Exercises For Knee Pain

Exercises For Knee Pain

by | Sep 25, 2024 | Healthcare

What are some exercises we can do for knee pain? First, we have to get to the root of the problem. Where is the pain located? Is it in the front of the knee, the back of the knee, the inside, the outside? 

We should then ask if the pain came on acutely or came on gradually. Was there any incident that caused the pain? For example, did you have any trauma where you fell on it, twisted it, heard a pop etc. If this is the case and it’s less than 10 days from the injury, we should be cautious in our approach and probably prioritize rest and low level exercises or movement. Conversely, if the pain came on gradually with no obvious cause, we should determine if you’re fairly sedentary or active. Sedentary individuals most likely have pain due to lack of movement or they were exposed to more stress than usual and should probably begin a training regiment of some sorts. Active individuals are more likely prone to an overuse injury or mechanical problem.

As you can see, coming up with the right formula and exercises for knee pain can vary greatly based off of your activity level, the acuteness of the injury, and if there was any trauma. But let’s assume that your injury has been there for a few weeks, your knee pain has either stayed the same for a while or has only mildly improved. It’s probably time for you to start moving and trying something. Disclaimer: the process and exercises below are just a guide, please book an in person or a virtual appointment with us for a more specific plan to reduce the probability and likelihood for aggravating an injury.

Exercise Progression:

Please perform these exercises IN ORDER. Each exercise progression is designed to either increase positional intensity or load to different structures around the knee. If the exercise feels completely pain free, please move on to the next exercise. If something hurts but improves the more you do, please continue to move forward. If something hurts a lot, or gets worse as you do them more then please stop and try training the exercises below the level that hurt for 3-4 days and then try again. For example, if #1-4 all feel fine, progress to #5. If #5 hurts a little but then feels better the more you do them, continue to move on to #6. If you have pain at #5 that doesn’t improve or gets worse, STOP here and practice #’s 1-4 for a few days before retrying to see if #5 now feels better.

  1. Walking 
  2. Glute bridges (2 legs) 
  3. Single leg glute bridges 
  4. Half Squat
  5. Full Range of Motion Bodyweight Squat
  6. Loaded Squat
  7. Lunge
  8. Lateral Lunge
  9. Loaded Lunge
  10. Loaded Lateral Lunge
  11. Two Footed Jump
  12. Single Leg Jump
  13. Jog
  14. Sprint

Follow the directions above explicitly. If you find yourself stuck at a certain level for greater than a week or it is only bothering with very specific positions, please schedule an appointment with us.

For video instructions for the above exercises, please see the YouTube channel here.

Training With Pain or Injury: Prevention vs Response

Training With Pain or Injury: Prevention vs Response

by | Sep 17, 2024 | Healthcare, Training

How do we go about training with pain or injury? We often over-complicate the process. There are only two things we can control in our body:

1. How well we prepare

2. How well we respond

If we look at diet as an example, we prepare the best we can by eating nutrient dense, well rounded, healthy meals. Most people know that we have a better chance for a healthy body the more regularly we prepare with healthy eating. When we have GI distress or heartburn or inflammation, we then need to make the necessary response by making certain accommodations (ie eliminating fatty, fried, processed foods if we get heartburn, taking some medicine). 

With regards to injury, all we can do is prepare our body as best we can and, when a tissue fails (pain or a tear), shift our focus to recovery. TRAINING IS THE SOLUTION FOR BOTH. The better you prepare your body with strength training, joint mobility, cardiovascular health etc, the better prepared you are to avoid pain and injury. When we have pain or injury, we respond with an adjustment in our training, but rarely remove training altogether. We may lighten the weight, we may move through a partial range of motion instead of a full range, we may reduce the reps or sets. Rarely is absolute rest the correct response. Modification is typically much better for healing. Even acute or traumatic injuries need input and load (lower levels) in order to heal effectively.

We often spend too much time focusing on things outside of what we can actually control. Things like:

Our anatomy is at fault – “I have flat arches”, “I have one leg longer than the other”, “I have a back that is out of alignment”

Or

Our posture is at fault – “My head is too far forward”, “My back is too flat or too rounded”, “I sit the wrong way or I sleep the wrong way”

We have the power to make things move better and the power to make them stronger or more resilient. But we can’t change our anatomy (without surgery) and we can’t really make permanent changes to our posture, nor do we have to (I’ll post more on this later because I  know this is a big and controversial topic). Spend more time preparing your body to move better and get stronger. Ultimately, those are the only things we can actually control day in and day out that can directly impact our likelihood for injury and our daily experience. Focus less of your attention on the flaws that we can’t change. It’s unproductive and inefficient. Create the best version of yourself in spite of the flaws you have. Don’t worry about what you cannot change. Life and pain alike become much simpler when we accept the fact that everyone has pain, and the best way to treat it is to prevent it as best as you can through good quality training. Let us help you to establish a healthy preventative program that will help you to move better and get stronger, the things you can actually change in your body. 

Plantar Fasciitis Physical Therapy. What Can We Do?

Plantar Fasciitis Physical Therapy. What Can We Do?

by | Sep 4, 2024 | Healthcare

Millions of people suffer from plantar fasciitis each year. About 1 in 10 people will be affected in their lifetime. It is one of the toughest injuries we treat as physical therapists. It tends to be extremely painful, become exacerbated quite easily, and last for many months. It also has a high recurrence rate, meaning after it’s gotten better, it’s more prone to coming back again. 

What is plantar fasciitis? It is an inflammation of the plantar fascia in the bottom of the foot. The plantar fascia is a thick band of connective tissue that attaches from the heel (calcaneus) to the midfoot (metatarsals). The significance of this hard connective tissue is that it has a strong role in shock absorption in the bottom of the foot, especially during running and jumping. It is also responsible for maintaining the arch in our foot during the loading phase of standing, walking or running. Because of its role in absorbing forces through the foot, athletes and runners can be susceptible to overuse or trauma that can irritate it.

But like many injuries, they can be more complicated than a simple inflammatory response that typically gets better with rest, ice and a deloading period. What else can cause foot pain? Some other potential foot related pain could be: bone spurs, loose body (floating piece of cartilage), neuropathy, sciatica (or other nerve related referred pain from the low back or leg), bone bruise, growth related issues (like Sever’s disease) and many others.

So what can we do about it? Do we have options for plantar fasciitis physical therapy? The answer is yes, we can treat it. But it’s important to note that there are many different possible sources of the pain and therefore treatment options may be ineffective or even worsen symptoms. Common treatment options include stretching of the ankle, foot, calf and big toe, lacrosse ball or golf ball rolling the bottom of the feet, icing, resting, and potentially orthotics. Combined, these can be very effective tools. The one I would advise NOT to do early on in a truly inflammatory condition is to beat it up with a lacrosse ball or golf ball. I’ve never understood the logic here and it rarely helps. When something is irritated, we shouldn’t be beating it up while also trying to rest it. It’s counterintuitive. But stretching, icing, and deloading are really good first steps.

In addition to some gentle stretching, icing, and deloading, I like to institute a heel lift into the shoe. This is temporary in order to help us unload stress to the bottom of the feet. What else can we do when these things don’t help? The next steps would involve increasing the load tolerance of the plantar fascia through a progressive loading program. Make the foot stronger over time with gradual introduction of more and more stress. Simultaneously, we should be looking up the chain for other possible sources of this pain. We can look at the low back, the pelvis, the hips, the lower leg etc for other possible causes of referred pain that often get missed or undiagnosed. Lastly, if continuing to struggle, we should seek out an orthopedist for imaging to rule out a more serious pathology.

Plantar Fasciitis is a very difficult injury to treat. Begin with conservative measures for a few weeks (rest, ice, heel lift, gentle stretching). If not getting better, begin a progressive strengthening program and also look for other potential sources of referred pain besides assuming the plantar fascia is the issue. Lastly, seek medical help to rule out more serious problems.

Check out our physical therapy services and let us help!

References:

Trojian, T., & Tucker, A. (n.d.). Plantar Fasciitis. AAFP. https://www.aafp.org/pubs/afp/issues/2019/0615/p744.html#:~:text=Plantar%20fasciitis%20is%20a%20common,the%20condition%20is%20not%20inflammatory.

What Makes Up Good Workout Routines?

What Makes Up Good Workout Routines?

by | Aug 27, 2024 | Training

Good workout routines are difficult to find and, ideally, are individualized and structured based on your injury and medical history, your experience levels, and your goals for training. There is never a “one size fits all” approach, and for good reason.  As a society, we love fads. Clothing, haircuts, music and…exercise. 

Over the years, we’ve seen many transitions in the fitness worlds: from calisthenics to weightlifting to crossfit to soulcycle to barry’s to orangetheory. Some may call it an “evolution” of fitness. But in reality, they are really just making a corporate structure for what people want out of exercise. They are a place to socialize, to create a community environment around getting healthier and a place to hold you accountable. This communal training helps many people to stay structured, to stay consistent, and to stay goal driven.

But what they don’t do well is cater to you as an individual. And there’s nothing wrong with that if you’re just looking to get healthy and you want to find a group of like minded individuals to support you on your journey. The instructors are intentionally going to design programs that incorporate a generalist approach. A bell curve strategy. Appeal to the middle of the pack where 60-70% of people will get what they need. But that leaves a big percent of the training groups either training above or below the necessary training stimulus for results. The ones at the bottom are at risk for injury from training above their current level, and the ones above are probably investing more time and energy into a system that isn’t going to yield much in the ways of progress.

We’ve established that ideally, a good workout routine should be individualized. But in general, there are certain factors that should be fundamental for nearly all workout routines. Exceptions to this might be injury limitations or a specialist athlete training for a very specific goal. Strength is mandatory. The approach by which strength is gained can vary, but strength is paramount to any good program. Tissues need to be strong for performance, injury prevention, and durability. Endurance should also be included. Being able to handle activity for longer durations and to reduce fatigue is an important thing to incorporate into any good training program. Mobility is also very important. We should be incorporating movements that are large ranges of motions and spend extra attention on deficits and limiting factors. We should also have elements of speed work, power work, control work and some cross-training.

Because a good workout routine should at least touch on most of these factors, you can see why an individualized program is so important. Having trouble building a workout routine for you? Let us build a program for you to help improve or begin your fitness journey (link)

References:

https://www.healthline.com/health/fitness-exercise/calisthenics#:~:text=Calisthenics%20are%20exercises%20that%20rely,levels%20of%20intensity%20and%20rhythm.

https://www.britannica.com/sports/weightlifting

https://www.crossfit.com

https://www.soul-cycle.com

https://barrys.com

https://www.orangetheory.com/en-us?utm_medium=sem&utm_source=gg&utm_term=tombras&utm_campaign=10199120119–FreeClass–NationalPromotion–Orangetheory-PPC-Brand&utm_content=:&gad_source=1&gclid=CjwKCAjw8rW2BhAgEiwAoRO5rAJTmMljjTStCu4lUZM5KWJ56vR99BAp0telPB4nwDIoRvmY9gWH8xoCpAoQAvD_BwE

Is Perfect Form Really Possible? And Does It Matter?

Is Perfect Form Really Possible? And Does It Matter?

by | Jul 15, 2024 | Training

Perfect form does not exist. We get so obsessed with the idea that we know the “right” and “wrong” way to do things.

We need guidance, structure and a general framework for movement in the novice populations, but at the end of the day, some of the greatest to ever do these movements have strayed from what was “correct”. We see innovation and creativity in competition in all realms of movement. They didn’t get there by following a structured methodology for how to do it.

Our bodies know far more about the most efficient way to perform a movement pattern than any device or coach can tell us. We all have different anatomies and body types. The only thing that matters is repetition and hard work. We all move differently and if we have aspirations of being elite at any one thing, then the things that make us unique should be promoted.

Examples:

*Basketball – Dame Lillard talked this week about his unique shot release, Rick Barry shot underhanded free throws

*Baseball – Ichiro and Pujols are hall of famers and had unique swings…look at any sidearm or knuckleball pitcher

*Boxing – Muhammad Ali and Roy Jones Jr had uncharacteristic fight styles

*Golf – Jim Furyk or Matthew Wolff’s swing would never be taught anywhere in a golf clinic

*MMA might be one of the best examples because we see different fight styles compete against each other to determine who is the best (and there is none!) – there are Judo champions, Karate champions, Wrestling champions, Boxing champions, Kickboxing champions, Jiu Jitsu champions…

*Strong man competitors, the pinnacle for strength athletes, often have very “poor” technique when lifting heavy objects because the strategy or the shape of the object demands it

There are competitors of every type of movement that excel. Every athlete should begin with a general framework, and every athlete should always be looking to improve. But we as coaches spend too much time trying to make our athletes fit what’s “right” or “wrong” instead of embracing and encouraging the idea that we all move differently