How We Can Help
Patients with hip/knee arthritis, tendonitis/bursitis, patellofemoral syndrome, meniscus tears and ligament tears are commonly prescribed physical therapy. It will assist in reducing pain and inflammation, and improving mobility and strength. We will provide you with an extensive evaluation by an expert physical therapist with years of training in medical evaluation of musculoskeletal conditions. Your physical therapist will then discuss the medical findings and formulate a unique plan of care for you. Treatment may include stretches, strengthening exercises, manual techniques, dry needling, and/or modalities including ultrasound, phonophoresis, iontophoresis and Electrical Stimulation.
Arthritis Causing Hip and Knee Joint Pain
The most common form of arthritis is Osteoarthritis. This affects over 27 million Americans and will continue to grow as our population ages. More than ½ the adults over 65 years are affected by this disease. It is a degenerative disorder that results from the breakdown of cartilage in the joints. Osteoarthritis involves not just the cartilage but the entire joint complex, including the subchondral bone and the synovial joint fluid that lubricates the hip and knee. With osteoarthritis, the cartilage becomes thin and worn in places, thus a loss of lubrication occurs. This causes stiffness, irritation and pain.
Daily stresses applied to the joints play an important role in the development of osteoarthritis. Risk factors include: age, obesity, trauma, genetics, muscle weakness, repetitive use and infection. Physical therapy plays
an important role in reducing pain and swelling in the joint. Severe degeneration of the joint may indicate a
joint replacement.
Tendonitis and Bursitis of the Hip and Knee
Tendonitis and bursitis of the hip and knee are overuse injuries commonly in active individuals who participate in running, cycling and cutting sports (i.e. football, basketball and soccer). Tendons, which attach muscle directly into bone, are structures that are subject to high tensile strength, meaning they must stretch as the muscles shortens, but they do not provide strength. Inflammation of a tendon from injury or repetitive stress is called tendonitis.
Several tendons are cushioned from the underlying bone by a lubricating and cushioning sac called a bursa. When the bursa becomes inflamed from an injury or repetitive stress it is called bursitis. The tendinous portion of the muscle has poor blood flow, so injury or stress at the attachment of the tendon onto the bone can lead to poor healing.
The cause of many overuse injuries of the hip and knee can be traced to biomechanical problems from the hip, knee or foot. A physical therapist can examine such problems. Physical therapy is important to help stimulate healing to the injured tissue, and also corrects any biomechanical problem that is causing the injury.
Patellofemoral Syndrome
Patellofemoral syndrome is knee pain that is caused by an abnormal tracking of the patella (knee cap). It may be a result of an unbalanced muscle pull of the quadriceps or from biomechanical abnormalities coming from the hips or feet. Patellofemoral syndrome is more frequent in females more than males, and is common in adolescence and young adults.
Pain is usually behind the knee cap and is worse with activities that require knee flexion and contraction of the quadriceps (i.e. during squatting, ascending/descending stairs). Pain may be exacerbated by sitting with the knees flexed for a long period of time (i.e. watching a movie, car ride or plane ride).
Physical therapy shows you specific exercises that with improve muscle balance and biomechanics from the hip down to the foot which will improve the tracking of the knee cap and reduce the pain.
Meniscus Tears
PATIENT RECEIVING ELECTRICAL STIMULATION TO ACTIVATE AND RESTORE QUADRICEP STRENGTH.
The meniscus is a small "c" shaped piece of cartilage that acts as a cushion in the knee joint. There are two that sit between the thigh bone (femur) and the tibia (shin bone), one on the outside (lateral menisus), and one on the inside of the knee (medial meniscus).
A meniscus tear occurs usually during movements that forcefully rotate the knee while bearing weight. A partial or total tear of a meniscus sometimes occurs if an athlete quickly twists or rotates the upper leg while the foot is firmly planted. This often occurs in field sports such as soccer and football. Frequently, an injury to the meniscus causes an audible click or pop, or the knee may lock, or feel weak. If the tear is minor, physical therapy can help the pain resolve through muscle strengthening exercises, stretches, and modalities.
If the tear is severe, some meniscus injuries may benefit from a surgical repair. Treatment varies depending upon the extent and location of the meniscus tear. The decision to have meniscus repair surgery is not a simple decision. However, the location of the meniscus tear may affect the surgical outcome. The meniscus gets its blood supply from the outer edge. Meniscus repairs near this blood supply tend to heal quite well, but research shows that meniscus repairs near the center do not heal due to a limited blood supply. Meniscus tears that occur in the center of the cartilage are usually removed.
Your physical therapist will follow a specific protocol whether you have a meniscus tear, meniscus repair, or meniscus removal.
Ligament Tears (ACL, PCL, MCL, LCL)
KINESIO TAPING TO HELP WITH SWELLING
The knee has four ligaments: Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL), and Lateral Collateral Ligament (LCL). The ACL and PCL are the two major ligaments in the knee that work together to provide stability in the knee. They cross each other and form an 'X' which allows the knee to flex and extend without side to side movement. ACL injuries are most common during sports that require a sudden change of direction, sudden abrupt stops and starts and lots of jumping, such as football and soccer. Most are non-contact injuries that occur during sudden twisting motion (for example, when the feet are planted one way and the knees are turned another way) or when landing from a jump.
PCL injuries are likely with impacts to the front of the knee, or from hyper-extending the knee. The PCL can also be injured by a direct impact from the outside of the knee joint, such as those that occur during soccer or football. Both the ACL and PCL can be injured or torn by a sudden twisting of the knee joint. Cruciate ligament injuries don't always cause pain, but typically a loud popping sound can be heard at the time of the injury. Incomplete ACL and PCL tears are treated conservatively to allow the body to heal on its own. Physical therapy is often recommended to regain and build muscle strength over time. For a complete tear of the ACL, surgery is usually performed.
The medial collateral ligament (MCL) is more easily injured than the lateral collateral ligament (LCL). It is most often caused by a blow to the outer side of the knee (such as occur in contact sports) that stretches and tears the ligament on the inner side of the knee. The classic sign of this injury is hearing a "pop" and feeling the knee buckle sideways. Pain and swelling are immediate.
Minor sprains of the collateral ligaments will heal with conservative treatment. Physical therapy can help you gradually return to your normal activities. A severely sprained or torn collateral ligament may occur along with a torn anterior cruciate ligament, which usually requires repair with Arthroscopic surgery.
Your physical therapist will follow a specific protocol whether you have a ligament sprain, tear or repair.