Knee Pain

Do you have difficulty ascending/ descending stairs, squatting, or walking up/down hills? Do you have pain in your knee that increases during these activities? If so, you may be suffering from patellofemoral pain.

Patello-femoral pain is the result of mal-tracking of the patella, usually caused by one of more of the following: weak musculature around the knee, decreased flexibility around the knee, decreased patellar mobility, and/or muscular imbalances around the knee.

No matter what the cause of your knee pain, King Physical Therapy & Fitness can assist, diagnose, and develop a program to return you to your full functional level. Contact us today for an appointment, we accept most medical insurances.

Attending Physical Therapy Without a Referral

In most instances physical therapy is prescribed and suggested to an individual by theirphysician following an injury or surgical intervention. With the prescription the individual is able to choose any physical therapy clinic that they desire and then be evaluated and treated by the licensed physical therapist for the frequency and duration prescribed. In many instances there may be a delay following seeing your physician and being evaluated by the therapist.

This has changed in the state of Pennsylvania and 43 other states in the country. You are now permitted to be evaluated and treated by a Direct Access licensed physical therapist of your choosing for a total of 30 days without a physician’s referral. The physical therapist has the discretion and education to choose if your injury is capable of being treated by physical therapy or if you need referred to a specialist for further testing. King Physical Therapy & Fitness currently has two locations that are able to provide Direct Access. If you are unsure if your insurance allows Direct Access, please call to find out.

Gait Dysfunction

Abnormalities in the way you walk/ambulate is considered a “Gait Dysfunction”. A gait dysfunction can be caused by many things including a recreational injury, following a surgery, muscle weakness, joint injury, or improper footwear. If your gait dysfunction is prolonged, you may develop additional injuries including low back pain or other lower extremity injuries. That is why ambulating normally is a vital part of remaining healthy and avoiding injury.

At King Physical Therapy & Fitness we will evaluate your gait by observing you ambulate several times concentrating on several areas of your body. We will evaluate your ankle heel strike and toe off, assess your knees and hips for adequate flexion/extension, your trunk for sufficient rotation and shoulders for proper arm swing. We will also evaluate your foot for excessive supination/pronation, your Great Toe for adequate extension, and also your footwear for wear patterns. If you are concerned about your gait causing you injuries please stop in and talk to one of our expert therapists or fitness specialists.

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Preparation and maintenance is the key to having a healthy spring, summer, and life.

The snow has melted, the plants are growing, and it’s time to get out and be active once again. Whether it’s mowing the lawn, pulling weeds, going for a walk/run, or playing your favorite sport, your muscles will be working at a level they haven’t worked at for a long time. This puts your body in a vulnerable state, but by doing some simple exercises and stretches you can make it through your summer pain free.

Just like your lawn mower’s engine may need a little work before mowing your lawn, your muscles may need a little preparation to prevent them from overuse injuries. One way to prevent these injuries is to start with small manageable projects or activities (don’t go landscape your whole yard in one day), and slowly increase the workload which will build up your muscular endurance. Another way to prevent these injuries is to warm up the muscles that are going to be used. The American College of Sports Medicine (ACSM) recommends that a warm up for aerobic exercise should last a minimum of five to ten minutes. Examples of a warm up for aerobic exercise could be a light jog or a brisk walk. Also a cool down should be done at the end of your activity. The cool down should mimic the procedure for the warm up. Some benefits of cooling down include reduced muscle soreness and prevents blood pooling in extremities which can cause dizziness or fainting. Those are good guidelines to follow for activities such as push mowing, playing soccer, or going for a run, but what if you were planning on moving lawn furniture or moving heavy bags of mulch? In this case you would want to find a resistance training activity similar to the activity being performed. For example, if you are lifting heavy bags, warming up with some light weight deadlifts will help your muscles warm up before the strenuous activity. The ACSM recommends that 12-15 reps should be performed at about 50% of your 1 RPM (a fairly low intensity), and that the warm up should take place no more than 3 minutes before the activity.

Stretching is another good way to prevent injury. Stretching should take place directly before or after the activity. The key is for the muscle to be warmed up before stretching to better enhance the results. Research has recently shown that stretching before activities may not actually prevent injuries, instead what people should focus on is stretching periodically. The ACSM recommends that individuals stretch at least two days per week, but stretching can be performed daily. They also recommend that each muscle should be stretched 3-5 times on each side for 15-30 seconds. Some common stretches from the ACSM and A. Lynn Millar, P.T., Ph.D., FACSM are outlined below.

  • Hamstrings – Sit on the ground with legs straight in front of you. Gently lean forward from the hips (try to keep the back fairly straight) until a stretch is felt on the back of the thighs.
  • Hip flexors/quadriceps – Stand on one foot, and bring the other foot to the buttocks. Pull back gently, while keeping your knee pointed at the ground and your hip straight. If needed, hold onto a counter or chair to keep your balance.
  • Calves – Step forward with one leg. Shift your weight toward the front leg while keeping the back heel on the ground. If you press the hip of your back leg forward, this will also help stretch the hip flexors.
  • Chest muscles – Standing in a corner, bring hands up to shoulder height and place against the wall on either side. Keeping hands in position, lean body forward until a stretch is felt in the front of the chest. This can also be done using a doorway, turning away from the hand that is on the wall.

Preparation and maintenance is the key to having a healthy spring, summer, and life. As always if you ever need a little help we are here to help you get where you want to be. Did you know that you can seek our guidance without a referral? If your insurance is out of network you can still seek our care with out of pocket payments. Just stop by or give us a call to get started!

Don’t let pain linger. See your physical therapist to stay in the game.

It is finally Spring! The grass is turning green, the leaves are returning to the trees, and the spring sports activities are in full “swing.” Along with the season of growth and rebirth come injuries. During this time of year I receive a lot of questions regarding injuries in youth, teen and young adult baseball/softball athletes, coaches, and weekend warriors. Yes, even coaches that are throwing batting practice need help. Whether it be from a lack of movement/participation in activities during the winter, utilizing different muscles now, applying stresses to the body that have not been applied since last season or overtraining while preparing for the upcoming season. No matter the cause, you need a solution and you need it quickly in order to be able to participate during the championship portion of the season. Most individuals that I see have attempted to improve their symptoms with ice, heat, and/or stretching techniques while seeing at least one healthcare practitioner with no improvement. And even though there are many guidelines (pitch counts, days rest, etc) in place in an attempt to avoid overuse injuries, it is inevitable that injuries will still occur.

Soooooooo, “What can we do for you?”

Here are a few thoughts regarding the treatment of these individuals and how our Physical Therapists at King Physical Therapy & Fitness can help.

The Shoulder

The area to investigate first is typically the shoulder, but as you read further this may not be the most important area to intervene. A total arc of motion is recommended to be able to achieve optimal mechanics. Rotator cuff strength is imperative and even a specific warm up is recommended from our therapist in order to be able to fully recruit and utilize the shoulder musculature immediately when throwing (Wilk 2009). A thorough evaluation will assess the integrity of the joint and associated ligaments and tendons. The shoulder blades (scapulae) play an extremely important role and strength here is imperative to maintain congruency in the shoulder joint and provide adequate support during extreme shoulder motions (Provencher 2014).

The Elbow

The medial elbow ligament (Ulnar collateral ligament, aka “Tommy John” injury) may be involved in overuse injuries and may require a rest period if it is not taken care of immediately at the onset. By evaluating motion and strength throughout the body a full program can be initiated to reduce stress through this area.

The Hips, Lower Body, and Core

This is the area that may be able to make to the most impact for prevention and recovery in all athletes and specifically in this case throwing athletes. Limited hip motion and strength may be associated with an increased risk of shoulder injuries in throwing athletes (Scher et al. 2010). Hip, core, and lower body motion and strength causes increased stress on the shoulder (Kibler 2006) and limited hip flexor flexibility and weakness in hip abduction was seen in 49% of arthroscopic labral tears (Burkhart 2000). Needless to say interventions to improve these areas is crucial.

Do not let your pain linger and seek help immediately. Did you know that you can see your Physical Therapist without a referral? Did you also know that even if your insurance is Out-of-Network you can still seek care with us out of pocket? Call for more details.