Motion Stability's Blog


What can I do for knee pain? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

Treating knee pain depends on the location and severity of the symptoms. If it is swollen, you should apply cold packs, compress, and elevate it to reduce swelling. You should consider contacting a qualified physician or physical therapist to assess your injury. 

If things are clear for any significant injury – and as swelling calms – determining where the location of knee pain helps guide things you can do to treat it.

Commonly pain is in either behind the knee cap or along the inside border. You may get a diagnosis of chondromalcia patella or patelofemoral pain which indicates that your knee cap is not tracking correctly along its groove. And with this pain, and most other types of knee pain – the pain usually originates from poor lower extremity mechanics, not just at the knee itself but at the hip and foot as well.

You have to look at the knee as a junction between two different stilts, one from above from the hip and femur, and one from below from the ankle/foot and shin. If the hip and/or ankle/foot are do not have the proper strength or flexibility many times the knee suffers increased stress and torque to it.

Exercises are then based on not only getting the knee stronger – but also improving the flexibility/strength of the entire leg.



Can physical therapy strengthen weak bones? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

Physical Therapy can focus on improving bone strength through proper prescription of exercise base therapy to properly gauge the intensity and load on a patient with weaker bones, such as osteoporosis, fractures, atrophic diseases. This could be through aquatic therapy, anti-gravity support systems, and other modified weight-bearing exercises. It is important to have an experienced Physical Therapist to know how to properly dose the intensity/duration of exercises to stimulate proper bone growth/density without over or under doing it.


How can I prevent repeat ankle sprains? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

It is important to improve ankle dorsiflexion after an ankle sprain. Research indicates a loss of ankle mobility with chronic ankle sufferers – primarily in ankle dorsiflexion – which is the motion you need to walk correctly. Reserach also indicates a change in muscle control patterns not only in the ankle but also up the kinetic chain, such as a loss of hip control.
Therefore:
1. Improve ankle dorsiflexion: calf stretching, seeing a Physical Therapist to mobilize your ankle and decrease swelling.
2. Ankle stability: ankle circles, resistance bands to strengthen lateral/medial ankle musculature/tendons.
3. Ankle proprioception: standing balance exercises as indicated
4. Hip stability: primarily with gluteus maximus and medius exercises. It is important to find a specialized Physical Therapist that can specifically help facilitate you gluteal muscle patterns.
5. Specific training for sports/function: proper footwork in your sports can help decrease you chance of ankle sprains as well.



Why do I get pain on the inside of my foot when I increase my training? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT
Pain that occurs on the inside of the foot when increasing your training is usually due abnormal forces placed upon it. This can occur with the foot either pronating too much (going flat) or the foot loading to the ball of it excessively.
Either way, increased stress is placed along the arch and pain can occur there.
Training then should be modified not to allow the arch to collapse or load to the front of the foot excessively. Small tips would include – putting more equal weight through the heel and ball of the foot, watching you knee angle so that it does not go into valgus (turning in) as that place more stress on the arch, and training hip stability primarily in the gluteal muscles as opposed to the calf and quad musculature.


Is stretching supposed to be painful? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

Stretching should at most be moderately uncomfortable. Many people think that stretching only targets the muscles, but consider that there the joints, ligaments, nerves, and fascia are also stretched. If you have a joint hypermobility or an irritated nerve, such as sciatica, over-stretching can actually injure the tissue and cause more problems than good.



What exercises can help relieve hip pain? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

Typically hip pain patients have restricted hip motion. We usually find the gluteal muscles are restricted with trigger points and fascial tightness.

1. Use of foam rolls or trigger point balls along the back and side of the hip can release the muscles around the hip.
2. Lunge stretches to the anterior hip can also help – but please consult with a Physical Therapist to see if this is indicated.
3. Long axis traction: have a friend hold your ankle and pull the leg – length wise – to distract the hip. This can give relief to the hip especially in acute sitatuion.
4. Nerve: something to consider is that the pain in your hip may be referred pain from the back, sacroiliac joint, or sciatic/femoral nerves. If you have associated back/pelvic pain, please see a health practitioner to rule out the cause.



Does stretching decrease the chance of getting injured? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

Most people present with imbalances in muscle forces. This may include anterior – posterior muscles and specific muscles affect joint mechanics. It is recommended that you have a qualified health practitioner assess your body mechanics to make recommendations what muscles should be elongated, and then other that should be stabilized to improve the efficiency of you body.

Also consider tight muscles may be due to an underlying irritated nerve. Many people with old sciatic nerve injuries feel tightness in their hamstring, however attempting to over-stretching the hamstring can aggravate the nerve again.



How long will I need therapy for chronic neck and back pain? by charlestlee
 


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Brian Yee PT, MPhty, OCS, FAAOMPT
It really depends, as chronic neck and back pain are usually from a multitude of problems. Some areas could be from tissue dysfunctions such as muscle trigger points, fascial restrictions, joint dysfunctions, or herniated discs. It could be from abnormal movement patterns such as poor muscle stability, muscle imbalances, or improper ergonomics or technique in sports/lifting. Pain itself can be categorized into different types as well..so depending on the type of pain you have, should dictate the type of treatment you get. Lastly, internal issues such as medical pathologies, food intolerances, vitamin/hormonal imbalnces can be causing your pain. Receiving a thorough examination to determine the major contributing factors is vital in comprehensively treating chronic neck and back pain.


Besides squats, are there other hip exercises to help my knee pain? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

If you’re experiencing knee pain, especially with weightbearing exercises, its best to train the hip in non-weightbearing. This would include bridges to strengthen the gluteus maximus, and side leg raises/clam shells to stabilize the gluteus medius. Focus on improving the gluteus medius without overcompensating with the lateral quadriceps or tensor fascia latae muscles.
Once pain decreases in the knee, weightbearing exercises to improve hip stability can then be applied.


Are crunches the best exercise to eliminate my back pain? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT 

No. There is a misunderstanding that the stronger your abs are, the better it is for your back. Although strong abs can help stabilize your spine, current research indicates that there are different roles of muscles in the trunk. Generally speaking, the smaller muscles of your spine called ‘local’ muscles help stabilize the spine in low load situations such as prolonged standing, sitting, and light movements such as bending to brush your teeth. While, there are ‘global’ muscles that are the larger muscles –  such as the rectus abdominis, obliques, and back paraspinal muscles that are designed more for movement, power, and stabilization at higher impact.
It is important to have both ‘local’ and ‘global’ systems working correctly. The ‘local’ muscles – transversus abdominis, pelvic floor, and diaphragm help provide intra-abdominal pressure to your trunk. This pressure is similar to a sealed can of soda that maintains the carbonation of a drink. If you were to open the can, you would lose its pressure. Similarly, research from the University of Queensland suggests that with back pain the smaller muscles lose control and thus your intra-abdominal pressure is not as effective to stabilize your spine. Also, along the back of your spine is a muscle called the multifidus. The deeper portions of it run vertebra to vertebra and they are also designed to provide stability to the spine.
We can utilize real-time ultrasound imaging to visualize and cue a client to contract the ‘local’ muscles correctly. Once the ‘local’ muscle work correctly, it is important to do exercises that integrate the ‘global’ muscles – not just with the abs, but also the muscles around the trunk. It is much more effective to do exercises that coordinate the use of these muscles rather than just doing abdominal crunches. Please consult with a qualified health practitioner to guide you through the proper exercise progression