Do You Know Why You Have Back Pain? Here’s How You Can Find Out

Are you experiencing low back pain and not sure why? You’re not alone, in fact: 9 out of 10 patients don’t know the primary source of their back pain. The problem is that most people seek treatment after they’ve begun exhibiting symptoms of back pain. While this may seem logical on the surface, here at Park Sports Physical Therapy we encourage our patients to take a more preventative approach to their wellness. At Park Sports, we understand how bothersome it may be to have the stress of back pain added to your daily life. Whether you are just trying to get through the work day, cleaning up after your children, or just taking a walk to get the paper, we know how much worse back pain could make these simple everyday tasks and want to help prevent it. We care about our community and hope to help prevent injuries before they occur/worsen.

The key is to go to a physical therapist before you begin to see the signs and symptoms of back pain. I’m sure that right about now you’re asking, “Why would I do that?” One, because physical therapists are trained to recognize the physical dysfunctions that may one day lead to back pain. And two, because eight out of 10 Americans suffer from low back pain at some point in their lives, so the chances are good that you or someone in our community could become a statistic one day.

Seeing a physical therapist on an annual basis is one of the most effective ways to prevent back pain from occurring in the first place, the way one might see a primary care physician. Doesn’t that sound like the better alternative? Great, now that you’re on board, let’s talk about what you can expect during that annual physical therapy appointment. The first time you go, your physical therapist will collect a complete picture of your medical history. During subsequent visits, it’ll be important to update your physical therapist about any changes to your health during the previous 12 months, but it won’t be necessary to review your entire medical history again.

Next, your physical therapist will perform an examination using a variety of tests and measures including a movement screen. A movement screen is a screening tool that’s designed to identify imbalances in your mobility and stability that may contribute to limited function or other impairments. This gives your PT the ability to see how your back, hips, core, shoulders, knees and ankles perform during a series of carefully selected exercises.

The information gathered during an examination helps your physical therapist to identify changes from one year to the next, a critical step in assessing your risk for back pain and a host of other debilitating conditions. If a problem is identified early enough, then your physical therapist is better equipped to discuss preventive measures instead of designing a treatment plan. And that’s how you identify the root cause of back pain and derail issues before they even begin. Mystery solved.

Our qualified and caring physical therapists here at Park Sports Physical Therapy are here to help! If you feel that you, a loved one, or any residents in the community could benefit from physical therapy please do not hesitate to give us a call at any of our locations in Brooklyn. We have locations in Park Slope, South Slope and Clinton Hill.

Unsure if physical therapy is right for you? Give us a call today and our administrative staff will be happy to accommodate!

Runner’s Injury Prevention Workshop Recap

We want to give a big thank you to all of you who came out to the Runner’s Injury Prevention Workshop. Boris and Julie really enjoyed presenting and getting to know more about your running goals.

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Recap

Whether you run recreationally, competitively, or for fitness, the information we shared last night is 100% applicable to you. We covered a lot of material, so we wrote up a brief recap for you and those who couldn’t make it out to our event.

Biomechanics of the Foot

foot pronation and supination chart

Boris and Julie discussed what pronation and supination is and how it can affect your foot if there is a mechanical abnormality. They mentioned individuals’ variations in the foot and ankle structure and how it is connected to the rest of your leg higher up. Other variables play a part in how fast, how long, and efficiently you run. They touched on proper running mechanics and emphasized the form over the speed and distance.

When you run your body experiences impact many times your body weight on each stride. It’s important to understand how your feet land to make the appropriate adjustments. A physical therapist or personal trainer specializing in gait analysis can help in this regard.

The Importance of Core Strength

core muscles

One cannot overstate the importance of core strength in any physical activity and this includes running. Your core ensures your body’s stability, balance, proper posture, and control. Strengthening your core comes with many benefits including injury prevention. In regards to running, when your core muscles – your pelvis, abdominal, hips, and back – all work in sync, you are able to remain solid as your foot strikes the ground. If you are a long distance runner, you know how important maintaining proper posture is. A strong core will improve your running time, endurance, stamina, and help reduce the chances of injury.

Strengthening Your Glutes

Glutes Breakdown

Your glutes are made up of the gluteus maximus, gluteus medius, and gluteus minimus. They all play an important role during your run. We want to make sure that each of these muscles is strong so that other parts of your body aren’t overcompensating for their lack of engagement.

Your gluteus medius and minimus are abductors and help move your legs away from your body. The gluteus maximus is used for hip extension.

Julie mentioned that too much sitting can lead to weak glutes since they are not activated in that position. On the opposite end, your hip flexors shorten since sitting keeps them in a contracted position. Both Boris and Julie recommend that you do the following exercises:

  • Glute Bridge
  • Lunges
  • Squats
  • Clamshells

Dynamic Stretching

Dynamic Stretching

Although recent research has shown that stretching before a run does not help to prevent injury, there are some benefits to stretchings.

Both Boris and Julie encourage dynamic stretching in which your body is moving while you stretch. This ensures that your muscles are warmed up and ready to go.

Common Tight Spots for Runners

We suggest that you keep a close eye on these parts of the body before, during, and after your run.

  • ITB
  • Achilles
  • Hip Flexors
  • Hamstrings

Plantar Fasciitis

plantar fascitiis

Some of you had concerns about plantar fasciitis. Your plantar fascia is a thin ligament that lies on the bottom of your foot. It connects from the heel all the way to the front of your foot. It helps to support the arch of your foot and plays an important role in walking and running mechanics. If you suffer from heel pain after a run, chances are high that you suffer from plantar fasciitis which is the inflammation of this ligament. Symptoms are described as a shooting pain near the heel. The pain is usually worse in the morning or after long periods of rest.

When you run there is a lot of pressure and force pushed on the plantar fascia. This can cause inflammation and tightness.

There are many factors that can contribute to plantar fasciitis. Tight calf muscles or having a high arch can both play a role in plantar fasciitis. Seeing a physical therapist can help identify these issues and provide a treatment plan to manage pain or prevent pain altogether.

Are you currently experiencing pain from running? Participating in races anytime soon? Our highly trained physical therapists can help.

Running can put a lot of strain and stress on your body. Seeing a physical therapist can help you address any biomechanical issues such as muscle imbalances, gait, or tightness to prevent injury, improve your performance, and keep you running for life.

Fill out the form below to get started.

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Want to learn more about the AlterG Anti-Gravity Treadmill and give it a try at our Clinton Hill location on Fulton Street? Schedule your first run here.

Brooklyn Half Marathon Crash Course Recap

We had a blast last night hosting the Crown Heights Running Club at our Clinton Hill location for our Brooklyn Half Marathon Crash Course.

The presenters included physical therapist and owner of Park Sports Physical Therapy, Boris Gilzon, PT, DPT, OCS, CHT, Certified Coach for the Road Runner Clubs of America, Nate Turner, and nutritionist, Tara Mardigan, MS, MPH, RD, AKA “The Plate Coach.”

They shared a lot of great information with us. This post will serve as a brief recap of some of the material that was reviewed.

Dynamic Stretching VS Static Stretching

Dynamic stretching is preferred over static stretching. You will want to focus on “warming up” your muscles before a run or undertaking any form of exercise. This can be in the form of jumping jacks, lunges, or any other full body movement. Core exercises are strongly encouraged.

There is no correlation between stretching and preventing injury, but stretching is still very beneficial in other ways. Boris recommends holding a stretch for twenty seconds or more for the muscles to get the full benefit of the stretch.

Tara recommends staying properly hydrated as that also plays a role in the performance and flexibility of your muscles.

Anywhere from 7-10 minutes of dynamic stretching will be enough to get you warmed up.

Cross Training

Cross training is useful, but depending on your goals, whether they be increasing mileage, speed, or endurance, nothing can replace running.

Boris and Nate both recommend strategic planning in terms of setting up a schedule for training to achieve your goals. The example given was a six-month training schedule. Boris recommends starting off with a light workout and running schedule at the very beginning and then increasing the intensity of theworkoutss as time progresses. This allows the body to adapt.

According to Nate, you should plan ahead and find ways to stimulate the climate of the actual race. For instance, if you are training during the colder seasons for a race that takes place during warmer seasons, you should try running in warmer temperatures some days. This could be done on a treadmill indoors with higher heat. Don’t forget to stay hydrated during these experiments!

Identifying Pre-Existing Structural Issues to Avoid Injury

Having a pre-existing injury or structural issue can lead to more serious injuries down the line. Both Nate and Boris strongly advise against working through the pain during training. Structural issues can be evaluated by a medical professional, physical therapist, or even an athletic trainer trained in identifying imbalances in the body.

A physical therapist will be able to assess your body’s strengths and weaknesses and will be able to offer valuable insight as to how you can improve your odds to avoiding injury, whether they be through strengthening exercises, modifying certain movements, correcting postural issues, or stretching and manual therapy.

If you are interested in getting a movement evaluation done by one of our physical therapists, schedule your appointment here.

Increasing Mileage Safely

Boris and Nate mentioned when training for a half marathon or even a full marathon, it’s best to work your way up to running that distance.

Instead of flat-out running thirteen miles, you could distribute a certain amount of miles each day that adds up to the full thirteen miles.

For example, on Monday you run four miles, Wednesday you run four miles, and Friday you run five miles. You can slowly increase your mileage safely in this manner instead of just deciding to run ten miles one day.

Nutrition for Runners

Tara put together an excellent handout reviewing some excellent advice in terms of nutrition, rest periods, and more. Here’s a PDF of the handout for those of you who couldn’t make it last night.

Wrapping Up

To those of you running the Brooklyn Half Marathon, we wish you the best of luck. You have trained hard and whether you aim to break a new personal record, finish the race, or have a set time that you would like to finish, we are here to help.

Want to learn more about Park Sports Physical Therapy and get started? Fill out this form here.

AlterG Anti-Gravity Treadmill

We are offering a 20% discount to Crown Heights Running Club’s members interested in trying out the AlterG Anti-Gravity Treadmill.

Schedule your first run today! Call 718.230.1180

Learn more about the AlterG treadmill and our rates here.

Injury Prevention for Youth Soccer Athletes Workshop Recap

On March, 28th 2018, physical therapists, Igor Kozlov, DPT, and Aaron Lentz, SPT, gave their first presentation at the new Park Slope United Club House, which just opened up their doors on March, 24th 2018 in Bedford Stuyvesant.

A lot of great material was covered including common injuries that soccer players face during training and games, the FIFA 11+ warm-up, proper footwear for different kinds of turf, and the benefits of the Movement Assessment.

Here’s a brief recap.

What is the Movement Assessment?

A Movement Assessment is an evaluation of your child’s body’s movement. Our therapists will assess your child’s body’s posture and core strength, search for any muscle imbalances, test their flexibility, analyze their gait, and test for balance.

This creates a baseline for them to improve upon. A Movement Assessment is useful for catching any inefficiencies in the body early on that can lead to injury. This assessment has proven to be an invaluable tool for many of the athletes we see at our practice.

Imagine your child being able to run with greater efficiency and producing less strain on their muscles and joints, or having the knowledge to jump, land, and pivot with a lower chance of injury.

Our therapists can help your child gain greater insight and control over their body, which will lead to greater athletic performance.

 

The FIFA 11+ Warm-up

The FIFA 11+

Aaron and Igor mentioned the importance of stretching and warming up before training and playing in any matches. The FIFA 11+ warm-up routine was created as an injury prevention program. Coaches and parents should be mindful and remind their young athletes to do a proper warm-up.

Recent studies have shown that the most common injuries in youth soccer players are torn ACL’s, Hamstring strains/tears, and ankle injuries.

Research has shown that implementing the FIFA 11/11+ warm up statistically decreases the number of injuries during soccer. The warm-up can be implemented before a game, practice or just kicking the ball around with friends.

The FIFA 11 is a series of warm-up exercises that are broken up into three parts.

Part 1 includes all running exercises, there are a series of 6 activities to be performed in part 1.

Part 2 is all about exercises that utilize plyometrics, balance training, and strength training. Part 2 includes another 6 exercises which can be changed to a more challenging level as the athlete improves.

Part 3 is the last section where there is just one exercise that again focuses on running. In part 3 the level of difficulty can be changed based on the ease of completion of the athlete performing the warm-up.

Download the FIFA 11+ warm-up sheet here.

 

Osgood-Schlatter Knee Pain
Medical Illustration originally sourced from https://orthoinfo.aaos.org/en/diseases–conditions/osgood-schlatter-disease-knee-pain/

Osgood-Schlatters (Knee Pain)

Osgood-Schlatters is an overuse injury that is more common among boys from the age of 9-15 and during growth spurts. The presentation and symptoms are a pronounced bump below the knee cap, that is painful with activity, but the pain decreases with rest. The details of the injury affect the patellar tendon at its insertion point on the tibia and may affect the growth plate. Osgood-Schlatters can be diagnosed with a radiograph. This injury is caused by a lot of running and jumping activities.

Read more about Osgood-Schlatters here.

Proper Footwear

The last topic that was discussed was proper footwear for playing soccer. The shoe should fit snug with just a little room for the toes to move. Proper soccer shoes should be worn while playing soccer, not running shoes or cross trainers or basketball shoes. This cannot be stressed enough!

For indoor play, there are specific indoor soccer shoes that should be worn. When playing on artificial turf there are specific turf cleats that aren’t as long and have more cleats on the bottom of the shoes.

When playing in wet or long grass that is softer the cleats should be a little longer to provide more grip while playing.

Schedule Your Child’s Movement Assessment with Our Expert Physical Therapists Today.

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Runner’s Injury Prevention Workshop w/ Pongo Power

RESCHEDULED to Monday, April 30th 2018 @ 7:00 PM

Park Sports Physical Therapy – Park Slope
142 Prospect Park West
Brooklyn, NY 11215

Register for the Runner’s Injury Prevention Workshop Here

The presentation will be given by Boris Gilzon, PT, DPT, OCS, CHT owner of Park Sports PT, an avid runner and triathlete alongside Julie Petrusak, NASM Certified Personal Trainer, and director of the Rev up to Run! Training Program at of Pongo Power.

Join Park Sports Physical Therapy and Pongo Power for a free injury prevention workshop geared towards runners.

Here are a few topics that will be covered during the workshop:

Part I

  • The Physical Demands of Running – What happens to your muscles and joints during a long run.
  • Common Running Injuries – How they occur & how to prevent them.
  • Self-Treatment – We’ll cover the basics of icing, stretching, rest periods, and what problems to look out for.
  • Knowing When to Seek Medical Attention – Benefits of Physical Therapy

Part II

  • Becoming an optimal runner. The efficiency of muscles, structural balance, and building up endurance.
  • Technique and proper form.
  • How to safely increase mileage during training.
  • How to become a faster runner the safe way.
  • Benefits of cross training

Part III

  • Q&A

Space is limited to 25 people. Reserve your spot today!

Register for the Runner’s Injury Prevention Workshop Here

Questions? Contact us by calling 718.230.1180 or emailing info@parksportspt.com

 

Pongo Power

Learn more about Pongo Power here.

Brooklyn Half Marathon Crash Course w/ Crown Heights Running Club

Monday, April 9th, 2018 @ 7:00 PM

Park Sports Physical Therapy – Clinton Hill
973 Fulton Street
Brooklyn, NY 11238

Register for the Brooklyn Half Marathon Crash Course

The presentation will be given by Boris Gilzon, PT, DPT, OCS, CHT the owner of Park Sports Physical Therapy and an avid runner and triathlete, Nathon Turner, Certified Coach, Road Runner Clubs of America, and Nutritionist Tara Mardigan, MS, MPH, RD, AKA “The Plate Coach”.

Are you a runner looking to build speed, improve your endurance, and increase mileage safely to prep for the Brooklyn Half Marathon?

Park Sports Physical Therapy would like to invite the members of the Crown Heights Running Club to a free crash course to help improve performance and prevent injury.

The topics being covered include:

  • How to prevent failure in critical joints and avoid structural imbalances.
  • Muscle efficiency – making sure opposing muscle groups are performing in harmony.
  • Proper running form and how to spot deficiencies.
  • Benefits of training with the AlterG Anti Gravity Treadmill.
  • Nutrition for runners.
  • Reviewing your current training plan.

We’ll have a short Q&A section at the end the presentation.

Space is limited to 25 people. Reserve your spot today!

Register for the Brooklyn Half Marathon Crash Course

Questions? Email us at info@parksportspt.com or call 718.230.1180.

Crown Heights Running Club

Learn more about Crown Heights Running Club

 

Injury Prevention Workshop for Youth Soccer Athletes

Presentation by Aaron Lentz, SPT & Igor Kozlov, PT, DPT of Park Sports Physical Therapy

Wednesday, March 28th, 2018 @ 7PM

Park Slope United
260 Jefferson Avenue, 2nd Floor
Brooklyn, NY 11216

RSVP to the Workshop Here

Join us for our very first injury prevention workshop at Park Slope United’s clubhouse presented by one of our physical therapists from Park Sports Physical Therapy.

This workshop is designed to inform parents of children playing soccer about some of the common injuries that can occur on the field during training or matches and what to do in the event of those injuries occurring. We’ll also review the most common injuries among soccer players, how to self-treat, what to look out for more serious injuries, and more.

Here are some other topics that we’ll be covering during the workshop:

 

  • Proper stretching before and after training and games.
  • Post-injury signs.
  • Common knee and ankle injuries.
  • Concussion symptoms.
  • Purchasing proper footwear for both indoor and outdoor soccer.
  • Landing and cutting mechanics.
  • Flexibility vs. Hypermobility.

 

To RSVP call 347-301-9613 or email  team@parkslopeunited.com or sign up on Eventbrite.

 

About Park Sports Physical Therapy

Park Sports Physical Therapy & Hand Therapy has been treating patients of all ages for over 20 years in Brooklyn. With three locations – two in Park Slope and one in Clinton Hill, patients have access to sports rehabilitation, vestibular rehabilitation, pelvic floor therapy, pre & post operative rehabilitation, Scoliosis Treatment / Schroth Therapy, and pediatric physical therapy.

About the Presenter

Igor Kozlov, PT, DPT - Physical Therapist

Igor Kozlov, PT, DPT

Physical Therapist

  • Received his Doctorate of Physical Therapy from Hunter College
  • Attended courses focused on manual therapy at the Institute of Physical Art (IPA) and Maitland Australian Physiotherapy Seminars (MAPS)
  • Pre and Post Operative Rehabilitation

Read Igor’s Full Bio

What Is A Total Ankle Replacement Surgery?

By: Allison Benson, Physical Therapy student at Hunter College, graduating in May 2018
Worked with Kristin Romeo, PT, DPT

With injury and with age, the joints of your body can be damaged by osteoarthritis, causing painful, aching joints. This pain can follow you throughout the day. You may feel stiff waking up, feel a dull ache when taking your dog for a walk, or feel a painful grinding as you stand up from sitting or as you climb the stairs.

Osteoarthritis (OA) is the most common joint disorder in the United States and is more common in women than men, according to an article published by Zhang & Jordan (2010). In healthy joints, where two or more bones meet and rub together, the bone surfaces are covered by a slippery substance called hyaline cartilage. This cartilage helps make your joints move smoothly and painlessly. With OA, this cartilage has broken down, leaving the bones exposed to each other, creating a grating or “bone on bone” feeling.

When a joint with OA becomes very painful, surgeons often recommend a total joint replacement—you probably know someone who has had a total knee or total hip replacement due to OA. Hips and knees are common sites for OA to develop, both because they move a lot, and because they carry the weight of the body.

You may not have heard of a total ankle replacement, though. Although ankles are also weight-bearing and mobile, they develop OA much less common; only about 1% of the population develops ankle OA (Valderrabano et al., 2009). This means many fewer people have ankle surgeries related to OA.

Another reason you may not have heard about ankle replacement is that it was a relatively unpopular surgery until recently. Total ankle replacements are complicated because there are a lot of important structures packed into a small area at the ankle. They also were associated with a very high failure rate, with surgeons needing to go back in and complete additional surgeries to replace, remove, or adjust the hardware they had placed.

That said, the popularity and success rate of total ankle replacements are on the rise.

In this surgery, a round metal ball is implanted into the talus, which is an important bone in your ankle. A metal implant is also implanted into the bottom of your tibia, which is the big bone in your calf. A plastic spacer is placed between these two pieces, which allows the tibia to slide smoothly on the talus, just like it does in healthy ankles.

After surgery, a patient will typically be in a surgical boot for 8-10 weeks, and cannot put weight on that foot for 4-6 weeks (Devries, Scharer, & Sigl, 2015). Patients may be referred to physical therapy prior to, or immediately following the procedure for prehab or rehab of the ankle.

Immediately after the surgery, therapists help with gentle work to reduce swelling and pain and prevent tissues from binding down as scar tissue forms. As time passes, therapists help patients regain their strength and range of motion, restoring their ankle to full use. Healing from an ankle surgery is a long process, and requires months of physical therapy, but can be a good option when faced with debilitating ankle OA.

Did you recently have a Total Ankle Replacement surgery? We can help. Schedule your appointment today.

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SOURCES

Devries, Scharer, & Sigl. (2015). Total Ankle Arthroplasty Rehab Protocol. BayCare Clinic; Foot & Ankle Center.

Zhang, Y., & Jordan, J. M. (2010). Epidemiology of Osteoarthritis. Clinics in Geriatric Medicine, 26(3), 355–369. https://doi.org/10.1016/j.cger.2010.03.001. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920533/

Valderrabano, V., Horisberger, M., Russell, I., Dougall, H., & Hintermann, B. (2009). Etiology of Ankle Osteoarthritis. Clinical Orthopaedics and Related Research, 467(7), 1800–1806. https://doi.org/10.1007/s11999-008-0543-6

Spinal Stabilization Exercises and Their Role in Alleviating Lower Back Pain

By Boris Gilzon, PT, DPT, OCS, CHT

The Effectiveness of Spinal Stabilization Exercises for Back & Neck Pain

There is no standard approach treating chronic lower back and neck pain. Although this may be unfortunate for many patients to hear, the good news is that there are many conservative methods to alleviate pain.

While conditions like degenerative disk disease, spondylolesthesis, lumbar and cervical radiculopathy are rarely cured completely by conservative measures alone, physical therapy does offer a fair amount of pain relief in the long run.

By utilizing spine stabilization exercises, our physical therapists are able to help patients reduce back and neck pain. This is an active form of treatment requiring the patient to perform exercises to strengthen the muscles and improve the stability of the spine.

Igor assisting his patient with a spine stabilization exercise.

Patients suffering from chronic spinal pain should be leery of physical therapists who mainly offer passive modalities. Examples of passive modalities include heat, electrical stimulation, and massage. Patients should be aware that passive therapeutic modalities do not have sufficient evidence to support their use in chronic spinal conditions.

Spinal stabilization exercises offer the empowerment of the patient and have plenty of research and evidence to support their effectiveness.

Pilates offers an excellent variety of spine stabilization exercise.
Pilates offers an excellent variety of spine stabilization exercise.

Extensive benefits in treating the spine of those who suffer from lower back pain have been discussed extensively in medical literature. Physical Therapists specializing in the spinal disorders are trained in recognizing the factors that affect spinal stability.

Igor Kozlov, DPT treating patient using TRX for back exercise

Components Affecting Spinal Stability

The concept of spinal stability is relatively new with research beginning during the 1970’s.

There are three components that affect spinal stability.

The first component is the passive spinal element: the bone and ligamentous structures. Studies of the cadaver spine in which the bones and ligaments are intact but the muscles were removed showed to buckle under about 20 pounds.

Spinal Ligaments - Medical Illustration Originally Sourced from Kenhub.com
Ligaments of the thoracic spine: posterior (a), anterior (b), lateral (c) and posterior with vertebral arch removed (d). 1, anterior longitudinal ligament; 2, posterior longitudinal ligament; 3, intervertebral disc; 4, ligamentum flavum; 5, intertransverse ligament; 6, supra- and interspinal ligament; 7, radiate ligament; 8, costotransverse ligament.
Originally sourced from: https://musculoskeletalkey.com/anatomy-of-the-thorax-and-abdomen/

The second component of spinal stability are the muscles that surround the spine. The muscular component provides a necessary ‘stiffening” of the spinal segment. In a healthy spine, a very modest level of muscular activity can create a sufficiently stable joint. In a degenerative disk disease, for example, there is more demand on the surrounding musculature. More strength and endurance reserve is needed to overcome an injury and pain.

Deep Muscles of the Back
Deep Muscles of the Back. Medical Illustration originally sourced from: https://pulpbits.net/7-deep-muscles-of-back-anatomy/the-deeper-muscles-of-the-back/

The third component of spinal stability are the neural elements: the central nervous system and peripheral nerves. They are akin to an orchestra conductor, coordinating the performance of various muscles, making sure they are firing at the right time, at the right amount of force.

Spinal Cord Nerves Originally Sourced from Health Jade
Spinal Cord and Nerves – Medical Illustrations originally sourced from https://healthjade.com/spinal-cord/

Multiple studies have shown patients with lower back pain make a “repositioning error” in which their spine would resume to its original position causing pain after performing a certain movement more than patients with a healthy, stabilized spine.

In physical therapy language, we call it a poor postural control.

Specific physical therapy exercises and treatment has shown effectiveness in treating chronic spinal pain.

Lumbar stabilization exercises improve muscular function which can, in turn, compensate for the structural damage to the spinal segment. A thorough dynamic assessment of the spine helps identify postural deficits.

A thoughtful exercise program is designed for each individual by the physical therapist based on their initial testing and evaluation. The most tangible benefit of a lumbar stabilization is that it gives a patient the tools to control their pain.

Interventional Pain Management

Going beyond the scope of physical therapy, interventional pain management is another passive option for chronic spinal pain. This approach serves as a temporary source of relief for patients dealing with low or medium levels of lower back pain. These techniques include performing procedures directly at the level of your dysfunction.

A pain management physician gains access to the areas causing lower back or neck pain by penetrating the surface of the skin. There is a plethora of interventional pain management options for the diagnosis and treatment of the spinal pain.

Epidural steroids are the most common example of the interventional spine management. However, the accuracy and effectiveness of interventional methods in managing lower back pain are not always clear.

In the comprehensive review article published in Pain Physician, 2013 Apr:16, the authors conducted a systematic review of literature in order to collect evidence for the effectiveness of various interventional pain management techniques in the treatment of chronic spinal pain.

The author came to the conclusion that the evidence was fair to good in 52% of therapeutic interventions. The evidence for diagnostic value fared slightly better at 62%.

One significant drawback of all passive techniques is that they do not require a participation of the patient. Without an active engagement of the patient, there is a limited self-control and independence in managing their own condition.

Do you suffer from chronic neck or back pain? Our therapists can help. Schedule your appointment today.

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How Physical Therapy Works To Eliminate Knee Pain

By Boris Gilzon, PT, DPT, OCS, CHT

In a 2006 health survey conducted by the National Health Interview Survey (NHIS), knee pain was reported as the second most common cause of chronic pain in America.

Another surprising statistic comes from the Society for Academic Emergency Medicine. They reported that “the knee is the most commonly injured joint by adolescent athletes with an estimated 2.5 million sports-related injuries presenting to [Emergency Departments] annually.”

Some studies even show us that there has been an increase in the amount of knee replacement procedures over the last few years. Researchers say this is caused by two major factors: the first being the obesity epidemic and the second being that we are living longer lives. While living longer is great, it also puts more years of wear and tear on our bodies which can lead to osteoarthritis.

So what can you do to prevent knee pain or if you already suffer from knee pain, how can you better manage it and get out of pain?

The knee joint can only move in one plane, like a door hinge, and does not accommodate well to external stress that falls outside of its natural axis. For example, imagine being pushed from the side while your feet are firmly planted. This is the most common mechanism leading to a knee injury. Anterior Cruciate Ligament (ACL) injuries, as well as meniscus tears, normally occur this way.

The knee joints bear multiples of your body weight in running and jumping. Climbing up the stairs, for example, loads your knee joint 2.5 times your body weight.

The knee is considered a biomechanical link between the hip and the ankle/foot complex. Dysfunction in any of these joints can negatively affect the others in the chain. Repeated abnormal stress can take a toll on the knee joint.

Knee pain is one of the most common conditions our therapists treat in our clinics. Our therapists know how to take care of a variety of injuries and conditions for people of all ages. Early intervention of knee pain will improve your quality of life, mobility, and prevent loss of muscle strength and instability.

Types of Knee Injuries

There are two categories that a knee injury can fall into: 1) acute/traumatic and 2) chronic/repetitive stress. Acute injuries are when the incidents occur immediately, like a fall, car accident, landing in a strange way, twisting/pivoting quickly, etc. Many sports injuries, especially sprains and strains, fall under this category.

Chronic injuries are caused by repetitive stress over a long period time. Poor posture and/or body mechanics can play a major role in chronic conditions. Physical therapy can be very beneficial in correcting these issues.

Osteoarthritis

osteoarthritis knee joint
Osteoarthritis of the knee joint. Medical illustration original source: https://drcolinmacleod.com/platelet-rich-plasma-arthritis

Knee pain can be caused by degenerative changes in osteoarthritis. Arthritis is when the cartilage cushioning the bones wear down leading to swelling, stiffness, and pain.

Unfortunately, in the cases of the knee pain due to severe osteoarthritis, Physical therapy intervention is limited and one should consult with an orthopedic doctor to assess whether a total knee replacement is appropriate.

Knee pain is more commonly seen in people who do not yet have visible arthritic changes on radiographic examination. Those people are engaged in various physical activities while struggling with the knee pain during and after the activity.

Anterior Knee Pain aka Runner’s Knee

knee medical illustration patella
The patella “floats” between the thighbone and shinbone in the trochlear groove. Medical illustration original source: https://orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-arthritis/

Anterior knee pain or the “Runner’s Knee” is related to an abnormal motion of the kneecap in the trochlear groove. It causes an irritation and eventual wearing out of the cartilage on the back of your kneecap. The knee pain gets worse when you first stand up, run and going downstairs. The knee pain worsens while performing your physical activity.

Patellar Tendonitis aka Jumper’s Knee

patellar tendonitis
Patellar Tendonitis Medical Illustration Original Source: https://www.vivehealth.com/blogs/resources/patellar-tendonitis

Patellar tendonitis, also known as “Jumper’s Knee,” is another activity related condition that is caused by repetitive motion. The knee pain, in this case, originates in the patellar tendon. A structure that connects your quadriceps muscle to the lower leg through the kneecap. When your quadriceps muscle is overloaded it causes an inflammation of the tendon, thus contributing to the knee pain. The symptoms are usually more pronounced when you are at rest and when you initiate your activity. In more severe and chronic cases the knee pain prevents you from participating in sports.

Knee Pain Rehabilitation and Treatment

The key in the rehabilitation of the knee pain is a correct biomechanical analysis of your kinetic chain. An exercise regimen performed at the proper angles and positions. Prescribed activities help to avoid further irritation of the joint and yet strengthening the weak elements. If you suffer from the knee pain, it does not mean that you need to halt your physical activities. Physical Therapist at Park Sports have the tools and knowledge to get you ‘back in the game”.

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