Farnsworth Orthopedic Physical Therapy

Orthopedic Physical Therapy

pain

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

Happiness is A Warm Theragun

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One of the “weapons” that our therapists have in their arsenal is the Theragun. Shaped like an electric drill, the Theragun is a tool that takes aim at muscle tension, zaps knots, and blasts through scar tissue. At the tip of the Theragun is one of several specialized heads that target your muscles with strong percussion. There are small tips that pinpoint trigger spots, and broad tips for larger areas like your back.

Wherever you’ve got pain, the Theragun delivers powerful percussion to relax your muscles and increase blood flow to the area. The vibrations stimulate your nerves enough that they stop sending signals for pain. Translation? You don’t hurt so much. If you smash your finger, you may immediately shake your hand around, stimulating your hand in a way that isn’t painful in hopes that you feel the shaking instead of the awful pain of a smashed finger. Likewise, when you have muscle pain, the Theragun is there to shake things up and get your nerves busy sending signals for something other than pain.

Additionally, your muscles have a casing around them called myofascial tissue. Sometimes this tissue can get tight and inflexible, kinked, or overlapped onto itself. This can lead to widespread muscle pain. Loosening this tissue and making it flexible again can increase flexibility and relieve pain. This release is an important part of recovery. The Theragun is a useful tool to work on trigger points that create myofascial release.

Lastly, it just feels nice and relaxing. Who wouldn’t want some percussive vibrations on their sore muscles? There may be some of us who might not. A Theragun is not the right tool for those who have injuries that are too recent. It also may not be the right option for patients who have certain conditions above the shoulders or who have had certain operations. Getting evaluated by a licensed therapist will help you to know if this therapy is right for you. If it is, you will soon be on your way to a more relaxed, flexible, and pain free you.

Post Written By: Tom Farnsworth, PT

The Bee’s Knees

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Patella Femoral Dysfunction (PFD) is a condition that affects the knee, resulting in pain in the front part of one or both knees. It may be caused from a mechanical difficulty in the knee itself, or from improper formation of the bone in the hip area. High or flattened foot arches can also contribute to this issue. Improper alignments of the hips, knees, or feet can place excessive forces on the kneecap. As the kneecap moves across the end of the leg bone (or femur) the surfaces become irritated and painful.

Most commonly found in young women and adolescent females, PFD is a condition that can affect anyone. A softening of the cartilage on the back side of the kneecap, or imbalances in the muscles that control the movement of the kneecap may also cause PFD. Improper force can be placed on the kneecap and femur if outside portions of the quadriceps muscles are stronger than the inside portions. Symptoms usually include pain with kneeling, walking, running, or climbing up or down stairs. Patients usually describe their pain as “aching” and “deep”. One can also experience tenderness and swelling around the knee area. When bending or straightening the knee, you may feel a creaking or crunching in the area.

Rehabilitation first begins with controlling the pain and symptoms such as swelling. Icing the knee will help control swelling and pain. You an read more about icing here. Electrical stimulation treatments may also help ease the pain. As much as you can, try to avoid activities that increase your pain. For instance, try taking an elevator instead of using the stairs. Painful activities may need to be modified but will be resumed gradually during the course of treatment. In some cases, a knee brace is issued to help control the movement of the kneecap and decrease irritation.

In most cases, strengthening or stretching exercises will help correct muscle imbalances. Be careful, as too much resistance during exercises can sometimes make the problem worse. Everyone reacts to exercise resistances differently. Because of this, it’s important to communicate any pain increases  to your health professional during the course of treatment so modifications can be made. Another intervention may be a detailed foot evaluation, and correction of any problems found in this area, including orthotics. Orthotics are custom-made shoe inserts that help correct improper foot mechanics directed to the knee.

It’s important to remain optimistic and patient while treating patellofemoral issues. PFD symptoms can flare up very easily. Another responsibility you have is to be very consistent with your treatment visits and home program so the knee can gradually adapt and heal. The condition can be difficult to remedy, but in most cases relief and return to your activities can be achieved.

Post written by: Travis Rohner, 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