Physical Therapy for Hip Pain
Do You Know What to Expect?
The hip is an inherently strong and stable joint. While it doesn't have the same degree of mobility as the shoulder (glenohumeral) joint, the acetabulum, or hip socket, is deeper than the shoulder socket. There are also strong ligaments that reinforce the ball and socket. What the hip lacks in mobility, it makes up for in stability.
As we all know, the hip transfers the power of the legs to the pelvis. The hip joint withstands 200-500% of our body weight during a typical day of standing, walking and recreational activities. If muscle imbalances have developed over the adult lifespan, the joint will not have the optimal support and joint breakdown occurs. Cartilage breakdown, or arthritis can develop. Inflammation, pain, and stiffness. We see many people with hip arthritis and Advance Physical Therapy. Other common hip conditions that we treat also include rehab from hip fracture or replacement, bursitis, tendonitis, muscle strains and tears.
In all cases, the hip is examined in detail during the first visit to physical therapy. We analyze the gait, measure muscle strength, examine the active and passive movement and palpate the muscles and ligaments that attach the hip to the pelvis and thigh. At times, it is necessary to also examine the low back, since many problem structures overlap in this region of the body.
Physical therapy treatment includes soft tissue mobilization to assist with optimization of the muscles' structure, joint mobilization to restore lost motion to the joint, and therapeutic exercise to optimize the muscles' function and retrain proper movement patterns. Many of the exercises also incorporate the hips into movement with the trunk and arms.
A problem hip, no matter the cause, will at best limit your recreational activities and at worst, make every step excruciatingly painful! We would be happy to answer any questions you have about your painful hip. Call us today.
Physical Therapy Treatment for Pregnancy & Back Pain
Pregnancy is an amazing experience that brings along many changes emotionally, mentally and physically for the expectant mother. Often times it's difficult to predict how pregnancy will go and the best thing we can do is listen to our health care providers on how to eat right, get rest and exercise. Every pregnancy is different and there is no magic formula to predict how one pregnancy will be like from the previous one.
Fifty to seventy percent of pregnant women experience back pain. The reasons for back pain vary from person to person, but the majority of back pain concerns can be accounted for by one of the following reasons:
- an increase in hormones
- a change of the body’s center of gravity
- gaining additional weight, decreased activity
- a decline in posture
- added stress
Over the last 40 years, the average age of women having their first child has risen from 21.4 to 25 years of age. Because many women are juggling both the demands of pursuing higher education and the competitive nature of today’s workforce, more and more women are having their first child after the age of thirty five. As a result, many women becoming pregnant are less physically active in their daily lives. This decreased activity, along with the increasing national prevalence of a sedentary lifestyle, leaves an alarming number of women less prepared for the strenuous journey of carrying and delivering a baby.
Physical therapy treatment plans take a comprehensive approach by focusing on the causes of back pain triggers:
- joint alignment
- muscle strength
- nerve and/or disc involvement.
Additional weight, decreased posture, stress and decrease control of the center of gravity are not independent from one another and as a whole, can contribute to progressive back pain.
A change in your center of gravity affects your posture which causes the muscles to work harder. Increased exertion creates fatigue which leads to decreased motivation to be active. The absence of an athletic release often results in increased stress. Though it is difficult, the domino effect can be slowed greatly with the help of physical therapy.
Lower back pain is an all too common reality for many expecting mothers. As the uterus and baby grow, the mother’s center of gravity moves forward. This shift increases the amount of force the muscles must generate for everyday support causing women to slump forward. Over time this poor alignment creates muscle tightness in the pectoral muscles, rolling the shoulders forward and creating increased stress on the muscles of the neck, shoulders and mid-back. If these muscular factors are not addressed, these forces will ultimately be translated down to the low back, an area which is already under a great deal of stress because it is supporting the increased center of gravity.
Today’s expectant mothers have a wide variety of options to consider for pre-natal care. The key is finding the appropriate program. Be wary of treatment programs that are passive, place increased stress on the joints and do not address muscle strength and flexibility with exercise. Here is what you should look for in a physical therapy program:
- Managed by a physical therapist or a certified professional
- Focused on building strength, increasing flexibility and improving posture
- Develop a safe, independent home exercise program
- Proactively looks for any weakness which may become a problem later
Pregnancy is the ultimate strain on the mother’s body and physical therapy can intervene to lessen this strain. A proactive strength, flexibility and stabilization program can be very beneficial to preventing or decreasing the intensity of painful symptoms, thus making your pregnancy experience a more positive one.
Physical therapy before, during and after pregnancy is an effective means to remedy back pain and for enhancing your body’s ability to experience an easier and smoother pregnancy and birth.
Talk to your health care provider or contact us about how to incorporate physical therapy into your prenatal and post pregnancy care.
| 5 Myths About Arthritis
Ways to Ease the Pain
One in six Americans experience osteoarthritis during their lifetime. And even though so many people have it, there is much misinformation about this condition that leaves many people not knowing how to effectively treat it. So what's true and what's not about osteoarthritis?
Myth: Running causes arthritis.
It's not true that the pounding on the knees and ankles during running causes cartilage damage and increases the risk for arthritis. A study that followed 75,000 people for 7 years found that those who ran 1.2 miles a day were 15% less likely to develop osteoarthritis and 35% less likely to need a hip replacement that those who merely walked. Even though runners strike the ground with a force that equals 8 times their body weight, they take longer strides (requiring fewer steps) than walkers. The cumulative jolts caused by running appear to be similar to the slower speed impacts among walkers. With this said, it's important to consult with your health care professional, your doctor and physical therapist before starting or continuing a running program. The joint stress from running can increase the progression in an already-deteriorating joint.
Myth: Don't move when you're hurting.
The traditional arthritis advice has been to rest your joints during a flare up. It makes sense not to overdo activities when a joint is inflamed, but what's more important to note is that gentle movements keep the joints mobile, flush out inflammatory chemicals and improve the flow of oxygen and nutrients to the arthritic tissues. On "good" days, swimming, lifting weights, light jogging, weight bearing exercises and yoga are great exercises to strengthen muscles and joints in a controlled fashion. Consult your doctor and your physical therapist on the appropriate types of exercise to perform with the correct amount of intensity and frequency that can decrease arthritic joint pain without limiting movement.
Myth: It's an age-related disease.
Over the last few decades, people have been experiencing osteoarthritis at younger ages. Today, the average age at which symptoms start is 45 - and the downward trend is likely to continue. While it's not clear as to why there is an increase in younger adults, what's true is that Americans are heavier than they used to be and obesity is strongly correlated with arthritis. Also, injuries to joints during sports can lead to joint pain down the road. As a result, ongoing inflammation leads to increased cartilage damage in the joints. If you have had a joint injury - a torn meniscus in the knee for instance - at any age, there's a good possibility that you will develop arthritis in that same knee joint. Therefore, it's important to work with a physical therapist to identify where the damage is and specifically prescribe the right exercises to strengthen the muscles and tendons around the joint before symptoms start or become worse.
Myth: A little extra weight is OK.
Studies show that people who are obese have more inflammation, less joint mobility and more cartilage damage than those who are lean. But what if you are just a few pounds overweight? It's still a problem since people tend to exercise and move less when they're overweight. Reduced movement leads to less joint mobility, less lubrication in the joints, stiffer muscles and tendons, and decreased flexibility which results in more pain in the joints. Even a small gain in weight contributes to increased pressure on the joints. Every 10 pounds of weight that's added above the waist generates an extra 70 to 100 pounds of pressure on the knees when you walk. Studies show that women who lose about 11 pounds can reduce their risk of developing arthritis symptoms by more than 50%.
Myth: You can't stop it.
Osteoarthritis may be persistent but it's rarely difficult to treat. Most people get good relief without having to resort to high-tech treatments or expensive medications. The American College of Rheumatology advises patients with hip and/or knee pain to start with acetaminophen (Tylenol), but acetaminophen is more effective for treating pain and less effective for treating inflammation. According to C. Thomas Vangsness, Jr., MD, professor of orthopedic surgery and chief of sports medicine at University of Southern California, Los Angeles, taking one of the NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen or naproxen will help reduce both the pain and the inflammation. To reduce any stomach irritation ( a common side effect of all the NSAIDs), take an anti-ulcer medication such as cimetidine (Tagamet) or misoprostol (Cytotec). It's imperative to consult with your doctor about the proper medication use and dosage that will help with your arthritic pain. Movement is key and proper progression of a prescribed exercise program can preserve the joints from further joint damage.