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Rehabilitation Articles

Acute Knee Pain: Tips & Exercises

You often lose strength and motion in your knee when it is painful and swollen. This can happen after injury or overuse. The exercises and tips listed below will help you decrease pain and swelling, increase range of motion, improve strength and help you return to your normal activities as soon as possible.

How to reduce pain and swelling

Rest: Avoid painful activities to give your knee time to heal. Limit your walking and other standing activities when your knee is painful or swollen. Use a cane or crutches to decrease the stress on your knee. It is best to use the cane on the opposite side of your painful knee. Use supportive shoes when you are standing or walking.

Ice & Elevation: Place a cold pack on your knee with a thin towel between your skin and the cold pack to prevent a rash or burn. Use ice 15-20 minutes, 2-4 times per day as long as your knee is warm, painful or swollen. Elevate your knee above the level of your heart to help with the pain and swelling.

Compression: If your knee is swollen, using a knee brace or wrap may help with the pain and swelling and provide support to your knee. Apply the elastic wrap loosely from your calf to right above your knee. You should be able to easily put two fingers under the wrap.

Range of Motion Exercises
It is important to begin moving your knee and ankle to prevent stiffness reduce swelling and increase circulation. Start by bringing your toes and foot towards your shin and then point your foot away 10-20 times every hour.


Rehabilitation for Arthritis

Arthritis is the most common cause of chronic disability. There is no cure for most forms of arthritis. But with some effort, you don't need to lose all the movement in your joints. A rehabilitation program can help you maintain and even improve your joints' strength and mobility. With some help from specialists and special equipment, arthritis won't always stop you from doing the things you enjoy or the things you need to do.

Rehabilitation is a hands-on form of care and relies on your participation and effort. It involves exercising, learning how to care for sore and swollen joints, and figuring out ways to minimize the stress on your joints. In the early stages of arthritis, the goal of rehabilitation is to maintain or improve your joint strength and range of motion. If your joint is severely damaged, rehabilitation will focus on managing your pain and finding special equipment to help you with necessary tasks. Rehabilitation also helps people recover from joint surgery. Your rehab program will involve managing your symptoms, exercise, and lifestyle changes.

Rehabilitation requires patience. It takes time to strengthen your joints and learn how to do familiar tasks in new ways. But the result can be a greatly improved quality of life.

Treating Patella Fracture

Overstressing patella fractures too soon could hinder the healing process

PT Focus
PTs face many unique challenges when treating a variety of orthopedic patients. To effectively manage orthopedic injuries, PTs must be knowledgeable of musculoskeletal tissue healing principles, be familiar with various rehabilitation programs, know how to skillfully apply rehabilitation techniques as well as fundamentally understand common and uncommon soft tissue injuries, fractures and diseases of muscles, bones and joints. Management of patella fractures, both nonoperative and postoperative, provides PTs with an opportunity to fully utilize each component of effective rehabilitation.

Causes and Types
Fractures of the patella most commonly occur from direct trauma, usually a fall on the knee or a direct blow to the patella. Less frequently, the patella can be fractured by a sudden, violent contraction of the quadriceps.
Patella fractures are classified as either transverse, stellate or vertical. These three categories can be further classified as displaced or nondisplaced. The arterial blood supply to the patella is derived from two systems of vessels from branches of the geniculate arteries. These two systems supply the middle third and apex of the patella. In cases of displaced transverse fractures, the proximal blood supply may be compromised leading to avascular necrosis of the proximal segment.

Overall, the management of patella fractures is based on classification and morphology of the injury. Treatment options range from nonoperative to operative with open reduction and internal fixation to partial or total patellectomy.

It's All In the Swing: Golf Injuries

Golf looks like an easy game to play, hitting a stationary object with a club into a relatively wide open space. Well, think again! To become a good golfer, it is recommended that you start young and practice, practice, and practice. Golf historically is perceived as being a low-risk sport when it comes to injuries. However, many young golfers, especially those who lack proper technique, suffer from acute or overuse injuries.


Acute injuries are usually the result of a single, traumatic episode, such as hitting the ground of a submerged tree root in a sand trap. Overuse injuries are more subtle and usually occur over time. These injuries will more often stem from the stress that the golfer puts on the back and shoulders when swinging. The three most commonly injured areas of the body are the back, shoulder, and elbow. They should be treated with rest, a good stretching/warm-up program, and good, sound advice from golf professionals.

Back to Basics for Balance & Gait

By Jennifer Bauer, MSPT on January 18, 2017

Achieve more with less while fine-tuning your fall prevention approach
The “Silver Tsunami” is approaching, and therapists need to be prepared. As the baby boomer generation enters retirement age and the medical system, therapists must ready themselves for a unique set of standards.
Cookie-cutter protocols simply aren’t acceptable any longer. Boomers want customized programs and more personalized care; this is the trend.

According to the National Council on Aging, 25% of the population over age 65 falls each year. As the population ages, this number rises. Therapists must fine-tune their approach to fall prevention, thereby streamlining their balance and gait training techniques.

Tools to Treat Foot Drop

From exercise to medications to modalities, clinicians have a lot of tools at their disposal to treat foot drop. Just as its causes are many, so are the treatments. While the same approach may not work for each patient, trial and error can help doctors and physical therapists figure out the best possible outcomes.

Foot drop is not a disease itself, but rather a symptom that develops as a result of various neurological, muscular or anatomical problems. Patients who suffer have difficulty lifting the front part of their foot due to muscle weakness or paralysis. Sometimes they drag their toes along the floor as they walk.

In a normal gait cycle, the toes pull up from the floor so a person avoids tripping on them. The toes of foot drop patients point down and strike the floor first, with their ankle flapping as they move the foot. They may develop a steppage or marching gait, raising their thigh when walking in a motion similar to climbing the stairs.

Evaluation and Treatment for Thoracic Outlet Syndrome

By Wendy Sue Powers, PT on March 4, 2002

Tests can be effective in diagnosing this sometimes confounding condition

Thoracic outlet syndrome (TOS) is a collection of syndromes resulting from abnormal compression of the brachial plexus and/or the subclavian artery/vein (neurovascular bundle) that occurs between the cervical spine and the axilla. Symptoms of TOS may include upper extremity pain, paresthesias, numbness, muscle weakness, sensation of heaviness, discoloration, edema, arm fatigue, ulceration and gangrene. Symptoms will vary according to the severity of the compression. Other clinical terms used to describe this presentation include the scalenus anticus, costoclavicular, hyperabduction, pectoralis minor and cervical rib syndromes.

Manual Therapy: A Hands-On Approach

Grounded in evidence, manual therapy improves patient outcomes

There is nothing new about the concept of “hands-on” physical therapy treatments. Various studies show that conditions such as low-back pain and musculoskeletal pain are effectively treated with a combination of manual therapy and other treatments such as exercise and strengthening.

Manual therapy, according to Craig O’Neil, PT, DMT, OCS, COMT, vice president of clinical excellence at Results Physiotherapy, a Tennessee-based network with over 100 locations, is much more than a set of techniques. “Current manual therapy is not only technique, but it is also skilled examination, clinical reasoning and a movement-analysis thought process that integrates the neuromusculoskeletal system at all levels,” he said.

Management of the Elbow Complex

•    Accurately describe at least two examples of the anatomic and bow mechanical relationships of the elbows that relate to normal function.
•    Describe without queues the pathomechanics of at least two selected elbow injuries.
•    Independently outline an evidenced based examination with at least three intervention techniques for selected elbow conditions.

There are three primary articulations: the humeral ulnar, humeral radial, and the proximal radial ulnar joint.

Carrying Angle
Another thing to consider when reviewing anatomy is the carrying angle.  There is a normal valgus angulation. In men, that normal angulation ranges between 11 and 14 degrees, and in women, 13 to 16 degrees. The female pelvis is a bit wider which may be a component on why there is a difference in gender. Again, keep in mind the normal position of the elbow is going to have a bit of a valgus angulation.

A Better Grip on Hand Therapy

Interrupting the damaging downward spiral of desensitization, weakness and pain

While edema, scar management, range of motion and strength are the four pillars, we must have a foundation on which to improve hand function. That foundation is sensation. Without sensation in the hands, we limit their use, protect the area or extremity, and slowly lose functional use of that limb.

Sensory limitations can be caused by carpal and cubital tunnel syndrome, surgical complication, and physiological response to surgery, including edema and excessive collagen production causing heavy scar tissue, among other origins.
Therapists primarily confront two types of sensation dysfunctions: hyposensitivity and hypersensitivity. Both are problematic in their own way, and both require education and rehabilitation to return the patient to the highest level of function. With sensation insults, we often see texture discrimination issues, stereognosis concerns, and diminished protective sensation including hot and cold sensation and touch-pressure threshold detection levels.

Challenging Geriatric Patients

Giving older patients the push they need to get results.

We talk a lot about the soft ageism of low expectations. Simply put, we often fail to ask our older patients to complete tasks that are challenging enough to create meaningful change. Nowhere is this more evident than in assessment and treatment of trunk strength and core stability. When was the last time you asked an older patient or client to perform a plank? More than 20 cross-sectional and longitudinal studies indicate that core strength is important for the successful performance of activities of daily living in old age.

Conversely, a number of studies have started to ask why balance and resistance training alone poorly translate into improvements in balance, functional tasks, activities of daily living and fall rates. A consensus is emerging that core strength training must be a component of any program aimed at the overall health and well-being of older adults.

What to Expect When They're Expecting: PTs Who Treat Patients During & After Pregnancy

Many women's health PTs treat patients during and after pregnancy. Here are some of the services they offer and why they say it's important to spread the word to other health care professionals.
By Michele Wojciechowski | December 2017

At Swedish Medical Center in Seattle, Washington, on any given day you might see certified lymphedema therapist Peg Maas, PT, DPT, performing lymphatic massage on a patient. But it's not because the woman has cancer, although she is a cancer survivor. It's because she's pregnant. Specifically, Maas is seeing the patient because of fluid retention due to pregnancy. "I've had women who have been pregnant after having cancer and have had fluid management problems from their lymphedema," she explains. "We do lymphatic massage and compression the same as we do when women aren't pregnant. We don't leave the swelling alone and just say, ‘You're going to be puffed up because you're pregnant.' It's not just fluid, and it puts women at greater risk of infection." Maas' experience is 1 example of what physical therapists (PTs) who focus on women's health can do to treat patients with and without specialized conditions during and after pregnancy. For this article, PT in Motion interviewed 5 PTs who all are board-certified clinical specialists in women's health physical therapy.

Tips from the Experts

Tips from the Experts

Tips For Injury Prevention While Snow Shoveling

It happens every winter in the Northeast, snowfalls, usually leaving heavy piles of snow and ice to clear from sidewalks and driveways. The extremely cold and fluffy start to 2009 has confirmed weather expert predictions of a colder than normal winter with heavier snowfalls. Physical Therapists and medical experts alike are concerned about reducing the number of injuries that may occur from shoveling snow.

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