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Q.

"I’m a 20 year old male and my back hurts all the time. After an x-ray, it was determined that one of my bottom vertebrae is raised 5 degrees on one side and this is where the pain in radiating from. Could physical therapy help lessen the pain?"



A. There are many components that contribute to back pain, one of which may include structural problems like the one you describe. Other contributing factors may include muscle imbalances of strength or flexibility, unfavorable postures or body mechanics, specific joint or general spine mobility restrictions, and disc derangements or dysfunctions. A thorough evaluation by a physical therapist may determine which of these areas you may need to address. Your pain may respond to specific repeated movements or exercises. You may require manual therapy to restore normal spine motion. The human body is a very adaptive machine and likely with a bit of guidance you can eliminate or minimize your back pain.



Q.

"I was recently diagnosed with a pulled muscle and slight dislocated rub. Could physical therapy help alleviate the pain?"



A. Pulled muscles in the rib cage area are fairly common. Weakness in the abdominal and upper back muscles, combined with stiffness in the spine can be contributors. A sudden twist, a heavy lift or sometimes a sneeze can lead to this type of injury. A rib may be partially dislocated (or subluxed) near the spine in combination with the muscle injury. A physical therapist can assist you in methods to release the muscle spasm. Additionally, manual therapy techniques to reposition the rib will help relieve pain and restore lost mobility. Simple exercises will be prescribed to help prevent further injury.



Q.

"I was recently diagnosed with Spondylosis, can physical therapy help to treat this disease?"



A. Spondylosis is a medical term that generally means wear and tear to the spinal structures similar to degenerative arthritis. It is a common problem that is seen more frequently in people above the age of 50. Fortunately, physical therapy can be very helpful in treating this condition. A thorough evaluation of your flexibility, strength and range of motion will help you and your therapist determine a brief, specific exercise program that can reduce your pain and improve your tolerance for an active life. The key of this treatment is to improve and maintain the health of the the muscles, tendons, ligaments, and other soft tissues in the low back and hip region so passive treatments such as electrical stimulation and ultrasound have very limited value. Steady and consistent self management is the long term solution to this nagging problem so developing an effective exercise program and staying the course is your best bet.



Q.

"What types of therapy would be used to help with a fractured patella injury?"



A. After your doctor has cleared you to begin physical therapy, you will undergo a physical therapy evaluation. During the evaluation, the physical therapist will assess your pain level, and any deficits you may have with motion and your strength. The physical therapist will also evaluate how you are walking. It is from this evaluation that the physical therapist will identify problem areas and tailor a custom treatment plan to address these issues. Modalities may be used to help ease your discomfort. Some examples of these modalities are hot and cold packs, whirlpool and massage. You will also perform exercises to regain your motion and strength in the knee. Strengthening exercises will be progressed, as you get stronger. The physical therapist may have you perform exercises and drills to address any deficits in your gait (walking) pattern. A home exercise program will be developed for you to perform on your days off from physical therapy.



Q.

"I’ve had 4 surgeries on my right knee over a period of 20 years. A medial collateral repair, 2 arthroscopics to clean-up knee, then an anterior cruciate repair using 1/3 of the patella ligament. All has been going well for many years... except I slipped yesterday. I don’t think I twisted, but my full weight landed on that leg with the knee if full flexion (I haven’t been able to bend it that much in a long time.) It immediately became swollen. Could I possibly just tore scar tissue, with no other damage?"



A. There is a possibility that no damage was done to your knee, and it was just overstretched and irritated when you slipped. However, it is impossible to be certain without evaluating you. If you are still in significant pain, or the knee continues to swell, you should see your doctor immediately to rule out a more serious injury. Keep in mind that a physical therapist can help restore the motion in your knee as well as guide you in an exercise program to strengthen your knee. With your history of knee surgeries, a regular stretching and strengthening routine is especially important to help prevent future injuries or problems.



Q.

"After several years of pain and swelling in my knee, an x-ray revealed my knee cap was not positioned properly. What exercises are best for this problem? I have pain going up and down stairs, and a recumbent bike also seems to agitate my knee."



A. There are many structures that can cause undue stress on your knee and subsequently cause chronic knee pain. Pain in this region is frequently diagnosed as Patello-Femoral Pain Syndrome, or Chondromalacia Patella. It is caused by a muscle imbalance around the joint forcing the knee cap to “track” improperly in the space that it should move within. The knee cap is forced into this space causing it to rub on the underneath surface during these activities you mentioned. Tightness of the iliotibial band, which is a tendon that runs down the outside of the thigh and attaches at the outside of the knee, along with weakness in the quadriceps musculature that straightens the knee and pulls up on the knee cap, are many times the culprits. Weak hip musculature and poor foot and ankle control can also transfer stress to this area. A good stretching and strengthening program for these specific structures should allow your knee cap to “track” more appropriately and control your pain. A physical therapist will evaluate your flexibility and functional muscle strength that affects this region and design a stretching and strengthening program specific to your needs.



Q.

"What types of physical therapy are used for broken toes and a fractured metatarsal?"



A. After the breaks have had time to heal, it’s time to start physical therapy. A therapy evaluation would be the first step. We would look to identify the problems such as tightness, joint stiffness, weak muscles, etc. Treatment may then consist of massage, stretching the foot muscles, mobilizing (moving) the joints in the foot and ankle, and balance exercises. We would also spend some time working to restore normal walking. You will also be given exercises to do at home.



Q.

"I have been diagnosed with a partial tear in my medial plantar fascia. The doctor recommended stretches and icing my foot. He told me that I can walk on it, but it hurts significantly when I walk on it for an extended period of time. Is a walking boot recommended for this?"



A. This type of injury will take time to heal. A Physical Therapist will be able to evaluate your foot mechanics and develop a plan that will help to facilitate healing. Treatments may include, but are not limited to modalities to decrease pain/swelling, soft tissue massage, stretching, strengthening of the muscles that support your arch, balance training, taping and/or orthotics. A boot is more designed to immobilize the foot during early stages of the injury. Physical therapy will help get you to walk normally without this type of assistance.



Q.

"I broke my leg almost 7 years ago and got a rod and screws in my leg. To this day I’m still in pain. Can physical therapy be beneficial to me and would it help with the pain?"



A. Following a fracture and subsequent surgery many people have decreased flexibility, strength and balance as well as deviations in their normal walking pattern. If these deficits go unresolved it can lead to lingering pain due to stress and strain on various structures throughout the leg. A consultation with a physical therapist would be of benefit to you. A physical therapist can assess your mobility, strength, and function to determine the source of your pain. The physical therapist can also use hands on techniques to improve joint mobility and prescribe an exercise program that leads to less pain and better function.



Q.

"My son is going into his last year of Little League and wants to learn how to throw a curve ball. Is it safe for him to do so?"



A. This is a very controversial question. The biggest concern from my stand point is that there aren't enough well qualified pitching coaches in this age group that can teach the complexities of this pitch. Young men also have a tendency to over work the arm while trying to master the pitch. There are studies which suggest a high correlation of elbow and shoulder pain in individuals who throw curve balls and sliders before bone maturity. Current recommendations by Dr. James Andrews of the American Sports Medicine Institute, recommend no breaking pitches before the age of 14.



Q.

"I fractured my acetabulum in several places in 2008- I still have pain in my upper groin and hip. What types of physical therapy are used to correct this condition?"



A. The acetabulum is the cup shape socket of the hip joint. The ball from the thigh bone fits into the acetabulum to make the hip joint. After injury or surgery there is a period of time when the patient is not allowed to put weight through the joint in order for proper healing to take place and to decrease the amount of further damage. This period of healing will cause weakness and loss of motion. Once the patient is weight bearing they will begin physical therapy for range of motion and strength. When there is still groin and hip pain present there could be arthritic changes or residual tightness or weakness. With weakness and tightness the hip is not getting the support it requires to perform efficiently. A Physical Therapist should evaluate your hip and inform you of any mechanical problems. From there stretching and strengthening will be given to decrease the pain and improve hip stability. These steps will insure the avoidance of compensations that might cause further damage to the joint itself.



Q.

"What type of physical therapy is administered after partial knee replacement surgery?"



A. A partial knee replacement involves replacing only the inner or the outer half of the knee. This involves less surgical cutting and may have a quicker recovery time. In the few weeks following surgery our role in physical therapy is very much like the total knee replacement of restoring mobility and reducing pain/swelling. The long term goals is to have our clients be able to walk smoothly, negotiate stairs and return to recreational activities. This is accomplished through an individually designed therapeutic exercise program.



Q.

"How long is the recovery period after a full total hip replacement and what kind of therapy is administered?"



A. Recovering from a total hip replacement is different for everyone due to many factors including the surgical procedure, pain, age, fitness level, other medical conditions, and lifestyle. Physical therapy can last up to 6-8 weeks and focuses on education for self care and exercise for strength, flexibility, and recovery of function. 80% recovery is expected at about 3 months when post operative restrictions are lifted. You and your physical therapist will establish goals that will fit your lifestyle. You will continue to gain in strength and confidence over several months. Maintaining a home exercise program upon discharge from physical therapy is highly recommended to ensure good stability to your new hip.



Q.

"Lately my knees seem tight and painful when bending. I have never had knee problems or injuries - can physical therapy help?"



A. The knee consists of bones, cartilage, ligaments, muscles, tendons, nerves and blood vessels that come together to form a rather complex joint. Typically most individuals think of the knee as a “hinge joint” that only allows for bending and straightening. However, the joint also moves in rotational and side to side motions during our normal activities. Furthermore, when going about our functional activities, such as walking, climbing stairs and squatting, the knee is assisted by the ankle from below and the hip from above. A physical therapist can perform a thorough evaluation to deterimine if in fact the cause of your pain is musculoskeletal in nature. An individualized treatment program will be designed by your therapist to address those findings. This would most likely consist of specific stretching and strengthening exercises.



Q.

"I am a 51 year old man with a right adductor tear and some scar tissue. What additional things can I be doing to assist my rehab other than rest and massage? Is there a typical/average time to get back on the field? What is the best strategy for preventing this in the future?"



A. The hip adductor muscles are located in the upper inner thigh region and their main job is to move the femur (thigh bone) inwards. Once your pain has significantly reduced gentle stretching should be started, focusing upon the hip/groin and knee musculature. Avoiding lateral movements, pivoting, twisting, and quick directional changes are recommended. As you feel fewer symptoms, aerobic conditioning should be maintained by cross-training with low impact activities such as deep water running, elliptical or biking. Furthermore, a common rehabilitation error is to solely focus upon the injured region; therefore, it is critical than you condition the muscles above and below the adductor muscles (i.e. trunk muscles, gluteals, and knee muscles). Consultation with a physical therapist will help you with an effective program. Depending on the severity of the tear and health and fitness level, an injury like this may take 6-12 weeks to rehabilitate. In order to reduce the susceptibility to re-injury care should be taken to perform a pre-and post-exercise / sporting activity stretching regimen.



Q.

"About 3 months ago I had a knee dislocation on my left knee. After the knee was put back in place, I wore an external fixture for about 2 months. It has since been removed and I can’t seem to bend my knee all the way back to sit down. I can only do about 40%. I am assuming since my leg was straight with the rods it stiffened, however how do I get it to bend again, it’s really stiff?"



A. The knee joint needs to move normally to be healthy. If you have not had any physical therapy following your time in the brace, it’ is important that you start. When the joint is immobilized muscles, tendons and ligaments all tighten. A certain amount of tightening is desired so the knee no longer dislocates. Your physical therapist will instruct you in the proper method and sequence of exercises to move the knee joint without causing more knee problems yet allow it to move normally.



Q.

"I was recently diagnosed with a pulled muscle and slight dislocated rib. Could physical therapy help alleviate the pain?"



A. Lifting, sudden twists and turns can strain muscles in the rib cage area. Occasionally the muscle can create stress on the rib attachment to the spine. The physical therapy evaluation will identify the injured structures. If it is muscle only, soft tissue techniques will be used to relieve tension and allow for normal function. If the rib is still slightly dislocated, manual therapy will help ease it into proper position. You will be given self care instructions as well as specific home exercises to ensure full healing.



Q.

"On September 15th of this year, I underwent a procedure to repair a posterior root avulsion of the medial meniscus and Grade IV chondromalacia patella on my left knee. The surgeon used a tunnel procedure to reattach the meniscus. I attend physical therapy weekly. I can bend my knee to 120 degrees and can extend it to the same extent as my normal right knee. However, after each therapy session, my knee swells considerably. Is this normal ten weeks post surgery?"



A. Your surgery was not simple. Both the meniscus repair and the patella work will take time to heal fully. Pain and swelling after a surgery like yours is not unusual. At ten weeks the assumption is that you are performing more advanced rehabilitation exercises, and that in itself may cause increased swelling. If a significant increase in pain accompanies the swelling, your program may need to be modified. If pain is decreasing and strength, motion and weight bearing are increasing, your swelling is less concerning to me. Make sure you also get satisfactory information from your physical therapist and surgeon.



Q.

"I’ve had 2 shoulder operations since Jan. 15 and I saw my doctor today and I am out of my sling. I asked when I start therapy, he said I should work it out at home. Is that normal?"



A. From a physical therapist’s perspective, a course of physical therapy would be rendered after most orthopedic surgeries. After a shoulder surgery, whether it is routine or highly involved, there is a great probability that your shoulder mechanics may have been affected and that you are experiencing post-operative pain. Physical therapists are experts in human movement and are trained to identify abnormalities in human mechanics. In addition, physical therapy can treat faulty shoulder mechanics and post-operative pain through manual therapy, therapeutic exercise, and modalities (i.e. electrical stimulation, moist heat, and ice). After a comprehensive physical therapy evaluation, the therapist will determine how to approach your shoulder rehabilitation. For example you may be a candidate for a course of formal physical therapy or be treated through instruction in a home exercise program with periodic office visits. In your specific case, consultation with a physical therapist would be strongly recommended in order to get you on the appropriate therapeutic track.



Q.

"My guy friend is 15 and has torn both meniscus’s. He has had surgery for both too. One was about 8 months ago and the other may be 5 months ago. He still has pain severe enough to hold him back from playing basketball sometimes. Is there anything he can take or do to relieve the pain?"



A. The meniscus is cartilage that sits between your femur and tibia in your knee. Their main job is to distribute force that is placed on the knee with weight bearing activity. It is not uncommon to still have knee pain after surgery for a torn meniscus. Having two surgeries in the past 8 months can be difficult to recover from without rehabilitation. Physical therapy after this type of surgery is usually recommended. If your friend did not have any rehab then he may still have stiffness in the joint or weakness in the muscles around the joint. Either or both of these scenarios could be contributing to his pain. Also basketball can be demanding on the knees, especially after surgery. It may just be too soon to be participating right now. My advice is to get a physical therapy consult to assess his joint range of motion and leg strength.



Q.

"How does a Physical Therapist treat low back pain?"



A. Our approach to low back pain includes a full assessment of structure and mechanics by a Physical Therapist to identify problem areas. Treatment will then include: 1. Pain relieving modalities and manual therapy to reduce muscle tension and relieve joint stiffness. 2. A therapeutic exercise program to regain lost motion and strength. During this phase, instructions will be given of how and when to resume normal activities safely. 3. Advanced home exercises are then given to help prevent further episodes.



Q.

"My doctor has suggested physical therapy 3 times a week for 4 weeks for a knee injury. My HMO co-payment is $40.00 and this will be a financial strain. What can I do?"



A. Our physical therapists have the ability to evaluate your knee problem and educate you in what structures are injured. Advice will be given in life style modifications to avoid further damage and exercises to enhance your recovery. With your cooperation during the healing process, physical therapy visits can be significantly reduced. Often times to less than 4 visits. The cost of long term knee pain, medication, reduced activity and surgery well be much more costly in the long run.


Physical Therapy Roll in Wellness

Most everyone recognizes the Physical Therapist’s role in rehabilitation following injury and surgery. Our experienced Physical Therapy staff also take a very active role in fitness, wellness and injury prevention. We may have some solutions for some of these more common complaints:
  • “I’m not as flexible as I once was”
  • “I’m afraid of falling”
  • “I need exercise but I don’t know where to start”
  • “I can’t use the stairs anymore”
  • “I have this constant ache...”
Following a complete evaluation our therapist will advise on simple strategies that will help most of these very common problems. You will be pleasantly surprised how easy it can be. Physical Therapy Associates of Schenectady, P.C. was established in 1982 by Thomas Houghtalen, PT, MTC and Thomas Cooney, MSPT with a simple philosophy: provide the best physical therapy available by the most experienced therapists in clean and well equipped offices throughout the Capital District. With caring hands, our physical therapists guide their patients to wellness after injury, surgery or disease. More importantly, they teach their patients preventive strategies to stay well. Visit our website or feel free to call any office if you have any questions.

This general Information is not intended to provide individual advice. Please make an appointment with a physician to discuss you particular situation and needs.
 

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