Pain related to the joints of the jaw is referred to as temporomandibular joint (TMJ) pain or dysfunction (TMD). The problem is often treated by dentists, oral surgeons and physical therapists. Symptoms may include pain in the head, neck or face and problems such as inability to fully open or close the mouth, difficulty chewing, or locking of the jaw. Many individuals with this problem experience clicking, popping, or cracking when opening or closing their mouth. In some cases, the jaw deviates to one side when the mouth is opened or closed. Some individuals have ringing in their ears or the sensation that their ears are “stuffed”.
Dentists will address TMJ by correcting tooth problems, such as how the top and bottom teeth fit together: occlusion. They also may fit the person for a night splint. In some cases, oral surgery is required. Often, while or after dental problems have been addressed, the sufferer may be sent to a physical therapist. Physical therapy can include exercises, stretching, posture correction, and various treatments to reduce pain.
Physical therapy treatment selection is aided by a determination of the cause of the problem. If the person has had jaw surgery, physical therapy will address regaining normal strength and flexibility for chewing and speaking. Often, people with TMJ problems will have neck pain. Regaining normal neck flexibility and posture is a frequent goal in these cases. Physical therapists may perform stretching to the neck, and sometimes the jaw muscles. One of the most popular treatments for TMJ is a home exercise program. In a home program, the patient is taught exercises which help to restore a normal resting position of the head, neck, jaw and upper shoulder girdle. Other exercises help to normalize opening and closing of the mouth. To reduce or eliminate pain, various treatments, such as infrared, ultrasound, electrical stimulation, heat, ice or massage may be given.
Showing posts with label injuries. Show all posts
Showing posts with label injuries. Show all posts
Tuesday, February 16, 2010
Hamstring Injuries
Injured hamstrings are seen quite often in both athletic and non-athletic individuals. Often referred to as a “pulled hamstring”, it is actually a strained or partially torn muscle. The hamstrings are of course the large group of muscles in the back of your thigh. These long muscles have their attachments at the base of the buttock and behind the knee, at the tibia and fibula bones. They have two main functions: to bend the knee and to extend the thigh from a position in front of the body to a position in line with or behind the torso, such as when walking, running, getting out of a chair, or climbing stairs.
An injury to the hamstring can occur with almost any activity which requires the use of your legs: from all the activities mentioned above to dancing or even a simple slip on the ice. These strains can range from a very small tear to a large rupture in the middle of the muscle or off an attachment to one of the bones. Why are hamstrings injured so often? To function optimally, hamstrings need to be somewhat flexible. However, sedentary activities such as sitting can cause these muscles to become tight. Stretching thus becomes the most important aspect of injury prevention. One of the simplest stretches for the hamstrings is to lie on your back, beginning with both knees bent; hold the back of one thigh with both hands and attempt to straighten your leg(foot pointing toward ceiling) for 15 to 30 seconds. Repeat 3 or 4 times on each thigh.
Treatment of hamstring injuries is dependent upon the extent of damage sustained. Minor strains will require some level of activity limitation, as well as careful stretching. Ice applications, of approximately 20 minutes each, are often helpful early on, as is use of anti-inflammatory medication. If your injury takes more than a few days to respond to your own treatment, check with a health care professional: you don’t want to cause more damage as you “treat” yourself. Severe hamstring injuries may even require crutches. Once the acute phase (pain!) has subsided, gentle strengthening and stretching exercises can begin gradually. Other modes of treatment, often performed by physical therapists or certified athletic trainers, include ultrasound and electrical muscle stimulation, both of which have been shown to speed healing. In addition, physical therapists, athletic trainers, and massage therapists often provide special massage techniques to the injured muscle; again speeding healing and breaking up scar tissue, or preventing it from forming. Unfortunately, some hamstring injuries heal very slowly, and patience is required.
An injury to the hamstring can occur with almost any activity which requires the use of your legs: from all the activities mentioned above to dancing or even a simple slip on the ice. These strains can range from a very small tear to a large rupture in the middle of the muscle or off an attachment to one of the bones. Why are hamstrings injured so often? To function optimally, hamstrings need to be somewhat flexible. However, sedentary activities such as sitting can cause these muscles to become tight. Stretching thus becomes the most important aspect of injury prevention. One of the simplest stretches for the hamstrings is to lie on your back, beginning with both knees bent; hold the back of one thigh with both hands and attempt to straighten your leg(foot pointing toward ceiling) for 15 to 30 seconds. Repeat 3 or 4 times on each thigh.
Treatment of hamstring injuries is dependent upon the extent of damage sustained. Minor strains will require some level of activity limitation, as well as careful stretching. Ice applications, of approximately 20 minutes each, are often helpful early on, as is use of anti-inflammatory medication. If your injury takes more than a few days to respond to your own treatment, check with a health care professional: you don’t want to cause more damage as you “treat” yourself. Severe hamstring injuries may even require crutches. Once the acute phase (pain!) has subsided, gentle strengthening and stretching exercises can begin gradually. Other modes of treatment, often performed by physical therapists or certified athletic trainers, include ultrasound and electrical muscle stimulation, both of which have been shown to speed healing. In addition, physical therapists, athletic trainers, and massage therapists often provide special massage techniques to the injured muscle; again speeding healing and breaking up scar tissue, or preventing it from forming. Unfortunately, some hamstring injuries heal very slowly, and patience is required.
Iliotibial Band Syndrome
The iliotibial band(ITB) is a thickening of tissue under the skin of your thigh, extending from the outside of the hip to just below the outside of the knee. In active people, such as runners, cyclists, and in-line skaters, this structure can cause lateral knee pain, with no apparent injury. Due to the fact that no trauma has occurred, many individuals struggle with this problem for long periods of time.
With every bend and straightening of the knee, the ITB rubs over the outside of the knee. In the vast majority of cases, this never causes a problem. However, certain situations can lead to pain. Some people, because of leg alignment, tightness in the ITB, muscle imbalances, and even foot problems will develop knee or thigh pain related to their ITB. Muscle imbalances occur when one group of muscles become either over or under-developed. Running on a banked track or on the shoulder of a road can cause stretching of the band against the outside of the knee. The band itself, and/or the outside of the knee can become irritated. In addition, inadequate warm-up and cool-down may also overwork the iliotibial band.
The pain associated with an ITB problem may develop gradually, or “come out of nowhere”. Most often, the pain is just above the outer side of the knee, but it may also be present all along the outer side of the thigh. Sometimes swelling is present at the spot where the band rubs over the outer side of the knee. The pain is usually not constant, but brought on by certain activities or positions.
Treatment of ITB problems often includes stretching of the band and its associated muscles. Runners may have to decrease their mileage or change their running route, to avoid too much running on the same banked surface. Cyclists may need to temporarily change their seat height. Ice and anti-inflammatory medication may be used to relieve symptoms. Once the problem is diagnosed, ultrasound, infrared or cold laser and advanced stretching techniques are often applied by physical therapists or athletic trainers. In addition, motion-control running shoes or a shoe orthotic may be recommended, to level out how the foot hits the ground. In many cases, we have found success by teaching specific exercises to improve strength from the hip down to the foot, thus creating greater stability and eventually eliminating the pain completely. In very rare cases, surgery(by an orthopedic surgeon) may be needed to solve this problem.
With every bend and straightening of the knee, the ITB rubs over the outside of the knee. In the vast majority of cases, this never causes a problem. However, certain situations can lead to pain. Some people, because of leg alignment, tightness in the ITB, muscle imbalances, and even foot problems will develop knee or thigh pain related to their ITB. Muscle imbalances occur when one group of muscles become either over or under-developed. Running on a banked track or on the shoulder of a road can cause stretching of the band against the outside of the knee. The band itself, and/or the outside of the knee can become irritated. In addition, inadequate warm-up and cool-down may also overwork the iliotibial band.
The pain associated with an ITB problem may develop gradually, or “come out of nowhere”. Most often, the pain is just above the outer side of the knee, but it may also be present all along the outer side of the thigh. Sometimes swelling is present at the spot where the band rubs over the outer side of the knee. The pain is usually not constant, but brought on by certain activities or positions.
Treatment of ITB problems often includes stretching of the band and its associated muscles. Runners may have to decrease their mileage or change their running route, to avoid too much running on the same banked surface. Cyclists may need to temporarily change their seat height. Ice and anti-inflammatory medication may be used to relieve symptoms. Once the problem is diagnosed, ultrasound, infrared or cold laser and advanced stretching techniques are often applied by physical therapists or athletic trainers. In addition, motion-control running shoes or a shoe orthotic may be recommended, to level out how the foot hits the ground. In many cases, we have found success by teaching specific exercises to improve strength from the hip down to the foot, thus creating greater stability and eventually eliminating the pain completely. In very rare cases, surgery(by an orthopedic surgeon) may be needed to solve this problem.
ACL Rehabilitation
The torn anterior cruciate ligament (ACL) of the knee is one of the most common season-ending sports injuries. This injury has received a lot of press recently, particularly regarding the numerous female athletes who have sustained it. Fairport’s Caitlyn Howe and WNBA star Sheryl Swoopes are just two of the most recent athletes to sustain the injury. Regardless of whether the injury affects a male or female, rehabilitation can be tedious and last from 6 to 12 months.
Although many athletes undergo surgical reconstruction or repair of the torn ACL, there are some athletes who are able to participate in their sport without a surgical repair. This depends upon several factors, including the type of tear they sustain, which other structures are injured, and the amount of stability provided by other knee ligaments, cartilage and muscles within the same knee. When this injury occurs, the knee usually collapses and there is considerable pain and swelling. Anyone suffering this injury can usually sense a certain amount of instability in his/her own knee.. The knee will feel somewhat loose, as if it is slipping or even give out at times. With the help of orthopaedic surgeons and physical therapists, athletes can make a decision regarding surgery. If the knee is very unstable, surgery will usually restore enough stability so that an athlete can return to their sport.
Following either surgical or non-surgical treatment (a prescribed period of rest and/or bracing), the injured knee must be rehabilitated. The goals of rehabilitation are to restore strength, motion, and functional ability, and to eliminate pain, swelling and instability. It is here where traditional strengthening exercises and specialized rehabilitation are merged. Traditional strengthening exercises will restore most of the strength to the muscles around the knee. Specialized stability exercises, usually taught under the supervision of a physical therapist, involve various hopping, pivoting, stepping and jumping maneuvers. This phase of rehabilitation is sometimes referred to as functional rehab, since it mimics things that the injured person may wish to be able to do without their knee giving out. The variety of functional rehab exercises used will depend upon what activity the injured individual is striving to return to. Some of the exercises are so helpful that many non-injured athletes are now using them to enhance performance and prevent injuries.
Tony Oliveri is a licensed physical therapist and owns Oliveri Physical Therapy and Sports Training in Rochester.
Although many athletes undergo surgical reconstruction or repair of the torn ACL, there are some athletes who are able to participate in their sport without a surgical repair. This depends upon several factors, including the type of tear they sustain, which other structures are injured, and the amount of stability provided by other knee ligaments, cartilage and muscles within the same knee. When this injury occurs, the knee usually collapses and there is considerable pain and swelling. Anyone suffering this injury can usually sense a certain amount of instability in his/her own knee.. The knee will feel somewhat loose, as if it is slipping or even give out at times. With the help of orthopaedic surgeons and physical therapists, athletes can make a decision regarding surgery. If the knee is very unstable, surgery will usually restore enough stability so that an athlete can return to their sport.
Following either surgical or non-surgical treatment (a prescribed period of rest and/or bracing), the injured knee must be rehabilitated. The goals of rehabilitation are to restore strength, motion, and functional ability, and to eliminate pain, swelling and instability. It is here where traditional strengthening exercises and specialized rehabilitation are merged. Traditional strengthening exercises will restore most of the strength to the muscles around the knee. Specialized stability exercises, usually taught under the supervision of a physical therapist, involve various hopping, pivoting, stepping and jumping maneuvers. This phase of rehabilitation is sometimes referred to as functional rehab, since it mimics things that the injured person may wish to be able to do without their knee giving out. The variety of functional rehab exercises used will depend upon what activity the injured individual is striving to return to. Some of the exercises are so helpful that many non-injured athletes are now using them to enhance performance and prevent injuries.
Tony Oliveri is a licensed physical therapist and owns Oliveri Physical Therapy and Sports Training in Rochester.
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