Motion Stability's Blog


What Can I Do to Prevent an ACL Injury? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT

An ACL injury is usually due to the knee going into excessive valgus (knee turning inwards) and/or some type of rotary /pivot force. Many people focus on training the musculature around the knee such as the quad and hamstrings. This does help, but one must also consider the stability of the joints above and below – which would be the hips and ankle/foot complex.The knee can be viewed as a junction between two different stilts. If the hip is not stable or has excessive mobility, or the foot / ankle is not supportive such as excessive flat feet or stiff ankles from an old ankle sprain – it can place excessive valgus force at the knee – possibly leading to increased stress to the ACL.
Training thus should consist of hip and thigh training that does not promote internal rotation/valgus to the knee – such as gluteus medius / lateral hip stabilization, as well as improving ankle mobility/foot stability exercises. Once proper movement patterns are established, progression to higher level plyometrics, as well as sports specific training should be introduced.

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How do I manage my back pain on a daily basis? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

First, remain positive. Many people dealiing with chronic back pain can become discouraged and even depressed that their pain does not let them do what they want to do. This can lead to a fear-avoidance belief that takes them away from doing activities that they physically should be able to do. 

From there it is important to establish 2-3 activites during the day that cause back pain – such as sitting, standing, or household activities such as vacuuming. It is just as important to determine the time in which the pain begins. Many patients will complain of pain with a prolonged/sustained activity after 10-20 minutes. What this means is that the muscle endurance of your body is fatiguing quickly and pain begins 10-20 minutes later as increase stress to your spine is occuring.

Like a marathon runner who is hurting and conditioned to run 2 miles. The runner knows well enough not to run 20 miles thereafter, as they will end up hurting themselves. They will instead train to run 2-3 miles until they can condition themselves to increase their distance without hurting worse.

Likewise, with chronic back pain, it is important to stay active, but stay just short of the time that your pain exacerbates itself. As a physical therapist can teach you ways to decrease your pain and improve your stability and movement, slowly you will be able to improve your time in activities that used to hurt you early on. As things progress, you will gain the confidence to do things you couldn’t do before with less pain. We call this ‘pacing’.



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.



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.



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.



What stretches should I do before I workout so I do not get back pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT
There are many stretches you can do to help loosen your back up before you work out. Please keep in mind  that stretching does not guarantee that your back will not hurt – as there other causes of back pain than just tight muscles. Some light stretches you can do to loosen your back include:
Pelvic tilts: Laying on your back with knees  bent – rock your pelvis back – flattening your back against the bed and return to neutral, and if it doesn’t bother you progress to arching your back a small amount. Oscillate back and forth.
Knee to chest: Bring one knee up to your chest, stretching your hip and your back. You can progress to both knees to your chest.
Trunk rotation: Laying on your back with knees bent and together slowly let your knees go to one side – allowing your trunk to rotate. Switch to the other side. If that does not bother you, you can progress to have one leg straight and let the other knee hook over it allowing the spine to rotate more. There should be a slow stretch in your spine.
Cat / Camels: On you hand and knees – you can arch your low back up and down. Focus on a slow stretch trying to move from your lower back and pelvis. Many times people arch their
backs but move mostly from the mid-back or thoracic spine, which does not stretch the lower back as well.
Prayer stretch: On your hand and knees – sit your bottom down to your heels and reach out along the ground with your arms to stretch your lower back. Take your arms and trunk side to side to feel more of a stretch along your sides of your back as well.
Please consult with a qualified health practitioner such as a Physical Therapist to recommend the proper stretches and form.