Archives: Conditions

The ACL is extremely important for the stability of the knee joint. It is often sprained or torn in a knee hyperextension injury, and often also involves a tear of the meniscus as well. Not only can we, at Goodell Physical Therapy, help diagnose and rehabilitate an ACL tear pre and post-surgery, but we can also help patients prevent ACL tears through education in proper movement patterns and stability exercises in both the athlete and the general population.

The meniscus is cartilage in the knee that acts as a shock absorber as well as helping control the motion of knee bending, straightening, and twisting. Often this tissue tears with excessive load in a weightbearing position with a knee twist. While a tear in the meniscus is often excised or repaired surgically, often people can rehabilitate through this injury without surgery. At Goodell Physical Therapy, we can help diagnose a torn meniscus and provide guidance in safe, proper rehabilitation technique, as well as recommend a good orthopedic surgeon if necessary.

After delivery of your baby, there may be some exercises you can begin right away.  For uncomplicated deliveries, isometric contraction (tensing the muscle without moving your body) of the pelvic floor muscles through a kegel exercise and isometric contraction of the stabilizing muscles of the upper and lower back can help get you back on track and feeling more comfortable right away.  Kegel exercises help improve blood flow and reduce swelling in the sometimes floor of the pelvis/region of the birth canal.  Shoulder blade squeezes can help improve firing and circulation in the posture muscles that are used to support you as you hold your new baby.  Sometimes it is difficult to feel or to adequately contract these muscles without guidance, and our physical therapists can teach you techniques to be more effective.

Most doctors agree that by 4-8 weeks after a normal vaginal delivery and 8 weeks after a cesarean delivery, you can begin an exercise routine.  James F Clapp III, MD reports on his research in his book Exercising Through Your Pregnancy that many women are able to return to a safe exercise routine by two weeks post partum.  It is important to start at the right intensity level and time for you which will be determined somewhat by your pregnancy fitness level, your body type, how your delivery went, and how you and your baby are faring post partum.  Your physical therapist can assess where to start and give you tips on when and how to safely progress.  It is important to protect your joints and have good form during your exercise because your joints stay loose and more vulnerable for some time after pregnancy.  We can also give you ideas on how to exercise so that your baby gets a “work out” too and you both have fun together.

We can help re-align your body after delivery of your child, which can put you back on track for a good recovery.  It usually takes 6 months after you stop breast feeding for your levels of relaxin (a hormone responsible for making your ligaments more loose) to return to normal.  This means it is really important to prevent malalignment by using proper body mechanics.  Our physical therapists can teach you to move correctly as you care for your child and yourself.

For more see Pelvic Pain

Pain can occur during pregnancy due to malalignment in the pelvis as the joints of the pelvis loosen in preparation for childbirth.  Sometimes the baby growing inside the mother places pressure on the low back or pelvis which can cause pain and muscle tension.  Our physical therapists can help re-align the pelvis and teach you or a friend to treat yourself at home should your pelvis become malaligned.  We can also teach rest positions that can help reduce the pressure of the baby on the pain provoking site.  Maintaining good trunk or “core” stability and strength throughout the pregnancy can reduce episodes of pain and malalignment.

It is best to begin exercises early in the pregnancy, or even better before becoming pregnant, so the body has a chance to adapt to the exercises before the body starts changing in size and shape and these new variables must be adapted to.  If you are anticipating becoming pregnant, call us for a fitness assessment and tips on where to start.

It is a commonly thought belief that beginning a new and intense exercise regimen part way through your pregnancy is not advised; however, research by James F. Cladd III, MD outlined in his book Exercising Through Your Pregnancy indicates that exercise can be initiated at safe levels throughout a healthy, low risk pregnancy.   Your physical therapist is the most highly trained person in this area, and if you are considering exercising during your pregnancy take advantage of our expertise in the do’s and don’ts based on most current research.  We can accurately determine what level of fitness and health you are currently at in order to determine the level at which you should safely exercise.

Plantar fascitis can be defined as pain in the connective tissue of the bottom of the foot.  Plantar fascitis can occur when the foot is placed under more load or stress than it can manage.  This can commonly occur due to overuse, excessive weight, excessive tightness, weakness, or malalignment in the lower leg and calf which requires additional use of the foot to compensate.  Plantar fascitis can become exacerbated by mechanical irritation of the bottom of the foot due to bone spurs that may dig into the connective tissue, or due to poor footwear.  Some people develop malaligned foot bones which the body responds to by compensating in other areas of the foot, sometimes causing plantar fascitis.  Your physical therapist can analyze your foot mechanics in the context of the mechanics of the entire rest of your body, to determine where the problem is coming from.  For example, in some cases, the foot is compensating and over working due to poorly aligned or weak hips.  When the cause is something that can be changed (bad habits, weak or inflexible muscles, or poor joint mobility) we can address the problems with physical therapy.  If the cause is due to abnormal foot alignment which is associated with the shape of the foot bones, then we can compensate for this by prescribing foot orthotics.   We have physical therapists trained in analyzing the cause of plantar fascia pain, and in fabricating custom foot orthotics.  We always try to go the conservative route and resolve the plantar fascitis by correcting the mechanics throughout the lower body through exercises, manual therapy, taping, and education in proper habits and posture first, to save the cost of custom foot orthotics.

We offer personal training also known as fitness training services, in which you are guided and coached in your exercises in a one on one setting to help you obtain the most from your work out.  We can coach you in sticking to your goals and in remaking your lifestyle to achieve a more healthy balance. We create personalized exercise regimens geared toward achieving your goals, whether they be to become stronger, to avoid pain and prevent injury with your exercises, to lose weight, or improve in your sport.  Physical therapists are experts at analyzing body mechanics and the micro movements that occur in the muscles and joints with every move you make.  We can uncover what problem areas may be limiting you by testing your strength, flexibility and joint mobility.  We are trained in cardiovascular exercise and know how to adapt programs no matter what your background, whether you are a high level athlete or someone managing serious medical issues such as recent heart surgery, diabetes, recent stroke, or obesity.    We can teach you to be your own guide, or we can take you through each step of the way.

Peripheral nerves are the nerves that exit the spinal cord (in the center of the spine) to feed the rest of the body.  They typically branch out into smaller and smaller sections to feed various areas.  There are specifically defined areas that the peripheral nerves feed, and an injury to one of these nerves usually occurs in a clearly defined pattern.  Injuries to the peripheral nerves can occur in a variety of fashions.

Traction injuries occur when the nerve is pulled beyond its normal flexibility, causing inflammation and sometimes tearing of nerve fibers.  For example, this can happen in the upper body when the head is forced away from the shoulder or when the shoulder is forced down away from the head.  Symptoms may include a burning pain down the arm that is worse when the head is tipped away from the arm.

Crush injuries occur when something crushes the nerve such as a blunt object or when a muscle surrounding the nerve constricts the nerve from contracting continuously on the nerve.  When this occurs in the buttock muscle, the sciatic nerve can get constricted, known as sciatica.  With sciatica, one typically feels pain from the center of the buttock down the back of the thigh and sometimes even down to the foot.   Treatments include releasing the pressure on the nerve which may mean relaxing the muscle that is constricting the nerve, or it may mean changing how we sit to get the pressure off the nerve, or possibly improving our low back and pelvis alignment to reduce pull on the nerve.  In the worst case scenario, one may need surgery to make room for the nerve as it passes out of the spine or buttock region.

Lastly, the nerve can become severed such as when we cut ourselves, or when one experiences an amputation.  In any of these types of peripheral nerve injuries, our brain becomes disconnected from the area fed by the nerve, and we may lose feeling and the ability to move the area fed by the nerve.  It is important to seek medical attention immediately if there are signs of loss of feeling or use in order to have the best possible chance of repairing the nerve.  Phantom limb syndrome occurs when someone who has had a limb amputated still feels the limb.  It is thought that reflexive firing of our nerves continues and continues to light up areas of the brain previously attached to the limb.

Our bodies can re-grow/repair peripheral nerves at the rate of about 1 centimeter per month; as long as the new nerve doesn’t get lost on its way to its final destination.

To learn more about how messages are carried from our body along our peripheral nerves, and how our nerves change in response to pain, click on all about pain.

Pelvic pain is defined as pain in the bowl of the pelvis, which is comprised of the 2 ileum and the sacrum at the bottom of the low back. Pain can occur due to problems with the reproductive organs of the body, the bladder, or the colon/lower part of the digestive tract. Pelvic pain can also occur when the 3 main bones of the pelvis become malaligned, placing undue stress on the ligaments and muscles that attach to the pelvis. The muscles that form the bottom of the pelvic bowl are known as the pelvic floor. They are important in sustaining good pelvic alignment as well as supporting the organs in the pelvis. Pelvic pain may occur after injury to the pelvic floor from a complicated birth, or due to severe weakness after stretching of the muscles with vaginal birth. In some cases, pelvic pain occurs as a response to emotional stress when the muscles of the pelvic floor become tense in a protective, guarding pattern. Physical therapy can be extremely helpful by re-aligning the pelvis, improving the pelvic floor’s strength and ability to sustain normal alignment, and by training muscles to relax and reduce unnecessary tension.

When the patella or knee cap is not tracking or gliding correctly in the groove made for it, pain can result. The undersurface of the patella/kneecap can become irritated and overtime can become roughened (known as chondromalacia patella) if the tracking is off. Often time the culprit causing poor tracking is poor firing or strength of the quadriceps muscles (the large muscle on the front of the thigh). When the quadriceps fires with normal strength it should pull the patella upward toward the head (superiorly) and inward toward the inner thigh (medially). After injury or surgery to the knee or thigh, the quadriceps muscle can become inhibited, which makes generating a strong contraction difficult. We often see people with patella femoral dysfunction/pain several years after a surgery or injury to the knee who never had the tracking of the knee cap addressed fully. It is important to restore normal flexibility of the soft tissues around the knee to allow good tracking as well as normal firing and strength of the quadriceps. For bicyclists who go through repetitive motions at the knee, having your bicycle properly fit to you is critical in avoiding patella femoral dysfunction. Our physical therapists are trained in proper bicycle fit, as well as in strengthening and soft tissue and patella mobilization techniques to restore normal mechanics at the patella femoral joint.

If you are interested in increasing your efficiency and improving your strength and skill in a specific sport then it is imperative that you develop sport-specific fitness. You may need strength, stability, flexibility, balance, coordination, agility, speed, endurance or power. Who better to instruct you on these things then a physical therapist, we are movement experts. Here at Goodell PT we will work with you to achieve any sport specific goal you have if it is to walk a mile or run a marathon, return to an organized sport or improve your personal best performance on land, water, or snow we are here to develop a program that helps you to reach your full potential.