Common Misconceptions About Physical Therapy

Common Misconceptions About Physical Therapy

By: Brooke Smith, DPT

There are many common misconceptions about what physical therapy entails.  Let’s discuss a few common misconceptions and explain how physical therapy can help you get back to the activities you love, without pain!

Myth: Physical therapy is the same as receiving a massage

While physical therapy utilizes soft tissue mobilization similar to massage, the main difference is physical therapists are more target specific with their techniques.  With soft tissue mobilization, physical therapists look for muscles that are tender to the touch, which means the muscle is in some dysfunction.  Therefore, to decrease the tenderness, more pressure is applied to release muscle tension and decrease tenderness by releasing scar tissue and increasing blood flow to the area.  Soft tissue mobilization usually includes some discomfort.  These techniques are not used on every patient and are injury specific.

Myth: Physical therapy is only for athletes or people who had surgery

Physical therapy is useful in treating a large variety of pain and injuries from simple strains/sprains to post operative care.  We also treat a large range of the population from pediatric conditions to elderly with a wide range of activity levels.   Physical therapy can be helpful to people injured in car accidents, weekend warriors (recreational sport players), pregnant women, seniors, teens, elderly, post-operative, and job related injuries.  Physical therapists are also trained to detect symptoms that might require a referral to another health care professional to help treat any underlying issues that might be causing the symptoms.

Myth: Physical therapists will only use passive therapy and exercise for my problems

Some of the passive techniques people commonly think of are ice, heat, ultrasound, and electrical stimulation.  While these techniques are utilized, they are used in conjunction with manual techniques and specific exercises to help assist in the healing process.  Yes, physical therapy does include exercise, but we use specific exercises to strengthen and stabilize areas of weakness that might be the underlying cause of your symptoms. 

Myth: Physical therapy will be painful

It is possible to experience temporary soreness from manual techniques or exercises.  However, these effects should not last more than 24 hours and the end result is usually relief of your initial symptoms/pain.  Physical therapists use specific techniques and exercises to assist the body by aiding with the normal healing process and help it rebuild to function normally.  Physical therapy is safe and the soreness/discomfort will be minor and temporary with the goal of decreasing your symptoms.

I hope after reading this article you have a better understanding of physical therapy.  If pain is limiting your daily activities, please contact AZOPT at (623) 242-6908 to schedule your evaluation. 

IT Band Syndrome

IT Band Syndrome 

By: Brooke Smith, DPT

Do you have knee pain or hip pain that occurs with walking or increased activity?  It could be caused by a tight Iliotibial (IT) Band.  The IT band is a thick band of fibrous tissue that begins at your hip and runs down the outer part of the leg, crossing the knee, and attaching to the top portion of your shin bone (tibia, figure 1).

http://www.aidyourhamstring.com/
_img/iliotibial-band-syndrome.jpg

The IT band and the associated musculature act to stabilize and coordinate muscle function of the knee with running and walking.  It is a common overuse issue that occurs in “4.3-7.5% of long distance runners”.3   However, IT band syndrome can also occur in military recruits, cyclists, tennis players, adolescents undergoing rapid growth, weightlifting, people who perform a lot of squats, short distance or sprint-distance runners, rowing, and cross training.   IT band syndrome has been reported to occur equally in men and women and most frequently occurs between the ages of 15-50 years old.

Some common mechanisms of injury, creating pain, could be decreased strength, decreased flexibility, abnormal hip alignment (pelvic tilt), “bowlegs”, improper alignment or mechanics of the feet with walking/running, improper posture/mechanics with running or exercises, running on angled or uneven ground, leg length discrepancy, poor footwear, sudden increase in activity, returning from injury too soon, overuse, or over-training.   

Someone who has IT band syndrome will usually experience pain on the outside of the knee.  However, some people can present with pain over the hip joint (greater trochanter), or pain starting at the knee traveling up to the hip. Sometimes the pain can be described as stinging or needle-like pricks that can occur every time your heel strikes the ground with activities.  Pain will usually increase with activities such as running or cycling, especially when running hills, and with walking up/down stairs.  This is due to inflammation of the IT band causing it to snap over the hip bones (greater trochanter), leading to pain.  Other common symptoms may include repetitive popping sounds in the knee when performing activities, as well as tenderness with pressure over the outside of the leg just above the knee. Some tenderness might also be present at the hip joint (greater trochanter).  

However, there could be multiple reasons for pain at your hip or knee and these include: hamstring strains, MCL and LCL injuries, meniscus injuries, myofascial pain, osteoarthritis, overuse injuries, patellofemoral syndrome, and trochanteric bursitis.  Therefore, it is critical to have a professional MD or physical therapist assess your individual problems to determine if it is truly IT band syndrome.

Physical therapists will help diagnose IT band syndrome by taking into account the patient’s history of the present condition, performing special tests specific to IT band syndrome, alternative tests to rule out any other pathology, and assess strength and joint motion/mobility.  Some common treatments provided by physical therapists include strengthening of weak musculature, stretching of tight muscles that are contributing to the pain, manual therapy, soft tissue mobilization, assisting in custom orthotics, modalities such as ultrasound, TENS, and ice, and providing home exercise program to maintain results.   All treatments are specific to each individual patient and their specific biomechanical faults are taken into consideration to fix the cause of IT band syndrome.

If you think you might have IT band syndrome here are some simple tips, exercises, and stretches you can try: rest, ice, appropriate use of ibuprofen/NSAIDs, IT band stretching, and use of a foam roller to release the IT band, use proper footwear, stretch prior to and after running, get adequate rest between workouts, and gradually increase your training or exercises.  If you continue to experience pain, you should seek the advice of a licensed physical therapist to assist in diagnosis and treatment.  If you have any questions, concerns, or would like to schedule an appointment contact AZOPT at (623)-242-6908.

References:

http://www.medicinenet.com/iliotibial_band_syndrome/article.htm

http://sportsmedicine.about.com/od/kneepainandinjuries/a/IT_Band_Pain.htm

http://emedicine.medscape.com/article/307850-overview

http://www.emedicinehealth.com/iliotibial_band_syndrome/article_em.htm

http://www.runnersworld.com/injury-prevention-recovery/treating-and-preventing-iliotibial-band-syndrome?page=1

http://orthopedics.about.com/cs/sportsmedicine/a/itbs.htm

http://www.webmd.com/pain-management/knee-pain/tc/iliotibial-band-syndrome-topic-overview

May is National Arthritis Awareness Month

May is National Arthritis Awareness Month

By: Brooke Smith, DPT

Do you or someone you know have pain in their joints, but do not know the cause?  You may have symptoms of arthritis.  Today, nearly 50 million Americans suffer from arthritis.  Arthritis is often misunderstood as minor aches and pain associated with getting old.  However, there are many different forms of arthritis that can occur at any age.  Two-thirds of the population with arthritis occurs in people under the age of 65, including children.  The three main types of arthritis are Osteoarthritis, Rheumatoid Arthritis, and Juvenile Arthritis.

Osteoarthritis (OA) is the most common form of arthritis and is characterized by progressive degeneration of the joint’s cartilage, causing bone to rub against bone.  It most commonly occurs in weight bearing joints such as the hips, knees, and lower back.  OA has also been known to affect the neck, small finger joints, the base of the thumb, and the big toe.  Some of the symptoms include gradual development of stiffness within the joint, pain or joint soreness after overuse or inactivity, morning stiffness, and loss of motion/movement within the joint.  Several risk factors can lead to the development of OA including obesity/overweight, history of joint injury, overuse, genetics, muscle weakness, and age.   OA usually occurs later in life as a person ages.  It is described as the “wear and tear” of your joints, and the older you are the more you have used your joints, putting them at greater risk for OA.   However, older age does not mean OA is inevitable.

Rheumatoid Arthritis (RA) is a systemic disease characterized as inflammation of the joint lining causing pain, stiffness, warmth, and swelling that can occur throughout the body.  RA is symmetrical, affecting the same joints on both sides of the body.  RA affects nearly three times the amount of women than men and most commonly begins between the ages of 30 and 60 years old.  RA has no cure and progression leads to development of rheumatoid nodules and joint deformities.   Although there is no cure for RA, highly effective treatments exist including medications, physical therapy, physical activity, weight control, and maintaining good overall health.

Juvenile arthritis (JA) can have many different forms but is generally described as an autoimmune and inflammatory condition that can develop in children ages 16 years and younger.  JA affects the joints like RA and OA; however, it can also affect the eyes, skin, and gastrointestinal tract.  There is no known cause for JA, but it has been suggested that toxins, foods, allergies, or genetics can cause a child to develop the disease.  Symptoms are similar to RA and OA and include inflammation of the joints, pain, and joint stiffness.  It is important with JA that the entire family maintains a sense of calm and normalcy, as well as sticking to daily routines and comforting habits.  It is also important to address emotions of sadness, anxiety, and anger the child may have to help maintain the attitude that “arthritis is something I have to live with but not what defines me”.

               

There are options, other than surgery, to help improve your symptoms like stretching, walking, strengthening, Tia Chi, and physical therapy.  As a physical therapist, my goals in treating arthritis are to decrease the amount of pain, improve strength of muscles to increase stability around the joint, stretch muscles that are tight and might be hindering proper body mechanics, and improve joint protection.  It has been shown in recent research that exercising is a valuable tool in decreasing the symptoms of arthritis.  Some specific interventions that physical therapy might provide include modalities, braces and splints to protect joints, and hot or cold packs.  A physical therapist will work with you to modify your daily activities and your environment to provide pain relief and improve function.  Physical therapy will improve flexibility in your hamstrings, quads, calves, and hip flexors while strengthening the muscles around your knee, hip, and ankle.  Your appointments may also include coordination and balance activities.

               

If you or someone you know is experiencing any of the signs and symptoms discussed above, or has been diagnosed with a form of arthritis, you might think about scheduling an evaluation with a physical therapist to address your symptoms.  You can contact AZOPT at (623) 242-6908 if you have any questions or concerns.

For more information, please visit www.arthritis.org.