Farnsworth Orthopedic Physical Therapy

Orthopedic Physical Therapy

Julie

Oh, Cramp!

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Cramps

One topic which has come up a lot with my patients lately is the issue of muscle cramps. You probably have experienced cramps yourself.  You are sleeping peacefully and all of the sudden there is an extreme pain in your leg, or your back. Suddenly, you have a spasm where it becomes difficult for you to move. This can be very irritating and painful and it may take a little while for you to return to normal. Why does this happen?

I myself experienced some bad cramping after a particularly difficult workout while I was swimming. I had pushed off the wall doing several laps and that night I woke up in agony. This can occur when there has been an overuse of your muscles. My body was not used to this repeated activity.  In a measure to protect itself, my body decided to contract the muscles I had overused.  To put it simply, I had cramps.

What is the cause?

There can be other reasons you might develop cramps as well.

  1. Poor Blood Supply: Cramps can occur due to inadequate blood supply. Narrowing of your arteries can cause cramp like symptoms in your legs or feet. This usually happens when you are in motion and generally stops once you stop exercising.

 

  1. Neurogenic claudication: This is a condition which has similar symptoms as those listed above, however it is due to issues in the neurological system. Stenosis, or a narrowing of the opening where your nerves exit the spinal cord, can cause pain in your legs while you are moving and exercising. This can also mimic sciatica or radiate pain down your legs. In any case, it is very painful.

 

  1. Dehydration: Dehydration can lead to a poor balance of potassium, calcium or magnesium in your system which can also cause cramps. Some medications can deplete these minerals.

Those who are most affected by this are people with certain medical conditions such as high blood pressure, the elderly (who are prone to dehydration), athletes who do not properly hydrate during activity, or those who live in a hot climate. Pregnancy is also known to lead to uncomfortable cramps.

How Can I Stop the Cramps?

What can be done to avoid and overcome these things? Well, the most important thing is to keep yourself hydrated. Drinking plenty of liquids is essential to your health. What is the right amount? Well, that depends on your age, activity level, medical condition or the weather where you live. It is best to speak with your health care provider in order to come up with the answer. Another thing you can do is stretch your muscles which are the most prone to cramping.  Your calves and your hamstrings are major offenders when it comes to cramps. There are several stretches for your calves which are good but I have one favorite. It looks like this:

 

Roll up a towel and step on it, keeping it on the front 1/3 of your foot. Hold this stretch for about 30-35 seconds and do it about 3 times. This supports the plantar fascia and stretches your calves very safely. Do this after activity, or before bed if you often get cramps at night.

Always seek medical attention if your symptoms are extremely severe, or if the pain is associated with swelling, extreme tenderness, or skin changes. Also, if you have weakness that you cannot explain. If you have any questions, please see your doctor or another health care practitioner. We are happy to answer any additional questions you may have.

Post written by Rod Walker, PT

TMJ: A Real Mouthful

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TMJ

The temporomandibular joint (See why it’s abbreviated?), also known as the TMJ, is the joint that connects your jaw to your skull. The mandible attaches to the temporal bone which is part of the skull. The joint is located just in front of your ear and is surrounded by muscle, bones, blood vessels and nerves. Problems in this area can often lead to neck pain and headaches, ear and face pain, or your jaw locking or snapping while you chew. This is known as temporomandibular dysfunction (TMD). Studies are unclear as to why, but the research shows that more females have TMD than males. Go figure.

Causes

The most common causes of TMD include trauma and osteoarthritis. Grinding your teeth is the most common type of trauma. This can result in inflammation of the joint and spasms of the surrounding muscles which help you chew. This occurs most often at night while you sleep and can be difficult to control. This inflammation of the joint can also happen with clenching habits such as chewing gum or fingernails, usually stress habits. Degeneration of the joint can also occur, as it can with other joints in the body such as the knee and hip.

A final cause of TMD includes rheumatoid arthritis which can again cause inflammation in the joint and deterioration of the cartilage in the area. As mentioned previously, symptoms may include your ear ringing, headaches, neck pain, dizziness, facial pain and difficulty opening the mouth completely. Another common symptom is lock jaw, when the jaw either cannot open all the way or when the jaw is stuck in an open position.  Not a very fun symptom.

Treatment

So how do we treat TMD? The treatment for this disorder is multifaceted. It involves the physical therapist, primary physician and dentist, all of which play an integral role. Your doctor can prescribe anti-inflammatories to help control the inflammation in the localized area. Your dentist may recommend a night splint or mouth guard created to help stop you from grinding your teeth at night. Finally, a physical therapist assists with soft tissue work both inside the mouth and outside the jaw in order to prevent and decrease spasms of the muscles for chewing. Joint mobility to the mandible will also help with improved biomechanics and smooth motion of your TMJ.

If you have significant TMJ pain, it’s important to take steps to alleviate it before it gets worse.  Don’t hesitate to come in and let us help you start a plan to become pain free.

Post written by: Casey Badder, PT

Much Ado About Foot Pain

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Ouch!

Pain in your feet is no joke.  Especially for those of us who find ourselves on our feet for long hours every day (aka just about everyone). If you find yourself feeling more than the usual aches and pains, it can quickly become a problem.  If you have severe issues, if your walking or ability to stand is being seriously impeded, physical therapy at our office can help.  However, there are some things you can do at home that can make a big impact and get you back on your feet without the pain.

 

A Hot Soak

First, your best friend when it comes to pain relief in your feet can be your bath tub.  A hot soak for your feet and legs in the tub is great for increasing blood flow.  Increasing blood flow helps your body repair the damage that causes pain.  It also helps loosen and relax your muscles.  Ten to fifteen minutes soaking in a hot bath is all you need to maximize the pain relief.

Do not underestimate the benefits of a relaxing hot soak.  (Cat not recommended.)

Exercise

Second, you can help correct the pain you are feeling in your feet by strengthening the muscles in your feet.  Working out the muscles in your feet is not exactly something you see people focusing on at the gym every day.  But some simple exercise can help you see big benefits.  You’ll just need a couple of things from around your house.  Find yourself a handful of marbles, if they are different sizes then all the better.  Next, find a plastic cup.  Sit down on the edge of a chair or your couch and place the marbles on the floor next to the cup.  Using only the toes on your feet, pick up the marbles one by one and drop them into the cup.  It may seem simple, and a little silly, but doing this exercise a few times per day will help build muscles in your feet that you otherwise don’t work directly.  Stronger muscles help your foot to function the way that it needs to in order to be pain free.

Chill Out

We’ve covered heating up, exercise, and last comes cooling down.  What you’ll need for this last at-home technique is a water bottle.  Stick the water bottle in the freezer and let it freeze solid. Now what you have is firm, cold roller for your feet.  Place the frozen water bottle on the floor, and place one foot on top of it.  Apply downward pressure and roll the bottle along the entire bottom of your foot.  Doing this stretches and massages the bottom of your feet, breaking down scar tissue.  The cold helps reduce inflammation, another important aid in pain relief. You want to chill your feet, but don’t do over do it.

 

With these three tips you can make a big difference and be happy on your feet again.

Battle of the Bulge

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Understanding Disc Bulges

Disc bulges can be caused by immediate trauma or injury (sports injury, auto accidents, etc.), as well as long-term trauma such as improper posture.  Discs are located between each of the vertebral bodies of the spine. The discs are the shock absorbers of the body. They also help to give the spine more movement and flexibility as we twist and bend.

The discs are shaped like a hockey puck and are made up of cartilage, which is tough and leather like. Each of the discs is constructed like an onion, layered in rings. At the center of each disc is a watery, gelatin-like center called the nucleus. The discs have a high content of water and this is what makes them flexible. As we age, the discs lose some of their water content and become less flexible. This makes the layers of the “onion skin” more brittle and weaker.

What Is Causing the Bulge?

As we do activities that place us in a bent or “flexed” position (sitting, driving, reading, or watching TV), the low back can lose its natural curve, and pressure from the nucleus can be exerted on the back side of the discs. Over time, one layer at a time of the “onion skin” splits or cracks and the gelatinous center moves closer to the outside. Eventually this nucleus begins to distort the shape of the disc, causing the disc to bulge. This can happen to the direct back side but most often is slightly to one side or the other. (In rare cases, the bulge can be on the front side.)

The pain is caused because the back side of the disc has many nerves. Another factor is that the spinal cord is directly behind the disc and, as the bulge increases, it begins to irritate the nerves that are attached to the spinal cord. In the low back, these nerves travel down the leg. This can cause feelings of pain as far down as the foot and toes, as well as numbness or tingling in the leg and foot. This is called sciatica.

Fixing the Problem

One way to help with this problem is by beginning flexion or extension exercises.  If this is done often, the layers of the annulus can begin to heal and can form scar tissue. As the disc heals, the bulges reduce in size and take the pressure off the nerves, decreasing or eliminating the sciatica.

“Traction” may also help relieve the sciatica. Consult your doctor or health professional to see if this is an option for you.

Another item that can keep the low back in its proper curve is a lumbar roll. The lumbar roll is placed behind the low back while you sit, and helps keep the back in its proper curve.

In some cases, surgery may be necessary if the exercise, traction, and lumbar roll do not resolve the condition. Your doctor or therapist will show you the exercises best suited to your situation.

Post Written By: Travis Rohner, PT

There’s No Fun in Foot Dysfunction

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Posterior Tibial Tendon Dysfunction

The posterior tibial tendon is one of the major supporting structures of the foot. It an important part that helps it to function while you walk. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon,that impairs its ability to support your arch. This flattens your foot. And that’s problem, because that can be painful.  More painful than stepping on a Lego.

 

PTTD is often called adult acquired flatfoot. That’s because it’s the most common type of flatfoot developed during adulthood.  PTTD is usually progressive (which means it will keep getting worse) especially if it’s not treated early.

Causes

 

Weakness and overuse of the posterior tibial tendon is often the cause of PTTD. In fact, you will usually feel these symptoms after repetitive motion activities that involve your tendon, such as running, walking, hiking or climbing stairs.

Symptoms

 

Symptoms of PTTD may include pain, swelling, a flattening of your arch and an inward rolling of your ankle. As the condition progresses, the symptoms will change.

For example, when PTTD initially develops, you will feel pain on the inside of the foot and ankle (along the course of the tendon). The area may also be red, warm and swollen.

Later, as your arch begins to flatten, you might still have pain on the inside of your foot and ankle. But at this point, your foot and toes begin to turn outward and your ankle rolls inward.

As PTTD becomes more advanced, your arch may flatten even more. The pain often shifts to the outside of the foot, below your ankle. At this point, the tendon has deteriorated considerably, and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle.

Nonsurgical Treatment

Because of the progressive nature of PTTD,we advise early treatment. If treated early enough, your symptoms may resolve without the need for surgery, and progression of your condition can be stopped.

In contrast, untreated PTTD could leave you with an extremely flat foot, painful arthritis in the foot and ankle and increasing limitations on walking, running or other weight bearing activities.

Post Written By: Clint Bunker, PT

We All Fall Down

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The Upward Costs of Falling Down

Falls are the leading cause of fatal and non-fatal injuries in elderly people. In fact, every 19 minutes, someone dies from a fall related injury. In recent research, Medicare and Medicaid are expected to spend over 100 billion dollars on fall related costs by the year 2030. So how can you identify if you are at risk for falls?

 

 

What Causes Falls?

Some risk factors include things that you can’t control, like your age. Others may include if you have a chronic health condition or polypharmacy, when you are taking multiple prescriptions at the same time. Consult with your primary care physician regarding the medications you are currently taking and how they may affect your ability to keep your balance. Two other factors that can affect your balance are your vision and hearing. Consult with your optometrist for a routine eye exam to rule out glaucoma and cataracts or a change in your vision. Also, a hearing exam will help to reduce potential risk factors.

 

There are, however, several risk factors that you can control to help your balance. Physical therapy can help with some of these. Weakness, decreased endurance, and poor flexibility can all affect your balance. Physical therapists can assist you in addressing these factors which can help improve your balance and decrease your risk for falls. By doing this, your confidence will also improve which can often lead to improved balance. Finally, a physical therapist can suggest if an assistive device can help you in walking. Assistive devices can also help you in your daily activities and help prevent falls.

Get Your Confidence Back

Feeling like you may be losing your ability to balance can be an awful experience. If you feel that you are a fall risk, or have recently had a fall, feel free to contact our office to get some advice on how we can help you get you get balanced on your feet again.  The strengthening and treatment we provide can help give you back the confidence you need.

Post written by Casey Badder, PT

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Areas Served:

Mesa, Gilbert, Chandler, Phoenix, Queen Creek, Apache Junction, Tempe, Globe, Gold Canyon

Postal Address

Gilbert Office
730 N. Greenfield Rd.
Gilbert, AZ 85234
Phone: (480) 633-0666

Mesa Office
342 N Val Vista Dr. Suite 106
Mesa, AZ 85213
Phone: (480) 325-3310