The OrthoGO Physical & Aquatic Therapy Blog

I hear it all the time from patients about the high/ rising costs of health care. Well yes the initial fees can look expensive, but in reality the provider rarely sees that amount. Most times those fees are reduced 50-75%! Sometimes even more. But what you need to look for is the kind of care you are getting for your dollar. While I can't speak for other professions I can speak about Physical Therapy.

All billing is done by codes. Each Code has a specific definition. A common example is 97110 Therapeutic Exercises for 15 minutes, one on one with a PT. From what I'm hearing few clinics see patients one on one, it's usually 1 on 3 or 4! So if you are being billed for one on one services and you aren't recieving that, you are being over charged! When not being seen one on one the code should be 97150 Group Exercise for 15 minutes. I certainly hope you are not being overcharged. Ask your therapist what you are specifically being charged for, it's your right. After all you are hiring us to perform a service.

One of the biggest issues our patients face if they have arthritis or after a total joint replacement is gaining back lost range motion. It's tough and not exactly a comfortable task but it can be done. First the best offense is a good defense and by that I mean keep your joints moving to the best of your ability. Yes I know it hurts but keeping the muscles loose is critical in maintaining and gaining long term flexibility. You see muscles adapt to how they are used. If you keep the joint still then the muscles respond by shortening to the range in which they are used. Once the joint is replaced the muscles are still tight and need to be worked to regain their length. The easiest way to avoid this work is by keeping everything moving BEFORE surgery. Use ice or heat to help make things manageable and remember it will pay dividends in the end.

I know I've touched on this subject before but the concept really needs repeating, unfortunately. First when I refer to a "cure" that is in reference to actually fixing a problem.

I've been seing more patients lately that are seeking out "Pain Specialists/ clinics" as a first line of care for an orthopaedic problem. The problem is that pain specialists deal with one thing...relieving pain. While that I'm sure is a relief they don't solve the problem, that of what is the CAUSE of the pain? I liken this as similar to "painting over rust". If you don't treat the problem it will only come back.

Don't get me wrong I know that pain specialists play a vital role in medicine, just not as the first line of treatment. They can provide a "window of opportunity" if initial treatment attempts are limited by pain or as a last resort after all attempts to fix the problem have failed.

It's very difficult to solve a problem if no signs or symptoms exist to guide us through to a diagnosis. Similar to driving on an unfamiliar unmarked road.

We here at OrthoGOPhysical & aquatic Therapy work to solve your problems.

So my advice...seek care to solve problems instead of covering them up, you will be much happier in the long run.

Your specific goals are important to consider when you begin an exercise/ strengthening program.

First if you are trying to rehabilitate an injury seek the advice of a Physical Therapist for specific exercises and do's and don'ts. In general you don't want to aggravate pain related to your condition, that's counter productive.

Try to tone up a bit? Just to reduce some sagging muscles? Use low resistances with higher reps say 3 sets of 10. Weights levels commonly used for this range from 1 to 10 pounds depending on gender and body type. You may want to focus on specific muscle groups but don't forget to work the antagonist (opposite) muscle group.

Looking to "get in shape"? Ok this is the next step up. You will want to balance your work out more with both cardio and weight/ strength training. All muscle groups will need to see work. Your routine will probably need to rotate day to day to get everything in. The weight levels you choose should be in the 50-70% of maximum range. Again 3 sets of 10 is a good number.

Looking to "bulk up"? This is where you need to increase your weight levels to 75% of your maximum or more. Reps are  going to be reduced to 10 due to the high weight level.

I always recommend monitoring your heart rate with all exercise programs. Age related maximums = 220 - your age. Your health  history will play a role in how close to your maximum is right for you. Consult your physician for advice.

As always the only "acceptable" pain you should experience is a fatigue related "burn" in the muscles. It should disssipate in a relatively short period of time. Pains within joints should always signal caution and should be addressed as soon as possible if they persist.

There are many theories as to "how to weight train". I'm going to give you mine based on safety and my training and 31 years of experience as a Physical Therapist.

Safety is above all paramount. While I tend to like machines a amethod of choice when it comes to safety, if done correctly with a spotter free weights can be nearly just as safe.

First we need to determine what our specific goals are. General fitness? Injury rehabilitation? Strengthening for a specific purpose/ activity? Body building? Each has it's special approach.

In general I support an overall balance in what ever routine you should choose. By this I mean spending equal time on each side of each body part. For example: If you want to get that "6 pack abs" look you need to work your back extensors just as hard. Looking for huge biceps? Then you should also work the triceps. Rock hard legs? Dont forget the hamstrings when it comes to strengthening. Balance is crucial for your all around joint health. Imbalances cause problems at the nearby joints by changing the forces that effect them. An example would be the spine. Overly strong abdominals will cause a decrease of the lumbar curve placing dangerous stresses on the intervertebral discs which will make them vulnerable to herniation. Another example would be an over emphasis on the pectoral muscles. Tightness here will cause the shoulders to roll forward again placing dangerous stresses on the upper back and cervical spine. Also anterior shoulder structures may become impinged upon yielding rotator cuff issues.

So in addition to strengthening we need to also stretch through a normal range of motion to maintain a functional level of flexibility. Which brings up another area...you should always work through the full available Range of Motion with all exercises. Working in a self- restricted range will limit the benefit to that range alone. In addition repetitively working in a shortened range can lead to muscle shortening or contracture. The body will always adapt itself to stresses placed upon it to make the body function most efficiently in the manner it is used. So self limiting range will cause more muscular tightness and limit your functional abilities.

Next installment we'll talk more about strengthening and means to achieve various goals. Thanks for reading. ss

Ideally an exercise program should contain both cardio and strengthening areas to cover all the systems for better health. However at times it may be more beneficial to start with a program that has more emphasis on cardio initially.

Why? Well there are physical factors that can make weight training "over bearing" for the beginner. When this happens there is a good chance of failure as the person may see it as "too difficult". This may be seen in people that are just weak physically, have degenerative joint issues or are significantly over weight. Cardio doesn't require any special equipment other than a decent pair of shoes. In my opinion it is the easiest way to begin an exercise program. Just start out slowly. Know what your target heart rate should be (220-your age x .80 = target HR unless otherwise advised by your physician if health issues exist). and start walking/moving. Try your best to get up to that target heart rate gradually during your session. Thats really all it takes to get started. Schedule a routine so that you can exercise regularly...daily or every other day are common schedules.

Once you get going you will note things "getting easier". Congratulations thats a big accomplishment. Now you need to keep challenging yourself. There are several ways to do this. If you are on a walking program you can try to increase your pace for the same distance, or you can go a longer time or distance. What ever you choose make it work for you so you can continue with your schedule.

As time goes on things will become easier and easier. Perhaps you notice a loss of weight. Once you start feeling comfortable with exercising and challenging your self it may be time to take a look at adding some weight/ strengthening exercises.

We'll take a look at that in our next instalment.

One of the first questions is usually where do I start when it comes to weight/ resistance levels. It's alawys safer to start low and work your way up to find a challenging yet "comfortable" level. What I mean by comfortable is confidence in your ability to control and complete the given task. Once again I MUST dismiss the mantra of no pain no gain. This falacy continues to be spouted in every gym. Fact is Pain is a sign of a problem not accomplishment. Fatigue, a light discomfort in the muscles is what should be revered. So once we have established a baseline for starting...what's next?

Home vs health club. There are pros and cons to each. Home: Pros-1) convieniece you can go home and exercise without going out again. 2) Once the equipment is paid for costs cease. 3) You don't have to worry about body image with all the hardbodies struting around the club, privacy. Home cons: 1) Exercise equipment is not cheap so there is an initial cash out lay. 2) Motivation- once you get home it's easy to sit in front of the TV or other distraction and before you know it it's time for bed. 3) You have to be able to push yourself along, no others to prod you along.

Club Pros: 1) Memberships are freqeuntly relatively affordable. 2) Many equipment choices at one low price. 3) Plenty of "competition" whether real or imaginary with other members. Avoids the "home trap" you are there so you exercise. Cons: 1) A constant cost. Given a long period it could exceed the cost of home equipment. 2) If it's a busy place you may need to wait in line for your piece of equipment to open up. 3) Some places have specific hours available.4) If you are easily intimidated some seasoned gym patrons are not very friendly to the out of shape beginners.

The next area of discussion is machines vs free weights. In the end they both accomplish the same results so the choice is yours. Free weights have the advantage of having "overflow" to other areas of the body because you must stabilize other parts of your body to do the exercises. Great if you don't have weaknesses or problems in other areas. Free weights are "free" in other words not supported by anything but you. Should you experience a problem mid-exercise loss of control of the weight can be dangerous. ALWAYS have a spotter working closely with you.

Machines: Unlike free weights the resistance is contained in a weight stack or is electronic. This makes exercise much safer. But in exchange for that safety you will lose out on some. if not all. of the over flow benefits mentioned previously. So you will have to use multiple stations to achieve the same results. Macines cost a lot more than free weights and usually take up more space.

Bands: Elastic or rubber bands have one major drawback...they give more resistance at the end of the range than a constant resistance level throughout the motion. Only do part of the job. If they fail or you let go get ready to be "snapped" by the returning band.

Next we'll talk about specific exercise methodologies. Have a great day.

Last time we touched on some pre-exercise thoughts and considerations. So now we have to decide what we're going to do.

First we need to determine if we have any physical limitations to certain types of exercise. The last thing we want to do is aggravate conditions that we currently have.

If you have arthritic or degenerate conditions of the legs special precautions are probably necessary with regards to impact type exercises like running, jumping or force loading exercises like free weight lifts. All of these activities if not done carefully could aggravate leg degenerative conditions making exrcises even more difficult. Even riding a bike stationary or road can aggravate some knee conditions. So start slow, experiment with a variety of activities to see which ones work best for you . Perhaps later on during your exercise regimine you may be able to do things that bothered you at the beginning, nothing is written in stone.

The same thing goes for upper extremity conditions, especially lifting over head. This can be a problem for people with shoulder problems like rotator cuff issues.

The next thing to decide is Aerobic exercise like running, cycling, swimming and the like. Not exactly strengthening per se but they all work the heart and lungs/ respritory system. OR strengthening exercise like weight lifting. Some heart and repritory work but more focused on skeletal muscles. Both are good and both are important. Some of the choice will be dictated by your limitations and desired effect. Ideally a work out should consist of both areas.

So as you start out experiment a bit. Use your head don't try and bite off more than you can handle. Make changes as you go along to find your challenging yet comfortable zone.

That last part is very important...you need to challenge yourself. If things are too easy you will not get anywhere. Like wise don't make it extremely difficult either. Potential injury can be a huge setback.

Ok next time will talk about strengthening specifically and some ideas to take into consideration. have a great day.

Exercise is good. I know profound isn't it. But there are better ways/ methods to employ before, during and after exercising that can make it safer, more productive and more enjoyable (yes, enjoyable). My next few blog entries will be on just that...making exercises "better".

Before starting any exercise regimine you should get a clean bill of health from your physician...ideally. So given that we've all done that we need to set some goals, realistic ones are the best. Have some short term goals for like 2-3 weeks out then some long term goals such as where I'd like to be in a year. Keep in mind that these are NOT carved in stone and you should know that chances are you will change them as time goes on and you get a feel of what you are actually reasonably capable of attaining. Goals that are impossible to attain are nothing but a frustration and who needs more of that in their lives.

You want to set a reasonable schedule to exercise with times, places etc that will be easy to maintain. Start small you can always get bigger, but starting big and having to downsize only breeds defeat.

You also want to start out slowly...yes I know everyone wants results yesterday but in reality it just dosen't happen that way. If you start small and slow you can always increase things which will make you feel good, decreasing things only breeds defeat. Know your limitations. To this end you know what is too much. Recocognize painful conditions, medical history etc.

As for your heart rate you maximum safe heart rate can be determined with this formula: 220-your age in years= maximum HR. Never exceed this number. Ideally most efficient exercises are done at 80-85% of your max. Sooooo 220-age x .8 = a safe maxHR to start out with. You can check your HR manually during the course of your workout or you can purchase a heart rate monitor for about $40-50. If you can afford it this is a very worth while purchase.

As for clothing chose things you are comfortable in. This not only includes physical comfort but also emotional comfort. We aren't all hard bodies. Be yourself, be comfortable.

Shoes, very important especially if you are going to be running or walking. They should fit properly and be comfortable from day one. Don't skimp here because poor quality will only cause problems, perhaps even pain. The support in athletic shoes lasts for approximately 750 miles. After that the cushioning and support will be down graded significantly and will effect your comfort and performance.

In our next installment we'll talk about types of exercise .

The computer work station. Many of us use one at least at some point every day.

First we want to sit up tall and straight, feet flat on floor, back being supported by the back of the chair (hopefully using a lumbar roll for support). The chair should not be so deep as to cut into the backs of your knees. If the back is small and adjustable place the pad in the small of your back just above the belt line. Our head should be back over our shoulders. If we need eye wear use them.

Next as we relate to the hardware of the computer...ideally elbows should be bent to 90' with arms straight down at your side with your fingers on the keyboard. A wrist pad is a good addition as it keeps wrist in neutral (too much down or up can lead to carpal tunnel problems). If you use a mouse it should be positioned immediately to the right or left end of the keyboard.

The monitor should be straight in front of you, at a height where with you in the proper sitting posture, your eyes are even with the top edge of the screen. Beware of positioning your work station to avoid office light glare on the screen.

If copying materials they ideally should be positioned to either side of the screen to limit downward positioning of your head. Also manuals that you may frequently use during the work day should be positioned within easy (not stretching) reach on your stations desk top.

Proper posture used during the course of activities is called body mechanics. Maintaining your core postures no matter what activity you perform will go a long way in preventing pain. This means maintaining a curve in the "small" of your back.

So if you are going to pick something up off the floor squat down and pick up the object. It does not matter how small the object is. Bending over at the waist increases the forces on your lumbar spine significantly. This could easily cause a herniated disc...yes that easily. If you are bending down to pick up something of an unknown weight use this trick first: attempt to move the object with your foot. If it moves easily then you should be able to handle the weight. If it doesn't move easily either get someone to help you OR get a tool such as a 2 wheeled cart to assist.

For items above shoulder height always get a secure ladder or step stool. Make sure to clear other items out of the way so that you can set up as closely as possible to the task. Reaching out of your base of support (feet base) you will be increasing the forces on your spine will be multiplied.

It is a good habit to alwyas bend your knees to "get down" to the level of your task.

Problems with your knees? This is unfortunately common. I suggest getting a chair to sit on to get down towards the floor if possible. Otherwise save your back and get someone else to help you. The last thing you need is yet another problem of a bad back.

While I have stated before posture is the keystone to keeping back and neck problems to a minimum...but how do we do it?

Let's start with sitting...sit tall keep your back against the back of the chair or seat ( that's what it's there for). Then work on getting your shoulders back. The easiest way of doing this is squeezing the shoulder blades together in back. Yes there will be some muscle strain but with repetitions and time it become easy. Next work to get your head over your newly repositioned shoulders. This is done by pulling your head backwards. Yes it will feel awkward at first but your neck will thank you for it later. Another easy trick to keep the head and neck in good position is to look with your eyes not your head.

Now still in sitting lets look at your lower back. Ideally there should be a space in the "small" of your back and the chair...that's normal and a good thing. To help maintain this curve place a small (4" diameter) roll above the belt line. This will aid in keeping you sitting tall and straight.

Our next blog installment will deal with body mechanics in other positions.

Ok to start with there are situations where surgery is inevitable...this blog is not about those. Today I want to talk about posture and body mechanics as simple ways to avoid back strain and potential disc herniation (bulges etc). The answer is posture, posture, posture. If one can maintain a normal lumbar curve though daily activities trhe chances are less to injure your back. How do we do this? Simple...stop bending over at the waist, stand and sit tall...NO Slouching,and limit sitting. As for the neck again SIT TALL, look with your eyes not your head, keep shoulders back and keep your head over your shoulders.

While initially all this good posture stuff will feel a bit awkward initially, in the long run it will allow your weight to be borne by the vertebrae instead of hanging on muscles and ligaments placing unbalanced forces on the discs and other joints.

Speaking of balanced, lets talk about core strength for a moment. First the muscles of the core aren't "strength" kinds of muscles, they are endurance muscles. They need exercise that build their staying power to maintain good postures. They aren't lifting and power muscles. Spaeking of that...all this focus on abdominal strength for relief of back pain is a bunch of baloney! Over strengthening one side of the core "cylinder" will only make it bend forward negating that postural balance needed for good disc health. Flexibility both forward and backward along with BALANCED strength and ENDURANCE into both flexion and extension are keys to keeping discs happy.

Now go out and be good postural role models for everyone...it looks better too!

I have heard a lot of people say they "just want the pain to go away". Unfortunately getting treatment that just makes you "feel better" can be a poor decision. There are practitioners out there that can "make the pain go away" but it's just that, getting rid of the pain symptom not addressing the actual cause of the symptom. This type of treatment is usually short lived and the problems return fairly quickly. Sometimes worse than before due to the false sense of security type of treatment they recieved.

So when you are looking for a PT or other medical practitioner ask questions. Don't fall for the "quick fix" or band aid types of care. You want and deserve something that corrects the problem and lasts. The other thing that you should demand is a plan, perhaps exercises, that you can implement if you start to have a relapse of your complaint so you may address it on your own before it requires medical attention.

We here at OrthoGO Physical & Aquatic Therapy do just that. We assess the problem and develop a plan to abolish your complaint. Everyone goes home with a home program to expediate the healing process.

With the school year rapidly approaching and along with that school sports seasons I would like to take this opportunity to caution all parents with regards to sports injuries. Already there have been a few heat related deaths in the news...but that's only the half of it. Sports injuries are a very prevalent situation. It is important for parents to be alert to even the slightest change in your childs physical functioning. While many coaches and trainers look out for their student athletes best interests...sadly many also do not. Even minor injuries can be severe and career ending in a split second. It's never really ok to "suck it up" and play on. Each and every injury should be examined by a physician...no an athletic trainer is not enough. The adrenaline rush from competition and winning can be a powerful drug. But common sense erring on the side of caution must prevail. I'm sure some readers are thinking that I'm "full of it" or treat kids like babies. Sorry that's furthest from the truth. My concern is their health and welfare both on and off the field...and long into thier future. Missing a game or two now could save a college career in the future or a happy pain free adulthood. Be smart, use you best judgement, be the best parent you can be.

This is an area of the body where there are lots of possibilites for causes of pain. The first thing you need to do is identify specifically the cause of your pain or when your pain began. This is critical in understanding what needs to be done to help reduce and hopefully abolish your symptoms. If the cause is physical trauma then it's usually best to seek medical attention so an xray/ MRI can be done to make sure there isn't significant structural damage that could result in a worsening of your condition.

Ok so the pain isn't from a physical trauma. The foundation for a healthy spine is posture. Yes, this simple change can make a world of difference. It may not be the complete answer but one can never go wrong by maintaining a good and correct postural alignment. Initially it may be difficult to get into "a good posture", Not unusual this may take a fair amount of patience and persistence on your part. What ever you do don't give up on posture. I suggest you get someone else to look at your posture for you as often we "can't see the forest for the trees" we think we are in a good position because "it feels like it". This is so misguided. Often times we become used to a position/ posture over time. This becomes second nature to us and we have no idea that we are not in a good position. So get someone else to give you cues. Posture is not only in standing, it's in sitting and even lying as well. Strive to keep your spine straight left to right and keep a forward ( concave) curve in both the neck and lower back regions.

Once you accomplish this work on performing your daily activities with a base of good posture. Use your legs to lift, no bending over, carry loads only easily manageable etc. Whensitting always use the back of the seat to support your entire spine. When lying place a pillow between your knees if sidelying.

Use of heat or ice is one of comfortable choice. However if there is swelling do not use heat.

As always these tips are not meant as a substitute for medical care. If symptoms persist or worsen seek medical care immediately.

As we get down to the very bottom of the body we find a frequently ignored area both in care and not taken seriously as a cause of problems further up the chain...the foot and ankle. Theorhetically a problem at the foot could cause problems (via a chain of events) in the neck. But we will skip the theorhetical and deal with the more common causes today.

Common injuries are sprains. Most of the time the foot rolls "in" at the ankle causing minor to severe pain and swelling. The best course of action here is to get off of it, rest, elevate and ice it down. If you need to walk use a can or crutch to take off weight. If this isn't sufficient get to a doctor to make sure there aren't serious injuries. If pain persists more than a day or two medical intervention should be considered. If by chance your foot rolls "outward" there is a good chance of a fracture. Get this checked out immediately.

Another common area of pain is about the heel. Often diagnosed as a condition called plantar Fasciitis. This is due to an increase of stress to the tendonous structure on the bottom of the foot. If the condition gradually worsens check for potential over use or even the type of foot wear you have been wearing. Frequently a change in this area will resolve the problem. Also orthotics may place the foot in a better position to reduce the stress. If the symptoms occur rapidly without a specific cause the problem could be a "jammed" tarsal joint in the foot. A knowlegeable PT will know how to mobilize this problem and get you back on your way in no time.

As always this advice is meant to be a guide and not as a medical diagnosis or evaluation. When in doubt seek care from a qualified medical professional. Thanks for reading. ss

Ah the knee, one of the most frequent complaint areas I see. Overall the knee is a fairly unstable joint by design. It's really just two bones the femur (thigh) and Tibia (the main "shin bone") stacked on top of one another. The Patella (knee cap) acts as a pulley for the quad muscles (front of thigh) to be more efficient in straightening out the knee. The Hamstrings (back of thigh) counter the quads from over straightening the knee and are important in hip function as well. The largest of the calf muscles Gastrocnemius crosses over the back of the knee as well. Laterally the Ilio-tibial band gives support and medially the Adductor magnus provides some support as well. But beneath all those muscles lie the all important ligaments that hold the knee in the right position. Most notable are the medial (inside) and lateral collateral ligaments. In the center of the knee are the anterior and posterior cruciate ligaments. They provide rotatory stability.

Common knee issues often stem from either impact or kneeling on the patella or over use as in stair climbing. Pain will be noted under and / or around the patella. Simple treatment is as easy as avoid the irritating factors, rest and ice. A simple exercise which will aid in stabilizing the knee cap is as follows: With knees straight thighten the quad muscles as tight as you can and hold for 5 seconds then relax. Repeat 10-20 times multiple times a day. This along with avoiding irritation will resolve minor patellar issues with a little time and effort.

Other issues where swelling is notable, pain is prominent and weight bearing difficult may be indications of more serious problems such as a sprain (partial to complete tears of ligaments) or torn cartilage. In either case rest, ice and immobilization is the best first aid until medical attention can be arranged. Use of a cane or crutch may be necessary to reduce stress to the knee.

As always these are simple tips for minor conditions. They do not substitute for evaluation and treatment by a health professional. If you have further questions please contact us at scott@orthogopt.com . Have a great day.

The hip is one of those joints that fortunately don't have many problems until later in life if even then. However other than one problem in particular (which we will discuss) hip issues frequently require surgical intervention. Degenerative arthritic conditions due to either wear and tear or traumatic injuries of femoral or acetabulum (hip socket) fracture usually do best with joint replacements.

Moving on to problems we CAN treat easily. One frequent problem is Greater Trochanter Bursitis/ tendonitis. Pain will be located below waist level on the "boney bumps"along the side of the upper thigh. This problem has a variety of causes ranging from falling on it or over use, to walking with a limp (possibly due to another problem). Ideally it's best to reduce stress to the area. Use of a cane or crutch on the opposite side can do wonders. When side lying a pillow between the knees reduces stress significantly. Ice is good for reducing swelling and to "numb" sharp pain. After wards use of heat for no longer than 20 minutes can be beneficial in improving circulation.

Other common hip issues are more chronic in nature. People who sit a lot may experience tightness in the front of their hips. This is dur to muscle tightness. The best way to remedy this issue is to sit less or to counter with lying prone to stretch out the hip flexor muscles. Initially this may be uncomfortable but is very effective.

Overall general flexibility of the hips should be maintained with basic motion exercise done in standing. while holding on to a stable object, kick slowly to front, out to side and backwards will help greatly in keeping things mobile.

As always these suggestions do not substitute for medical care. If pain is significant, or if you are unable to stand on the effected leg seek medical attention immediately.

The most common and significant problem at the wrist is Carpal Tunnel Syndrome. There are other issues predominantly tendonits situations but we will address CTS here.

The Carpal Tunnel is a "trough" on 3 sides made up of the wrist or Carpal bones. The 4th side is the Transverse Carpal Ligament. Through this tunnel run nerves, blood vessels and tendons to control the hand. Injuries to this area can be a variety. Trauma (such as falling on your wrist while breaking a fall), over use ( hammering, repetitive screwdriver use) and positional (keyboarding). Symptoms frequently begin as occasional tingling or numbness in the hand and fingers. With time this will worsen. Occasionally temperatute and swelling issues may be seeen. Muscular weakness and muscular wasting is a sign of severe nerve impingement.

As always it's best to catch this problem early to avoid requiring surgery and a lengthy rehabilitation. Frequntly the situation can be reversed by changing work habits and postures of the wrist. Use of ice, rest, and gentle stretching may be of benefit.

If surgery is needed the Transverse Ligament is cut to allow pressure that has built up in the tunnel to be relieved there by taking the pressure off the nerves and blood vessesls. Afterward a lengthy program of strengthening and stabilization exercise needs to be done to stabilize the joints.

Other conditions at the wrist such as tendonitis can be reduced with use of ice, rest and stretching in the opposite direction of the aggravating forces.

As always these tips are meant as a guide and do not replace medical attention to reduce significant problems.

Most common issues at the elbow are not within the joint itself. If there are problems actually inside the joint they are either arthritic in nature or due to trauma ie a fracture. The elbow is a very "tight" joint, very little play is the norm and actual joint injuries often cause a reduction in motion. Many elbow problems however occur outside the joint proper and are frequently tendon orientated.

"Tennis and Golfers Elbow" are the two most common tendonitis'. Tennis elbow or Lateral Epicondylitis is located on the outer side of the elbow just above the joint line. It is frquently caused by over use of the wrist extensor muscles. Golfers elbow is just the opposite. It is Medial epicondylitis on the inner side of the elbow and is most frequently caused by over use of the wrist flexor muscles.

Treatment is a combination of rest, ice, and intially a gentle streching program done in the opposite direction of irritation. EXAMPLE: for lateral epicondylitis you want to gently stretch the extensor muscles by extending the elbow and bending the wrist downward. Several repetitions periodically along with non aggravation will yield results. After the symptoms are under control then a gentle but progressive strengthening program is in order. For a medial epicondylitis just reverse direction of stretch. Many times a strap placed below the elbow over the upper forearm can take the stress off the tendons as well.

Other tendon problems about the elbow are either bicep or tricep tendonitis located either over the front or back of the elbow respectively. Again rest, ice and non aggravation are the key. Gentle stretches progressing to light strengthening is best.

If you have sustained a traumatic injury to the elbow and "it's stuck" get to a doctor for xrays. Frequently bone chips can get lodged between the bones and will need to be removed.

As always these tips are for basic information only. Severe, or recurrent problems should be evaluated by a PT or orthopaedic physician.

The shoulder is one of the most complex joints in the body. In actuality it's not just one joint but a series of joints acting in unison to provide the motion we see.

First we need to make sure if the problem is indeed from a part of the shoulder complex or being referred from your shoulder. A simple way is to move your neck in all directions...does it cause or recreate your symptoms? If yes then see the previous blog entry on the neck because the primary problem is not likely your shoulder.

If it is not your neck then we need to pin point the area of issue. Is your pain from a traumatic incident? I'd have things checked prior to self treatment to make sure there isn't serious injury that could easily be made worse by movement.

Pain on either end of the clavical or collar bone involve the sterno-clavicular (SC) joint if its near the breast bone or Acromio-clavicular (AC) joint if its out over the front of the shoulder. These joints have little muscular stability and pain/ injuries here are frquently of a sprain nature. Not much you can do except rest and immobilization. Have this checked out by a PT or physician.

Pain lower over the front of your shoulder is frequently the long head of biceps tendon. A quick treatment for this is GENTLE full range stretching in a backwards (extension) direction. Use the non effected arm to assist and perform many (10) repetions to assess benefit. If better do more reps. Use caution to avoid increased symptoms.

If your pain is over the top of your shoulder try putting forearm behind your back and again GENTLY stretch the arm up behind your back with the unaffected arm. Follow instuctions as for biceps tendon repetitions.

Certain problems have certain signs that should be identified. Frozen shoulder or Adhesive Capsulitis is characterized by very limited motion that is stuck at a certain point. It is usually very painful. The only good treatment for this is supervised exercises to loosen the joint. I'll be honest this tretment is fairly painful and takes a lot of diligent effort by the patient. Seek physician and Physical Therapist advice.

The last condition I'll address here is a rotator cuff tear. Frequently the person will not be able to lift their arm past shoulder level without assist or hold it up under light pressure. These are positive signs of a tear in the muscles that are the prime movers and supporters of the shoulder joint. A tear will require physician intervention.

Once again I must remind the reader that these tips are general in nature. They do not replace medical care. they are designed to help reduce simple problems. If in doubt always seek medical attention. ss

This guide is meant to be a general guide for non-trauma types of aches and pains. If you have been in an accident OR have sustained an even mild traumatic incident we advise you see a physician prior to any self care.

First check your posture. Your head should be directly over your shoulders with your shoulder blades pulled backwards...in otherwords no slouched postures. If after about 5 minutes this doesn't alter your discomfort then...

From this position pull or tuck your chin backwards...NOT DOWN! Hold 5 seconds and repeat gently trying to get you chin back as far as possible. If after 10 repetions this hasn't helped then...

From the "tucked" position gently tilt your head backwards, relesing the tuck as you go. Let your head go as far as it will go. keep it there about 5 seconds. Then return it to the start position with the chin tucked. repeat 10 times and assess your discomfort.

If you are no better then repeat once every waking hour, always assessing your complaint afterwards. If at any time your condition worsens stop these exercises and seek a PT evaluation. Also if you do not experience any relief then you need to be evaluated by a Physical Therapist.

Once again this exercise is NOT an answer for everyone. Remember if your pain is severe or trauma related seek medical consultation prior to any self help methods.

Headaches sound fairly mundane but the ones we're talking about here are the recurrent ones.

First you need to identify if there is a pattern to their occurence. A specific activity, position, time of day?

Many headaches are due to poor head and neck postures such as when spending time at the computer or other "desk work". Try repositioning your head so it is upright with your head over your shoulders. See if that helps after a couple of minutes.

When was the last time you had your eyes checked? Frequently eye strain is a cause of headache pain. Try changing the distance between you and what you are looking at and see if things improve.

Are you out in the bright sunlight without sunglasses? Long term squinting can easily cause facial muscle strain leading to a headache.

Under a lot of mental stress? Frequently tightend neck muscles can lead to a tension headache across you forehead. Start with improving your posture and work on some stress management techniques to help yourself relax.

Do you eat meals infrequently? Low blood sugar levels often are the causes of headaches. Get something to eat, let it digest.

Lastly...have you had a recent head injury? Does the pain never go away? Do you have dizziness and vision problems along with the headache? Is the pain getting worse? Is the pain severe? Do you have a weakness on one side of your body? These signs are just a few that scream GO TO THE HOSPITAL, NOW!!!

The advice given here is not meant in any way to be a substitute for medical attention. Headaches if persistent and worsening can be warnings of severe health problems.

Most of us have them from time to time, maybe a few more as we get older or if you play and/ or work hard age is not a factor.

If you get them while you are being active take a look at your body position...good posture, repetitive movements, constant position? These are the most common issues. That along with your prexisting issues perhaps arthritis are the main sources of aches and pains.

So how do we deal with them? First don't take on more strenuous activity than you can comfortably handle, keep the weight low. Work to maintain good sitting or standing postures, being constantly bent over will put a great deal of stress on intervertebral discs and spinal joints. Change activities frequently. Usually we all have several things we are doing at once. Alternate easy and difficult, standing and sitting, walking and sedentary. Changing positions may be as simple as moving and stretching gently in the opposite direction of your work. If you've been bending over, stretch backwards, leaning left, stretch to the right, etc.. Of course it doesn't hurt to interject a rest period in here or there.

When it comes to actually treating the aches and pains after the fact I always recommend ice over heat. It acts as a topical anesthetic and keeps swelling at bay. Over the counter anti inflammatories also work well, just follow the instructions on the packaging.

Just remember tommorrow is another day and those projects will be waiting patiently for you.

If you have persistent aches and pains it might be a good idea to give us a call to check things out. Remember we offer free injury screens and will make recommendations on how to get you going in the right direction again. Give us a call...815.344.9727.

Despite there being a whole page dedicated to Aquatic Therapy I am going to give you a synopsis in a nutshell. The biggest advantage is that it makes exercises easier and less stressful. This benefits anyone who has significant weakness and/ or pain that keeps them from exercising to an effective degree on land. The ultimate goal being able to progress from the "assistive" environment to that of the real world on land.

That said a water environment can become a resisted/strengthening one by moving rapidly through the water. This is ideal when getting ready to advance the client to a land based program.

If you have difficulty getting an exercise program under way due to weakness or joint pain, call or e mail us at scott@orthogopt.com to get yourself started in the right direction.

Thought working around the yard was harmless, huh? Well larely it is but here are just a couple of hints to keep things safer/ less potential for injury.

First lifting...as I'm sure every body knows by now we need to lift with our legs not our backs. So squat down, keeping your back perpendicular to the ground, and return to standing maintaining that back position. If your legs are a little weak then firmly plant a shovel into the ground next to you and use it for leverage. Nothing is too small to use this technique just bending over could have dire circumstances when it comes to our backs. If the object is heavier than you can easily lift either get a tool, such as a 2 wheeled cart or wheelbarrow to help. Tools are our friends.

Reaching/ raking: Again in an effort to keep our backs happy avoid bending over at the waist. Take short strokes, standing tall raking only 1-2 feet out in front of us, don't over reach.

Trimming bushes, etc.: The prcaution here is especially important when on a ladder. First make sure the ladder is planted firmly on the ground, no wobbles allowed. Next only reach objects that are EASY reaches. Extending yourself too far frequently ends up in falling off the ladder. If you are holding a tool such as a hedge trimmer, be extra cautious as this extra weight can throw us off balance very easily.

If using electrical gadgets make sure the cords are grounded and secured away from all cutting surfaces and away from your feet, you don't need to trip.

Use of any power tool necessitates the use of quality eye protection. All kinds of things can go flying when edging, sawing and trimming.

This is just a short list of the basics. If you have any additions please feel free to add them on. Have a great day! ss

Our title for todays entry comes from a saying I have borrowed from an old Fram oil filter commercial..."You can pay us now (refering to changing oil and filter regularly) or you can pay later" ( as in an engine overhaul due to poor maintenence by yourself).

I use this when I talk to employers about improving the ergonomics if their workplace. Many are hesitant to spend dime one on preventative measures to reduce stress and strain to employees. The end result is employee injury...and a much bigger than expected cost to deal with said injury.

Let's start with the fact you need to pay for the medical care they will require (sure an insurance Co. will pick that up initially, but we all know they will recoup that expense in next years premiums). Second you are paying a worker who's not working and you lose their productivity as well. Sure you could hire a new person to do their job...so thats a 2 for 1 deal that you'd rather not get. In addition you get to pay for the replacements training and benefits. When the old employee returns you get to pay that replacements unemployment benefits too!

The easy way to reduce these occurences is to examine each job you have. Make sure you hire people that are physically capable of doing the job. Next have the job itself analyzed for minimal physical stresses to avoid repetitive use and potentially injurious tasks and positions. Instruct workers and supervisors in proper compliance with all safety precautions REGULARLY.

How do you get all this done? OrthoGO Physical Therapy has a complete program available in addressing each and evry issue listed here...at the fraction of the cost of paying for 1 or 2 lost time injuries. Think about it..."you can pay me now or you can pay me later".

Many people, women of middle age in particular, have been diagnosed with this problem. It is catagorized as a "rheumatic" disease yet does not have any degenerative characteristics. It's sole defining factor is pain in 11 distinct areas. People that have this problem complain of stiffness, joint soreness and reduced movement. Generally speaking I find clients that have been diagnosed with this problem as just as debilitated by the diagnosis name as with the condition itself. I also frequently note that many patients that have "aches and pains" are simply given this diagnosis as nothing else fits. This can be emotionally disasterous.

The best method to treat this problem is movement. Yes you will feel tight and stiff but the longer you allow the complaints to limit your movement the more difficult it will be to over come. Always move to the full extent of your range of motion. Don't stop short. Remember there are no degenerative joint issues associated with this problem. Heat or cold applications may ease discomfort. Consult your physician with regards to medication options. But above all DON'T STOP MOVING!! If you have questions please contact us : scott@orthogopt.com or give us a call at 815.344.9727.

This is a huge area and I'm really only going to address things that YOU can do about it easily. If these tips/ ideas help marginally or not at all I'd suggest consulting a medical professional.

If your complaints have become second nature and you've lived with them for years we need to look at basic mechanics. Do you have flat feet? Don't know? Try this easy test: When you get out of the shower look at the wet foot prints you leave. If they are one elongated triangle shape then you have pronated (flat) feet. If they appear to be an elongated "C" or reversed "C" then your arches are probably ok. If you have flat feet the usual solution may be orthotics. These shoe inserts may be custom made or you could try visiting one of those "Dr Scholls" computerized kiosks. You can get a less expensive pair of orthotics and try them out. If they work for you then I'd recommend going and getting a permanent pair made.

If your complaints are more acute we need to examine what was it that caused the problem in the first place. Is it swollen? Bruised? Is there a specific point tenderness? Twisted ankles are common and may injure ligamnets (sprains). Rest and ice are the best first aid. You may want to keep it immobilized and take weight off it with a cane or crutch. If it is bruised the situation is a bit more serious, ice it for comfort but go get it checked out by a medical professional. Is it a toe? Is it red, swollen, tender to touch? It may be gout. Again see a doctor for advice.

These are just a couple of ideas. If you have specific questions email, or give us a call we'll be happy to help. Scott@orthogopt.com or 815.344.9727.

This is an issue that I see frequently in the clinic. A new cllient presents with shoulder pain. No significant cause of injury.

The fact is that pain in the shoulder can be an indication of either an actual shoulder dysfunction or an issue dealing with neck positions and postures.

First make note of what types of activities aggravate and reduce your complaint symptoms. Is it movement of your arm that makes thins worse? If so, there's a good chance that it is a shoulder issue. However if you are "just sitting there" without moving your shoulder there is a good possibility that your problem may be stemming from a neck issue.

To check the shoulder maintain a good neck posture and move your shoulder around in various directions at a slow pace. Any recreation of complaints would probably indicate a shoulder dysfunction.

To check the neck gently move the neck both forward, back, side to side and rotate right and left. Did that recreate your complaint? The first line of defence for neck( cervical spine) issues is improving your postures with daily activities.

In the end if symptoms do not improve I would suggest seeing your physician or stopping in here at OrthoGO Physical & Aquatic Therapy for a quick injury screen. If we see something that needs attention we'll get a hold of your physician to let them know of our findings to get you back into shape.

I talked about those "rocker" shoes earlier. But what Kind of shoe is right for you? Well first what are you going to be doing when you wear them? Any specific activity? They make such a wide variety of specialized shoes these days because certain sports or activities require different support, protection and shock absorption. Next make sure they fit right. Don't go by what you've always worn. Go to a GOOD shoe store and thave then measure your feet. You remember from when you were a kid those black metal things? Good shoe stores have them. Also it's not just size but also width thats important. A GOOD shoe store will have a variety of widths in each style or be able to order them for you. DON'T SETTLE! GET IT RIGHT! Budget stores often have lesser quality shoes (maybe even of a famous brand). They also will usually only stock the "average" widths...not good. Shoes as a rule wear out a lot quicker than you would think. Athletic shoes last for about 750 miles. Sounds like a lot but if you wear them daily at approximately 4 miles a day for the average person, that's significantly less than a year. If you were to try on an identical shoe after 7 months you will be able to feel the difference. The foam degrades over time and with use.

I'm sure you know of some GOOD shoe stores in your area. But I'll throw in a plug for New Balance here. (No, I'm not getting anything for this). I have found their products to be of very high quality and at least at the Crystal Lake store, excellent service and knowledgeable staff. They will actually measure your feet and they stock a variety of widths (or will happily order them for you). They have a wide variety of athletic shoes for men, women and kids plus with their affiliated brands have dress casual and work/ outdoor shoes as well. Happy shopping, your feet will thank you.

Since it is on my home page I've had people ask this question. An Independent PT is a practice that DOES NOT have any financial ties with physicians that refer to them. So they are not employed by a referral source, they do not rent from a referral source and they do not "pay" for their referrals from physicians. It is a statement of ethics...if there is no financial exchange then the relationship is based solely on professional abilities and respect.

Well obviously we need to watch our exposure to the sun. Avoid burning and use an appropriate sun block for your skin type. I'd suggest something odorless to help keep bees and wasps away. Speaking of those critters watch where you put your hands, hives can be almost anywhere.

Now back to the PT related things:

Protect your back by bending at the knees to pick up or place things on the ground. Another way to help your back is to use "tools" like a wheelbarrow to make your life easier and carry heavy or awkward things. When up on a ladder work close, don't reach far. Fall risks are obvious but reaching out especially if you have something heavy in your hands can really strain your back. When digging stand tall let the shovel do the work. Take small loads of material and avoid twisting, turn toward your destination. Raking, again stand tall avoid long reaches and take short sweeps closer to your body.

As for knees I always suggest knee pads of some sort. Also crawling can really aggravate knee cap issues. Try side sitting and change your positions frequently. Those little garden carts can be helpful but watchout for too much forward leaning...bad for your back.

I'm sure there are other things I'm missing. I'll post them here when I think of them.

Enjoy your spring!

You know the ones, manufactured by a few companies. Guaranteed to firm you legs and buttocks... Yes you know the ones. It's a shame people go out and spend lots of money on special shoes when all it takes is walking correctly. The rounded sole promotes a normal gait pattern...heel, foot flat, toe off...that's it. It's how we are supposed to walk. I realize that women, in particular ones that live in heels, think walking on their toes is normal...it's not. Before you go out spending lots of money on shoes you are only supposed to walk in try focusing on heel, foot flat, toe off...it works. Now if you are a died in the wool heel wearer you will probably need to work on some serious calf and hamstring stretching first. Then work on the sequencing, it won't be hard its a natural pattern of movement. If you have questions, CONTACT ME either here or via email, I'll answer your questions. ss

We all remember as kids being told to "stand up straight" by a parent or teacher. We thought they were nuts. Fact is they couldn't have been more correct. Posture is extremely important in bodily functions it's amazing. First...it takes the stress off our spinal structures (joints, discs, muscles, ligaments etc). It is the cornerstone for reducing back and neck pain. Second...it allows better physical function. If the spine is in proper alignment we can move better as the joints and muscles are in their optimal positions, ie a better golf swing. Third... (this is what amazes most folks) our internal organs function better Yep, really. Being slouched compresses our lungs, heart and internal organs. We can't take as full a breath, our hearts are compressed reducing (slightly) its out put function and our digestive tract can be restricted.

So there you go see how important proper posture is? Now sit up straight, stand up straight and feel better!

We have teamed up with PayPal to accept credit, debit and PayPal payments for account balances. We hope this will make things a little easier. Let us know if there are any problems. ss

Not really an uncommon question. Here in Illinois we PTs can evaluate without a referral. If you have a documented relevant medical diagnosis (ie you were seen in an ER or have a chronic condition) we can begin treatment with a call and approval from your physician. Some physicians, however want to see you first. We will do everything in our power to advocate for you with your physician to get you the treatment you need.

One thing you should know is that almost all of the time an insurance company will not pay claims without that prescription for PT.ss

Another myth I've heard is that you have to break down muscle tissue before building it up. WRONG!! The last thing one wants to do is break down muscle. Damaging tissue creates only one thing...scar tissue. Other than holding damaged tissue scar tissue has NO value. It is not contractile, it just sits there. It gets in the way of normal muscle function if it interupts the normal fiber alignment. Work out with gradually increasing intensity. Let your body accomodate naturally and you will be miles ahead. Injuries of muscle can take a long time to heal and the result is that you will be further away from your goal.

An example of how scar tissue can interfere with muscle tissue function can be seen in women who have a certain ceasarean section surgery. Many women opt for the "bikini cut" vs the vertical abdominal cut because it is nicer cosmetically. What they don't tell you is that the bikini cut cuts across the lower abs disabling the lower half. The result: a pouch of useless lower abs. The vertical cut while more visible cuts through the Linea Alba a tendonous area of the abs. End result is NO muscle damage. The scar can be reduced with soft tissue work and fade into the background.

What it really comes down to is one's definition of pain. It is the percieved discomfort associated with an incoming sensory stimulus.

The above, some what infamous saying, must have been developed by some one with an extremely low tolerance for pain.

It is most commonly related to exercising at a very intense level. The "burn", "fatigue ache", maybe cramping that comes with working out hard. The question is "Are those sensations really painful?" I will concur that they aren't comfortable, not at all. But painful? As we cool down or rest those sensations dissipate relatively quickly.

To me pain is a warning signal that something is indeed wrong, very wrong. It doesn't dissipate quickly, is frequently associated with swelling, perhaps redness and an inability to perform a specific function. A "burn" doesn't do that. Pain is a signal that your body part has been pushed too far.

So if you are exercising to the point of pain which causes you to be unable to perform a given function you've gone too far. Potentially injuring yourself. I like to use the saying " No STRAIN, No Gain" Take care of yourself when you are out there working or exercising. ss

I've had a lot of patients commenting on how they feel achey this week. Well let's talk about how the weather effects your pain.

When one has an inflamed or compromised joint the body increases the amount of fluid in the joint to act as a cushion and aid in healing. What that does is increase the pressure within the joint (a sealed in a capsule structure). The atmosphere also has high and low pressure zones as we see pointed out on the weather forecasts.

So an inflamed joint is in effect a high pressure zone. If the weather is pleasant out (as in sunny, no precipitation) the atmosphere is also in high pressure mode. With this scenario there is little additional discomfort. If, however, the weather turns bad, as in rainy/snowy) the atmospheric pressure is low. This combined with an internal high pressure in the joint causes an imbalance. The high pressure wants to balance itself with the environment but can't, it's a sealed system. The joint will get tight, stiff and maybe painful as a result. It will stay that way until the barometric pressure rises again and the presures equalize.

This is how some people can "predict" the weather. Approximately 18 hours before a storm arrives the barometric pressure begins to drop. The joints sense the change and start being stiffer than usual.

So in the end it has nothing to do with dampness, rain, snow, or temperature, it's all about pressure.

So let's talk about the rehabilitation portion of Knee replacement surgery. First and foremost the better your knee FUNCTIONS prior to surgery (no matter how painful it may be) the better your results will be after the surgery.

WHY? because the joint itself is only part of the problem. As the joint gradually deteriorates and becomes painful we tend to "favor it". We don't bend or straighten it as much and may use it less as time goes by. This causes changes in the soft tissue, muscles among other structures. This decreased or lack of use causes the muscles to shorten and weaken.

So when we get the joint replaced the painful structures are removed and replaced by artificial ones...the Soft tissue problems remain and that is what is being rehabed to get the most out of your brand new knee.

In therapy you will work on basic functions like walking, stairs etc. Use of an assistive device varies person to person. Hopefully these devices are just temporary. Other exercises include exercises to increase Range of Motion, strength, endurance, weight bearing and confidence. All are parts to the puzzle that will make your surgery a success.

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Once again I need to remind everyone that each surgeon has their own approach and methods/ preferences of how to perform TKRs. From what I've seen one approach is not particularly better than others. Most differences lie in the patients pre-op condition and how hard they work in rehab.

When it comes to TKRs they may be cemented or non-cemented. Each has advantages and disadvantages.

A cemented TKR is most frequently used when the patient is not very active, is older or they have a condition which will require them to bear weight on the effected leg immediately. The cement dries almost immediately allowing full weightbearing. The down side is that on a rare occasion (higher than expected activity levels) the cement may deteriorate and the parts may loosen. To fix this another surgery is necessary. It is happening more now that frequently the surgeon will add screws to help stabilize the parts during the installation surgery.

Non-cemented TKRs require a period of limited weight bearing of up to 6 weeks (occasionally more). This is because time is needed to let the bone grow into the parts (almost making them one) to hold them in place. No cement means nothing to deteriorate. These are best for younger or stronger patients where increased activity levels are expected.

In the end your surgeon will make the recommendations that he/she feels are best for you.

Opinions written here are of the writer. OrthoGO Physical Therapy is not responsible for the writings and opinions other than our own. When it comes to discussions of surgery or other proceedures they are meant to be used as a general guideline only. Every physician and surgeon may have a different opinion or approach. We welcome physicians and surgeons to join in and share their views. ss

While we try to write and comment daily it doesn't always happen. We are moving our feature definition column to the blog starting today.

Total Joint Replacements- part 1: The first thing to understand is that given todays technology TJRs are designed for basic function, not to become the "Six Million Dollar man or woman" (younger folks may need to google that!). There are limitations in stability and flexibilty as in most cases the anatomical stabilizers are gone. BUT the big thing is no more joint pain. Most replacements under intended use will last 10-15 years. If you remember a few years ago, two-sport star Bo Jackson of the White Sox attempted a comeback with a total hip, it lasted 1 1/2 seasons before needing to be replaced. As a general rule the better your flexibility and strength PRIOR to surgery will provide a better outcome afterwards.

For this entry we will talk about knee replacements. Basically the are two categories partial and complete. Partials are relatively new on the scene. They are less invasive and usually have a quicker rehabilitation. That said the initial damage/ wear must be confined to a specific area and the patient should be functionally in good shape. Obviously these aren't for everyone. Total Replacements are far more common replacing the entire joint except the knee cap (patella) in most cases. Rehabilitation can be as little as 6 weeks for patients that start off in relatively good condition as noted previously. As with most Therapy the harder you work the better your results and the faster you will be finished.

In our next installment we'll discuss types of surgeries (in general) and what you can expect.ss

Having just changed this site from a windows based platform to a UNIX platform to allow publication of this blog, some text and photos were lost in the transfer. I am working on making those corrections. If , by chance, you find confusing text on the site let me know so I can address the problems. Thank you. ss

The primary purpose of this blog is to provide patients/ clients a forum to discuss topics as they relate to Physical Therapy. If you have specific injury or treatment questions fire away. I will do my best to answer them for you. In addition I will be transfering my "Definition of the Day" column from the home page to the blog as well. Hope you are having a great day. ss