How Important Is Physical Therapy To Stroke Patient Rehabilitation

evaluate the movement of the stroke patient and create a personalized plan to help them regain strength

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evaluate the movement of the stroke patient and create a personalized plan to help them regain strength

Key Points

Stroke Rehabilitation

Over 800,000 people in the United States experience a Stroke. A Stroke is a brain injury that can lead to long-term disability. Almost all stroke survivors will need some form of physical or other therapy.

 The role of the Physical Therapist is to evaluate the movement of the stroke patient and create a personalized plan to help them regain strength, coordination, balance, and control of their movement. Physical Therapists can also communicate with the patient’s doctor to refer them to other therapies (Occupational & Speech Therapy) to also help with their rehabilitation goals. ARSO offers both Physical and Occupational therapy in our outpatient clinics. We contain all the up-to-date and high-tech equipment used to help with stroke rehabilitation.

A Stroke Can Cause:

Benefits Of Physical Therapy For People With Stroke

Stroke Rehabilitation

A physical Therapist helps motivate and encourage stroke patients throughout their recovery process. Physical Therapists are experts at movement who improve patients’ quality of life through hands-on care, patient education, and prescribed movement.

If you are interested or have any questions about the equipment we use CONTACT US at (301)-588-3929 or email arso@arso-rehab.com

We would love to help you get back to your ideal life

WHAT IS AQUATIC THERAPY

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HydroWorxs Pool

Key Points

Aquatic Therapy

Water can make doing exercises and movements easier and less painful. The use of water activities removes excessive forces on joints and allows your body to transition to land-based rehabilitation. ARSO currently has one Hydroworx pool shown in the photo at our Lanham location. At this location for aquatic therapy, you will receive a physical therapy plan tailored to your health concerns. 

Exercise performed in water can bring relief to patients who suffer from neuromuscular or musculoskeletal disorders. Water makes aquatic therapy much different from land therapy as patients can use water for resistance in place of gravity or weights.

Deciding to do Aquatic Therapy

  • Aquatic Therapy is unique it allows patient to benefit from less pressure on joints, reduced inflammation, and it’s a safe environment to improve balance and strength.
  • Aquatic therapy is also a great option for those who are unable to exercise on land.
  • Aquatic therapy is a complementary solution to help improve  strength and endurance to recover or improve from the conditions below

If you are interested or have any questions about the equipment we use CONTACT US at (301)-588-3929 or email arso@arso-rehab.com

We would love to help you get back to your ideal life

ARSO REHAB IS THE BEST CLINIC FOR AQUATIC THERAPY

Physical Therapy Isn’t Just For Pain

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Key Points

Physical Therapy Isn’t Just For Pain. It Can Keep You Healthy For Life.

You know that physical activity is good for you. The benefits are well researched and the list is

impressive. Here’s just a sampling:

● Releases endorphins to make you feel good and fight depression

● Helps control weight

● Prevents diseases like stroke, diabetes and some forms of cancer

● Improves sleep

● Helps you live longer

Recent studies even show that physical activity strengthens your immune system, with a

protective effect against COVID, and that staying active through middle age protects your brain

as you age.

Physical activity is a wonder drug. If it was a pill, you’d buy it and take it every day. But even

though activity is free, less than 25% of Americans meet the CDC recommendations for activity.

We clearly need help.

Physical Therapists Are The Experts in Human Movement

To be active, you need to be able to move. Physical Therapists do more than help you recover

from surgeries or major injuries. They are the experts in human movement. Sure, you could see

a strength coach to lift weights, hire a personal trainer, go to a yoga class to work on your

flexibility and balance, and see a chiropractor for adjustments. But that seems like a lot of

people when a PT can help you with all of these things and more. Nobody knows more about

human movement or looks at your health the same way a PT does. Your PT can help you

with every aspect of movement including strength, range of motion, flexibility, endurance,

balance and coordination.

As medical professionals they can help you with injuries or other issues. Your PT can work with

your doctor to help use activity to manage things like diabetes, cholesterol levels or blood

pressure instead of prescriptions. Your PT is also trained to work with people of all ages, so you

can develop a long-term relationship and they can continue to adjust and modify your routine as

you age or your goals change.

The #1 Thing You Can Do To Improve Your Physical Therapy Experience

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Key Points

The No. 1 Thing You Can Do to Improve Your Physical Therapy Experience Dealing with the pain and limited mobility associated with an injury or illness can be stressful for so many reasons. You might have questions like, “How long will I be sidelined?” and “What do I need to do to get better?” Or maybe you’re worried about how you’ll pick your children up from school, walk to the train for your commute or prepare meals for your family. 

These are all perfectly normal concerns. Luckily, there are some ways that you can gain control over the situation and ensure that you return to the activities you care most about—especially if physical therapy is part of your plan. 

What you can do before your very first appointment—and during physical therapy—to take control of that injury-related stress? First and foremost, it’s important to come prepared for physical therapy. And no, I’m not talking about dressing appropriately and arriving on time (or even better, 15 minutes ahead of your scheduled appointment). That stuff is important, of course, but there’s one thing you can do in the days leading up to your appointment that will set you up for success.

 Any guesses? I’m talking about starting a list. What kind of list? Well, every time that you feel pain in the affected area or notice an activity that is harder than it was pre-injury, add it to the list! And the more specific you are, the better. Here’s an example to help drive this point home: Let’s say that you’re recovering from a moderate meniscus tear and you have an appointment with your physical therapist in three days. Take notes on how your knee feels first thing in the morning after you’ve been off your feet. How does your knee react when you stand up from a chair—does it feel unstable? Or do you find that you need to clutch the back of the couch on your way to the bathroom? Sharing each of these details helps your physical therapist understand your limitations beyond the injury printed on your intake form.

 Now let’s take that list a step farther and add some details about the activities that you typically participate in on a regular basis. Let’s say that you normally play a weekly round of golf, spend your mornings weeding your garden or meet up with friends for a four-mile walk two evenings a week. These activities have become an important part of your life so let’s make sure that they’re factored into your list, perhaps in the “what you hope to get out of physical therapy” category. Painting a clear picture of how active you are—and what types of activities and sports you participate in—can help your physical therapist design an individualized treatment plan and to better help you on your road to recovery.

Physical Therapy Guide to Multiple Sclerosis

Physical Therapy Guide to Multiple Sclerosis

Multiple sclerosis is a disease that impacts the brain and spinal cord which make up the central nervous system and controls everything we do. The exact cause of MS is unknown, but we do know that something triggers the immune system to attack the brain and spinal cord. The resulting damage to myelin, the protective layer insulating wire-like nerve fibers, disrupts signals to and from the brain. This interruption of communication signals causes unpredictable symptoms such as numbness, tingling, mood changes, memory problems, pain, fatigue, blindness and/or paralysis. Everyone’s experience with MS is different and these losses may be temporary or long lasting.

Signs and Symptoms

MS leads to multiple signs and symptoms that may include:

Fatigue that does not go away with rest.

Difficulty walking and problems with balance.

Stiffness and spasms or a feeling of heaviness in your legs or arms.

Bladder and/or bowel problems, such as urgency or leaking.

Sexual dysfunction, such as less sensation, dryness, less desire, and trouble reaching orgasm.

Memory and thinking problems.

Pain and other unpleasant sensations.

Emotional or mood problems, including depression and apathy.

Vision problems, such as control of eye movements, seeing double, and blurry vision.

Dizziness or vertigo.

Speech and swallowing problems.

How Is It Diagnosed?

At this time, there are no symptoms, physical findings or laboratory tests that can, by themselves, determine if you have MS. Several strategies are used to determine if you meet the long-established criteria for a diagnosis of MS, and to rule out other possible causes of whatever symptoms you are experiencing. These strategies include a careful medical history, a neurologic exam and various tests including magnetic resonance imaging (MRI), spinal fluid analysis, and blood tests to rule out other conditions.

How Can a Physical Therapist Help?

Physical therapy for people with MS focuses on helping them return to the roles performed at home, work, and in the community. Your first physical therapy visit will consist of a complete examination to determine your impairments (ie, weakness, pain, loss of sensation, balance, or coordination), activity limitations (ie, daily activities that you are having difficulty with, such as walking, dressing, or getting into your vehicle), and participation restrictions (ie, an alteration to your normal activities, such as difficulty completing work and household tasks, caring for yourself or your family, or performing recreational and/or social activities). Following the examination, your physical therapist will develop a specific exercise program for you based on your condition and goals, including a home-exercise program and education on community-based exercise options.

Research studies have found that people in the early stages of MS may experience changes in their walking ability, balance, and breathing. If ignored, these early signs can lead to further disability. When someone receives a diagnosis of MS, the best option is to begin physical therapy right away to help improve any mild challenges, and possibly slow down the progression of the symptoms of the disease.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat multiple sclerosis. However, MS is a unique condition and you may want to consider:

A physical therapist who is experienced in treating people with neurological conditions, specifically multiple sclerosis.

A physical therapist who is a board-certified clinical specialist or who has completed a residency or fellowship in neurologic physical therapy and uses the designation NCS. This physical therapist has advanced knowledge, experience, and skills that may apply to this condition.

The Physical Therapist’s Guide to Plyometric Exercises

Plyometric exercises are a series of drills that utilize explosive forces in functional or sport specific patterns that help you develop strength, power, and coordination. This type of exercise challenges demands of the stretch shortening cycle, which involves an eccentric contraction of a muscle followed by an immediate concentric contraction of that same muscle. The stretch shortening cycle is significantly hindered following injury and/or surgery, as muscles lack the ability to attenuate eccentric loading and preserve the energy needed to complete powerful movements in series.

In physical therapy the stretch shortening cycle and eccentric control is typically evaluated through the single hop test, triple hop test, crossover hop test and 6 meter timed hop test. It is recommended that an individual has to score >90% on the tests to have a reduced risk of reinjury when they return to their sport. These tests are most often used after rehab following ACL reconstruction. Although these tests are commonly used in PT, patients are often discharged after achieving >90% on these tests and acquire another injury shortly after their return to sport. This is a common occurrence because patients are trained to pass these return to sport tests and measures; however, the patient is truly not trained to return to their specific sport.

With the concepts of the stretch shortening cycle explained above it is essential to challenge a patient maximally through the stretch shortening cycle in order to ensure that a patient can appropriately absorb and produce the forces needed to compete in their sport without reinjury. It is also important to assess the psychological readiness and fear avoidance for a patient to return to sport. This can be easily evaluated by giving patients the Injury-Psychological Readiness to Return to Sport Scale (I-PRRS) and evaluating the progression of this questionnaire throughout the plan of care. Below are exercise examples to challenge the patient maximally throughout the stretch shortening cycle.

Written by Arsalan Nejad, SPT

5 Tips to help stay healthy this Winter Season

Staying healthy is likely at the top of your list almost every winter. But this year, in the midst of a pandemic, it may be even more of a concern than usual. You might wonder: should you be taking special supplements to boost your immune system, or investing in cleaning devices to zap germs?
While the viral threats may be different from usual this year, the truth is that you should still be using many of the same strategies that you use in a typical year. Below are five of his top tips that can help you keep yourself and your loved ones safe.

Clean your hands

Practicing good hand hygiene. Washing with simple soap and water, and using an alcohol-based hand sanitizer when soap and water aren’t available, can help keep you from transporting germs from an infected surface to your eyes, nose, or mouth. Also, be sure to follow local and state recommendations, which may include additional strategies such as wearing a mask and avoiding large gatherings, particularly indoors.

Eat healthy and exercise

Prime your immune system to effectively fight disease by keeping your body healthy. Follow a nutrient-rich diet that includes lots of fruits, vegetables, and whole grains. Also, exercise regularly, and get enough sleep. “Being in good health helps us to resist infectious diseases.

Don’t skip doctor visits

Some people may fear getting exposed to illness, so they decide
to avoid routine screenings and doctor’s appointments. But they may be putting themselves at higher risk by doing so.
“Doctors’ offices are now equipped for routine visits in a coordinated and safe manner.” Whether you show up in person or visit via video, it’s important to check in periodically with your doctor. Screenings are important for maintaining overall health and catching potential problems early, when they are most treatable.

Get vaccinated

Vaccinations aren’t only for kids; they’re a proven means of boosting your immune system to
protect against certain viruses and other infectious agents. Although COVID-19 has taken center
stage recently, don’t forget about traditional threats, such as the flu. Getting your annual flu shot
is essential this year. Adults should also make certain that they are up to date on their tetanus shot,
which should be given every 10 years, and consider getting the newer shingles vaccine, called
Shingrix, which is recommended to everyone over age 50. It’s designed to prevent the virus that causes
chickenpox (which remains in the body even after the infection has cleared) from reactivating and
causing the painful shingles rash and other symptoms.
Adults over age 65 may also want to consider the pneumococcal vaccine to protect against a type of pneumonia unrelated to COVID-19. And stay tuned for news about about the vaccine that could protect against COVID-19.

Be skeptical

A host of products on the market claim to protect you from germs — “self-cleaning” surfaces, ultraviolet (UV) lights, and even substances you’re supposed to ingest, says Starnbach. Many of these items have some scientific basis, but it’s often a big leap from that basic science to the final product, he says. For example, one type of “self-cleaning” surface claims to use crystals to kill germs. While those crystals might indeed kill germs in a laboratory, it’s not at all clear that they work the same way to kill germs in a real-life setting, says Starnbach. So, there is much room for skepticism.

The same is true for UV lights. UV light at certain wavelengths definitely has the ability to kill bacteria and viruses; however, those specific wavelengths are also dangerous to human eyes and skin. Plus, in order to work, the light has to come into contact with the virus. Most viruses you pick up in the environment are contained in droplets of mucus, he says. UV light typically can’t penetrate the mucus, which means it can’t deactivate the virus. Even something as simple as dirt can cast shadows that keep the light from reaching its target. Fogging devices run into the same problem. They can really disinfect only if the surface is cleaned first. Ultimately, the best way to keep your environment germ-free is to wipe surfaces clean and then disinfect to deactivate any virus. You don’t need any special devices, just a rag and some generic cleaning products

How to prevent “tech neck” pain while working from home.

By: Dr. Ariel Ross, PT, DPT, E-RYT 200, YACEP and Kevin Chavez, PTA

COVID 19 has definitely changed everyone’s ideals of work life balance. As a society we are sitting now more than ever. Neck pain is a common condition that can occur due to a sedentary lifestyle. At ARSO, we see many of our patients coming in with neck pain due to poor ergonomic and biomechanical set-ups at their desks. In this blog, we’ll talk about some ways to prevent neck pain during the pandemic and what to do if you have an episode of neck pain.

So what is neck pain and what causes it?

Neck pain can be dull, achy, sharp, or boring pain that is in the muscles at the top of where the head and neck meet and can go all the way into your shoulders.

How can physical therapy help?

A physical therapist is an expert in ergonomics and movement. They can help you with your desk setup, help identify muscle weakness that may be causing your pain, give you exercises to improve your range of motion and posture, apply modalities to help break the acute pain cycle, and use manual therapy techniques to address any restrictions in your joints.

How should you set up your desk to prevent neck pain?

What to do if you have neck pain?

  • Do not panic. Pain does not necessarily mean that something is structurally wrong or “out of place”.
  • Please give us a call to schedule an appointment. We are currently offering both in-person and telehealth appointments. Maryland is a Direct Access state, so a physician’s referral is not necessary for an initial evaluation.
  • Seek immediate emergency care:
    • If your neck pain is 10/10 with pain into your arms
    • If you hit your head
    • If you have neck pain and dizziness, lightheadedness, double vision, trouble swallowing, nausea, or episodes of fainting.
    • If you have neck and sudden clumsiness in your feet

Physical Therapy for Chronic Pain

It is estimated that about 100 million people in America are living with chronic pain. Chronic pain can interfere with your day-to-day work and recreational activities, and it may have a profound effect on your ability to concentrate, relax, and enjoy life.

There are a multitude of treatments available for chronic pain: medication, massage, exercise, acupuncture, and a host of other treatments. Physical Therapy (PT) for chronic pain is also an option, and it may help you manage your pain and regain your normal mobility.

If
you have chronic pain, working with a physical therapist can help your pain go
away, and your therapist can give you strategies to keep the pain away. So,
what does physical therapy for chronic pain look and feel like, and what can
you expect from PT for chronic pain?

What Is Chronic Pain?

The simple definition of chronic pain is pain that has been
present for greater than 12 weeks.

However, it can be more complex than that, and the best way to understand chronic pain is to learn about its cousin: acute pain. Acute pain is pain that comes on suddenly and lasts for a few weeks. Typically, acute pain is caused by some traumatic event that injures your body’s tissues.

If you smash your thumb with a hammer, for instance, this causes
acute pain. The pain is sudden and severe, and you can easily discern the cause
of it. Your thumb becomes red, swollen, and painful. Over the course of a few
weeks, however, the pain goes away as your thumb heals.

Now imagine that you smash your thumb with a hammer again. Your
thumb becomes red, swollen, and painful. This time imagine your thumb pain
continues long after the signs of injury have gone away. The tissues are
clearly healed, but your thumb still hurts. When you try to move your hand, the
pain increases. This is chronic pain.

Chronic pain can be confusing, and it can prevent you from
moving normally and concentrating on your daily activities. Plus, dealing with
chronic pain can leave you and your doctor perplexed.

Often, pain occurs when there is little or no tissue damage. Why
is the pain lasting long after the tissues are healed? Why are medicines not effective
in treating your pain? Is there something really wrong? These questions may be
difficult to answer and finding the best treatment for your chronic pain may be
equally difficult.

Treatments Types

There are many different treatments available for chronic pain.
Finding the best one for you can take a little trial and error.

  • Physical therapy (PT)
  • Medication (oral or injected)
  • Supplements and natural remedies
  • Chiropractic care
  • Massage
  • Acupuncture
  • Exercise
  • Meditation
  • Cognitive behavioral therapy (CBT)

There are likely more items to add to this list, and you may
find one remedy helpful while another may not be effective for your pain at
all. Physical therapy may be an option to treat your chronic pain and working
with a physical therapist has been shown to help chronic pain sufferers improve
their function while decreasing or eliminating their pain.

What to Expect

When attending physical therapy for chronic pain, your first
session will be an initial evaluation. During this session, you will meet your
physical therapist and discuss your condition.

Your therapist should ask questions about your pain and how it
behaves. Is your pain present constantly or intermittently, and how does it
affect your life? What makes it better or worse? Your physical therapist should
also ask about any previous treatments you have received and the effect those
treatments have had.

He/she might do a review of your overall medical history and
will perform various tests and measures to get a sense of any impairments that
may be contributing to your pain, including:

  • Range of motion
  • Posture
  • Strength
  • Balance
  • Endurance

Some of these tests may increase your pain, while others may
cause your pain to decrease. Be sure to communicate with your physical therapist
how you are feeling and how sensations are changing during your evaluation.

Once your PT evaluation is complete, your physical therapist should work with you to develop realistic and attainable goals for therapy. Goals may include pain relief, extended range of motion, increased strength and improved functional mobility. Your goals should be personal and should give you a road map to follow during your rehabilitation program. Finally, your treatment can begin.

PT Treatments

When you attend physical therapy for chronic pain, you may
experience various treatments that may be used to decrease pain, improve your
mobility, and help you fully function. Common treatments used by physical therapists
for chronic pain patients include:

  • Exercise: Exercise should be your main PT tool in the treatment of
    chronic pain because it can help your body improve strength and mobility. Think
    of exercise as a feedback loop. Your brain moves your body, so exercise is
    output coming from your brain. When you can move with little or no pain, you
    are reinforcing to your brain that the movement is not going to hurt. This
    positive feedback allows you to move more with less pain. So while you are
    getting stronger and improving mobility, you are also training your sensitive
    nervous system to trust that the movement is safe.
  • Ultrasound:
    Ultrasound is a deep heating modality that you may encounter while in PT. It is
    applied to your skin and as your body’s tissues are heated, it is thought that
    this improves circulation and blood flow. It is important to note that
    ultrasound has not been proven to be an effective treatment for chronic pain.
    Still, you may encounter this treatment during your PT sessions.
  • TENS and
    Electrical Stimulation
    :
    Transcutaneous electrical nerve stimulation (TENS) is a
    therapeutic modality that uses electricity to decrease pain signals coming from
    your body to your brain.
  • Massage:
    Some physical therapists employ massage
    techniques to decrease pain by improving muscular blood flow and relieving
    tightness.
  • Dry
    Needling:
    Dry needling is a
    newer treatment employed by some physical therapists to decrease painful muscle
    knots and trigger
    points
    . This treatment involves using
    small needles (such as acupuncture needles) to pierce muscle tissue and knots,
    relieving the pain in these spots.
  • Heat
    or Ice:
    Modalities like heat
    and ice are often used by PTs to help decrease pain and inflammation. These
    treatments have not been proven to be effective with patients dealing with
    chronic pain, but they are often used as adjunct treatments during your PT
    sessions.
  • Pain
    Neuroscience Education (PNE):

    New research indicates that teaching patients about their pain and why it is
    happening can have a positive effect on their rehab. Your physical therapist
    may spend time teaching you about why you have pain, how your pain might
    behave, and things you can do to take control of your pain.

Each of these treatments is designed to achieve a specific goal.
It is important that you discuss with your physical therapist the intent of the
treatment, so you know what to expect.

Finding What Works

Some Treatments Not Proven Effective

Some PT treatments for chronic pain are based on theoretical
models and have not been proven to be effective for pain. Does this mean that
they will not be effective for you? No. It simply means that in studies of
large groups of people with similar characteristics, some treatments have not
been proven to work. Understanding the research can help you make informed
decisions about your care.

Some treatments that may not be as effective for chronic pain
include ultrasound, TENS, or heat and ice.

A meta-analysis (study examining conclusions of many different studies)
concluded that ultrasound was not effective for chronic low back pain (LBP)
when compared to exercise alone or a placebo (fake treatment). The authors
concluded: “No high-quality evidence was found to support the use of
ultrasound for improving pain or quality of life in patients with non‐specific
chronic LBP.” Another meta-analysis of the use of massage for chronic pain
concluded that patients may report a 20 to 80 percent reduction in pain after a
massage, but that these reductions are temporary. Massage, however, may help
improve the mobility of tissues and feelings of well-being. Dry needling
studies show similar results, and both heat and ice are shown to give slight
short-term relief of pain.

Treatments Proven to Be Effective

Exercise has been proven to be effective for chronic pain. Pain
neuroscience education (PNE) or learning about pain and how it affects your
body, has also been shown to offer long-term benefits with pain reduction and
improved mobility.

Research published in the Archives of Physical Medicine
and Rehabilitation
showed that a graded walking program can have a
positive effect on patients with chronic pain. However, one important caveat of
the study was that adherence to an exercise and a walking program can be
difficult. Still, finding ways to maintain walking and exercising is important.
(Your PT can help with this.)

In addition, neuroscience pain expert Adriaan Louw has found
that learning about pain through pain neuroscience education (PNE) can improve
symptoms, mobility, and feelings of psychological well-being in people with
chronic pain.

Overall, passive treatments like heat, ice, or massage may feel
good. However, if you want to take control of your pain, more active treatments
like exercise and learning about your pain are recommended.

The most important thing to remember is that your pain is
personal. Your physical therapist can work with you to find specific things
that can help you move better and feel better.

If you have chronic pain, you may find that it is difficult to
function well. Managing your pain can be challenging, as there are many
different options for you, all with varying degrees of effectiveness. Physical
therapy, with a focus on exercise and pain neuroscience education, can be an
effective way to decrease your pain and improve your mobility.

Physical Therapist’s Guide to Knee Pain

Knee pain can be caused by disease or injury. Among American adults, approximately 25% have experienced knee pain affecting the function of the knee. The prevalence of knee pain has increased over the past 20 years, with osteoarthritis being the most common cause in individuals over the age of 50. Knee pain that is caused by injury is most often associated with knee cartilage tears. Knee injuries can occur as the result of a direct blow or sudden movement that strains the knee beyond its normal range of movement. Knee pain can cause difficulty performing activities such as walking, rising from a chair, climbing stairs, or playing sports. Physical therapists are specially trained to help diagnose and treat knee pain, and help individuals return to their normal activities without pain or limitation.

What is Knee Pain?

The knee joint is a hinge joint that connects the tibia (shin bone), and the femur (thigh bone) at the patella (kneecap). There are 4 main ligaments that support the knee joint. They are the anterior cruciate ligament (ACL); posterior cruciate ligament (PCL); medial collateral ligament (MCL); and lateral collateral ligament (LCL). There are also 2 rings of cartilage that act as shock absorbers in the knee, called the medial and lateral meniscus.

The most common cause of knee pain is osteoarthritis, a condition that occurs when the cartilage that protects the inside surfaces of the tibia and femur bones called articular cartilage gradually wears away, resulting in pain and swelling in the knee.

How Does it Feel?

Knee pain can occur suddenly for no apparent reason or develop slowly, as the result of repetitive trauma. Knee pain occurs in different parts of the knee, depending on what structures in the knee are involved. Below is a general breakdown of the areas in which knee pain may occur and the structures of the knee that may be involved:

  • Anterior knee pain, also referred to as patellofemoral pain, is pain around the kneecap (patella) in front of the knee, caused when the kneecap shifts out of position. This condition commonly affects younger females and may be due to overuse injury. Pain often occurs when performing activities like squats or stair-climbing.
  • Lateral knee pain is pain that occurs on the outside of the knee. It is a type of overuse injury that commonly occurs in runners when the tendon called the iliotibial band (ITB) becomes irritated. Pain is often felt when performing activities such as climbing stairs, or when walking or running.
  • Medial knee pain is pain that occurs along the inside of the knee when the MCL or the medial meniscus become irritated due to direct injury or overuse. Pain is felt when squatting, walking up or down an incline, or going downstairs.
  • Pain caused by a ligament tear may result from a direct blow to the knee, or when twisting or pivoting the knee while the foot is planted on the ground. Immediate pain and swelling usually occur, and the knee may feel unstable—like it will “give out”—when an individual attempt to put weight on the involved leg.
  • Pain caused by osteoarthritis may occur anywhere in the knee where cartilage has broken down. This type of knee pain may begin as mild and progressively worsen. It can become increasingly difficult to walk long distances, fully bend and straighten the knee, climb stairs, or squat to sit in a chair. The knee also may swell intermittently with increased activity. 

 

How Is It Diagnosed?

Your physical therapist will make a diagnosis based on your symptoms, medical history, and a thorough examination. Your physician may order an X-ray and magnetic resonance imaging (MRI) to complete the diagnosis.

Your physical therapist will perform an evaluation that will start with discussing your medical history and your symptoms. Your therapist will ask questions to determine where your pain is located, if you sustained any trauma or injury to the knee, and what functional daily activities are painful or difficult for you to perform. Your physical therapist will perform tests to find out if you have:

  • Limited range of motion in the knee.
  • Pain in the knee with certain movements.
  • Weakness in the muscles around your hip, knee, or ankle.
  • Limited flexibility in your hip, knee, or ankle.
  • Difficulty walking.
  • Difficulty performing activities, such as rising from a chair or climbing stairs.
  • Problems with your balance or coordination.
  • Difficulty controlling the knee during certain activities.
  • Difficulty performing specific sports activities (for athletes). 

 

How Can a Physical Therapist Help?

Based on the findings of your evaluation, your physical therapist will develop a customized rehabilitation program to ensure a safe return to your desired activities. Some general treatment techniques may include:

  • Pain management.  Your physical therapist may provide treatments using different “modalities” such as ice, heat, ultrasound, or electrical stimulation to help decrease pain and swelling.
  • Manual therapy.  Your therapist will apply manual (hands-on) therapy to gently guide movement of the knee area to restore joint and tissue mobility.
  • Therapeutic exercises. Your physical therapist will prescribe specific strengthening, flexibility, and endurance exercises to address your specific needs and goals.
  • Functional exercises. You will learn individualized exercises designed to help you return to your home, work, and sport activities. These also may include balance and coordination exercises.
  • Self-care instruction.  Your physical therapist will teach you ways to manage your pain at home and design a safe and effective home-exercise program based on your specific condition, which you can continue long after your formal physical therapy sessions have ended. You also will learn how to avoid placing unnecessary forces on the knee during your daily activities for years to come. 

 

How Can a Physical Therapist Help Before & After Surgery?

Your physical therapist, in consultation with your surgeon, will be able to tell you how much activity you can do depending on the type of knee surgery (such as total knee replacement) you undergo. Your therapist and surgeon also might have you participate in physical therapy prior to surgery to increase your strength and motion. This can sometimes help with recovery after surgery.

Following surgery, your physical therapist will design a personalized rehabilitation program for you and help you gain the strength, movement, and endurance you need to return to performing the daily activities you did before.

Can this Injury or Condition be Prevented?

To help reduce knee pain, it is important to maintain a healthy lifestyle, perform regular safe exercise, get adequate rest, and eat healthy foods. Weight management is important for maintaining healthy knee function, as increased body weight puts extra pressure on all the joints, including the knees. Ideally, individuals of all ages should regularly perform some form of flexibility, strength, and heart-conditioning exercises.

It also is important for athletes to perform appropriate warm-up exercises and stretches on a daily basis and before beginning physical activity.

CAUTION: If any exercise or activity provokes knee pain, seek professional help before the symptoms worsen. 

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat knee pain. However, you may want to consider:

  • A physical therapist who is experienced in treating people with knee pain. Some physical therapists have a practice with an orthopedic and sports medicine focus.
  • A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic, manual, or sports physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.

General tips when you’re looking for a physical therapist (or any other health care provider):

  • Get recommendations from family and friends or from other health care providers.
  • When you contact a physical therapy clinic for an appointment, ask about the physical therapists’ experience in helping people who have underlying knee pain.
  • During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.