Farnsworth Orthopedic Physical Therapy

Orthopedic Physical Therapy

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Knee Time

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Back to Sports

The sports world is beginning to return following the pandemic. But, athletes in all sports are finding that they are not in playing shape. After taking several months off, getting back into shape has been more of a challenge than expected. Unfortunately, this has led to several injuries. The knee is one of the most injured body parts not only for professional athletes, but the weekend warriors as well.

Knee Trouble

The meniscus in the knee is a cartilage space that sits between your shin bone, or tibia, and your femur.  The meniscus is C shaped and redistributes forces between the two bones. It does this when you are walking, running, or doing other sports related activity. People injure their meniscus when bearing weight and rotating, or twisting. This can lead to swelling and stiffness in your joint. People often complain about a clicking in their knee, as well as the inability to fully extend their knee. A lack of strength and stability in your knee is also common. There are different types of tears, however an X-ray and MRI are most effective to see what the issues are.

Treatment

Treating a torn meniscus depends on the location of the tear as well as the severity or size of the tear. Often, treatment is effective and include cortisone injection and physical therapy to help restore range of motion and strength.  If it’s serious enough, you will need arthroscopic surgery, in which the torn area of the meniscus is removed. After the surgery, physical therapy is required to help restore the motion and strength so you can return to normal activity.

Therapy for a torn meniscus focuses on the range of motion, or straightening of your knee. This often limits your motion. This is motion you need for all activities including walking and running for sports related activity and everyday life. Physical therapy will also focus on strengthening and stability of your quadricep muscle as well as stability of your hip and ankle as well. Over time, moving into sports related activity will happen to help you make a safe transition back to on field activity. A meniscus will heal in 6-12 weeks depending on the severity and whether or not you need surgery.

Written by Casey Badder PT

Little League Elbow

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As a state, Arizona is beginning to see a decrease in numbers of people who are diagnosed with the Corona Virus. There are beginning to be less restrictions and people are cautiously returning to activities. One activity my children participate in is youth baseball. They are between the age of 10 and 13, and children in these ages are normally pretty healthy. There have been several instances that have come up with my children’s friends and teammates which can be extremely painful and reduce their ability to participate in athletics. These are problems in the growth plate. I have witnessed this mostly in one body part: the elbow.

What is it?

The issue at the elbow almost exclusively occurs due to the repetitive action of throwing. This is why this is commonly called Little Leaguer’s Elbow. The medical term for this is Medial Epophysitis. This is basically an irritation on the inside of your elbow joint caused by repetitive motions. Excessive throwing causes a lot of stress on the inside part of the elbow which can be sometimes too much for growing bones and muscles. In extreme cases, part of the bone can actually break off. This typically happens in youth athletes between the ages of 8-17, when bone and muscle growth is most likely to occur.

Does my kid have it?

Typically, there is no specific incident that leads to this injury, but there can be. Usually, the young athlete will begin feeling pain on the inside of the throwing elbow where the bump is. This is where several muscles attach. The pain will worsen with the activity and if it gets bad enough, they will not be able to throw anymore. It will be fairly tender to the touch and you may notice swelling.  Pain when extending their elbow or wrist flexion is also a common occurrence.

What do we do about it?

If you notice your child has this, there are two things to immediately do.

  1. STOP THROWING!!! With repetitive stress injuries, the very first thing is to stop doing what is causing the pain. In this case, throwing. It is very important to not push through and play with this injury as it can lead to a much more serious condition.
  2. ICE: Ice at the initial stages can reduce swelling and irritation.

With all injuries that deal with soft tissues (muscle, tendon, ligament) there are several stretches and exercises which can be done. Almost always, the muscles on the palm side of your athlete’s forearm will be very stiff, and most times weak. These muscles should be stretched lightly and strengthened. The two stretches which are important are these:

With your elbow extended, gently extend your wrist to where you feel a gentle stretch on the palm side of your forearm. Hold for about 30 seconds and repeat 3 times.

Now, do the exact opposite. Hold for the same amount of time about 3 times.

Strengthening the forearm, wrist, and shoulder muscles of your throwing arm is extremely important. These should be prescribed specifically for the individual athlete.

How long does it take to heal?

The answer to this question really depends on the severity. It can be anywhere from a few weeks, to 1-3 months.  Coaches and leagues take special care with pitch counts depending on ages and this is an excellent thing to do, however any position player who throws often can be at risk. If you want to prevent this, a doctor or a physical therapist can identify the most important activities to do in order to prevent.

Weightlifter’s Shoulder

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Weightlifter’s Shoulder is a term that describes painful wear and tear of one end of your collar bone. It’s an injury that happens due to overuse.  It causes small fractures that can be quite painful and effect your range of motion. In some instances, something called osteolysis or bone breakdown occurs.

It’s called Weightlifter’s Shoulder because weightlifters are commonly affected due to the repetitive motions and heavy weight put on the shoulder joint when lifting weights. However, they are not the only ones affected. Jackhammer operators, baseball and football players and even soldiers can develop this problem.

Symptoms

The symptoms of this condition include tenderness over the front of the shoulder. You may also have pain while doing bench presses or dips, or you may be unable to do a push up due to the pain.  If you’re experiencing these symptoms it is very important that you do not try and push through the pain.  This will only lead to further damage and a longer healing process.

(Not being able to do a pushup due to lack of exercise is not a symptom.)

What Causes this Condition?

Repetitive stress from training and lifting can be a cause. For example, when your elbows drop below or behind your body during bench press, excessive traction on the AC (acromioclavicular) joint occurs. As a result, your shoulders extend too far.  If the bone does not have a chance to heal prior to your next workout, your shoulder can become painful and suffer from reduced strength and range of motion.

How to Treat It

Treatment for weightlifter’s shoulder usually starts with physical therapy and no surgery. This may include rest and changes in weight-training activities. You have to avoid over-training so that your joint can heal.  We can also help with suggesting modifications and design strength training for your condition.

(Rest is very important)

For those who don’t improve with therapy alone, or have a lot of damage to the shoulder joint, an arthroscopic surgery may be recommended. During the surgery, the surgeon removes portions of the damaged end of the collarbone in a procedure known as “distal clavicle excision”.  It is usually an outpatient procedure.  Most patients are able to return home the same day.

Physical Therapy is often recommended after surgery to improve strength and restore range of motion. Fortunately, most patients suffer no loss of function in the shoulder after surgery and are able to resume normal activities following rehabilitation.

Written by Travis Rohner PT

 

Complex Regional Pain Syndrome

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Complex Regional Pain Syndrome (CRPS) is a syndrome that affects the nervous system. It has been called by many names including, Reflex Sympathetic Dystrophy (RSD), Sudek’s atrophy and shoulder/hand syndrome. The condition is more prevalent in women, but can be present in all age groups and genders. The exact cause is unknown, although it usually associated with an injury or physical trauma such as a fracture, crush injury or surgery. CRPS also tends to show up in the extremities; but it can happen anywhere. Early treatment may improve the long-term outcome but doesn’t guarantee complete recovery.

 

CRPS can become functionally limiting both in terms of range of motion and strength. The constant pain associated with the syndrome can make work and activities of daily life very difficult and frustrating.

 

Signs and Symptoms

 

CRPS symptom progression has 3 stages. The first stage begins as burning pain, swelling, stiffness, excessive sensitivity, and increased sweating in the area. This stage can last from 1-3 months.

 

As CRPS progresses into the second stage, which may last for 3-6 months, the pain becomes more intense and the swelling increases and may spread out from the affected area. Hair growth in the area may decrease. In the hands or feet, nails may become brittle and cracked. On X-rays the bone may show loss of density. The muscles begin to atrophy or diminish in size.

 

Stage 3 begins any time after 6 months. The condition may be permanent and some of the muscle changes may become irreversible. The pain may progress to such intensity that it is incapacitating. Bone density continues to decrease. Range of motion continues to decrease as a result of avoiding motion due to pain.

 

Treatment

 

The goals of treatment are to decrease swelling and pain, maintain or improve range of motion, educate about the condition to reduce or eliminate frustration associated with it, and restore function.

 

Swelling can be decreased with cold compresses, contrast baths, compressive wrapping or massage. Massage, however, may be difficult because of the pain and sensitivity.

 

 

Decreasing the pain and sensitivity is done through several methods. Moist heat can sometimes help. Desensitization is another means. Desensitization can include the use of electrotherapy. Gradual acclimation is another way. It begins by touching the area lightly with a soft material such as tissue paper for several minutes at a time throughout the day. As the area of sensitivity decreases, the tissue is switched to a soft cloth with slightly more pressure. As the sensitivity decreases again, the material is changed to a rougher type and the pressure is increased.

 

Therapeutic exercise can be help to return strength, range of motion and function. Your health professional can show you the specifics of the rehabilitation program. Quite often the exercises involved with CRPS will include weight-bearing activities to help.

 

It is important to understand the psychological problems associated with this condition so you can cope with any emotional stress. Because of the constant nature of the pain associated with CRPS, counseling may help. Your health professional can refer you to the proper source.

 

The use of all the treatment methods as stated above may help to break the pain cycle, decrease pain and improve overall function. It is important for you to maintain independence in the activities of the day, both in work and leisure activity.

Written by Clint Bunker PT

 

Concussion? We Can Help.

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Concussion

A concussion is defined as rapid acceleration and deceleration of the brain tissue within the skull. This type of injury occurs most often in a car accident or sports related injury. A concussion  is estimated by the CDC to happen over 3.8 million times per year. Unlike many issues, this injury can be difficult to manage and treat on your own since it is an injury that you can often not see.

What are the Symptoms?

Common symptoms following concussions can include dizziness, headaches, light and noise sensitivity, vision changes, difficulty with focusing on tasks, and difficulty thinking. Another common symptom following a concussion is difficulty in sleeping.This is related to the trauma and your brain working harder than it normally does for routine tasks.

Treatment

Immediately following this injury, rest for the body and brain is effective. If symptoms persist longer, physical therapy intervention can be extremely effective. The treatment includes balance testing and progression, memory recall, vestibular rehabilitation, and cervical spine treatment. The goal is to restore normal mobility and decrease headaches present caused by tension in the surrounding tissues. Treatment techniques are slow and progressive in nature. We start out with low demand on the body, both physically and mentally.

The goals of concussion treatments include allowing the patient to return to full activity performance, whether that be playing sports or returning to a full work shift. Ultimately, your individual brain’s reaction to treatment will determine how quickly you will progress.

As with most efficient therapeutic experiences, communication between the therapist and referring physician is crucial.  This is true for returning to sports or to work activity. Making sure the patient is progressing at the right pace, not too fast or slow, is important. The doctor can help with these progressions based on imaging results following an injury. If you feel that you are suffering from concussion-like symptoms, or have recently had a head injury, please feel free to contact our office for consultation.

Written by Casey Badder PT

Exercise, Your Body Will Thank You

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A Changing World

There is a lot of change happening in the world right now. The global outbreak of COVID-19 is at the forefront of all our minds. We are all trying to decide how to keep ourselves and our family as safe as possible. There are many regulations that have recently been put in place including the mandate to wear masks in public. We have seen that this horrible disease often attacks our most vulnerable populations, most notably the elderly. It has also been noted, there are other risk factors which can exacerbate these cases, which have everything to do with a person’s individual health. Obesity and diabetes have been noted as two major risk factors. Although there is nothing we can do to stay 100% safe short of complete isolation, exercise can have excellent benefits on our immune system. As a physical therapist, I have always thought of exercise as a “Fountain of Youth”. It also can be a huge boost for our immune system.

(Actual images of the immune system at work.)

Risks and Benefits

We have known for a long time the benefits of regular exercise on cardiovascular health. In fact, we call running biking, and sustained activities by the name, “cardio.” A quick internet search will show many great benefits for moderate aerobic activity. Even with something as a simple as a walk you can boost your immune system. With each brisk walk or any other workout with moderate intensity, your natural antibodies are increased as well as anti-inflammatory factors which can help your body fight all germs and other invading bacteria.

You don’t have to go on an hour-long run in order to feel these benefits. In fact, exercising too hard for too long can actually increase stress hormones and reduce any benefit for your system. Research says that moderate exercise under 60 minutes is the best. What is moderate activity? Basically, anything that gets you breathing hard, but where you’re still able to talk to a friend (obviously from 6 feet away.)

Where to Start?

What can you do if you want this immune system increase if you are not already active? Do you have to worry about injury? The answer to that second question is unquestionably yes. Any sudden increase in your activity level can seriously increase your risk for soft tissue injury. And soft tissue injuries can make you get to know people like me way better than you want.

The best advice is just to start moving a little more than you already are. Go for a walk. Go for a short bike ride, wake up early and play a short round of golf. Have fun with it and get creative. There are several different workout routines of all different intensities which are readily available online or on YouTube. Several different individuals and companies are offering workouts on such web services like Zoom or even social media outlets like Facebook and Instagram. There are countless ways to learn to safely be a little more active.

You Are What You Eat

Lastly, don’t forget the importance of developing good nutritional habits as well. It is well documented that a key to good health is a healthy diet. Get plenty of vegetables and lean proteins. If you are like me, vegetables are difficult to eat. One thing that helped me was purchasing an air fryer. I have found many different recipes to air fry vegetables in order to make them more palatable.  So remember, exercise and a healthy diet are great ways to give your immune system a much needed boost. Your body will thank you.

Written by Rod Walker 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