.
• Mild carpal tunnel syndrome can improve without treatment in as many as one in three people.
• The chances of getting better without surgery are less when
o both hands are involved.
o the longer the problem has been going on.
o the older the person is.
o the more severe the symptoms of numbness and tingling are.
• The longer the nerve is irritated, the longer numbness or tingling are constant, the harder it is to have a full recovery - even with surgery. If the problem is severe, however, surgery is a reasonable step to prevent further nerve damage even if full recovery cannot be guaranteed.

If you are suffering from Carpal Tunnel Syndrome and are looking for relief, call us today to schedule an appointment and one of our Certified Hand Therapists can discuss therapy options with you.  We take most major insurances.  1-386-898-0443.


Online resource: http://www.eatonhand.com/hw/hw006.htm

Search the web for carpal tunnel syndrome, or go to these on line brochures: American Association of Orthopedic Surgeons: CTS Patient Education Brochure. American Society for Surgery of the Hand: CTS Patient Education Brochure.

Top 5 Repetitive Strain Injuries in Runners and Ways to Treat Them

Running is a popular sport enjoyed by many people of all ages. While running is great exercise for the muscles, joints, heart and lungs, it may also cause repetitive strain on body parts and be a source of injury.  

While not all running injuries can be avoided, many repetitive strain injuries from running can. By maintaining adequate flexibility and strength, you can limit your chances of suffering from the top five running injuries.

1.              Iliotibial Band Syndrome: Iliotibial band syndrome (ITBS) occurs when there is repetitive friction of the iliotibial band, a thick mass of tissue that courses down the outside of the thigh from the hip to the front of the knee. Irritation of the ITB usually causes intense burning pain in the outside portion of the kneecap. Treatment of ITBS involves rest and ice during the initial phase of injury. This can help limit the inflammatory response.

After a short period of rest, gentle stretching of the ITB can be started. Occasionally hip and abdominal strength limitations can have an effect on knee position during running, which can place stress on the ITB. Therefore, hip and core strengthening may be required to fully recover from ITBS. Your doctor and physical therapist can help you determine which specific muscles groups you should focus on.

2.              Piriformis Syndrome: The piriformis is a muscle that resides deep in the hip and serves to rotate and stabilize the hip. Irritation of the piriformis muscle can cause hip and buttock pain. The piriformis muscle courses over the sciatic nerve, and tightness in the piriformis muscle can cause pain that runs down the leg, much likesciatica. If you have piriformis syndrome, your doctor and physical therapist should evaluate you to determine the biomechanical cause of the pain. Since low back pain is sometimes felt in the hip, examination of your low back and spine should occur. Initial treatment of piriformis syndrome involves a period of rest. Once the acute pain has subsided, stretching and strengthening the muscles of the hips and legs should occur.

3.              Patellofemoral Stress Syndrome (PFSS): This common knee problem occurs with improper tracking of the kneecap in the groove of the femur and causes pain around the kneecap. It can be caused by tightness in the iliotibial band, weakness in the thigh muscles, or weakness in the hip muscles. Treatment of PFSS involves rest and ice to control initial inflammation. After a short period of rest, gentle stretching and strengthening can be done. Your physical therapist should also evaluate your gait and running stride to assess if other mechanical faults are causing your problem.

4.              Shin Splints: Shin splints are caused by inflammation of the anterior tibialis tendon in the front of the shin. Symptoms of shin splints include pain, numbness and burning in the front of the shin. Occasionally poor foot position can cause shin splints, so your physical therapist should evaluate the position of your feet while you are standing and lying down. Orthotics are sometimes necessary to correct foot position.

5.              Plantar Fasciitis: The plantar fascia is a thick band of tissue on the bottom of the foot that helps form the arch of the foot. Irritation of the plantar fascia can cause pain on the bottom of the foot near the heel bone. You should initially treat plantar fasciitis with a period of rest and ice. Gentle stretching of the calf and leg muscles should be started. As with shin splints, a foot evaluation may be necessary to see if the position of your feet may be a mechanical cause of plantar fasciitis.

If you are a runner experiencing any repetitive strain injuries, you should speak with your doctor and physical therapist to decide on the best treatment for you. A thorough evaluation of your specific biomechanics while running can help you treat the current problem and prevent future episodes of pain.

This article originally appeared on: 

http://physicaltherapy.about.com/od/sportsinjuries/a/The-Top-Five-Running-Injuries.htm

Early Therapy Can Help Knee Surgery Patients

Beginning physical therapy within 24 hours of knee arthroplasty surgery can improve pain, range of joint motion and muscle strength as well as cut hospital stays, according to new research in Clinical Rehabilitation.

Physical therapy and public health researchers from Almeria, Malaga and Granada in Spain compared patients who began treatment within 24 hours of surgery with those who began 48 to 72 hours after their operation in a random, controlled clinical trial. Each group had more than 150 patients, ages 50 to 75.

The post-operative treatment began with a series of leg exercises, breathing exercises, and tips on posture. By the second day, walking short distances with walking aids was added. In subsequent days the regimen built up to adapting to daily life activities, such as beginning to climb stairs on the fourth day.

On average, those beginning treatment earlier stayed in hospital two days less than the control group and had five fewer rehabilitation sessions before discharge. An early start also led to less pain, greater range of joint motion both in leg flexion and extension, improved muscle strength and higher scores in tests for gait and balance.

Other benefits of early mobilization after this surgery are fewer complications, such as deep vein thrombosis, pulmonary embolism, chest infection and urinary retention. With hospital-acquired infections, such as MRSA, also a serious concern, a shorter hospital stay also might lower the risk to patients of contracting this type of secondary infection.
source: todayinpt.com