Don't Let Pain Stop You!

The sun is out and the warm weather calls many of us to go outside to run, but any new activity means using muscles in ways they haven’t been used and can lead to injury. We were "wearing" these muscles all winter long but haven’t used, trained, or conditioned them to turn on at the right time and be strong for running. These overuse injuries creep up on us one day and can prevent us from running for weeks and that won’t be fun if the sun continues to shine without you!

The most common injury is called Patellofemoral pain, otherwise known as "Runner's Knee."
Symptoms include: Pain in your knee when running, going up or down stairs, squatting, when sitting for prolonged periods of time, and sometimes walking. Xrays reveal no structural damage and may show your kneecap, or "patella" is mal-tracking, which means it is not in the correct position and improperly aligned during movements. MRI is not immediately necessary and your doctor will send you to physical therapy instead.

Diagnosis: A physical therapist will ask you for a detailed history of your knee pain. Then, with a thorough evaluation of your hips, knees, ankles, feet, core, and running form, the cause of your knee pain will be confirmed as patellofemoral pain vs. other knee injuries. Your PT will also analyze the movements of your trunk, hips, knees, and ankles to see how they are contributing to your pain.

Causes of patella mal-tracking: Muscle imbalances (tightness and weakness in the muscles that control the hip, knee, and ankle) cause the soft tissues around the patella to get irritated with repeated motions. This leads to mal-tracking of the patella. Excessive wear and tear of the patella will cause the cartilage to break down, leading to pain. Muscle imbalances are caused by inadequate stretching, repeated vigorous activity using muscles that are not conditioned, improper running form (which can also be caused by foot abnormalities such as flat feet), and/or improper footwear.

Treatment with Physical Therapy

Joint mobilizations: your PT will perform specific hands-on techniques to mobilize any joints that are stiff or improperly aligned, which are affecting your body mechanics during movements.

Exercises: A stretching and strengthening program will be designed specifically to meet your body’s needs based on the findings from your evaluation. You will learn how to stretch the muscles that are tight and how to strengthen the weak muscle groups, which are contributing to your painful runs.
Pain management: modalities, such as ice, may be applied to sore areas in order to alleviate pain.

Injury Prevention

• General conditioning - Keep all major muscle groups surrounding your hips, knees, and ankles in good condition through regular strengthening exercises 2-3x/week. Don’t forget to keep your core strong too because that is the foundation of your body.
• Warm up - Before running, walk briskly for 3-5 minutes.
• Increase miles gradually - Avoid sudden increase in the duration and intensity of your running.
• Proper footwear - Run in shoes that are right for YOUR foot type, not any sneaker that sounds promising in TV commercials.
• Use proper running form - Ask your P.T. to assess your running form to correct any improper movements in the trunk and legs that can lead to injury and pain.
• Stretch - After your run, spend at least 10 minutes performing a stretching routine for every muscle group that has just been used.

 P.T. is extremely successful in treating this problem. However, prevention is the best way to have a healthy, fun, and active lifestyle this summer, so before you start a new activity, consult a physical therapist so you won’t have to come face to face with pain.

Helen Nam, DPT

IT'S NEVER TOO LATE TO START!

It seems like just yesterday we were watching the ball drop as we toasted to the fresh start of a New Year. As we speed thru the first hundred days of 2012, many of us have forgotten the resolutions and promises we made to ourselves. We had all sorts of plans, goals and aspirations that we wanted to attain. Then somewhere along the way, we lose heart, as the hustle and bustle of everyday life gets in the way. Some of us have even given up all together on the things we wanted to accomplish. Feeling that it is too late to start now or settling back into old habits is not uncommon. But whether your resolve was to quit smoking, lose weight or to save more this year, it's NOT too late to pick up right where you left off.

Here are some useful tips to help you finish what you started:

1. Be realistic! Set a specific achievable goal that allows you to plan out exactly how you can accomplish it. Instead of saying "I want to lose weight" say, "I want to lose 10 pounds."

2. Don't take on more than you can handle! Pick just one goal to focus all your energy on and make tiny steps towards reaching it.

3. Teamwork makes the dream work! Find someone with a similar goal that you can work with to achieve your goal together. Using the buddy system helps to keep you motivated.

4. Tell other people! Discuss your objectives with trust worthy family and friends so that they can support you through the process.

5. Eliminate people, places or things that encourage old behavior! Your environment can make you or break you. So keep motivated by being around others who will encourage you, not hinder you.

6. Stick it through! Be patient with yourself. Keep in mind that change is a process, so don't give up prematurely. Remember that life is a marathon not a sprint!

Kieffer Pearce
Director of PR & Marketing
Duffy & Bracken, PT