Clinical Question

Common Knee Ligament Injuries

LCL-This ligament is in charge of resisting a force that pushes the knee laterally (outward). The lateral collateral ligament is generally injured by a force pushing the knee from the inner side of the joint, causing stress on the outside of the knee usually from a direct blow to the knee or hyperextension of the knee.

MCL-This ligament is in charge of resisting a force that pushes the knee medially (inward). The medial collateral ligament is usually injured by landing hard, bending, twisting, or when the outside of the knee is struck.

ACL– This ligament stabilizes the knee when turning or planting the foot. The ACL can be injured in a variety of sports when you twist the knee when the foot is planted on the ground or when you are running and stop suddenly. Also injuries can occur when you land on a straight knee or get a direct blow to the knee.

PCL– This ligament prevents the femur from sliding off the front edge of the tibia. A posterior cruciate ligament injury generally occurs during sports, from falling on the knee or hitting it on the dashboard during a car accident.

“I Slipped and Fell on Ice, What do I do?”

1. Carefully and slowly get up.
2. Use ice on sore muscles for 24 to 48 hours. If you continue to have discomfort, switch to heat after 48 hours.
3. Most muscle strains resolve in several days and or weeks. Consult your doctor if you have persistent severe pain that makes standing, walking, and or breathing difficult.
4. If pain persists for weeks, your doctor may send you to a physical therapist. A physical therapist can perform manual techniques to reduce muscle tightness and instruct you in a home exercise program to decrease your pain and difficulty with daily activities.

Please contact Harbor Physical Therapy, if you have fallen and require physical therapy or you are unsure how to proceed with medical care.

Do you suffer from morning heel pain?

The most common cause of morning heel pain is plantar fasciitis. The plantar fascia is a long ligament in the bottom of your foot. It can become inflamed causing pain on the bottom of your foot and heel.

Symptoms include pain on the bottom of the foot either after not weight-bearing through the foot for a long period of time or after a lot of weight-bearing activity.

Treatment includes:
1. Replace worn out shoes. Make sure you have a pair of good supportive tennis shoes for when you are
on your feet a lot.
2. Stop any excessive exercising or jogging until symptoms subside. If you have recently started a new
exercise program or changed jobs where you are doing a lot of standing or walking, see what you
can do to limit being on your feet a lot.
3. Use heat on the bottom of your foot followed by rolling a tennis ball underneath your foot for a few
minutes for a self massage to the plantar fascia area.
4. Perform calf stretches. Stand on the bottom of a step and drop one heel down until you feel a stretch
in your calf. Hold for 20 seconds and repeat a couple times on each foot.
5. End with some ice on the bottom of your foot. Wrap a bag of frozen peas or corn in a towel and put it
under your foot for about 10 minutes.

What is a Trigger Point?

A trigger point is a specific spot on a tight band of muscle that is hyperirritable. Usually you can feel a nodule or knot in the muscle. When you put pressure on the trigger point, it will feel tender and possibly radiate pain to another area.

Trigger points are most commonly located in the postural muscles of the neck, shoulders, and upper back. Trigger points can manifest themselves in tension headaches, ringing in the ear, and jaw pain.

Lack of exercise, sitting at a computer with poor posture, vitamin deficiencies, lack of sleep and micro trauma that occurs with sports and repetitive activities can all contribute to trigger points.

Physical therapists are trained to help inactivate these trigger points. Physical therapists will use modalities such as heat or ice, soft tissue massage, ultrasound and stretching to help reduce pain and tightness at the site of the trigger point.

Can stress lead to pain?

Are you wondering if your back or neck pain can be related to stress? Many times stress alone can cause pain and if your spinal nerves are already irritated due to a previous injury, degenerative changes or scar tissue, it may only take a little extra muscle tension to increase your pain.

Stress creates muscle tension. This can cause compression to the nerves that run through your muscles. The compression of the nerves can result in symptoms such as aching, numbness, tingling, and sharp pains. Muscle tension reduces blood flow through the tissues robbing them of nutrients and oxygen. Sciatica is one of the most common problems that can be worsened with stress.

Try to manage your stress with techniques such as meditation, progressive muscle relaxation, guided imagery, massage therapy, walking or warm baths. Also, see your physical therapist as soon as your symptoms worsen. Physical Therapy will provide you with exercises and manual techniques to reduce muscle tension.

Fall Prevention

The risk of falling increases with age and is greater for women than men.  There are many causes for falls such as medication side effects, environmental hazards in the home, poor vision, and decreased muscle strength. Being too sedentary can result in poor muscle tone, decreased strength, and a loss of bone mass. Listed below are tips to lessen your risk of falling. 

  1. Repair cracks in sidewalks/steps or raised thresholds in doorways.
  2. Make sure there are handrails on both sides of steps.
  3. Trim shrubs next to walkways.
  4. Have adequate lighting in each room and the hallways.
  5. Don’t wax floors.
  6. Don’t climb stools or ladders.
  7. Change the color of the transitions into different rooms and on the steps.
  8. Put nonskid pads under rugs so they won’t slide.
  9. Get rid of throw rugs.
  10. Use a raised toilet seat and make sure there are grab bars in the bathroom.
  11. Use nightlights.
  12. Use a walker or cane if the doctor advised you to and make sure you are using it properly.
  13. Sit on the edge of the bed for a few minutes before standing to avoid dizziness.
  14. Get regular eye checkups.
  15. Wear supportive shoes.
  16. Make sure you are taking enough calcium and vitamin D.
  17. Make sure you are doing some weight bearing exercises.

Weight bearing exercises build bone mass. If you are not sure which exercises to do, Harbor Physical Therapy can instruct you in a home exercise program to help decrease the likelihood of falling.

Tips to Prevent A Back Injury While Gardening

As spring and summer are approaching, we begin to get back to our gardening.  While gardening, many people develop back injuries due to improper body mechanics. Therefore, listed below are tips to decrease the likelihood of a back injury this gardening season.

  1. Before gardening, take a 10 minute walk or warm up with some light exercises to warm up your muscles.
  2. While shoveling, remember to bend at your knees and hips, not at your waist.
  3. When you empty a shovel full of mulch or dirt, make sure you pivot your feet while turning your upper body.
  4. Sit or kneel on a small stool or bucket while weeding and planting so you are not bending over. Use knee pads to kneel to avoid pressure on your knees.
  5. Switch jobs every 30 minutes and take a break every 15 minutes.
  6. Working on raised beds is less strenuous for your back because you are not bending over as much.
  7. Use a cart or wheelbarrow to move things.
  8. Use lightweight hoses for watering.
  9. Keeps loads light. Buy smaller bags of dirt and mulch. They might be more costly but they will save your back.
  10. Use ergonomic tools for pruning and planting. Buy long handled tools so you don’t have to reach as far.
  11. Keep your body straight and get under the wheelbarrow to tilt it. Stand straight while emptying the wheelbarrow.
  12. While mowing the lawn, keep a comfortable distance between your hands and your body.
  13. If you experience any pain while doing lawn work or gardening, stop.
  14. Do gentle stretches when you are finished gardening to prevent tightness/pain the following day.

Frozen Shoulder

What is Frozen Shoulder?

Frozen shoulder has an idiopathic gradual onset resulting in pain, stiffness, and decreased range of motion. Due to pain, the person tends to use the shoulder less.  Frozen shoulder causes the shoulder joint to become inflamed resulting in thickening, scarring, and shrinkage of the joint capsule that surrounds the shoulder joint. Scar tissue and adhesions form around the shoulder joint resulting in chronic stiffness.

 Some reasons people may get a frozen shoulder are from having poor posture, prolonged immobility from a previous injury, diabetes, or disuse from pain. Research shows, frozen shoulder is often the first sign of undiagnosed diabetes.  This is more commonly found in women over 50 years old. 

 Diligent physical therapy is the key to recovering from a frozen shoulder. Rehabilitation from a frozen shoulder can take weeks to months, depending on the severity. Your therapist may apply heat and ultrasound to warm up the joint and instruct you in stretching/strengthening exercises to restore the range of motion and strength of your shoulder. Ice is often applied after exercises to reduce inflammation.

Auto Accident Injury, Do I see a Physical Therapist or a Chiropractor

After an auto accident, it is common to sustain an acute injury to your muscles. An acute injury has a rapid onset and involves an inflammatory process of the soft tissues. Soft tissue injuries consist of the muscles, fascia, and tendons. A neck and back injury is the most common injury sustained from an auto accident.

For an acute injury, it is best to visit your local physical therapist because therapists are trained to rehabilitate injured muscle in a conservative manner. After an auto accident, physical therapy focuses on decreasing muscle tightness and inflammation, which is ultimately causing pain and decreasing function.

If you have tried physical therapy for approximately 6 weeks and have not seen any results, it is recommended you contact your physician. Your physician might at that point suggest seeking chiropractic care and or imaging tests. After an auto accident, most people receive positive results with approximately 6 weeks of physical therapy.

Open vs. Closed Fracture

An open fracture is an injury that not only damages the bone but will break the skin. This can cause the bone to protrude out of the skin. Surgery is required to repair the bone and to close the wound in the skin. Antibiotics may also be necessary to prevent infection.

A closed fracture occurs when there is bone breakage but no break in the skin. Typically bruising and swelling are present at the fracture site.