My Knee Hurts…So Why am I Strengthening my Hips and Core?

Posted on March 27, 2013 by Devin Blessing, PT, DPT

Have you ever had nagging pain in the front of your knee with running, squatting, going down stairs, or sitting? If you answered yes to any of these, chances are you may have been experiencing what is known as Patellofemoral Pain Syndrome (PFPS). Although it is one of the most frequently diagnosed knee injuries, the underlying cause of PFPS is vague and controversial. Pain around the knee cap (aka patella), with the absence of other structural injury, is typically diagnosed as PFPS. Proposed causes of PFPS include poor knee alignment, muscle imbalances, tightness of muscles in your thigh, limited ankle mobility, or flat feet.

How can you get rid of your knee pain? With a variety of possible causes, one thing is for sure; poor knee alignment (as seen below) needs to be corrected. This type of knee alignment causes your patella to move the wrong way and may eventually lead to pain. The ability to prevent this knee position comes from the muscles of your hip. Furthermore, research shows that people diagnosed with PFPS have weak hip muscles.¹ A study demonstrated that a six-week exercise program that improved hip strength and flexibility of muscles in your thigh had a 93 percent success rate in reducing pain.²

What does this have to do with my core? Well, we can all agree that the picture above is bad news for your knees. A recently published study showed that when women actively contracted their core during a single leg squat activity, their knee alignment significantly improved.³ So train your core and hips and keep your knees healthy.

Recognizing the Symptoms of a Blood Clot

Written by: Drew Jenk, PT, DPT

Posted on March 6, 2013 by Drew Jenk, PT, DPT

The New York Mets seemed to be one of baseball’s unluckiest teams when it came to injuries this past season. Among the many injuries sustained, pitcher Dillon Gee was lost for the season due to a blood clot in his pitching shoulder.

Gee threw 8 innings and got the win versus the Chicago Cubs on Saturday, July 7. The following day, he complained of numbness in his fingers. By Monday, he was diagnosed with a blood clot in his shoulder. Soon after, Gee underwent a procedure to break up the clot with a catheter.

So the question arises: How does something like this occur in a young, healthy, active individual? The answer is somewhat unknown at this time. However, it is most important to recognize the symptoms of a blood clot, and to know what to do if you suspect that you may have one.

Blood clots are often referred to as deep vein thrombosis, or DVT. They are often thought to occur in sedentary individuals and affect mostly the lower extremities. The truth is that blood clots can affect anyone, can occur anywhere in the body, and have the potential to be a life-threatening situation. If not treated promptly and effectively, a blood clot can break off and travel to the lungs, resulting in a pulmonary embolism. A pulmonary embolism is a critical event requiring immediate emergency medical care.

It is important to recognize the symptoms of a blood clot. Symptoms include:

- Heaviness, weakness, achiness or numbness in the fingers or toes

- Moderate to severe swelling in the area often accompanied by warmth of the area

- Unrelenting pain that is difficult to resolve and severe tenderness to the touch

- Discoloration and skin changes

- Large distended veins

Any of these symptoms are a reason for immediate medical attention. Blood clots can be treated effectively and safely if recognized early. So, let your body be your guide; play it safe because sometimes it can really be a matter of life and limb.

Make Physical Therapy Your First Stop for Orthopedic Injuries

Written by: Sports PT Blog Team

Posted on February 25, 2013 by Sports PT Blog Team

A cheerleading injury scare! My daughter is a flyer for her high school varsity cheerleading team and with that responsibility comes many hours of practice each day, including separate sessions of tumbling. While performing a back handspring, she landed off balance and the pain began.

After applying general first aid to her ankle overnight, it became very apparent that the injury was more than a slight bruise. Her orthopedic doctor didn’t have an available appointment for nearly 3 days and we were worried the situation would get worse, especially if she continued to practice with her team.

Fortunately, I learned about Direct Access from Sports PT and knew we had other options. I immediately called the Liverpool, NY clinic and they saw her that day! After a thorough initial evaluation, it was evident that her ankle may have been broken in the landing, and the physical therapist recommended a visit to the orthopedic urgent care that evening for x-rays. Her ankle was broken, but due to the immediate attention provided by Sports PT, we had already begun the healing process.

So what is Direct Access?

It is legislation enacted by the NYS Education Department in November 2006 that allows a licensed physical therapist to provide a patient with treatment in the practice of physical therapy without a referral from a physician, dentist, podiatrist or nurse practitioner, for 10 visits or 30 days, whichever occurs first, provided the licensed physical therapist meets specific requirements. It was designed to be a first line of defense where patients could start treatment immediately to begin the healing process. It also allows for patients to be seen sooner by expert medical professionals rather than clogging up emergency rooms and urgent care centers with these types of issues.

Did you know that physical therapists are some of the best qualified individuals to evaluate an orthopedic injury, next to Orthopedic Surgeons? There is even a research study that presents data supporting the diagnostic accuracy of physical therapists.

At Sports PT, we have physical therapists who meet the requirements in nearly every clinic. If you have an acute or chronic injury or condition that impairs your movement, such as back and neck pain, sprains and strains, hip, knee or ankle pain, tendonitis or a sports injury, I encourage you to contact us to make an appointment! It will save you precious time and may result in lower out-of-pocket insurance expenses.¹ We’ll check your insurance policy for you to make sure your insurance carrier allows for Direct Access. We look forward to helping you soon!

By: Dot Hall, Mother of Patient

Sportsmetrics™ Program Helping Our Student Athletes

Written by: Sports PT Blog Team

Posted on February 4, 2013 by Sports PT Blog Team

Dr. Alison Synakowski, Facility Manager of Sports PT’s Saratoga clinic, will be running a Sportsmetrics™ program from February 4, 2013 through March 15, 2013 at the SPA Catholic High School. Dr. Synakowski is a certified Sportsmetrics™ trainer, and has successfully affected student athletes who have participated in this program in the past.

Sportsmetrics™ is proven to reduce the risk of knee ligament injuries, especially in female athletes. In addition, participants have also seen an increase in agility, strength, vertical jump height and power. Sportsmetrics™ is an evidence-based approach to reduce the risk of anterior cruciate ligament (ACL) injuries. This program is ideal for individuals who would like to reduce their risk of knee injuries as well improve performance in their sport. It is also appropriate for individuals who are returning from ACL surgery and need to improve their confidence and mechanics in order to return safely to sport. Many basketball, soccer and lacrosse players have seen significant improvements.

The components include:

Dynamic warm-ups
Jump training series
Mechanics with jumping
Agility, Strength, and Flexibility work outs

There is testing completed on the first and last day of the program to measure outcomes.

Classes run from 7-9pm on Mondays and Wednesdays, and 8-10am on Saturdays. Participants must complete all 18 sessions. Class size is limited to 12 participants. The cost is $150. To register, contact Dr. Synakowski at asynakowski@sptny.com or 518-583-7537. Don’t miss this great opportunity to get stronger, higher, and flexible!

The ACL: The Crucial Knee Ligament

Written by: Lisa Martin, PT, DPT

Posted on January 15, 2013 by Lisa Martin, PT, DPT

Are you an athlete? Do you have children involved in sports that might be susceptible to a knee injury? Your anterior cruciate ligament (ACL) is located in the center of your knee, connecting your femur (thigh bone) to your tibia (shin bone). The ACL provides stability to prevent forward movement and rotation of your knee joint especially while running, cutting in sports, or skiing down a mountain. A complete or partial ACL tear is common in both contact and non-contact sports. An ACL injury can leave a person unable to finish out a sports season and even possibly result in surgery. Many studies have shown that prevention programs can decrease your risk of sustaining an ACL tear.

Females are 4-6 times more likely to injure their ACL due to overuse of their quadriceps muscle (thigh muscle), knees coming together more during landing, and decreased ankle, knee and hip bending during athlete performance compared to males. ⁽¹^,²⁾Other risk factors include: footwear, surface type (e.g. grass, snow, ice, turf, wood), knee laxity (e.g. looseness), foot overpronation (flat feet), and body mass index (BMI). ⁽³⁾

Screening examinations by a physical therapist can identify if you have any of these predisposing factors for an ACL injury. The examination may include an assessment of your stomach (core) and leg strength, hip, knee, and ankle range of motions, and completion of a series of functional tests to help determine if you are at risk for an ACL injury. ⁽¹^,²⁾ Your mechanics will be assessed during tasks such as jumping off a box to the floor, during single leg jumps or with cutting motions. Once these factors are identified, your physical therapist can then develop an individualized treatment plan focusing on strength, sports mechanics, and flexibility to help you reduce these risk factors and in turn reduce the risk of ACL injury. Your physical therapist can educate and train you on the proper way to land to improve absorption of weight through the legs and muscles avoiding increased forces through the knee.

Have you ever had knee pain or a feeling of instability in your knee after playing in a sports game or skiing?

Free Weights or Machines?

Written by: Julie Wolfley, PT, DPT

Posted on January 7, 2013 by Julie Wolfley, PT, DPT

One of the main objectives of physical therapy treatment is to strengthen weak muscles. Usually if a muscle is weak, the forces on your body become unbalanced. This can lead to pain and an inability to perform a normal daily activity. A common question posed by patients is: “Should I strengthen my muscles with free weights or machines?”

Machines are designed to keep your body in proper form to work the muscle(s) indicated. Pictures are often attached to the equipment to indicate the muscle(s) being strengthened and proper set up.

Free weights can be more challenging because you have to use your muscles to stabilize and balance your body while performing the exercise. In addition, free weights allow you to increase the range of motion of an activity as well as lend creativity to developing exercises that mimic your daily activities. For example, a bicep curl on a machine usually just targets the bicep, but with free weights your shoulder, neck, back and leg muscles also turn on to perform the exercise. As a result of the greater demand on your stabilizing muscles, it is important to focus on your form when using free weights. Failing to do so could lead to injury.

Our physical therapy clinics are focused on restoring normal function and reducing your pain. Daily activities at work, home and play all require your stabilizing muscles to work. Therefore, we prefer to use free weights during your rehabilitation program to help retrain your muscles to work properly with your daily routine. We focus on proper form with each free weight exercise to prevent re-injury or creation of a new injury.

Despite continued debate by some health professionals, both methods are effective ways to strengthen muscles. However, if one of your goals is to strengthen in a functional movement pattern, consider free weights over machines. Our physical therapists at Sports PT of NY can help you establish your functional free weight routine with a referral from your MD or via Direct Access.

Ski Trip Preparation

Written by: Adrian Miranda, PT, DPT

Posted on December 17, 2012 by Adrian Miranda, PT, DPT

With the winter weather season coming up, many of my patients are getting excited about returning to the ski slopes. When I hear this, I immediately turn my attention to reducing the risk of injury. Typically, when we learn about ski-related knee injuries many of the images we picture are those of a knee twisted in and the skis going in opposite directions. This position is often referred to as the “position of no return” and is commonly associated with the dreaded anterior cruciate ligament (ACL) injury.

An important factor in skiing is control of the knee. This control is provided by strength of the muscles of the hip and core. The knee is designed to move in a forward and back direction with very limited rotational and side-to-side movements. The hips have greater degrees of movement and are meant to move in rotational and side-to-side directions, in turn, sparing the knee from these excessive movements. A lot of skiing is turning and moving side-to-side and resisting the skis from going too far out to the sides. Therefore, having a strong core and hips is essential to decreasing the risk of lower extremity injuries.

So, before hitting the slopes, it is important to prepare yourself by increasing your balance, core, and hip muscle strength to avoid getting an injury that may take you out of ski season early. An exercise that can be easily done is balancing on one leg. To increase the difficulty, you can balance on a BOSU ball or perform a one-legged deadlift.

Utilizing the skill and knowledge of your physical therapist at Sports PT of NY will allow you to obtain an individualized ski program and help to keep you healthy on the mountain.

6 Tips for Proper Lifting

Written by: Julie Wolfley, PT, DPT

Posted on December 10, 2012 by Julie Wolfley, PT, DPT

About 80 percent of the US population experiences back pain in their adult life with a small percentage developing long term disability.1 Lifting the wrong way can contribute to back injuries. Lifting improperly can also cause injury to other areas like the neck, shoulder and knee muscles, joints and ligaments. To prevent injuring yourself and adapt proper lifting techniques, here are a few helpful tips:

When lifting a heavy object from the ground…face the object you will be lifting, bend your knees into a squat position and use two hands to lift the object. You could also put one knee on the ground, pick up the object and then stand up.

Once the heavy object is lifted…hold and carry it at your belly button region to avoid twisting your back. For example, carry your laundry basket in front of you rather than on your hip to avoid twisting your back.
When lifting an object from above shoulder level…avoid arching yourself backwards too far. Get a stepping stool to get yourself closer to the object or stagger your legs and shift your weight onto your back leg.
When getting out of bed…roll to your side first and then sit up instead of sitting straight up. This will decrease stress on your low back.
When vacuuming…push and pull the handle from your belly button region to prevent twisting your back repetitively.
When standing up from a chair…bring your buttocks to the edge of the chair, lean forward a little and push up from your legs.

If you would like one-on-one instructions on proper ways to move, you can call any of our Sports PT locations and one of our physical therapist’s can work with you. If you have injured yourself while lifting, you should call your doctor or call Sports PT and with Direct Access we can get you in within 24 hours to start your recovery.

Kinesio® Tape~ Fad or For Real?

Written by: Susan Kim, MPT

Posted on August 1, 2012 by Susan Kim, MPT

So what’s the deal with all the colored tape you see elite athletes wearing now? From Keri Walsh to Lance Armstrong to David Beckham to Kevin Garnett, professional athletes in all sports have been seen with a colorful new look.

The tape is called Kinesio® Tape and was developed by Dr. Kenzo Kase, a chiropractic doctor and acupuncturist in Japan. Developed in 1979, it was first introduced to rehab hospitals in Japan and was exposed to the international market during the 1988 Seoul Olympics. Kinesio® Tape found its way to the US in 1995 and has become more and more popular since then.

So what’s the difference between Kinesio® Tape and other taping methods? First of all, it is completely latex free! Since it is made of 100% cotton and elastic fibers, it is more “breathable” and easier on the skin, allowing people to wear it for up to 3-5 days at a time. In addition, it is water resistant, which helps it stay on even after you shower. It also allows for more normal range of motion than athletic tape and McConnell® tape. Finally, the different ways of applying the tape allow for the different functions and taping effects.

The major uses for Kinesio® Tape are the following:

Relieving pressure on the skin
Improving remodeling of soft tissue (known as fascia) after injury
Promoting circulation to decrease swelling
Help activate or inhibit specific muscles (e.g. to decrease muscle spasms)
Improving joint alignment and motion

I recently used Kinesio® Tape on a patient that is a waitress who was overusing her biceps tendon. I put the tape on in a way to inhibit the use of the biceps so that her tendon would perform less work and therefore get some rest. It was not an option for her to stop working in order to rest her arm, so this was a great alternative for her and made a significant difference in her ability to get through her work day.

Some people will respond well to the techniques, so it is worth looking into and seeing if it can work for you!

3 Steps to Proper Bike Fitting

Written by: Lisa Martin, PT, DPT

Posted on July 30, 2012 by Lisa Martin, PT, DPT

The summer months are upon us and I’m sure that many of you are out riding your bikes to enjoy the beautiful weather. I’m going to give you a few easy steps on proper fit for your bike to make sure your bike riding is enjoyable and comfortable.

First of all, proper seat height is very important. When you’re sitting on the seat with your feet on the pedals, you should only have a slight bend in your knee when the pedal is at the bottom position.¹ I usually tell my patients when standing next to the bike, their greater trochanter or hip bone should be about even with the seat. If you can sit on your seat and plant your feet on the ground your seat is too low. If you have to rock your hips side to side while pedaling, your seat is too high.² When having to stop, you should have to get off the seat or be on your tip toes when seated.¹

Second, your seat should be level. Try to avoid tilting it too far forward or backward. You should feel like you are sitting on the same spots on your bottom that you do while sitting upright in a chair, often referred to as your “sit bones”.^1,2 On most bikes you can also move the seat forward or backward allowing you to make sure that you are centering your weight over the bike.¹ Also, in this process make sure that you can still reach the handlebars. Your elbows should not be locked and you should not feel like you have to shift forward on the seat to reach the handlebars.²

The third step is adjusting the handlebar position to avoid having any strain on your back, neck, shoulders, or wrists.¹You should never feel like your arms are falling asleep or your upper body is too heavy to hold up. If you are feeling that way, try adjusting your handlebar position. This will vary depending on the type of bike you are riding, your body type, and just personal preference. Here are the three main types of bikes and you can experiment with what you like the best.

Road Bike (skinny tires): Handlebars about 1-2 inches lower than the seat allowing you to lean forward and be more aerodynamic.¹
Mountain Bike (rugged tires): Handlebars often 3-4 inches lower than the seat allowing for a lower center of gravity to better negotiate obstacles you might find on trails or in the woods.¹
Cruisers: Handlebars about 1-2 inches higher than the seat allowing the rider to sit more upright and take a more leisurely ride.¹

A good rule of thumb is that if you’re having increased back, neck, shoulder, or wrist pain, your handlebars are likely too low.²If you’re feeling every bump on the road and your bottom is hurting, your handlebars are likely too high.²

Hopefully these few easy steps will make your bike riding experiences this summer more fun and long-lasting. If you’re having pain while riding your bike and you don’t have any previous aliments, you’re likely just not positioned correctly on the bike. Hope you have a safe and fun summer! Please share any exciting bike riding experiences with us.