Motion Stability's Blog

What can I do for knee pain? by charlestlee

image source:

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.

How do foot related sports injuries affect the body? by charlestlee

Image Source:

Brian Yee PT, MPhty, OCS, FAAOMPT

I pay particular attention to foot injuries and how it relates to the rest of the mechanics of the body. How the foot hits the ground affects how other joints in the body absorb shock as well as how the muscles around those joints work in sports performance.

The most classic example that we see are patients that have a one sided knee, hip or back injury – say the right side. When we take our medical history the patient tells us they sprained their ankle on the same right side ‘way back in high school…but that got better’. But what the patient does not realize is that after the ankle was swollen from the sprain the swelling settles and makes the ankle joint stiffer. As years go by, after running, walking, and playing sports, the limitations in ankle motion directly affect the way the hip works – causing the hip to lose mobility as well. Injuries can then occur at the hip, the knee, or the low back as both the ankle and hip are not able to provide proper support and power production in sports performance.

What conditions can lead to a ‘groin’ pull? by charlestlee

image source:

Brian Yee PT, MPhty, OCS, FAAOMPT

‘Groin pulls’ typically are due to over-compensation and poor mechanics in the legs and core stability. Groin pulls comprise mostly of the adductor muscles of the inner thigh. These injuries usually occur with sports that requie cutting, pivoting and side to side movement  such as soccer, lacrosse, and football. It can also occur in runners and cyclists when the hip is required to be used in situations like uphill terrain.

Strength deficits with these injuries are not necessarily in the adductor muscles, but instead from the posterior hip muscles – gluteus maximus and medius. The gluteus maximus and medius are the key stabilizing muscles for the hip to be able to plant and pivot off the leg. When the gluteal muscles are not strong enough to stabilize the hip, the adductor muscles are used to compensate. Anatomically, the adductor muscles are primarily designed to pull the hip inwards, but many people do not realize that the adductor muscles also have a role in extending the hip. As the gluteal muscles should extend the hip to push off, run, climb, the adductor muscles can be used instead – and with time groin strains occur due to overuse.

Groin pulls can also happen due to poor foot contact. Especially if someone is more flat footed or pronated, it causes the knee to draw inwards when you step through it. In this position, the adductor muscles are in a better mechanical advantage to stabilize the hip than the gluteal muscles. Again, groin pulls can occur due to repetition in a poorly aligned position.

Differential diagnosis of ‘sports hernia’, nerve referred pain – primarily from the obturator nerve, sacroiliac joint dysfunction, internal pain from the hip such as arthritis, or referred pain from your internal organs should also be considered as they all commonly refer to the groin.

What do the callouses on my feet say about my sports injury? by charlestlee

image source:

Brian Yee PT, MPhty, OCS, FAAOMPT

Even by looking at someone’s callouses on their feet we can begin to make an assessment why and where the patient is injured somewhere higher in the body. For example, runners that have an excess of callousing along the entire ball of the foot tells us that they are putting an excessive amount of force their. Like pressing on a gas pedal, we can deduct that the athlete is using alot of their calf muscles to generate movement and power. It is possible to make assumptions that calf cramps, achilles tendinitis and shin splints occur due to the increased stresses at the ball of the foot.

Another example are bunions along the first toe. What that indicates is an excessive force on the medial or inside of the foot. Like a rudder, if the foot turns inward when you step through it, the knee and hip will follow that line of force causing increased stresses along the inside of the leg. Commonly we see people with bunions have some type of medial knee or patellar pain as well as hip or back pain as the foot is not adequate in absorbing shock causing increased forces into the joints above. If you’re not sure what the callouses on your feet mean in terms of your overall sports performance, we recommend that you contact a qualified Physical Therapist that understands the relationship of your foot to the rest of your mechanics.