Strengthen Your Core: Conquering Chronic Low Back Pain with the Physioball

Chronic low back pain can be a debilitating condition that affects every aspect of life. From sitting at your desk to picking up groceries, the discomfort can be constant. However, strengthening your core muscles is a proven method to alleviate this pain. One versatile and effective tool in this journey is the Physioball. Let's explore how you can use this simple equipment to build core strength and bring relief to your life.

Understanding Core Strength and Low Back Pain

The "core" refers to the muscles around your trunk and pelvis, including your abs, back, and sides. These muscles are fundamental in supporting your spine.

Weak core muscles can lead to poor posture, which in turn, contributes to low back pain. By strengthening these muscles, you provide better support for your back, which can reduce pain and prevent further injury.Studies show that exercises to strengthen your core are one of the most effective treatments for back pain, and the reverse is also true: A strong core is your best defense against developing back pain

Why the Physioball?

The Physioball, also known as a Swiss Ball or stability ball, is a dynamic tool for core strengthening. Its unstable surface forces your body to engage multiple core muscles to maintain balance, providing a comprehensive workout. Exercises performed on the Physioball can be easily adjusted to suit various fitness levels, making it an excellent choice for beginners and experienced athletes alike. Unlike doing crunches and other traditional “core” strengthening exercises which only strengthen the outer “pretty” layer of muscles, the physioball can strengthen the deep, middle, and outer core musculature, some of which are excellent shock absorber muscles for the spine. The physioball is also a low to no impact way to strengthen and the exercises are performed in a “spine neutral” position which avoids strain on the lower back.

Getting Started: Physioball Exercises for Core Strengthening

Before starting, choose a Physioball that matches your height. When sitting on the ball, your hips and knees should form a 90-degree angle. Always perform exercises in a safe, spacious area to avoid injury.

  1. Physioball Bridges

Physioball Bridge

How to: Lie on your back with your feet resting on the ball, knees bent. Lift your hips towards the ceiling, forming a straight line from shoulders to knees. Hold, then slowly lower.

Benefits: Strengthens the glutes, hamstrings, and lower back.

2. Physioball Planks

How to: With your forearms on the Physioball, step your feet back to come into a plank position. Keep your core tight and hold as long as possible.

Benefits: Engages the entire core, including the deep abdominal muscles.

3. Physioball Wall Squats

How to: Place the ball between your lower back and a wall. Slowly bend your knees to lower into a squat, keeping the ball in place. Return to start.

Benefits: Strengthens quads, hamstrings, and improves lower back and core stability.

4. Physioball Ab Rollouts

How to: Kneel with the ball in front of you. Place your hands on the ball and roll it forward while keeping your back straight, then pull back.

Benefits: Intensely works the core, particularly the abs and lower back.

5. Physioball Back Extension

How to: Lie face down with the ball under your hips and feet against a stable surface. Place your hands by your sides or behind your head and slowly lift your chest off the ball, then lower.

Benefits: Strengthens the back extensors, which are crucial for spinal support and posture.

Safety Tips

Always warm up before starting your exercise routine.

Move into and out of positions slowly and with control to avoid injury.

Stop any exercise that causes pain beyond mild discomfort.

Integrating the Physioball into your core strengthening routine can offer significant relief from chronic low back pain. By focusing on building the muscles that support your spine, you can improve your posture, enhance your mobility, and reduce your pain. Remember, consistency is key. Incorporate these exercises into your routine 3-4 times a week for 15 minutes for the best results. Always consult with a healthcare provider before starting any new exercise program, especially if you have existing health concerns.  For more core strengthening program ideas that more tailored to your health issues and fitness level, feel free to schedule a consult with one of our Physical Therapists today using the link below.  Also, check out the Beginner, Intermediate, and Advanced Physioball Program videos in our Store. 

Embrace the journey to a stronger core and a pain-free life with the Physioball. Your back will thank you!

Hopping Back to Health: How the Easter Bunny Overcame Jumper’s Knee

This year, apparently toward the end of his annual egg deliver, the Easter Bunny faced an unexpected challenge: a case of jumper’s knee. Known for his legendary hopping abilities, this setback threatened the joyous tradition of delivering Easter eggs worldwide. This is the tale of how dedicated physical therapy helped our fluffy friend bounce back stronger than ever, ensuring he could continue spreading Easter cheer.

Understanding Jumper’s Knee:
Jumper’s knee, while common among athletes, was a rare sight in magical creatures. Our hero experienced pain below his fluffy tail, precisely at the base of his kneecap - a result of his endless enthusiasm for hopping. Recognizing the urgency, he sought the expertise of our renowned forest physical therapist.

The Role of Physical Therapy:
The journey began with a thorough assessment in a cozy, leaf-lined clinic room. The physical therapist, resembling a wise old owl with spectacles perched , crafted a custom treatment plan. Goals were set: alleviate pain, strengthen the Easter Bunny’s legs, and ensure a full return to egg-delivering duties by next Easter.

Key Physical Therapy Techniques:

  • Stretching the Forest Way: The Easter Bunny embarked on a series of stretches, including the "Carrot Reach" and the "Burrow Stretch," focusing on flexibility and easing tension in his muscles.

  • Strength Training with a Twist: Under the experienced therapist’s guidance, our hero performed squats using acorns for resistance, and "Log Hops" to build muscle strength without straining his tender tendon.

  • Eccentric Training on Hills: The sloping hills around the burrow became the perfect setting for eccentric exercises, carefully lowering his body to strengthen the muscles around his knee.

  • Gentle Plyometrics: Gradually, the Easter Bunny introduced low-impact jumping exercises, practicing soft landings on leaf piles to mimic the gentle touch needed on Easter morn.

Supportive Practices for a Magical Recovery:

  • Ice Therapy with Glacier Water: Post-exercise, the bunny applied ice wrapped in maple leaves, chilled by the mountain’s glacier water, soothing inflammation.

  • Willow Bark Bracing: A supportive brace crafted from willow bark and vine provided additional support, ensuring safe hopping practices.

  • Rest and Recovery in a Moss Bed: Embracing the importance of rest, our bunny found solace in his moss-lined bed, allowing nature to aid his healing.

Advanced Therapies for That Extra Spark:
With the therapist’s guidance, the Easter Bunny explored gentle manual therapy and magical laser treatments powered by fireflies, enhancing his recovery and adding a bit of sparkle to the process.

Lifestyle Modifications for a Bright Future:
Adjustments were made to the bunny’s routine, incorporating cross-training with swimming in the brook and cycling on a miniature bike made from twigs and leaves. Proper footwear was introduced: soft, moss-lined shoes that provided support and cushioning.

Through dedication to his physical therapy regimen and expert treatment plan, he made a

miraculous recovery. We expect a release to full duty Easter Egg delivery by next year.

Our fluffy hero's journey teaches us the importance of care, determination, and the magic of physical therapy. So next Easter, when you find a brightly colored egg hidden in your garden, remember the tale of the Easter Bunny and his triumphant hop back to health.

Let's hop into a healthier future together! If your Egg Hunting activities have left you a little worse for the wear, don’t hesitate to schedule your consult with one of our expert Physical Therapists. 

The Power of Touch: How Manual Therapy Can Ease Your Low Back Pain

Low back pain is a common affliction that can disrupt daily life, making even simple tasks feel daunting. Whether it's a result of poor posture, an injury, or chronic conditions, finding relief is often a priority for those suffering. That's where manual therapy, a cornerstone of physical therapy, comes in as a beacon of hope.

What is Manual Therapy?

Manual therapy is a hands-on treatment by physical therapists to manipulate muscles and joints to decrease pain caused by muscle spasm, muscle tension, and joint dysfunction. It can include techniques such as massage, mobilization, and manipulation. These methods are not only aimed at relieving pain but also at restoring mobility and improving overall function.

The Role of Manual Therapy in Treating Low Back Pain

Low back pain can stem from various sources, including muscle tension, herniated discs, or degenerative disc disease. Manual therapy addresses these issues by:

  • Reducing Muscle Tension: Through specific massage techniques, such as trigger point release, therapists can help relax tight muscles, offering relief from pain and discomfort

  • Improving Joint Mobility: Mobilization techniques gently move joints through their natural range of motion, reducing stiffness and improving flexibility.

  • Decreasing Pain: Manipulation techniques can help to realign joints and reduce the pressure on nerves, thereby decreasing pain.

The Benefits of Manual Therapy for Low Back Pain

  • Immediate Pain Relief: Many patients experience a reduction in their pain levels right after a manual therapy session.

  • Increased Mobility: By addressing joint and muscle stiffness, manual therapy can help increase your range of motion.

  • Customized Care: Physical therapists tailor manual therapy techniques to your specific needs, ensuring the most effective treatment for your low back pain.

  • Comprehensive Approach: Manual therapy is often part of a broader physical therapy plan that includes exercises and education, providing a holistic approach to managing low back pain.

What to Expect During a Manual Therapy Session

Your first session will typically begin with a detailed assessment of your condition. Your physical therapist will ask about your medical history, pain, and any activities that aggravate or alleviate your low back pain. They will then perform a physical examination to assess mobility and pain points.

Based on this assessment, your therapist will use specific manual therapy techniques tailored to your needs. You may also receive guidance on exercises you can do at home to complement your therapy sessions.

Embracing a Pain-Free Life

Low back pain doesn't have to be a life sentence. With the right approach, including manual therapy, you can take significant steps towards pain relief and improved quality of life. Remember, the goal of physical therapy is not just to treat symptoms but to address the root causes of your pain and prevent future episodes.

If you're struggling with low back pain, consider reaching out to a physical therapist trained in manual therapy. It could be the first step towards a more comfortable, active life. Schedule your consult with one of our Physical Therapists today.

Unraveling the Benefits of ASTYM Therapy for Soft Tissue Injuries

Soft tissue injuries are not just painful; they can also significantly impede our daily activities and athletic endeavors. Traditional treatments often focus on symptom relief without addressing the root cause of the problem. Enter ASTYM therapy, a cutting-edge rehabilitation technique that is gaining traction for its effectiveness in treating soft tissue dysfunctions. Let's dive into what ASTYM therapy is, how it works, and why it might be the solution you've been searching for.

What is ASTYM Therapy?

ASTYM therapy stands for A-Stimulation Therapy, a non-invasive treatment designed to heal soft tissue injuries. It uses specific instruments to massage and gently scrape the skin in areas afflicted by soft tissue damage. This innovative approach is not only about treating the symptoms but stimulating the body’s natural healing processes.

The Science Behind ASTYM Therapy

At the heart of ASTYM therapy is the principle of regenerative medicine. The technique targets areas with scar tissue or degeneration, using special tools to apply specific pressures and movements. This process creates microtraumas in the tissue, which might sound alarming, but is actually beneficial. These microtraumas stimulate the body's healing response, leading to the breakdown of unwanted scar tissue and the regeneration of healthy soft tissues.

Conditions Treated by ASTYM Therapy

ASTYM therapy has shown remarkable success in treating a wide range of conditions, including but not limited to:

  • Tendinitis

  • Plantar fasciitis (Heel pain)

  • Carpal tunnel syndrome

  • Scar tissue adhesions

  • Chronic pain conditions

  • Frozen shoulder

This versatility makes it a sought-after treatment option for athletes, active individuals, and anyone looking to recover from soft tissue injuries more effectively.

The ASTYM Therapy Experience

ASTYM treatment is typically administered by certified physical therapists over multiple sessions. Each session involves the therapist using the ASTYM instruments to treat the affected areas, followed by specific stretches and exercises tailored to the patient's needs. Patients often report feeling immediate improvement in terms of mobility and pain reduction, with the best results seen after completing the recommended treatment course, usually 2 times weekly for 4-6 weeks.

Why Choose ASTYM Therapy?

Here are some compelling reasons to consider ASTYM therapy:

  • Non-invasive: Unlike surgery, ASTYM therapy does not require any incisions or extended downtime.

  • Addresses the root cause: By promoting the regeneration of healthy tissues, ASTYM therapy helps resolve the underlying issues causing pain and dysfunction.

  • Complementary treatment: ASTYM therapy can be integrated into a broader rehabilitation plan, enhancing the effectiveness of other treatments.

  • ASTYM therapy is covered by most insurance plans as part of physical therapy. 

Final Thoughts

In the evolving landscape of physical therapy and rehabilitation, ASTYM therapy stands out as a forward-thinking treatment for soft tissue injuries. By harnessing the body's inherent healing capabilities, it offers a promising solution for those seeking to overcome chronic pain and regain their full range of motion. If you're struggling with a soft tissue injury, consider consulting our ASTYM certified therapist to explore how this innovative therapy could benefit you.

Dry Needling for TMJ Pain

Dry needling, an innovative and increasingly popular therapy, offers a promising solution for those suffering from temporomandibular joint (TMJ) disorders. This blog post delves into the essence of dry needling, its application for TMJ conditions, and what patients can expect during and after treatment.

Understanding TMJ Disorders

The temporomandibular joint (TMJ) acts as a sliding hinge, connecting your jawbone to your skull. Disorders of this joint can cause pain in your jaw joint and in the muscles that control jaw movement.

The temporomandibular joint (TMJ) and associated muscles

Symptoms often include pain or tenderness in the jaw, aching pain in and around your ear, difficulty chewing, and locking of the joint, making it difficult to open or close your mouth.

What is Dry Needling?

We have discussed Dry Needling in previous posts, but let’s do a quick review.  Dry needling is a physical therapy technique used to treat muscle pain and dysfunction. It involves the insertion of a thin, sterile needle into the skin and muscle directly at a myofascial trigger point. Despite its similarity to acupuncture in the use of needles, dry needling is based on modern Western medical principles. It targets muscular tension, knots, and trigger points that are contributing to pain and functional limitations.

Dry Needling for TMJ Disorders

Dry needling can be particularly effective for TMJ disorders by targeting muscles involved in jaw movement. The muscles of mastication, such as the masseter, temporalis, and pterygoid muscles, can often become tight or dysfunctional due to TMJ disorders, leading to pain and restricted movement.

The Procedure

A qualified physical therapist, trained in dry needling, will first assess your condition to identify trigger points contributing to your TMJ dysfunction. The therapist will then insert a thin needle into these points. The insertion of the needle can lead to a "twitch response" from the muscle, which is a desirable therapeutic reaction indicating the release of muscle tension and pain relief.

What to Expect

During the procedure, patients may experience a twitch response and a brief period of discomfort as the needle is inserted. Post-treatment, there might be some muscle soreness similar to that experienced after a vigorous workout, but this typically subsides within a day or two. Many patients report immediate relief from their TMJ symptoms, including reduced pain and improved jaw movement.

Benefits of Dry Needling for TMJ

  • Pain Relief: By releasing trigger points, dry needling can significantly reduce jaw pain and discomfort.

  • Improved Mobility: Treatment can lead to an improvement in jaw movement and function.

  • Reduced Tension: It can help relax the muscles of mastication, reducing overall tension and discomfort.

  • Complementary Therapy: Dry needling can be an effective complement to other TMJ treatments, such as physical therapy exercises, massage, and medication

For those suffering from TMJ disorders, dry needling presents a promising treatment option. By targeting specific trigger points within the muscles of mastication, it can offer significant pain relief and improved jaw function. If you would like to explore whether physical therapy and dry needling can help with your jaw pain, schedule your consult today with the link below and get started on the path to recovery.

Unlocking Relief: The Power of Trigger Point Dry Needling for Headaches

Headaches can be more than just a minor inconvenience; for many, they are a debilitating condition that can severely impact daily life. Traditional treatments often include medications, lifestyle changes, and physical therapy. However, an innovative approach known as trigger point dry needling (TPDN) is gaining traction for its effectiveness in providing relief from chronic headaches. This post delves into what TPDN is, how it works for headaches, and what you can expect if you decide to pursue this treatment.

Understanding Trigger Point Dry Needling

Trigger point dry needling is a physical therapy technique that involves inserting a thin, sterile needle into specific areas of muscle known as trigger points. These are tight knots within the muscle that can cause pain over a large area. The goal of TPDN is to release these knots, easing muscle tension and improving function. While the idea of needles may sound daunting, the procedure is minimally invasive and often results in significant relief from pain.

How TPDN Offers Relief from Headaches

Headaches, particularly tension-type headaches and migraines can often be traced back to muscular issues in the neck and shoulders. These muscular issues can include tightness and trigger points that contribute to the headache pain. By targeting these trigger points directly, TPDN can help alleviate the tension and discomfort associated with headaches.

Examples of trigger point headache pain patterns

The Mechanism Behind the Relief

The precise mechanism by which dry needling provides relief is not entirely understood, but it's believed to involve several factors:

  • Stimulating the Muscle: The needle helps stimulate the muscle, encouraging it to relax.

  • Increasing Blood Flow: Inserting the needle can increase blood flow to the area, helping to ease muscle tension and promote healing.

  • Reducing Inflammatory Chemicals: The process may help reduce the concentration of inflammatory chemicals in the tissue, thereby decreasing pain.

  • Neurological Effects: TPDN is thought to have effects on the nervous system, potentially altering the way pain is perceived by the brain.

What to Expect During a TPDN Session

If you're considering TPDN for your headaches, here's a general overview of what to expect:

  1. Assessment: A qualified physical therapist will first assess your condition to determine if TPDN is an appropriate treatment.

  2. Preparation: You'll be positioned comfortably, and the skin where the needles will be inserted is cleaned.

  3. The Procedure: The therapist will insert needles into specific trigger points. You may feel a slight twinge or muscle twitch, which is a good sign that the trigger point has been effectively targeted.

  4. Post-Treatment: Some people experience immediate relief, while others may notice improvement over the following days. It's common to have some soreness after the procedure, similar to what you might feel after a vigorous workout.

Is TPDN Right for You?

While TPDN can be incredibly effective for many people suffering from headaches, it's not suitable for everyone. It's essential to consult with a healthcare professional to discuss your specific situation. They can help determine if TPDN is a viable option for you and guide you towards the best treatment plan.

Trigger point dry needling offers a promising alternative for individuals seeking relief from chronic headaches. By directly addressing the muscular factors contributing to headache pain, TPDN can provide significant, lasting relief. If you're struggling with headaches and traditional treatments haven't provided the relief you're seeking, consider speaking with a physical therapist about whether TPDN might be right for you by scheduling your consult below. 

An introduction to Physical Therapy for Heel Pain

Heel pain can be a debilitating condition that affects your daily activities and quality of life. Whether it's the first step out of bed in the morning or standing after a long period of sitting, the sharp, intense pain can be overwhelming. However, physical therapy has a lot to offer those suffering from heel pain. This guide will explore how physical therapy can help alleviate heel pain, detailing exercises, techniques, and tips to get you back on your feet pain-free.

Understanding Heel Pain

Heel pain is often caused by plantar fasciitis, a condition where the plantar fascia, the thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes, becomes inflamed. Other causes include Achilles tendinitis, heel spurs, and bursitis. Understanding the underlying cause of your heel pain is crucial in tailoring a physical therapy regimen that addresses your specific condition. This week we will be focusing on physical therapy for plantar fasciitis. 

Plantar fasciitis is a common foot condition that affects millions of people worldwide, causing heel pain and discomfort that can significantly impact daily activities. While it often resolves with conservative measures such as rest, stretching, and orthotics, some individuals experience chronic plantar fasciitis, where symptoms persist despite these interventions. For those facing persistent pain, physical therapy offers a comprehensive approach to managing symptoms, restoring function, and improving quality of life.

Understanding Chronic Plantar Fasciitis: Plantar fasciitis is characterized by inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes. Chronic plantar fasciitis occurs when this inflammation becomes prolonged, leading to persistent pain and discomfort.

Common contributing factors to chronic plantar fasciitis include:

  • Overuse or repetitive strain on the plantar fascia due to activities such as running, walking long distances, or standing for extended periods.

  • Biomechanical abnormalities such as flat feet, high arches, or improper gait mechanics.

  • Tightness or weakness in the muscles of the foot, calf, or hamstring.

  • Poor footwear choices that lack adequate support or cushioning.

The symptoms of chronic plantar fasciitis typically include:

  • Heel pain, especially upon waking or after prolonged periods of rest.

  • Pain that worsens with activity and improves with rest.

  • Stiffness and discomfort in the bottom of the foot, particularly near the heel.

  • Difficulty bearing weight on the affected foot.

How Physical Therapy Can Help: Physical therapy plays a crucial role in the management of chronic plantar fasciitis by addressing underlying biomechanical issues, improving flexibility and strength, and promoting proper foot mechanics. Here are some key components of physical therapy for chronic plantar fasciitis:

Manual Therapy: Hands-on techniques such as massage, joint mobilization, and stretching can help reduce pain, improve tissue flexibility, and restore normal range of motion in the foot and ankle.

Dry Needling: Plantar fasciitis is often associated with trigger points in the calf muscles or other muscles of the lower leg that can refer pain to the foot. Dry needling can target these trigger points, helping to alleviate referred pain and discomfort in the heel and arch of the foot.

ASTYM Therapy: ASTYM involves the use of specifically designed instruments to apply controlled pressure and stimulate the body's natural healing response in affected soft tissues. This process can help break down scar tissue, adhesions, and other abnormalities in the plantar fascia, promoting tissue remodeling and regeneration.

Therapeutic Exercises: Specific exercises are prescribed to strengthen the muscles of the foot, ankle, and lower leg, helping to stabilize the arch and improve overall biomechanics. These may include calf stretches, toe curls, and balance exercises.

Gait Analysis and Correction: Physical therapists assess the patient's walking and running patterns to identify any abnormalities or inefficiencies that may contribute to plantar fasciitis. By making adjustments to gait mechanics and prescribing appropriate footwear or orthotics, they can help alleviate stress on the plantar fascia.

Modalities: Modalities such as ultrasound, electrical stimulation, or cold therapy may be used to reduce pain and inflammation, especially during the acute phase of treatment.

Education and Home Management: Patients are educated about proper foot care, including the importance of supportive footwear, appropriate stretching techniques, and activity modification to prevent exacerbation of symptoms. Home exercise programs are prescribed to reinforce the benefits of in-clinic therapy sessions.

Progressive Loading: As symptoms improve, physical therapists gradually reintroduce weight-bearing activities and functional movements to rebuild strength and endurance while minimizing the risk of re-injury.

Conclusion: Chronic plantar fasciitis can be a challenging condition to manage, but with the right approach, many individuals can find relief and resume their normal activities. Physical therapy offers a holistic and evidence-based approach to addressing the underlying causes of plantar fasciitis, reducing pain, and improving function. By incorporating manual therapy, modalities, therapeutic exercises, gait analysis, and patient education, physical therapists empower individuals to take an active role in their recovery and reclaim their mobility and independence. If you're struggling with chronic plantar fasciitis, don't hesitate to schedule your consult with our physical therapist to explore your treatment options and take the first step towards walking free from pain.

Effective Physical Therapy Treatments for Knee Osteoarthritis

Knee osteoarthritis (OA) is a degenerative joint disease that affects millions globally, leading to pain, stiffness, and reduced mobility. While there's no cure for OA, physical therapy stands out as a cornerstone in managing symptoms and improving quality of life.

This blog explores the role of physical therapy in treating knee osteoarthritis, offering insight into effective treatments that can help patients navigate their journey toward better knee health.

Understanding Knee Osteoarthritis

Osteoarthritis is characterized by the breakdown of cartilage, the cushioning material at the end of bones. In the knee, this degeneration can lead to pain, swelling, and difficulty in performing daily activities. Factors contributing to knee OA include age, weight, genetics, previous injuries, and overuse.

Goals of Physical Therapy

Our primary objectives of physical therapy for knee OA are to:

  • Alleviate pain and inflammation

  • Improve joint mobility and flexibility

  • Strengthen the muscles around the knee to support and stabilize the joint

  • Educate patients on managing symptoms and preventing further joint damage.

Effective Physical Therapy Treatments for Knee OA

1. Exercise and Strength Training

A core component of OA management, exercises tailored to individual needs can significantly reduce pain and improve function. Key focuses include:

  • Strengthening exercises for the quadriceps, hamstrings, and hip muscles which support and provide shock absorption for the knee joint.

  • Range-of-motion exercises to maintain and improve knee flexibility which can decrease pressure inside the knee joint.

  • Low-impact aerobic exercises, such as walking, cycling, or swimming, to promote joint health without exacerbating symptoms.

2. Manual Therapy

Manual therapy techniques, such as joint mobilization and soft tissue massage, can help improve joint movement and relieve pain. These hands-on treatments are performed by physical therapists to gently move muscles and joints.

3. ASTYM

Using specially engineered acrylic instruments, the knee is treated using a protocol that will promote the release of healing cells inside the knee soft tissue structures known as platelet derived growth factor which can be truly regenerative to cartilage, tendons and ligaments inside the knee.  When performed twice weekly for 4-6 weeks in conjunction with an exercise program, the protocol has been shown to be highly effective even in cases of bone on bone arthritis. 

4. Pain Management Techniques

Physical therapists employ various methods to manage pain, including:

  • Hot and cold therapy to reduce inflammation and relieve pain.

  • Electrotherapy, such as TENS (transcutaneous electrical nerve stimulation), to reduce pain through electrical impulses.

  • Ultrasound therapy, which uses sound waves to penetrate deep into tissue, reducing inflammation and promoting healing.

5. Education and Lifestyle Advice

Part of physical therapy involves educating patients on knee OA, including weight management strategies to reduce stress on the knees, and advice on appropriate footwear or assistive devices like braces or orthotics.

Tailoring Treatment to the Individual

It's crucial that physical therapy treatments are customized to the individual's symptoms, severity of OA, lifestyle, and goals. A combination of treatments may be necessary for optimal results.

Conclusion

Physical therapy offers a beacon of hope for those grappling with knee osteoarthritis, providing tools and techniques to manage pain, enhance mobility, and improve quality of life. By focusing on a holistic approach that combines exercise, manual therapy, and education, patients can take active steps toward managing their symptoms and maintaining an active lifestyle. Remember, early intervention is key to slowing the progression of OA and minimizing its impact on your life.  If you would like to get started with a rehab program which has been shown to be highly effective in managing knee osteoarthritis and returning to full activity, schedule you physical therapy consult today.

How Physical Therapy Can Ease Your IT Band Pain

Introduction

Iliotibial Band Syndrome (ITBS) is a common cause of knee pain, particularly among runners, cyclists, and other athletes. The discomfort stems from inflammation of the iliotibial band, a crucial ligament that extends from the hip to the shin and stabilizes the knee. If you're grappling with outer knee pain, physical therapy might be your path to relief. Here's how.

Understanding ITBS

Before diving into treatment, it's important to understand what ITBS is. This condition occurs when the iliotibial band becomes tight or inflamed, often due to overuse. Symptoms include sharp or burning pain on the outer knee, which can radiate up or down the leg, worsening with activity.

The Role of Physical Therapy

Physical therapy plays a pivotal role in treating ITBS. It aims to reduce pain, decrease inflammation, and increase flexibility and strength in the affected area. Here’s what to expect from a physical therapy program for ITBS:

Assessment and Personalized Treatment Plan

Your journey begins with a thorough assessment by a physical therapist. They'll examine your knee, hip alignment, and gait to identify specific factors contributing to your ITBS. Based on this evaluation, they'll craft a personalized treatment plan tailored to your needs.

Stretching and Strengthening Exercises

A core component of ITBS treatment involves targeted exercises. Here are a few examples:

IT Band Stretches: Gentle stretching of the iliotibial band can help relieve tightness and pain.

Hip Strengthening: Weak hip muscles can contribute to ITBS. Exercises like hip abductors and glute bridges can build strength in these areas.

Core Strengthening: A strong core supports proper posture and alignment, reducing strain on the IT band.

Manual Therapy

Manual therapy techniques, such as massage and mobilization, can be applied by your physical therapist to help loosen the IT band and surrounding muscles, promoting healing and flexibility.

As a physical therapist working with runners, I often see trigger points that have developed in the quadriceps and gluteal musculature that is causing tightness in the iliotibial band.  Trigger Point Dry Needling is excellent at eliminating trigger points and the IT band tightness. 

Education and Prevention

Education is a key part of the treatment process. Your therapist will provide advice on proper form and technique for your activities, recommend footwear, and discuss strategies to prevent ITBS recurrence, such as gradual increases in activity levels and proper warm-up routines.

Conclusion

Physical therapy offers a comprehensive approach to managing ITBS, focusing on pain relief, healing, and prevention. With the right exercises and guidance, you can return to your favorite activities without the shadow of ITBS looming over you. Remember, early intervention is key to a speedy and successful recovery. If you suspect you have ITBS, schedule a consult to get started on your path to wellness.

Physical Therapy for Runner's Knee: A Step Towards Recovery

Runner's knee, medically known as patellofemoral pain syndrome, is a common ailment among athletes, especially runners. It's characterized by pain around the kneecap and is often caused by overuse, misalignment, and muscle imbalance. As a physical therapist, I've seen many runners bounce back from this condition. Here’s a comprehensive guide on how physical therapy can help.

Runner's knee isn’t just a runner's issue; it can affect anyone. It's usually a result of increased load on the knee joint, which can stem from various factors such as poor running mechanics, inadequate footwear, or muscle weaknesses.

Physical Therapy Approach

Assessment: The first step is a thorough assessment. This might include analyzing your running gait, checking for muscle imbalances, and understanding your training routine.

Pain Management: Initially, the focus is on reducing pain. This could involve techniques like icing, taping, or gentle stretching exercises to alleviate stress on the knee.  One of the things we typically see with runner’s knee is that the muscle imbalances have resulted in overuse of the quadriceps and the runner has developed trigger points in the large quadriceps muscles.  Trigger point dry needling of the quadriceps can immediately provide relief as it releases the constant tension on the patella (knee cap).

Trigger Points in the quadriceps musculature can place tension on the quadriceps tendon and patella

Strengthening Exercises: A key part of recovery is strengthening the muscles around the knee, particularly the hip and gluteal musculature, the quadriceps, and hamstrings. Your therapist can show you how to strengthen the muscles in a pain free manner. 

Flexibility and Mobility Work: Tight muscles can contribute to runner's knee. Hence, stretching and mobility exercises are crucial. This could include stretches for the hamstrings, quadriceps, hip flexors and iliotibial band. 

Gait Retraining: If your running form is contributing to your pain, gait retraining is essential. This might involve working on your stride length, foot strike, or overall posture.

Proprioceptive Training: Enhancing your body’s proprioception (awareness of movement and position) is vital. Balance exercises, like single-leg stands, can be very beneficial.

Education: Understanding the condition and knowing how to prevent future occurrences is part of the therapy. This includes advice on proper footwear, running surfaces, and training load management.

Recovery Timeline

Recovery time varies depending on the severity of the condition and your body's response to therapy. It's crucial to progress gradually and not rush back into intense running.

Conclusion

Physical therapy offers a holistic approach to treating runner's knee, addressing not just the symptoms but the underlying causes. With a tailored treatment plan, commitment, and patience, you can return to running pain-free. If your training or exercise program is being hampered by knee pain, start your path to recovery by scheduling your consult today.

Avoiding Surgery: Physical Therapy for Hip Arthritis

Hip arthritis is a common condition that can cause significant pain and mobility issues. Fortunately, physical therapy offers a variety of techniques to manage and alleviate the symptoms. This blog post explores the role of physical therapy in treating hip arthritis, offering insights and guidance for those seeking relief.

Before diving into treatment options, it's crucial to understand what hip arthritis is. It's a degenerative condition where the cartilage in the hip joint wears down over time, leading to pain and stiffness. The most common type is osteoarthritis, though other forms like rheumatoid arthritis can also affect the hip.

Hip Osteoarthritis

Physical therapy plays a pivotal role in managing hip arthritis. It focuses on improving joint function, increasing range of motion, and reducing pain. Here’s how:

Strengthening Exercises: Strengthening the muscles around the hip joint can provide more support and reduce stress on the joint. This might include exercises like leg lifts, squats, and resistance band exercises.

Flexibility and Stretching: Tight muscles can exacerbate arthritis pain. Physical therapists teach stretches to increase flexibility and decrease tension around the hip.

Pain Management Techniques: Modalities and techniques to alleviate trigger points in the hip musculature reduces pain and allows therapeutic exercises to be more effective. 

Education and Lifestyle Advice: Physical therapists also provide advice on lifestyle changes that can ease symptoms, such as weight management and avoiding activities that strain the hip.

Every case of hip arthritis is unique, so treatment plans are tailored to each individual's needs. A physical therapist will assess your condition and create a program that addresses your specific symptoms and goals.

The Benefits of Physical Therapy for Hip Arthritis

Reduced Pain and Stiffness: Regular therapy can significantly reduce the discomfort associated with hip arthritis.

Improved Mobility: Enhanced joint function and strength can make daily activities easier and less painful.

Slowing Disease Progression: By maintaining joint health, physical therapy can help slow the progression of arthritis.

Hip arthritis doesn't have to control your life. With the right physical therapy regimen, you can manage your symptoms and maintain an active lifestyle.

If you're struggling with hip arthritis, consider consulting a physical therapist. With their expertise, you can embark on a journey towards reduced pain and improved mobility.

Easing the Pain: Physical Therapy for Hip (Trochanteric) Bursitis

Hip bursitis, otherwise known as Trochanteric bursitis is a common cause of hip pain, often resulting from overuse, injury, or postural issues. This condition, involving inflammation of the bursa at the outside point of the hip, can significantly impact your mobility and quality of life. Fortunately, physical therapy offers effective strategies to alleviate symptoms and address the underlying causes. In this blog, we explore the role of physical therapy in treating trochanteric bursitis.

Understanding Trochanteric Bursitis: Before diving into treatments, it's essential to understand what trochanteric bursitis is. The condition arises when the bursa – a small, fluid-filled sac that acts as a cushion between bones and soft tissues – becomes inflamed. Common symptoms include pain and tenderness at the outer hip, which may extend down the thigh.

Trochanteric Bursa and surrounding musculature

Key Physical Therapy Treatments:

Stretching Exercises: Physical therapists often recommend specific stretching exercises to relieve tightness in the hip and thigh muscles. These exercises aim to reduce strain on the bursa and surrounding tissues.

Strengthening Exercises: Strengthening the muscles around the hip, particularly the gluteal muscles, can help stabilize the hip joint and reduce the burden on the bursa.

Manual Therapy: Techniques like massage and mobilization can help reduce pain and improve range of motion in the hip.

Heat and Ice Therapy: Applying heat can loosen tight muscles, while ice can help reduce inflammation and pain.

What we often see in therapy is the patient has a history of lower back problems which has caused trigger points to develop in the hip musculature resulting in muscle imbalances and chronic strain and pressure around the hip bursa.  Addressing the trigger points with manual therapy techniques or trigger point dry needling can relieve the pressure on the bursa and allow recovery. 

Lifestyle and Postural Modifications: Your physical therapist may also recommend changes in daily activities or posture to prevent aggravation of the condition. For instance, avoiding prolonged standing or sitting in positions that strain the hip can be beneficial.

Long-Term Management and Prevention: Physical therapy for trochanteric bursitis isn't just about immediate pain relief; it's also about preventing future occurrences. Your therapist will guide you in maintaining proper hip strength and flexibility and advise on activities to avoid or modify.

Trochanteric bursitis can be a painful and frustrating condition, but with the right physical therapy approach, you can manage your symptoms and regain your mobility. Remember, each person's journey to recovery is unique, so it's important to work closely with your physical therapist to develop a treatment plan tailored to your specific needs.

If you're struggling with hip pain and suspect it might be trochanteric bursitis, don't wait for it to worsen. Contact us today and schedule your consult to start your journey toward pain-free movement.

Fix Your Snapping Hip

Snapping hip syndrome, also known as coxa saltans or dancer's hip, is a condition where a person experiences a snapping sensation or sound in the hip when walking, getting up from a chair, or swinging the leg around. This sensation is typically painless and harmless, but it can be uncomfortable and annoying. In some cases, it can lead to pain or discomfort. The condition is more common in athletes, dancers, and people who engage in activities involving repetitive hip movements.

Causes

Snapping hip syndrome can be caused by several factors:

Iliotibial Band (IT Band) Snap: (External Snapping Hip) This occurs when the iliotibial band, a thick band of tissue that runs from the outside of the pelvis to the knee, snaps over the greater trochanter of the femur (the outer part of the thigh bone).

Hip Flexor Snap: (Internal Snapping Hip) This happens when the iliopsoas tendon, a primary hip flexor, snaps over a bony protrusion in the pelvis or the femur.

Cartilage or Labral Tear: Cartilage damage or a tear in the acetabular labrum (the cartilage surrounding the hip socket) can also cause snapping sensations.

Loose Bodies: Small pieces of bone or cartilage that become loose and move around in the joint can lead to snapping.

Symptoms

1.     Audible snapping or popping noise in the hip.

2.     Sensation of snapping when moving the hip, especially in certain directions.

3.     Pain or discomfort, which can vary in intensity.

4.     Feeling of the hip being unsteady or giving way (less common).

Treatment

Treatment for snapping hip syndrome often starts with conservative approaches:

·      Rest and Activity Modification: Avoiding activities that cause symptoms.

·      Physical Therapy: Exercises to strengthen and stretch the muscles around the hip.

·      Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications to reduce pain and inflammation.

·      Corticosteroid Injections: Injections to reduce inflammation in severe cases.

·      Surgery is rarely needed and is typically considered only when conservative treatments fail and the symptoms are severe.

Prevention

Preventative measures include regular stretching, strengthening exercises for hip and core muscles, and avoiding repetitive motions that could irritate the hip.

 

In cases of snapping hip syndrome, the focus on muscle strengthening usually revolves around the muscles that support and stabilize the hip joint. These include:

Gluteal Muscles: Strengthening the gluteus medius and gluteus maximus can help stabilize the hip joint. Exercises like squats, lunges, and hip bridges are effective for targeting these muscles.

Hip Flexors: These muscles, particularly the iliopsoas, help in hip flexion. Strengthening exercises can include leg lifts and gentle resistance training.

Core Muscles: A strong core, which includes the muscles of the abdomen, lower back, and pelvis, is crucial for stabilizing the entire lower body. Planks, abdominal crunches, and Pilates exercises can be very beneficial.

Adductor Muscles: Located on the inner thigh, these muscles help in hip stabilization. Exercises like side leg lifts and adductor machine exercises can strengthen these muscles.

Abductor Muscles: These muscles, located on the outer thigh, are important for moving the leg away from the body and stabilizing the hip. Side leg raises and using an abduction machine are helpful exercises.

Hamstrings and Quadriceps: These muscles support the overall movement and stability of the hip joint. Exercises include leg curls for hamstrings and leg extensions for quadriceps.

Often times when assessing snapping hip syndrome, we find trigger points in the gluteal or thigh musculature which are causing tightness, weakness and muscle imbalances around the hip on the affected and even unaffected side.  Therefore, it’s important to approach strengthening exercises with balance and to focus on both sides of the body to prevent further imbalance. Active trigger points need to be addressed before strengthening can be optimized.  Additionally, stretching and flexibility exercises are also crucial in managing snapping hip syndrome, as tight muscles can exacerbate the condition.

Before starting any exercise regimen, especially for a condition like snapping hip syndrome, it's advisable to consult with a physical therapist or healthcare provider. They can provide a tailored exercise program that suits your individual needs and ensures that you're performing exercises correctly and safely.  If you would like to have your hip evaluated by one of our licensed Physical Therapists, please schedule your consult today. 

Treating your Thumb Pain

The thumb is a unique and complex part of the human hand, notable for its range of motion and ability to oppose the other fingers, a feature crucial for fine motor skills. Here's a brief overview of its anatomy:

1) Bones: The thumb consists of two major bones:

    • Metacarpal bone: This is the larger bone that forms the base of the thumb, connecting to the wrist.

    • Phalanges: There are two phalangeal bones in the thumb (as opposed to three in the other fingers). These are the proximal phalanx and the distal phalanx.

2) Joints: The thumb has two primary joints:

    • Carpometacarpal (CMC) joint: This joint is between the metacarpal bone and the carpal bones of the wrist. It's a saddle joint, allowing for the swiveling and pivoting motions that make the thumb so versatile.

    • Interphalangeal (IP) joints: These include the metacarpophalangeal (MCP) joint between the metacarpal bone and the proximal phalanx, and the interphalangeal joint between the two phalanges.

3) Muscles and Tendons: Several muscles and tendons control thumb movement:

    • The opponens pollicis allows the thumb to oppose the fingers.

    • The abductor pollicis brevis and abductor pollicis longus move the thumb away from the hand (abduction).

    • The flexor pollicis brevis and flexor pollicis longus bend the thumb (flexion).

    • The adductor pollicis moves the thumb towards the hand (adduction).

4) Nerves: The thumb is primarily innervated by the median nerve, which provides sensation and motor control.

5) Blood Supply: Blood is supplied to the thumb by branches of the radial and ulnar arteries.

The thumb's unique structure and the ability to oppose the other fingers (opposition) make it crucial for gripping and manipulating objects, setting humans apart in the animal kingdom for fine motor skills and tool use. This complexity also means that injuries to the thumb can be particularly debilitating, requiring careful medical attention.

Two conditions that seem to be occurring more often in our technology based society are painful thumb conditions such as DeQuervain’s tenosynovitis and CMC Osteoarthritis.  Let’s explore these conditions. 

DeQuervain's tenosynovitis (also called “Texting Thumb”) is a painful condition affecting the tendons on the thumb side of your wrist. It's sometimes known as DeQuervain's syndrome or DeQuervain's disease. Here are the key aspects of this condition:

1) Affected Area: DeQuervain's involves the two tendons that control thumb movement: the abductor pollicis longus and the extensor pollicis brevis. These tendons run side by side through a tunnel (sheath) near the wrist.

2) Symptoms: The primary symptoms of DeQuervain's tenosynovitis include:

    • Pain or tenderness at the base of the thumb.

    • Swelling near the base of the thumb.

    • Difficulty moving the thumb and wrist when doing activities that involve grasping or pinching.

    • A "sticking" or "stop-and-go" sensation in your thumb when moving it.

3) Causes: The exact cause of DeQuervain's tenosynovitis is not always clear, but it can be associated with:

    • Repetitive hand or wrist movements, particularly those involving twisting or gripping.

    • Chronic overuse of the wrist.

    • Inflammatory conditions, like rheumatoid arthritis.

    • Pregnancy and hormonal changes can also be contributing factors.

4) Risk Factors: Certain factors can increase the risk of developing DeQuervain's, including:

    • Gender: It's more common in women than men.

    • Age: People between the ages of 30 and 50 are at higher risk.

    • Certain activities: Jobs or hobbies that involve repetitive hand and wrist motions.

5) Diagnosis: Diagnosis is often based on symptoms and a physical examination. A common test is the Finkelstein test, where you bend your thumb across the palm of your hand and bend your fingers down over your thumb, then bend your wrist towards your little finger. If this causes pain on the thumb side of your wrist, it's indicative of DeQuervain's.

6) Treatment: Treatment options may include:

    • Resting the affected hand and wrist.

    • Splinting the thumb and wrist to restrict movement.

    • Anti-inflammatory medications to reduce pain and swelling.

    • Corticosteroid injections to reduce inflammation.

    • In severe cases, surgery may be necessary to release the pressure on the tendons.

7) Prevention: Preventive measures can include ergonomic adjustments to work and activity practices, stretches, and exercises to strengthen the wrist and improve flexibility.

Carpometacarpal (CMC) osteoarthritis is a condition that affects the joint located at the base of the thumb, where the thumb metacarpal meets the trapezium bone in the wrist. This particular form of osteoarthritis is also known as thumb arthritis or basal joint arthritis. Here are the key aspects of CMC osteoarthritis:

1) Anatomy Involved: The CMC joint of the thumb is a saddle joint, allowing for a wide range of thumb movements. However, this flexibility also makes it susceptible to wear and tear.

2) Symptoms: The symptoms of CMC osteoarthritis typically include:

    • Pain at the base of the thumb, especially during activities that involve gripping, pinching, or twisting motions.

    • Swelling, stiffness, and tenderness at the base of the thumb.

    • Decreased strength and range of motion in the thumb.

    • In advanced cases, a bony prominence or bump may develop at the base of the thumb.

3) Causes: The exact cause of CMC osteoarthritis is not always clear, but it is generally attributed to a combination of factors, including:

    • Age-related wear and tear of the joint.

    • Previous injuries to the thumb or wrist, such as fractures or sprains.

    • Repetitive stress on the joint over time.

    • Genetic predisposition to osteoarthritis.

4) Risk Factors: Certain factors can increase the risk of developing CMC osteoarthritis:

    • Gender: It's more common in women, especially after menopause.

    • Age: The risk increases with age.

    • Certain activities and occupations that place repetitive stress on the thumb joint.

5) Diagnosis: Diagnosis typically involves a physical examination of the thumb and hand, assessment of the symptoms, and imaging tests like X-rays to evaluate the extent of joint damage.

6) Treatment: Treatment for CMC osteoarthritis aims to relieve pain and restore function. It may include:

    • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation.

    • Thumb splints or braces to restrict movement and provide support.

    • Corticosteroid injections into the joint to reduce inflammation.

    • Physical or occupational therapy to strengthen surrounding muscles and improve joint function.

    • In severe cases, surgical options such as joint fusion, osteotomy, or joint replacement may be considered.

7) Prevention and Management: While it's difficult to completely prevent CMC osteoarthritis, managing risk factors, maintaining a healthy lifestyle, and protecting the thumb joint from excessive stress can help slow its progression.

One of the things we see in Physical Therapy is that long before arthritic changes have occurred in the carpometacarpal joint, people begin experiencing pain and tightness in the muscles around the base of the thumb. 

 

Both of these conditions respond readily to Trigger point dry needling and  ASTYM therapy in conjunction with a home stretching and strengthening program which addresses the chronic inflammation and allows the thumb to heal. 

 

If you would like help treating your thumb condition, please schedule your consult with a Physical Therapist at Lanier Therapy in Motion today. 

Trigger Points and Carpal Tunnel Syndrome

The carpal tunnel is a narrow, tunnel-like structure in the wrist, which is a key area in the anatomy of the hand. Understanding its structure involves several components:

Location and Structure: The carpal tunnel is located on the palmar side of the wrist. It is a narrow passageway bounded by the bones of the wrist (carpals) on three sides and a strong band of connective tissue called the transverse carpal ligament on the fourth side.

  1. Bones: The floor and sides of the carpal tunnel are formed by the carpal bones - a group of eight small bones that make up the wrist. These bones are arranged in two rows, each containing four bones.

  2. Transverse Carpal Ligament: This is a broad band of fibrous tissue that forms the roof of the carpal tunnel. It stretches across the wrist, attaching to the carpal bones and forming the superior boundary of the carpal tunnel.

  3. Contents of the Carpal Tunnel:

    • Median Nerve: One of the major nerves of the hand, it provides sensation to the thumb, index, middle, and part of the ring fingers. It also controls some muscles at the base of the thumb.

    • Tendons: The carpal tunnel also contains the flexor tendons, which are long strands that attach the forearm muscles to the bones of the fingers and thumb. These tendons are enclosed in a synovial sheath, which allows smooth movement of the tendons.

    • Vascular Supply: Although primarily a passageway for tendons and the median nerve, the carpal tunnel also contains important blood vessels that supply blood to parts of the hand.

Function and Movement: The carpal tunnel serves as a conduit through which the flexor tendons and the median nerve pass into the hand. This arrangement allows for the efficient and smooth flexion of the fingers and thumb.

Carpal Tunnel Syndrome:

Carpal tunnel syndrome (CTS) is a common condition characterized by compression of the median nerve as it passes through the carpal tunnel in the wrist. Understanding the epidemiology of carpal tunnel syndrome involves examining its prevalence, risk factors, and demographic characteristics. Here are key points regarding the epidemiology of carpal tunnel syndrome:

Prevalence:

    • Carpal tunnel syndrome is one of the most prevalent nerve entrapment disorders, affecting a significant number of individuals worldwide.

    • The prevalence of carpal tunnel syndrome is estimated to be around 3-6% in the general population.

Age and Gender:

    • Carpal tunnel syndrome is more common in middle-aged and older individuals, particularly those over the age of 40.

    • Women are more likely to develop carpal tunnel syndrome, with the prevalence being 2 to 3 times higher in women compared to men.

    • Hormonal factors, such as those related to pregnancy and menopause, may contribute to the higher prevalence in women.

Occupational Factors:

    • Certain occupations that involve repetitive hand and wrist movements, forceful gripping, or exposure to vibration (e.g., manufacturing, assembly line work, typing) are associated with a higher risk of developing carpal tunnel syndrome.

    • Workers in jobs with repetitive motions and use of hand tools are at an increased risk.

Underlying Medical Conditions:

    • Conditions like obesity, diabetes, rheumatoid arthritis, hypothyroidism, and metabolic syndrome are associated with an increased risk of developing carpal tunnel syndrome.

    • Chronic medical conditions that cause fluid retention or inflammation can contribute to nerve compression within the carpal tunnel.

Pregnancy:

    • Carpal tunnel syndrome is relatively common during pregnancy, likely due to fluid retention and hormonal changes that can increase pressure on the median nerve.

Genetic Factors:

    • Some evidence suggests a genetic predisposition to carpal tunnel syndrome, with a higher risk observed in individuals with a family history of the condition.

Repetitive Stress:

    • Repetitive or sustained stress on the wrist and hand, especially with poor ergonomics and prolonged use of handheld devices, can contribute to the development of carpal tunnel syndrome.

Treatment of carpal tunnel syndrome non-surgically involves a process of reducing the pressure around the median nerve in the tunnel.  This can include the use of splints to reduce the repetitive strain on the wrist or modifying the way repetitive tasks are performed.  It is common on examination to find tendons around the nerve in the tunnel to be thickened by chronic inflammation due to repetitive strain.  The thickened tendons reduce the space available in the tunnel causing compression on the median nerve.  Often, examination reveals that trigger points in the muscles associated with the tendons have resulted in the thickening and chronic inflammation due to the constant tension in the muscles containing the trigger points.  In these cases, physical therapy interventions directed at eliminating the trigger points can be very effective, including trigger point dry needling techniques.  Trigger Point Dry needling to address the muscular portion of the problem in addition to ASTYM treatment to correct the tendon thickening can result in a nearly 100% non-surgical correction of carpal tunnel syndrome if addressed before permanent nerve damage occurs. 

Dry Needling Technique for Carpal Tunnel Syndrome

If you are experiencing pain, numbness and tingling in her hand and would like to explore non-surgical options, please schedule a consult with one of our licensed professionals at Lanier Therapy In Motion. 

Trigger Points and Elbow Pain

The elbow joint is a complex structure pivotal to the movement of the forearm. It involves three bones:

Humerus: The upper arm bone.

  1. Ulna: One of the forearm bones, located on the side opposite the thumb.

  2. Radius: The other forearm bone, located on the thumb's side.

The Elbow Joint

These bones are connected by a combination of ligaments, muscles, and tendons, which facilitate movement and provide stability. The elbow joint is actually a combination of two types of joints:

  • Hinge Joint: Allows the elbow to bend and straighten; involves the interaction between the humerus and the ulna.

  • Pivot Joint: Enables the forearm to rotate, turning the palm up (supination) or down (pronation); involves the interaction between the radius and the ulna.

Key structures in the elbow joint include:

  • Articular Cartilage: A smooth tissue covering the ends of the bones, allowing them to glide over each other with minimal friction.

  • Synovial Membrane: Lining the joint, this membrane produces synovial fluid for lubrication.

  • Ligaments: The primary ligaments in the elbow are the ulnar collateral ligament, radial collateral ligament, and the annular ligament. These provide stability and support to the joint.

The Elbow Ligaments

Muscles and Tendons: The biceps and triceps muscles are crucial for the flexion and extension of the elbow. The tendons of these muscles attach to the bones of the elbow, allowing for movement.

The Elbow Muscles

The elbow joint's design and structure allow for a wide range of motion and the ability to lift and carry objects, making it essential for many daily activities. However, it's also prone to injuries like fractures, dislocations, and strains, particularly in athletes and individuals engaging in repetitive motion tasks.

 

Now that we have a foundation in elbow anatomy, let’s take a look at some of the most common elbow problems treated in physical therapy such as tendinits and bursits.

Elbow tendinitis, also known as lateral epicondylitis (tennis elbow) or medial epicondylitis (golfer's elbow), is a condition characterized by inflammation and irritation of the tendons around the elbow joint. Understanding the epidemiology of elbow tendinitis involves examining its prevalence, risk factors, and demographic characteristics. Here are key points regarding the epidemiology of elbow tendinitis:

Prevalence:

    • Elbow tendinitis is a common condition, especially among individuals engaged in repetitive or strenuous activities involving the forearm muscles and wrist.

    • The prevalence of elbow tendinitis is estimated to be around 1-3% in the general population.

Age and Gender:

    • Elbow tendinitis most commonly affects individuals in the age range of 30 to 50 years old.

    • It occurs more frequently in men than in women, although both genders can be affected.

    • Occupational Factors:

    • Occupations or activities that involve repetitive wrist and forearm movements, forceful gripping, or use of vibrating tools (e.g., painters, carpenters, tennis players) increase the risk of developing elbow tendinitis.

    • Sports and Physical Activity:

    • Sports or activities that involve repetitive motions of the wrist and forearm, such as tennis, golf, weightlifting, and racket sports, can increase the risk of elbow tendinitis.

    • Dominant Arm Involvement:

    • Elbow tendinitis often affects the dominant arm, as it is typically subject to more strain and use in daily activities and sports.

    • Comorbidities:

    • Certain medical conditions, such as obesity, diabetes, and rheumatic diseases, may increase the risk of developing elbow tendinitis.

    • Trauma or Overuse:

    • Previous trauma or overuse of the elbow joint, even in the absence of a specific injury, can contribute to the development of tendinitis.

    • Smoking:

    • Studies suggest that smoking may be a risk factor for the development of tendinopathies, including elbow tendinitis.

Elbow bursitis, also known as olecranon bursitis, is a condition characterized by inflammation and swelling of the bursa located at the tip of the elbow (olecranon). Understanding the epidemiology of elbow bursitis involves examining its prevalence, risk factors, and demographic characteristics. Here are key points regarding the epidemiology of elbow bursitis:

Prevalence:

    • Elbow bursitis is a relatively common condition, accounting for a significant number of cases of bursitis in the general population.

    • While the exact prevalence varies, it is estimated to affect approximately 10-20 per 100,000 individuals per year.

    • Age and Gender:

    • Elbow bursitis can occur at any age but is more common in adults, particularly in individuals between the ages of 30 and 60 years.

    • It affects both men and women, with no significant gender predilection.

    • Occupational Factors:

    • Occupations or activities that involve repetitive pressure or trauma to the elbow (e.g., resting the elbow on hard surfaces, prolonged leaning on the elbow) can increase the risk of developing elbow bursitis.

    • Trauma or Injury:

    • Acute or repetitive trauma to the elbow, such as falls or direct blows, can cause irritation and inflammation of the olecranon bursa, leading to bursitis.

    • Underlying Medical Conditions:

    • Certain medical conditions, such as gout or rheumatoid arthritis, may predispose individuals to develop elbow bursitis.

    • Infection:

    • In some cases, elbow bursitis can be caused by infection (septic bursitis), particularly if the bursa becomes infected due to a break in the skin or an underlying infection elsewhere in the body.

    • Repetitive Motion:

    • Activities that involve repetitive motion of the elbow, such as throwing sports or manual labor, can increase the risk of developing bursitis.

Elbow problems are relatively common among athletes, particularly those involved in sports and activities that place significant stress on the elbow joint and surrounding structures. These problems can range from minor overuse injuries to more serious conditions requiring medical intervention. The prevalence and types of elbow problems can vary based on the specific sport, the level of competition, training practices, and the age of the athletes. Here are some common elbow problems and their prevalence among athletes:

Tennis Elbow (Lateral Epicondylitis):

    • Tennis elbow is a common overuse injury among athletes involved in sports that require repetitive gripping and wrist extension, such as tennis, golf, and racquetball.

    • It is estimated to affect approximately 1-3% of the general population, and athletes, especially tennis players, have a higher incidence.

Golfer's Elbow (Medial Epicondylitis):

    • Golfer's elbow is another overuse injury involving the tendons on the inside of the elbow and is common in golfers, baseball players, and other athletes who use repetitive wrist flexion and gripping motions.

    • Its prevalence is lower than tennis elbow but still significant in sports involving repetitive arm movements.

Ulnar Collateral Ligament (UCL) Injury (Tommy John Surgery):

    • UCL injuries are prevalent among baseball pitchers, particularly at the professional and collegiate levels, due to the repetitive and forceful overhead throwing motion.

    • UCL reconstruction surgery (Tommy John surgery) is a common intervention for severe UCL injuries.

Little League Elbow:

    • Little League elbow is an overuse injury commonly seen in young baseball pitchers and throwers. It involves stress to the growth plates at the inside of the elbow.

    • The incidence is higher among adolescent athletes participating in high-intensity throwing sports.

Fractures and Dislocations:

    • Athletes, especially those involved in contact sports or activities with a risk of falls, may experience elbow fractures or dislocations.

    • The prevalence varies based on the sport and level of contact involved.

Biceps Tendinitis:

    • Athletes participating in sports requiring repetitive arm motions, such as weightlifting, can develop biceps tendinitis, characterized by inflammation of the biceps tendon.

    • Prevalence is higher in weightlifters and strength athletes.

Olecranon Bursitis:

    • Athletes involved in activities with a risk of direct trauma to the elbow, such as football or hockey, may develop olecranon bursitis.

    • The incidence can vary based on the sport and exposure to potential injury.

Elbow problems can impact an athlete's performance, necessitating appropriate prevention strategies, rehabilitation, and, in some cases, surgical intervention. Athletes should receive proper training, conditioning, and medical care to mitigate the risk of elbow injuries and optimize their athletic performance.

Trigger points and the elbow:

Trigger points can cause elbow pain that mimics or directly leads to many of these conditions due to the effects of trigger points on the elbow joint structures.  

The elbow is a complex joint, and pain can be referred from muscles, tendons, ligaments, or other structures in the surrounding area. Trigger points in muscles like the forearm flexors, extensors, or those around the upper arm can cause referred pain to the elbow. This pain can sometimes be mistaken for primary elbow issues.

Here are some of the common trigger points around the elbow:       

Brachialis Muscle:

    • Location: Center of the upper arm on the inside.

    • Referral: Pain can refer to the front of the elbow and may extend down the forearm.

Brachialis Trigger Point

Brachioradialis Muscle:

    • Location: Outer part of the forearm near the elbow.

    • Referral: Pain can be felt around the outside of the elbow.

Brachioradialis Trigger Point

Triceps Brachii Muscle:

    • Location: Back of the upper arm.

    • Referral: Pain can refer to the back of the elbow and may extend down the forearm.

Triceps Trigger Points

Extensor Carpi Radialis Longus Muscle:

    • Location: Outer forearm, extending from the back of the elbow to the wrist.

    • Referral: Pain can radiate down the forearm to the wrist and hand.

Extensor Carpi Radialis Longus Trigger Points

Extensor Carpi Radialis Brevis Muscle:

    • Location: Outer forearm near the elbow.

    • Referral: Pain can radiate down the forearm to the wrist and hand.

      Extensor Carpi Ulnaris Muscle:

    • Location: Outer part of the forearm near the elbow.

    • Referral: Pain can radiate down the forearm to the wrist and hand.

ECRB and ECU Trigger Points

It's important to note that trigger points can vary from person to person, and the referred pain patterns may differ based on individual muscle anatomy and sensitivity.

The source of elbow pain can be complex.  If you would like to have your elbow evaluated by one of our Licensed Physical Therapists, schedule your free consult today. 

Trigger Points and Shoulder Pain

Let’s begin with a brief discussion of shoulder joint anatomy. 

The shoulder is a complex and highly mobile joint, crucial for many activities. Its anatomy can be understood in terms of bones, muscles, ligaments, and tendons:

  1. Bones: The shoulder is comprised of three main bones:

    • Scapula (Shoulder Blade): A large, triangular bone with a complex surface, providing attachment sites for muscles.

    • Clavicle (Collarbone): This bone connects the scapula to the sternum, helping to stabilize the shoulder.

    • Humerus (Upper Arm Bone): The ball at the top of this bone fits into the socket of the scapula to form the main shoulder joint.

Bones of the Shoulder Joint

2. Joints: There are several important joints in the shoulder:

    • Glenohumeral Joint: The main shoulder joint, where the head of the humerus fits into the glenoid cavity of the scapula.

    • Acromioclavicular Joint: Where the clavicle meets the acromion of the scapula.

    • Sternoclavicular Joint: The joint where the clavicle meets the sternum.

    • Scapulothoracic Joint: Where the Scapula contacts the thoracic spine.

Joints of the Shoulder

3. Muscles and Tendons: These provide movement and stability to the shoulder:

    • Rotator Cuff: A group of four muscles (Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis) and their tendons that stabilize the glenohumeral joint and facilitate arm rotation.

Muscles of the Rotator Cuff

Deltoid: This large, triangular muscle covers the shoulder joint and aids in arm abduction.

  • Biceps and Triceps: Located in the upper arm, they also play a role in shoulder movement.

4. Ligaments and Bursae:

    • Ligaments: Bands of tough, elastic tissue that connect bones to each other, providing stability to the shoulder joint.

    • Bursae: Fluid-filled sacs that reduce friction and cushion the areas between bones, tendons, and muscles.

This intricate structure allows for a wide range of motion, including lifting, pushing, and pulling, but also makes the shoulder susceptible to injuries and disorders such as dislocation, impingement, or rotator cuff tears. Regular exercise and proper ergonomics can help maintain shoulder health and prevent injuries.

Shoulder pain can arise from various causes, including muscle strain, joint issues, or nerve compression. Trigger points, specifically, are a common source of muscle-related shoulder pain.

Trigger Points: These are tender, tight spots in a muscle, often described as "knots." They can cause localized pain or refer pain to other areas, a phenomenon known as referred pain. Trigger points in the shoulder muscles can cause pain that radiates to the neck, arm, or upper back.

Common Causes of Trigger Points in the Shoulder:

  1. Overuse or Injury: Repetitive motions or injuries can lead to the development of trigger points in the shoulder muscles.

  2. Poor Posture: Prolonged poor posture, like slouching or working at a desk, can strain shoulder muscles.

  3. Stress: Stress can lead to muscle tension, contributing to the formation of trigger points.

  4. Lack of Movement: A sedentary lifestyle can lead to stiff muscles, increasing the risk of trigger points.

Symptoms of Trigger Points:

  • Sharp, aching pain in the shoulder

  • Pain that radiates to other areas

  • Limited range of motion

  • Muscle knots felt under the skin

Treatment and Management:

  1. Physical Therapy: Exercises and stretches can help alleviate pain and improve mobility.

  2. Massage Therapy: Trigger point pressure release techniques to deactivate.

  3. Heat Therapy: Applying heat can relax tight muscles and improve blood flow.

  4. Dry Needling: This modality can target trigger points directly to relieve pain.

  5. Rest and Activity Modification: Avoiding activities that exacerbate pain can help in recovery.

Prevention:

  • Regular exercise to maintain muscle strength and flexibility

  • Good posture, especially when sitting for long periods

  • Stress management techniques like meditation or yoga

In the coming weeks we will see how trigger points can lead to common shoulder problems such as tendinitis, bursitis, osteoarthritis, adhesive capsulitis, and rotator cuff degenerative changes and tears. 

If you feel your shoulder pain may be related to trigger points and would like an evaluation by our licensed physical therapists, feel free to schedule your free consult.