Motion Stability's Blog


What are the treatment options for back pain? by charlestlee
Brian Yee PT, MPhty, OCS, FAAOMPT

Accurate diagnosis of the sources of back pain will indicate the type of treatment you should receive. However, after structural reasons of back pain have been ruled out (such as a herniated disc), the majority of patients are diagnosed with ‘non-specific low back pain’. 

What we find clinically is that traditional interventions such as medications and injections, although perhaps needed and based on a physician’s recommendation, provide short-term relief.

There is growing research and clinical attention on trying to diagnose or sub-group ‘non-specific low back pain’. This can include movement dysfunction, fascial restrictions, muscle control dysfunction, myofascial trigger points, psychosocial variables, pelvic pain, nerve referred pain, or internal/systemic issues such as referred pain from internal organs or hormonal/vitamin deficiencies.

It is important to find a clinician that is able to differentially diagnose the various contributing factors of back pain, and then be able to provide effective treatment for those sources – and then coordinate with other practitioners that can address other needed areas. Especially in chronic low back pain management, a multi-disciplinary team of health practitioners is usually needed.

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What Can I Do For Plantar Fasciitis? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT

Pain in the arch or heel of your foot is commonly diagnosed as ‘plantar fasciitis’. However, there are several reasons that can cause pain at the bottom of the foot.

Plantar fasciitis: Usually due to an over-stretched arch. Treatment by taping, manual therapy, orthotics, and use of night splints can provide short-term relief. Long term prognosis is based not only treating the plantar fasciitis itself, but also restoring proper mechanics of the entire leg.

Nerve Pain: The tibial nerve, which is a branch of the sciatic nerve can cause symptoms in the bottom of the foot. The key to treatment in nerve injuries is to determine why and where the injury occurred and treat the nerve accordingly.

Muscle Trigger Points: According to Travell and Simmons, muscle trigger points in the calf and foot muscles can cause referred pain to the foot. Soft tissue techniques and intramuscular manual therapy can be used.



Will I Need Physical Therapy After Hip Replacement Surgery? by charlestlee

Brian Yee PT, MPhty, OCS, FAAOMPT

It is recommended that you work with a skilled Physical Therapist after hip replacement surgery. The Physical Therapist will coordinate with the operating surgeon to improve your hip range of motion, strength, and progress your weightbearing and walking on your hip appropriately. They will also demonstrate to you safe and proper movement with your hip with functional activities such as sitting to standing, getting in / out of cars, and progress you back to your other functional and recreational goals.



How Is Rehabilitation Used to Treat Neck and Back Pain? by charlestlee

In Physical Therapy we treat neck and back pain by the following interventions:

1. Examination: Take a thorough subjective and physical examination to determine the causes and severity of pain. The examination helps determine what specific interventions need to be done. Each patient is unique in the medical history and interventions should also be individualized to the patient’s progress.

2. Reduce Pain: Especially in more severe pain complaints, it is important to reduce the symptoms to allow for the patient to simply feel less pain. This can include manual therapy to decrease muscle spasms, restricted joint mobility, or decrease nerve irritation. Modalities such as ultrasound, electrical stimulation and traction can also be used.

3. Restore Motion: As pain decreases, it is the goal for rehabilitation specialists to restore patients back to their functional activities. Mobility / range of motion is important to allow the patient to move again. Manual therapy, exercises including stretches and stability training, posture and gait/walking education are all necessary to improve the patient.

4. Improve Stability and Strength: In the neck and back there are key muscles that are designed to stabilize the spine, while others provide power and torque. In chronic pain conditions, it is important to improve the efficiency of muscle function rather than just ‘get people stronger’. Such muscles as the longus colli in the neck, shoulder blade / scapular stabilizers – such as the lower trapezius, or trunk stabilizers -including the transversus abdominis, multifidus, obliques, and gluteal muscles are all necessary to provide proper stability for dynamic function. Rehabilitation specialists have strategies to improve the stability of these muscles.

5. Function / Sports Specific Training: Once basic stability has been established, it is important to provide the patient the tools to return to full work, functional, and sports-related activities.



What can I do for knee pain? by charlestlee

image source: specialistpainphysio.com

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


image source: clinicianleader.com

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.


Why should I work with a rehab specialists for back pain? by charlestlee

Image Source: collegesurfing.com

Brian Yee PT, MPhty, OCS, FAAOMPT

A rehabilitation specialist is able to identify reasons why your back pain is occurring based on the way the you move, palpation of the involved tissues, and rule out serious medical pathologies such as spinal based cancers. Back pain can derive from multiple sources including a herniated disc, a joint injury, a muscle strain, or referred pain from such things as vitamin D deficiency or internal organ issues.  If your back pain is due to musculoskeletal causes, the rehabilitation specialist should then be able to provide an accurate treatment plan that addresses the underlying causes of your pain and provide education, exercises, and ideas how to get your back to the functional or sports related goals you have.