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Keep moving with kneecap pain

Keep moving with kneecap pain

Pain in the front of the knee, around the kneecap can be a common issue in people presenting to Physiotherapy. This issue can be caused by an irritation of the patellofemoral joint, the joint between your kneecap and the base of your thigh bone. Often pain can occur in this joint when running, walking up or down stairs or during other exercise such as squatting. Pain in this area often relates to pressure on the kneecap as it articulates with the bottom of your thigh bone – your femur. The force on this joint is mainly influenced by two things: the amount of force being produced by the quadriceps muscles on the top of your thigh, and the amount of knee bend or flexion that occurs when the joint is under load.

Here are a few strategies you could implement to reduce your patellofemoral pain whilst continuing to exercise:

  1. Choose exercise activities that gradually expose the knee to greater stresses.
  There is a systematic review by Hart et al. (2022) that has looked at the average reaction force that different activities place on the patellofemoral joint in healthy individuals. Walking: 0.9x body weight Descending stairs: 2.8x body weight Ascending stairs: 3.8x body weight Running: 5.2x body weight Squatting: 1 – 18x body Looking at these averages, a good way to try and reduce the load on the patellofemoral joint could be to target start with a low loading exercise such as walking and gradually progress to stairs and then running. As you can see, there is a very large variability in the loads that are placed on the knee during squatting movements. Therefore, if you can minimise the amount of knee bend during your squats, you may be able to reduce your knee pain.
  1. Modify your current exercise program to reduce the stress on the knee joint.
  We know that the joint reaction force will increase with greater knee bend. Choosing squat variations that limit your knee from bending more than 90 degrees could allow you to maintain lower body strength whilst reducing your pain. Choosing exercises that are double-legged rather than single-legged may reduce the tendency of your knee to track inwards, which may help to settle your patellofemoral pain. If you are a runner, increasing your step rate may help you to settle your knee pain and keep you running. If you keep the same running pace, an increased step rate will reduce your stride length, which reduces the amount of knee bend through the weight-bearing portion of the running cycle. This can then reduce the reaction force in the patellofemoral joint, and it will be easier to maintain better alignment through your hips to avoid a scissoring pattern. Then once symptoms have settled you can begin gradually re-expose the knee to more loads over time so that it can get used to it. As with many areas of the body, this advice is generalised and may not be affective for individuals with varied anatomy and movement patterns. Try a few of these strategies, and if you’re still having issues with your knee pain, we’d be happy to help you here at the clinic. Reference: Hart, H. F., Patterson, B. E., Crossley, K. M., Culvenor, A. G., Khan, M. C. M., King, M. G., & Sritharan, P. (2022). May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis. British Journal of Sports Medicine, 56(9), 521–530. https://doi.org/10.1136/bjsports-2021-104686

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Lateral hip pain

Lateral hip pain

Pain on the outside of the hip is a common complaint especially for those who have shifted towards an increase in their physical activity or ceased physical activity leading to a stress to the tendons that surround the hip.

Some times this pain can also be a result from an inflamed bursa in the hip but it is important to note that there is often an issue with the glute tendon itself and so this muscle and tendon also needs to be addressed in order to restore pain free movement.

To help manage this pain it is important to reduce compressive loads on the outside of the hip, so try to avoid sleeping on that side or crossing your legs, as this stretches and puts pressure on these structures. If you do sleep on your side, place a pillow between your knees. Also try to avoid stretching out the glutes as this also puts compressive pressure on the area of pain. Until you build more strength around the hip, it is best to reduce walking up hills and stairs. Putting an ice pack or frozen peas right over the widest part of the hip is helpful to reduce the pain.

A really helpful exercise in the early management of this pain is a simple exercise using a belt or a tied up scarf around your thighs. You can do this in sitting or laying on your back with the feet on the bed and the knees bent up. Once you have the belt around your thighs, simply press the affected side into the belt and hold. This is called an isometric exercise, where you switch on a muscle and keep it switched on so as to stimulate blood flow and it is also a really good way to desensitize the area of pain. It is a gentle way to begin activating these glute muscles so that you can then progress slowly with more challenging glute exercises once the pain settles more and more.

Be patient with yourself, lateral hip pain can be tricky and can sometimes take a while to get on top of. There are other treatments that can help, such as shockwave therapy and corticosteroids injection but as this pain is often a result of an issue in your glute tendon, it is important that you rebuild the strength and control around your hips.

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Golf: The Most Dangerous Sport?

Golf: The Most Dangerous Sport?

The PGA may not look like it has much in common with professional rugby - but you may be surprised to learn that golfers are actually injured more often than rugby players. It’s true. In fact, 62% of amateurs and 85% of professionals will sustain a significant injury associated with playing golf. And with a staggering 60 million golfers worldwide - that’s a whole lot of people getting injured. The problem is, amateur golfers are usually out of shape or have poor swing mechanics, and professional golfers often overuse their muscles with frequent play. Trauma to the lower back accounts for one third of all injuries and can happen to anyone regardless of age or ability. There are a couple of logical reasons for this. Firstly, a good golf swing requires significant club-head speed, which is something that is only achieved by applying a lot of torque (force) and torsion (twisting) throughout your lower back. Secondly, compared to other sports, golf puts a lot of pressure on your spine. Consider the average golf swing produces a compression load on your back equal to 8 times your body weight, whereas a sport like running produces a compression load just 3 times your body weight.  

Golfers experiencing low back pain typically have one of the following types of injuries:

 
  • Muscle Strain or Ligamentous Sprain
  • Disc Injury
  • Altered Joint Mechanics or Motor Control
  • Degenerative Arthritis
  • Bone Fracture
  Other top golf-related injuries include trauma to the elbow, wrist/hand or shoulder. (So much for golf being a low-impact activity!)   It’s helpful to understand not only the types of injuries associated with golf but also the main causes of injury which include:
  • Frequency of repetitive practice (overworked muscles)
  • Suboptimal swing mechanics
  • Inadequate warm-up routine
  • Poor overall physical conditioning
With the average recovery time lasting 2-4 weeks, addressing the main causes of injury is well worth the effort. SO, the question is - How can you enjoy the wonderful game of golf while reducing your risk of injury? The simple answer is through targeted and routine conditioning.  Golf requires strength, endurance, flexibility and explosive power in order to play the game well - and not hurt yourself in the process. Physical conditioning routines designed specifically for golfers can help you stay on the green and out of pain. And as a bonus, conditioning your body to avoid injury while playing golf also helps you improve your game. An 11-week targeted conditioning program found participants:
  • Increased their clubhead speed by 7%
  • Improved their strength up to 56%
  • Improved their flexibility up to 39%
  • Increased their drive distance up to 15 yards with sustained accuracy
  Whether you’re a casual golfer or serious about your game we can help you avoid injury and improve your skills. That’s why we’d like to share with you fun, informative tips and tricks to help you stay injury - free  be sure to check out our Facebook page https://www.facebook.com/pottsvillephysiotherapy/ where we’re posting tips and tricks - whatever you’re doing.    

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10 top tips for Cyclists

10 top tips for Cyclists

 

Common injuries in Cyclists include knee, lower back, neck and shoulder

 

  1. Make sure your bike is suitable for the type of riding you are doing

  2. Make sure your body fits the bike

  3. Have a great pedalling technique

  4. Vary your riding from day to day

  5. Stretch and activate, slow build your effort as you start your ride

  6. Target sleep, stress, diet and alcohol

  7. Eat well especially during and after a ride of 2 hours or more

  8. Have a strong and consistent recovery routine

  9. The recovery ride – An easy one our ride at high cadence and low power is essential to good recovery after a hard day.

  10. Massage

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Achilles Tendon Injuries

Achilles Tendon Injury

A tendon is a band of tissue that connects muscle to bone. The Achilles tendon, connects leg muscles to the heel bone, allowing you to walk and run.   Achilles tendonopathy is a common injury among runners, but may also occur in people with pronated feet, high arches, tight calf muscles and those who wear inflexible running shoes. Overuse of the Achilles tendon at the back of the heel occurs in the case of dancers, runners and walkers who exert a lot of stress on the tendon during their activities. It is a very painful condition and if one continues to put pressure on the tendon, it may snap, often with a loud popping sound. The primary symptom of an Achilles tendon injury is pain to the back of the heel, which increases with exercise and lessens when exercise stops. Achilles tendonopathy also manifests itself with warmth, swelling and tenderness at the site. Range of motion may be limited. Achilles tendonopathy can lead to small tears in the tendon, making it susceptible to rupture, however rupture may also take place without any previous Achilles tendon problems. If any of these symptoms occur, it is best to rest and elevate the leg while icing it and of course, see us or doctor as early as possible. Achilles tendon ruptures are most often seen among middle-aged people who play a sport on weekends or in their spare time.

Symptoms of Achilles tendon rupture are:

 Sudden pain in the back of the ankle which feels like a kick or a stab. It may turn into a dull ache.  Swelling between the heel and the calf.  Difficulty walking or rising up on the toes.

 

A rupture may be treated surgically or non-surgically, depending on the extent of the damage and your condition.

  Until you can get professional help, the RICE formula should be applied:  Rest. This is important as walking may cause further problems.  Ice. Use an ice pack wrapped in a towel. Never apply directly to the skin and leave on for twenty minutes.  Compression. Bandage the foot to prevent further swelling.  Elevate the leg at or above the level of the heart to decrease swelling. For non-surgical intervention, we (or a doctor) will recommend a brace or special insoles for your shoes, as well as physiotherapy. We will work with you to manage your pain with ice and instruct you in stretching exercises for the calf muscles. We will also help you modify your training schedule to match your recovery and advise you on wearing proper shoes to prevent further injury.  

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