Lower Extremity

 

The Athletic Hip Series: What is IT Band Syndrome?

Post by Maggie Gebhardt, PT, DPT, OCS IT, otherwise known as the Iliotibial Band, is a common source of lateral knee pain in runners. However, most people do not realize that this is an issue oftentimes stemming from the hip. Pain generated from disorders of the IT band can be present at its origination along the lateral pelvis all the way to the lateral knee. The IT band is usually over-utilized due to poor lower extremity mechanics. Weak hip musculature, primarily the glutes, cause increased reliance on the IT band to stabilize the knee. This scenario can cause the IT band to get caught in a “catch-22”: overuse of the IT band causes increased tightness of the TFL (Tensor Fascia…

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The Athletic Hip and its Injuries

Post by Maggie Gebhardt, PT, DPT, OCS You may be asking yourself, “What IS the Athletic Hip?” It is a joint that serves as a junction zone for the leg and the pelvis or low back. It is a hip that is often painful and injured as a result of overuse or traumatic activities. It is a joint that is not arthritic and in need of a replacement, but is very painful and can interfere in a person’s ability to participate in all kinds of physical activity. It is an area that is often hard to diagnose, which results in many trips to physicians, multiple xrays and MRIs, and many bouts of unsuccessful physical therapy. It is a joint that…

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SI Joint Dysfunction… Under or Over Diagnosed?

Post by Maggie Gebhardt PT, DPT, OCS A patient of mine recently forwarded me this article. I found it interesting because as a Physical Therapist, we are told more often than not that the SI joint is overly diagnosed by us PTs. So after reading this article I was wondering…which is it? If doctors are not diagnosing it enough and PTs are diagnosing it too much, what’s the problem? Where is the disconnect? I think the happy medium is that with a thorough examination and evaluation both the SI joint and lumbar spine should be screened for possible involvement. Oftentimes I have found with my own patients that it is not nearly as black and white as we clinicians want it…

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Exercises To Prevent Lower Back Pain

What Exercises for My Core Can Help Prevent Lower Back Pain? Brian Yee PT, MPhty, OCS, FAAOMPT First – generally there are different roles of muscles in your trunk. Typically the smaller ones closest to your spine are considered ‘local’ muscles. Such muscles as the transversus abdominis, diaphragm, pelvic floor, and lumbar multifidus provide segmental control of your lumbar vertebra. Real-time ultrasound imaging can be used to visualize the proper contraction of these muscles as we cannot see these muscles from the superficial skin. So first step in core stability is to ensure that the smaller muscles are engaging properly. Then you have ‘global’ muscles which are the larger muscles – such as rectus abdominis, obliques, paraspinal muscles. These muscles…

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What Can I Do to Prevent an ACL Injury?

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…

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What Can I Do For Plantar Fasciitis?

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…

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Play Golf? Avoid Lower Back Pain With These Stretches.

Brian Yee PT, MPhty, OCS, FAAOMPT There are numerous studies that have come out recently that show the loss of lead leg internal rotation of the hip in the golf swing has a high prevelance of low back pain in golfers. This is due to the lead leg in the golf swing acting as your swivel / finishing point in the swing. With limitations in the hip, the back has to work harder to finsh the swing.  You should work on the foam roll to loosen the lead leg hip musculature, knee to chest and pirformis stretches can also help. Standard back stretches can help alleviate your back after golf, but consider the causitive reasons why your back is hurting…

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Will I Need Physical Therapy After Hip Replacement Surgery?

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.   _________________________ Medical Disclaimer: Motion Stability has created and compiled the content on its websites for your information and use. This information is not intended to replace or modify the medical advice of your…

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How Does Posture Affect Back Pain?

Brian Yee PT, MPhty, OCS, FAAOMPT The way you sit and stand significantly affects your back. Especially for prolonged duration, the tissues around the spine experience what clinicians call ‘creep phenomenon’. Think of a cold piece of taffy. As you hold it, warm it up, and then hold it by its ends, it slowly stretches and lengthens. Very similarly, the tissues in the back can due the same thing. The fascia, muscles, nerve, joints all experience increased strain when the spine is statically held in one position for a long duration of time. When you then place yourself in a poorly sitting or standing posture, that then accentuates the amount of tissue loading that is placed on the spine and…

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How Can a Weak Core Lead to Back Pain?

Brian Yee PT, MPhty, OCS, FAAOMPT According to Panjabi’s model, we can view spinal stabiilty based on 3 key elements:1. Passive Structures: The spinal column itself and the ligaments, fascia and other static tissues that hold it together. 2. Active Structures: The muscles that surround the trunk and pelvis ‘actively’ contract to provide muscle support. 3. Cognitive / Motor Control: The brain has a way to coordinate how muscles will be used to anticipate how the spine is used with functional activities. The passive structures and the spine itself is limited in its ability to stabilize the spine, especially in dynamic function or prolonged positions such as standing or sitting. The brain thus needs to coordinate the proper timing of…

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Motion Stability