Are you experiencing inflammation, pain, and/or stiffness in your joints? If so, a possible cause may be arthritis. It may be accompanied by a limited range of motion as joints are too inflamed to move. Arthritis is quite common, in fact, there are more types of arthritis then you know. It can affect men, women, and even children.
The most common are osteoarthritis which onsets from wear and tear of cartilage and rheumatoid arthritis that occurs from an overactive immune system. It’s important to treat the specific condition as it can interfere with work or everyday activities. Physical therapy has been proven to be highly effective in treating the effects of arthritis.
A physical therapist will create an individualized treatment plan based on your diagnoses and pain level. The goal should be to improve mobility by restoring the use of affected joints and to increase strength for joint support. Your physical therapist may also focus on increasing flexibity, coordination, and balance if appropriate.
He/she will provide knowledge on exercises to do at home and what activities to avoid. Depending on their condition, patients may be advised to use assistive devices such as a cane or walker to relieve pressure. The physical therapists will work consistently with patients to maintain progress and safe return to daily activities.
It’s important for patients to adhere to their exercise regimen as regular physical activity can keep surrounding muscles strong, decrease bone loss, reduce stiffness, and control swelling and pain. Exercising can also enhance energy and stamina, thereby, decrease fatigue and improve sleep. Patients with arthritis who are overweight can forsee additional benefits as exercising can promote long-term weight management.
Besides exercises, your treatment program may consist of manual therapy. Evidence shows that joint and soft tissue mobilization can help patients relieve pain and stiffness. Specific modalities may be used during treatments such as a hot/cold pack and electrical stimulation to relieve pain.
These techniques can increase blood flow, reduce inflammation, reduce pain, and enhance mobility. Thus, it’s important to consult your doctor to see if physical therapy is appropriate for you as it can be a safer alternative to surgery and pain medications.
Many people believe that surgery alone can lead to full recovery. However, without proper care and rehabilitation, any work/progress completed during surgery may be undone. Post-surgical rehabilitation concentrates mainly on increasing strength and mobility. The physical therapist will provide appropriate modalities, manual therapy, and exercises to improve patient’s endurance, strength, and flexibility.
They will work with the patient to create an individualized treatment program that will cater to the patient’s surgicial procedure, pain level, and goals, allowing them to bounce back successfully. Physical therapy for post surgery should focus on progessing patients to a pain free state without limitations and risks of future injuries.
Surgerical procedures that often recommend follow up physical therapy somer common surgeris include :
- Rotator Cuff Tear
- Hip, Shoulder, and Knee Joint Replacements
- Ligament Tears of the Knee (ACL, LCL, MCL and PCL)
- Tendon Rutprue Repair
- Arthroscopy and Meniscus Repair
- Spinal Surgery
- Additional Operations Resulting in Weakness or Stiffness
Physical therapy can reduce pain/discomfort from surgery with techniques such as electrical stimulation, ice, hot pack, massage and manual therapy. Once the pain subsides, the treatment program will focus more on the challenges of each surgical procedure.
For instance, if a patient received a knee replacement, the therapist will prescribe strengthening and range of motion exercises to promote recovery. Patients can also experience weakness from being sedentary after surgery, but physical therapy can help increase muscle mass to its previous levels.
Without physical therapy, there are possibilities of re-injury or prolonged recovery, post surgical complication like stiffness, contractures, weakness. It is necessary for the patient to be aware of what activities to avoid and how to safely perform daily activities to prevent future setbacks.
Physical therapy will also help patients return to regular activities quicker as it enhances healing in damage tissues. Thus, physical therapy is essential in achieving a safe and fast post-surgery recovery.
Physical therapy is a great option to consider in relieving knee pain. The main goals of a treatment program should be decreasing pain and increasing mobility. If someone experiences difficulty standing up from or sitting down on a chair, going up or down the stairs, or walking to run errands, it’s important to treat the problem earlier on before it exacerbates.
During the initial evaluation, the physical therapist will examine the patient’s strength, range of motion, and functional abilities. From there, a personal treatment plan will be created for the individual, taking in account of any goals he/she may have in mind.
A session of physical therapy may include stretching, strengthening, balance and gait training, and joint mobilitization /stabilization. If the therapist deems appropriate, a hot pack, ice pack, electrical stimulation, ultrasound, or althetic taping may be used.
People with knee pain should consider physical therapy because it can be an effective treatment in place of surgery. Therapy has been proven to be successful for patients with meniscal tears and moderate osteoarthritis; allowing them to avoid possible risks, side effects, and expenses of surgical intervention.
If surgery is inevitable, therapy can be essential both before and after surgery for efficient recovery. Therapy beforehand, can help patients become stronger and help them accustom to an exercise routine, thus, requiring less intensive therapy post-operation. After surgery, therapy can help individuals regain mobility, increase strength and balance, walk without an assistive device, and return to previous activities of everyday life.
After an injury, exercises can help patients prevent joints from stiffening, increase movement, and reduce pain. Some beneficial exercises include stretching for the quadriceps and hamstrings, strengthening the hip and knees with clamshells, squats, and strengthening the calves with heel raises.
However, every patient start off at different levels and experience different types of pain, therefore, it is important to consult a physical therapist so they can make an exercise regimen catered to the patient alone.
For many years, the dominant technique for hip arthroplasty replacements has been the posterior approach. For this type of surgery, an incision is made at the back of the hip, muscles are cut to reach hip joint, the head and neck of the femur are removed, a stem with a “ball” at the end is inserted into the femur, and finally the hip joint is rejoined and surrounding tissues are repaired.
There are many risks of dislocation including sitting with hip hyper-flexed, leg internally rotated, and crossing one leg over the other. Because of this, many surgeons have taken different approaches that may be more beneficial such as the anterior approach.
In this case, a smaller incision is made in the front of the leg. Instead of cutting and possibly causing damage, muscles are separated to reach hip joint.
Post-operation will require a shorter recovery and hospital stay time compared to the posterior approach. Less precaution is needed as the patient should only avoid keeping their leg externally rotated.
There are many disadvantages to the anterior hip replacement approach as well. Because of the smaller incision, there is a restricted view of the hip joint. A special operating table is required for the anterior approach that may give rise to femoral and ankle fractures.
There may be risk of lateral femoral-cutaneous nerve damage which may lead to numbness, tingling, or burning sensation along the thigh. Finally, obese and muscular patients are not good candidates since additional soft tissue makes it difficult to access the joint.
Physical therapy can help patients with hip arthroplasty replacements regain mobility and strength. Exercise routines can increase the lifetime of an implant, thus, post-phoning another surgery.
Patients who received the anterior approach may have better range of motion, thus, there is less restriction on their exercise prescription. Studies show that they may use crutches or a walker unaided 6 days sooner than patients who received the posterior approach.
They may also experience less pain, thus, they are able to bend at hip and bear weight sooner, leading to faster recovery.
However, this is just general information. Always consult your doctor or surgeon to decide which procedure is appropriate for you.
The shoulder is one of the most common body part in which injuries take place. There are multiple underlying conditions that can cause pain and limitations on movement. Shoulder problems can be obtained in many ways such as a fall, strain from reaching an object, or injury from sports.
However, most conditions emerge over time from overuse or simply aging. If left untreated, minor irritations and symptoms can exacerbate and become greater, more limiting problems that are harder to treat.
Common types of shoulder pain include:
- Tendonitis/Tendinopathy: This condition results in the inflammation of a tendon causing motions such as reaching up or across the body to become painful. If left untreated, it can progress into a “frozen shoulder,” where the person loses some or all of his/her normal range of motion.
- Bursitis: Bursitis occurs when the fluid filled sac (bursa) that cushions the tendons and joints, become irritated or inflammed. It may lead to symptoms such as pain and stiffness.
- Impingement: Another condition that can lead to inflammation and pain is impingement of the tendons and bursa by surrounding bones. These symptoms can limit everyday activities such as reaching overhead, lifting, or carrying objects.
- Rotator Cuff Injury: This occurs when the muscles that aide in movement weaken or tear causing weakness, pain, and limited range of motion.
- Arthritis: Arthritis can also cause stiffness and pain during motion. This condition causes the tissue or cartilage that protects the joints to wear down.
- Postural Dysfunction: Using computers or sitting for extended periods can lead to muscle imbalances in the shoulder which can progress to pain and injury.
Physical Therapy for Shoulder Pain
Although some injuries may require surgery to fix the “damages”, physical therapy alone can be used as treatment. In fact, shoulder pain physical therapy is effective in treating most shoulder conditions and injuries.
During the initial evaluation, the physical therapist will conduct a series of tests and assessments to determine the appropriate diagnosis and treatment plan. They may measure the patient’s strength, range of motion, evaluate his/her posture, and/or perform screening tools to pinpoint the exact area of injury.
The best treatment plans are individualized to each patient based on their needs and pain level. They may include exercises to increase strength, mobility, and flexibility, which are important factors in preventing the development of chronic shoulder issues.
The physical therapist may also use passive treatments such as a cold or hot pack, electrical stimulation, and/or ultrasound to alleviate pain and increase blood flow to the area. They may also conduct manual therapy such as mobilization or massage if deemed appropriate.
Since many shoulder conditions have the ability to become more severe, it’s important to seek help right away. Physical therapy may lasts between several weeks to several months depending on the condition and whether the patient underwent surgery. It’s important to adhere to the treatment plan and remain committed to obtain optimal results and faster return to normal routine.
Hip pain can occur on the outside of your hip, upper thigh, or outer buttock from problems with any muscles, ligaments, tendons, and other soft tissues surrounding the hip joint. It can be felt in simple functional activities such as walking, running; sit to stand, and climbing stairs, therefore, limiting our daily lives.
There are many factors that can cause hip pain including physical injuries, previous injuries, repetitive use, pregnancy, strenuous physical activities, age, and musculoskeletal conditions. Even the type of shoes a person wears can lead to hip pain.
Lateral hip pain (on the outside) is a common category of hip problems experienced by patients. One possible cause for this can be Trochanteric Bursitis, a condition where the bursa, the fluid filled sac that cushions the joints and tendons connecting the gluteal muscles to the great trochanter, becomes irritated or inflamed. It can lead to an onset of symptoms such as pain, limited movement, and weakness of the hip muscles.
However, the most common cause for lateral hip pain is tendinopathy of the gluteus medius and minimus tendons. This condition can lead to tenderness on palpation and pain over the lateral hip and gluteal region when moving or exercising. Although some symptoms may appear mild, they can become severe over time with further agitation, therefore, it’s important to seek help right away. This can lead to a faster recovery time as well.
Arthritis, tendonitis, and muscle strains can also be possible factors. With arthritis, the hip joint becomes worn out resulting in hip, groin, or lower back pain, or even pain going down the leg. This condition can be caused by factors such as injury, repetition of movement, or aging. Tendonitis and muscle strains are caused by inflammation of the muscles and tendons surrounding the hip joint.
Physical Therapy Treatment
A physical therapist may first evaluate the patient’s gait to notice any abnormalities in hip movement during different phases of walking. They may continue with palpation, by touching various structures around the hip to locate the source of the pain.
They may also measure range of motion and strength to help direct treatment and to see if any muscle weakness or imbalance is causing the pain. The therapist may also ask if the pain interferes with daily activities such as walking, climbing stairs, or walking. He/she will take these observations and responses into consideration and create a treatment plan.
Treatments will vary for each person based on their needs and the severity of their condition. A treatment plan may include various manual techniques, appropriate modalities such as heat, ice, ultrasound, and/or electrical stimulation, and specific exercises as the patient progresses.
The hip pain physical therapy program would focus on decreasing or eliminating pain, increasing range of motion, and increasing strength. Overall, the goal is to help patients return to their normal functioning mobility so they are able to resume their daily lives.
Ever get a painful or uncomfortable clicking in your jaw while chewing? Or stiffness as soon as you wakes up in the morning? If you do, you may have problems with your temporomandibular joint.
The TMJ is located where the mandible (jaw) meets the skull. A thin disc separates the bones and it aids the mouth in opening and closing. When it becomes loose, it can shift more than usual resulting in a clicking or popping sensation. In the worst case scenario, the disc can get stuck causing the mouth to remain locked open.
Another factor in developing problems with temporomandibular joint is Arthritis as the disease can damage the cartilage within the joint. The most common symptoms people with TMJ dysfunction experience are pain and limited movement of the jaw joint and surrounding muscles.
TMJ dysfunction is more prevalent among the younger population and 5 to 12 percent of Americans may suffer from this disorder. It’s important to treat temporomandibular joint dysfunction before symptoms exacerbates because it can interfere with diet and sometimes require surgery to fix. Physical therapy is a great route in potentially correcing many problems that can arise from temporomandibular joint.
The physical therapist will start by evaluating the degree of the condition. They may ask you questions about type and duration of muscle, joint, and facial pain, any difficulty with chewing, and any clicking or popping sound present. Manual therapy can be very effective as it helps decrease muscle, joint, and facial pain as well as frequency of spasms.
With this information, they can determine a treatment plan by using a combination of stretching, joint mobilization, soft and deep tissue release, and/or modalities to increase the range of motion and strength of the joint.
They may educate patients on techniques they can practice and good habits to adapt in order to regain normal jaw function. The physical therapist can also help post-operational patients by minimizing scar tissue and tightness of the surrounding muscles.
Good Habits to Remember
- Posture: Be aware of your posture in any setting where you tend to hold your head forward and slouch your shoulders (i.e. sitting in front of the computer or in your car).
- Diet and Chewing Changes: Cut your food into small amounts and stray from opening your mouth wider than the thickness of your thumb. Avoid food that would require prolonged chewing (i.e. gum). Chew your food with your molars instead of your front teeth.
Tongue Positioning: Produce a clucking sound by positioning your tongue on the hard palate of the mouth. Placing the tongue in its resting position can provide muscle relaxation and appropriate nasal breathing which aids in reducing pain.
Postural dysfunction, also known as “poor posture”, occurs when we position our spine in unnatural positions such as rounding our shoulders and protruding the head. This can place great stress on the vertebrae as well as the joints and muscles in the surrounding area. It’s important to correct our posture before too much pressure accumulates leading to the onset of more pain.
Essentially our body is designed for movement. It’s not meant to stay stagnant for long but today, more and more people are adapting stationary lifestyles and habits (i.e. sitting at work for long hours, watching television, or using the computer).
As technology continues to boom, more time is spent looking down at phones and tablets causing our bodies to maintain a flexed posture far longer than what’s appropriate. In fact, the ideal stance is where the ears, shoulders, hips, knees, and ankles should be aligned.
A number of factors can cause posture problems including:
- Muscle Tightness: If a muscle continues to be shortened, it will eventually accommodate that position by becoming shorter. For instance, sitting for long periods can cause our hip flexors to shorten, thus, interfering with our gait and causing a flexed forward posture.
- Muscle Weakness: If a muscle continues to be lengthened, it will eventually become weak due to overuse. For instance, sitting for long periods can cause our gluteus Maximus muscle to lengthen which increases the possibility of atrophy. This can cause lower back pain and less hip mobility, ultimately leading to poor posture when we stand.
- Soft Tissue Shortening or Adhesions: When a joint remains immobile, it can become stiff and lose some of it’s range of motion.
- Poor Neuromuscular Control: Injury can alter neuromuscular control, thus, affecting joint stability and posture.
- Inflammation: Inflammation can cause muscle spasms, guarding, and changes in posture.
How can physical therapy help?
Postural Dysfunction Physical therapy is a great method to correct poor posture and restore proper balance. A physical therapist will observe your posture and educate you on good habits to maintain. Most treatment plans concentrate on reducing compensations and strains while aiming towards the optimal load on muscles and soft tissues.
You may also receive an exercise prescription to strengthen specific muscles and to correct body alignment. It’s important to note that’s everyone’s body is designed and shaped differently; therefore, every treatment plan will be individualized to meet goals and needs.
Your treatment plan may include:
- Assessment and diagnosis of postural habits
- Postural education and training
- Manual therapy and soft tissue massage
- Joint mobilization
- Postural taping
- Corrective exercises and movements to improve flexibility, strength, and posture
- Activity modification advice
- Advice regarding ergonomic work stations
Gait defines our manner of walking and any correlated dysfunctions can deviate our walking from the norm. They can transpire from several underlying medical disorders including ones that involve the inner ear, Parkinson’s disease, muscular dystrophy, arthritis, neuropathy, stroke, vertigo, multiple sclerosis, disc problems, and musculoskeletal abnormalities such as fractures.
The onset of gait and balance problems is very common as we grow older. It’s important to treat this issue as it could lead to falling, one of the major causes of injury among the elderly population.
Most treatment plans for balance and gait physical therapy abnormalities involves exercises to strengthen the lower extremities. The main goal is to build up muscle back to its original state or above so the patient can perform activities of daily living without difficulties.
The physical therapist will individualize the treatment program based on the patient’s needs, goals, and how much they can tolerate without injury or onset of pain. Every program would be catered to the patient’s specific condition. The best exercise programs will be changed routinely based on the patient’s progress to optimize muscle strength and balance.
Your treatment may include:
- Pre-Gait Training. Your physical therapist may ask you to perform simple activities that can help improve your gait such as standing on one leg, marching in place, and walking heel first.
- Gait Training. Your physical therapist will observe, educate, and help you retrain your gait. Since an underlying vestibular, neurological, or muscular condition may be present, training will differ from patient to patient. Also, if your doctor requires you to use crutches after a surgery, your physical therapist will teach you how to use them properly while walking and using the stairs. Ultimately, the program will be modified to ensure the safest training.
- Balance and Coordination Training. Your exercise prescription may include balance activities to help stabilize your walking pattern.
- Neuromuscular Reeducation. If any inactive or weak muscle groups are affecting your gait, your therapist may enforce neuromuscular reeducation techniques to activate them.
- Bracing or Splinting. If your gait dysfunction is caused by the weakness or paralysis of a ligament, your physical therapist may teach you how to use adaptive equipment, like a brace, splint, or cane, to help you move.
The neck bears a considerable amount of weight; as much as one-seventh of the body’s weight! It’s one of the most unrestrained body parts but pain in this area can limit our range severely. Many people try to alleviate their symptoms by taking pain killers; however, this does not stop the pain from returning. Instead, the best solution is to locate and treat the underlying problem and physical therapy is great in doing just that.
Signs and Symptoms
Neck pain can affect any age group and it ranges from a dull ache to a sharp, intense pain. In more severe cases, it can travel to the arms, shoulders, upper back, chest, and head. In fact, the most common complaint is pain occurring in the form of a headache.
Neck problems can also prevent movement because of muscle stiffness, tenderness, and tension. This can limit our participation in activities of daily living such as looking down to read a book and turning our head to look behind our shoulders.
Types of Neck Pain
The source of most neck pain is strained neck muscles. People can place stress onto the area with the most simplest of actions. Common ways that cause strains, sprains, or spasms include poor posture, looking down at your phone, carrying a heavy bag, and sleeping in an odd position.
Falling or whiplash is another way to cause the problem. For instance, in a car accident, your neck may go backward and then forward, in a whip like motion, a movement likely to harm the area. Other impact or force-related trauma can cause similar injuries.
If muscle knots, tension, or stiffness is left untreated, it can lead to chronic neck pain that lasts for three or more months. It’s capable of spreading to the following areas: shoulders, chest, upper back, and/or arms causing weakness, tingling, and/or numbness to develop.
Thus, it’s important to address neck pain in its early stages before it exacerbates and limit our mobility even more. Apart from physical, additional symptoms of chronic pain include fatigue, depression, and anxiety.
Physical therapy treatment for neck pain may include:
- Applying ice, heat, and/or electrical stimulation
- Muscle energy technique
- Joint mobilization and soft tissue massage
- Cervical traction (light stretching of the neck)
- Postural corrections as well as ergonomics consultation
- Strength and stretching exercises
- Neural mobilization
Neck Stretches: It’s optimal to include stretching exercises in the treatment plan to increase range of motion and flexibility of the cervical joints. It can also relieve the stiffness that accompanies the pain.
Neck Strengthening: Strengthening exercises can improve posture, which in turn decreases recurrent flare-ups of pain.
Aerobic Conditioning: Aerobic exercises can benefit blood flow to the neck and upper back muscles and soft tissues, thus, loosening the muscles and increasing range of motion. Also, after 30 minutes of cardio, our body naturally produces endorphins, a “painkiller” that can help relieve symptoms.