Independence From Pain Through Physical Therapy

Physical therapy can be your answer to independence from joint and muscular pain. Chris Stulginsky from Ayrsley Town Rehab explains how treating the underlying cause of pain is the only way to be truly pain free. No more just treating the symptom, solve the problem that’s causing the pain!
Ayrsley Town Rehabilitation (ATR) provides performance-enhancing, preventative and rehabilitative programs and services that maximize functionality and promote well-being in patients of all ages and abilities.

Visit us online to learn more at: http://ayrsleyrehab.com/

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Knee Pain Doesn’t Always Mean Surgery

As discussed in the video, chronic knee pain doesn’t always mean surgery. Our patient, Rosa Underwood’s* experience demonstrates how physical therapy helped resolve her chronic knee pain, even though she had been advised that surgery was her only option.

Patient Spotlight: Rosa Underwood*

The Issue: I had severe knee pain, constant arthritis pain in my right knee that was affecting my quality of life. The limited mobility affected my ability to shop, play with my grandchildren, garden, enjoy myself in general. I was fearful of being stigmatized professionally because of my limping and the possibility of not working due to needing knee surgery. I was miserable.

How was your physical therapy treatment? The physical therapy felt immediately empowering! I felt that I had an active role in getting better and the better I understood how muscles functioned the more I realized I was not helpless, that a lot of my pain was due to extra stress being put on my knee because of how I moved at many joints and that my knee was not going to crack in half.

The moment things changed: Chris found that I was compensating by clenching my jaw, he treated that and my knee pain decreased significantly. I thought, “What just happened?” My knee pain was decreased significantly, and I was able to garden that weekend kneeling with very little pain, I have not been able to do that in months.

The difference over the past few weeks is incredible… I am walking longer, my attitude is hopeful, I don’t describe my pain as severe…I play with my grandchildren and enjoy myself again. I have not worn a knee brace or wrapped my knee since. My doctor is pleased with my progress and so am I! The ATR team is truly outstanding!

The Therapist’s take: Rosa had significant movement restrictions in her knee, ankle, and hip which piled on top an existing arthritic condition. Her Gluteal muscles were not firing much, and her knee was not able to get straight. It is a common compensation pattern, inhibited gluts put more pressure on the muscles that surround the knee. We tested her glut, it was strong, but she was clenching her jaw. Retesting with a relaxed jaw decreased the glut strength drastically. Palpation revealed increased tenderness at her right masseter, and quick, patient-directed release resulted in the gluteal muscles firing again so they tested strong with a relaxed jaw. With the gluts back on line, it took pressure off of the knee and the patient’s squat test improved dramatically. This is a great example of how the pain is rarely problem, it is the symptom of dysfunction. This is why we examine and treat function, treating structure alone without addressing function rarely leads to long term success.

*Use of quotations and names are with permission of patient

Charlotte Area Clinic Making Strides in Knee Pain Treatment

Knee Pain affects 18-20% of US population and many are frustrated with treatment and feel that surgery is the only option. Recent treatment breakthroughs at a local physical therapy clinic are helping patients who feel they have run out of options.

PRLog (Press Release) – May 11, 2012 – Knee Pain is a very common condition that is reported by 18-20% of the U.S. population. It affects the way one walks, works and lives. It can make hobbies and leisure activities such as going for a walk with your husband or wife, playing with your kids, and fitness activities very difficult.

Any pain or dysfunction at the knee can result in back, hip or foot and ankle pain. There are many common causes to knee pain, most of which are as a result of overuse or improper mechanics.

“During our evaluations, we often find that pain is the symptom of dysfunction elsewhere. Treating it without looking at the entire kinetic chain may offer some short term relief, but it does not address the cause of the problem and often leads to a more chronic condition,” says Chris Stulginsky, PT who is the owner of Ayrsley Town Rehabilitation.

Cortez Curtis has had pain in the front of his knee for three years. “I have been to 4 different doctors. They all took x-rays and told me I needed to exercise and lose weight. I was frustrated because I was never told what specifically to do and exercise made my knee worse.”

The knee pain located in the front of the knee was indicative of a problem elsewhere. “During the initial evaluation, Cortez was not getting much hip extension at all. Decreased hip extension typically results in increased bending of the knee, rotating the hip to the outside or positioning the foot and ankle outward while walking. In Cortez’s case he had compensated with external rotation at the hip, the knee followed suit and we had our issue.”

For the most part the primary motion of the knee is bending or straightening, which is called flexion and extension respectively; however, there is mild rotation at the knee joint which often goes unnoticed and can easily cause a great deal of dysfunction and pain throughout the joint.  The popliteus is a muscle that crosses from the outside of the knee to the inside of the knee at a 40 to 45 degree downward angle and is primarily responsible for this movement. The muscle also attaches to the lateral meniscus and often mimics meniscal derangement.

“Many knee exams are performed in sitting or while lying down. Traditional knee tests were negative. After watching Cortez walk just a few feet I had some clarity on what was going on, and confirmed it with further examination”, added Stulginsky.“When he started pressing on my knee, he was right on it,” says Curtis, who explained that for 3 years he has had difficulty playing with his kids, putting his feet on the ground when getting out of bed, and making it through his shift without intense discomfort.

Stulginsky says, “After seeing this presentation a number of times in the last few years, we have developed a protocol for this issue, which includes a simple, 2 step, self-care program. Everyone is built a little differently, it is not the same exact thing for every individual, but the themes are similar.

“I felt an instant difference,” said Curtis. “After two treatments, my pain is down 75%. Playing with my kids is easier, shifts at work are better.”

This dysfunction can cause a great deal of pain in many people, including competitive runners and weekend warriors. Stulginsky states that if this is the primary cause, it can be addressed relatively quickly in a very conservative, non-invasive fashion without medication or injections.

Mr. Curtis concludes, “I am happy that someone can finally tell me what was going on with my knee, and I have a solution that is fast, effective and easy enough that I can do it on my own.”