Friday, January 20, 2012

Knee Pain Without Injury

GET HIP TO YOUR KNEES
By
Tony Oliveri, P.T., D.P.T
Anterior knee pain, or “patello-femoral” pain is one of the most common orthopedic problems in adolescents and young adults. It can occur in more than 25% of people in those age groups. Of course, it can occur at just about any age. It is even more common in females than in males. Since there is often no injury that precedes the pain, the diagnosis and treatment is difficult to determine. The pain can come and go for years if the cause remains undetermined.



Research has determined that many individuals with patello-femoral pain also have weak hip muscles. To investigate the theory that hip weakness may lead to knee pain, researchers at the University of Southern California placed individuals with patello-femoral pain on a physical therapy program to strengthen their hips. Patients on the program experienced significant reduction in knee pain. A few of the exercises that can be done at home include sideways leg raises, as well as balancing on one foot, while not allowing the hip to sag to either side.



Along with identifying weak hip muscles, physical therapists and physicians are often able to identify abnormal movement and alignment of the thigh or lower leg which may be putting excessive stress on the patello-femoral joint (or front of the knee). Those problems can be addressed with individually-tailored exercises to correct the movement, strengthen the muscles performing the movement, and reduce knee pain. Those types of exercises are often very successful.



Other treatments that are done for anterior knee pain include quadriceps strengthening, taping of the kneecap, bracing, stretching, ultrasound and electrical muscle stimulation. Hands-on techniques performed by some physical therapists also assist in bringing muscles around the knees into proper balance. In addition, arch supports for the feet are sometimes prescribed to control foot movement, which can improve leg alignment and relieve knee pain. The emphasis on treatment of the body parts and movements connected to the knee has decreased the frequency of surgery for this particular knee problem.

Friday, October 14, 2011

Mechanical Thigh Numbness

Mechanical Thigh Numbness




By Tony Oliveri, DPT

Thigh numbness can arise from many causes. This article will address the issue of mechanical thigh numbness, which occurs when there is pressure on a nerve, or the nerve has been stretched. There are many other causes for thigh numbness, which should be addressed by your physician, should the problem linger or not appear to be mechanical. With a mechanical problem, the numbness or tingling in your thigh will often change, depending upon the position of your thigh, hip, or lower back.



Sometimes, a slight contusion, such as bumping into a table or counter with your hip or thigh, can bruise a nerve and lead to numbness which may not occur until days later. If that is the case, you may not even recall the incident that led to the numbness. Another characteristic of thigh numbness that can be confusing is that it may not be constant. When the nerve is not compressed or stretched, there may not be any numbness. Compression or irritation of nerves supplying your thigh can occur in the thigh itself, parts of the lower back, hip, or groin. For example, many of us have had or know someone who has a pinched nerve in the lower back. If that is the case, changing positions of the lower back will often affect how the thigh feels.



On the other hand, if only the lower back is addressed during treatment, there may be little or no affect on thigh numbness. In some cases, thigh numbness can arise from actual stretching of a nerve, or compression from a surrounding muscle or other body part. Excessive stretching of a nerve can occur in a similar fashion as straining or over-stretching a muscle. Compression can occur directly on the nerve, (ever sat too long at the movies and your foot went numb?!), or on a nearby blood vessel. Since nerves do need oxygen, compression of circulation can lead to symptoms such as numbness or tingling.



Thigh numbness or tingling that lasts more than a few days should be addressed by a health care professional. In physical therapy, the cause of the numbness is explored prior to initiating treatment. That treatment may involve gentle movements to help restore normal mobility and circulation to the area. Your physical therapist may teach you exercises to help in this regard. Care must be taken, however, to avoid stretching a nerve that may be already over-stretched. In addition, physical therapy may also include treatments such as ultrasound, infrared, or cold laser, which have all been shown to promote healing.