Hip, Knee, Osteoarthritis, Running
Mandie Majerus
Bone Stress Injuries

What is a bone stress injury (BSI) and how do I know I have one? How long will it take to get me back to running? As a physical therapist who treats a lot of runners and as a lifelong runner myself, I have always had a passion for keeping runners running. The act of running can make someone’s day tick along better, can help with consistent sleep, calm the nerves and can even make a runner more fun to be around. It can be social or an act of solitude. It can be alarming for a runner when they start to experience a nagging pain that doesn’t warm up or even worsens as they run. Pain that doesn’t dissipate with a warm-up routine or is vague at first but then becomes localized or intensifies through the run can be a sign of a bone stress injury or BSI. BSI is a general term indicating mechanical load is exceeding the bone’s structural ability to withstand the load. However, BSIs occur on a continuum. One end of that continuum is a stress reaction, the other end can be stress fracture or even a full fracture of the bone. The runner recognizes this as pain that isn’t normally present. BSIs can occur for many reasons whether due to biomechanics or from a nutritional standpoint or a combination of both. As high-school and college cross-country runners prepare now for this upcoming season, they should be aware of the common causes and ways to prevent bone stress injuries.

Bone Stress Injuries
Physical Therapy, Fitness, hiking, Knee
Mark Bouma, PT, DPT, OCS, COMT, FAAOMPT, CFI
Raking Leaves

Mark Bouma, PT takes readers through the areas to watch out for while raking leaves. The fall changes in the PNW is a time of beautiful color but also typically wet and heavy leaves.

Patellofemoral pain is largely a diagnosis of exclusion. There can be many causes of knee pain and it is important for your healthcare provider to properly assess your individual condition. Many individuals have anterior knee pain with prolonged sitting with flexed knees.

There are three common provocative diagnostic tests that are most closely correlated with patellofemoral joint pain:

  • Squatting

  • Climbing Stairs

  • Eccentric Step-Down Test

Research has linked several key factors that may contribute to an individual developing patellofemoral pain. These factors are not present in everybody who has symptoms, but there are often impairments in one or more of these areas found during a physical therapy exam.

Raking Leaves
Physical Therapy, Fitness, Knee, Football, Hip, Neck pain, Running
Victor Kolar, PT, DPT, CSCS, TPIc
Turkey Bowl

Victor Kollar, PT takes you through the areas to think about as you get ready for your annual turkey bowl football game.

Turkey Bowl
physical therapy, Fitness, Physical Therapy, Ankle
Ben Wobker
Riq Woolen: Foot & Ankle Injury

The Seattle Seahawks have been dealing with a challenging season on the injury front, and the ankle injury to standout cornerback Tariq Woolen has added yet another layer of complexity. Woolen, a key figure in Seattle's defensive scheme, has demonstrated elite skills throughout the season, allowing a league-low 27.3% completion rate and an astonishing 1.7 passer rating when targeted. His injury has not only affected the team's defensive depth but has also posed significant challenges in maintaining consistency in coverage. In this article, we delve into the details of Woolen’s injury, its implications for the Seahawks, and what the team can do moving forward.

Riq Woolen: Foot & Ankle Injury
physical therapy, Ballet, Cross-Fit, Fitness, Physical Therapy
Ben Wobker
Relative Energy Deficiency

If you're a runner, you may have heard of the Female Athlete Triad, a term once used to describe a combination of low energy availability, menstrual dysfunction, and bone health issues. However, our understanding of these conditions has evolved, giving rise to a broader concept: Relative Energy Deficiency in Sport (RED-S). This condition is not just for elite female athletes; it affects athletes of all levels and genders. Let’s break down what RED-S is, why it's important, and how you can protect yourself as a runner.

Relative Energy Deficiency

Lower Back Pain

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Mom Posture

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Mom Posture

There are a number of body changes that mothers experience during and after their pregnancies that can cause unique challenges and that often get overlooked in prenatal and post-partum care. These challenges involve increasingly new spine stresses, adaptations, and difficulties maintaining a “neutral spine”.


A neutral spine is the ability to maintain the natural curves of the spine that allow for shock absorption when we stand and walk and allow for our center of mass to be maintained at our belly button region. Women are often challenged through their pregnancies to maintain neutral spine postures due to the fast changing size of the babies and the increased distribution of weight in their mid section.   


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Pregnancy & Postpartum

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Pregnancy & Postpartum

The pelvic floor consists of several layers of muscle contained within the pelvis that are designed to support the abdominal and pelvic organs, allow for proper bowel and bladder voiding, sexual activity, and child birth. Just like any other muscle in the body, we can experience issues from these muscles being too weak, too short, too long, overactive, or underactive. However, pelvic floor muscles can be rehabbed similarly to our other muscles as well. For example, if I strain a muscle in my leg, I’m going to work on getting the injured muscle and the surrounding area stronger, improve muscle length, and activate at the appropriate times. The pelvic floor muscles function in the same way as other muscles in our body, and need similar attention if there is pain or dysfunction.


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Pregnancy & Postpartum Incontinence

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Pregnancy & Postpartum Incontinence

The pelvic floor consists of several layers of muscle contained within the pelvis that are designed to support the abdominal and pelvic organs, allow for proper bowel and bladder voiding, sexual activity, and child birth. Just like any other muscle in the body, we can experience issues from these muscles being too weak, too short, too long, overactive, or underactive. However, pelvic floor muscles can be rehabbed similarly to our other muscles as well. For example, if I strain a muscle in my leg, I’m going to work on getting the injured muscle and the surrounding area stronger, improve muscle length, and activate at the appropriate times. The pelvic floor muscles function in the same way as other muscles in our body, and need similar attention if there is pain or dysfunction.


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March for Larch

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March for Larch

Hiking is high on the list of PNW pastimes. It’s a great excuse to explore the mountains and enjoy every bit of the natural beauty that Washington State has to offer. Peak hiking season in Washington tends to run from late Spring through summer, as the snow melts and the temperatures get warmer. However my personal favorite is a short window of a few weeks in early Autumn– larch season. Larches are a variety of trees that may at first glance resemble a typical pine, but larches do not stay green year-round. Unlike their evergreen neighbors, larch tree needles turn a beautiful golden yellow color in the early fall. For two to three weeks at the end of September until the first snows in October, the Pacific Northwest is blessed with beautiful variation in the forests as those golden yellow pine trees reach peak color. It’s a short window before the trees begin to lose their pine needles as temperatures drop, so you don’t want to miss out on the annual larch madness.

Precautions for Hiking

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Sacroiliac Joint Pain

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Sacroiliac Joint Pain

The diagnosis and treatment of the sacroiliac joint (SIJ) can be challenging and is highly debated within the research and among clinicians. While the existing research is focused on investigating variations of mobilizations and manipulations to treat SIJ dysfunction, it is deficient in how to enhance treatment and patient’s self-efficacy with specific exercises. With that in mind, I’ll aim for brevity in my review of the anatomy and biomechanics of the SIJ region so I can focus on existing research and a few “clinical pearls” that I have picked up through my continuing education and practice treating SIJ pain in the clinic. The pelvis can be thought of as a ring or bowl holding our internal organs. The interface between the sacrum (triangular bone at the base of the spine) and ilium bones form the sacroiliac joints. Because of this orientation, the SIJ is well equipped to help manage forces through the pelvis through a combination of bony connections, ligamentous attachments, and muscular attachments. While the sacrum is the attachment point for several major muscle groups (multifidus, erector spinae, latissimus doris, gluteus maximus, piriformis, and portions of the pelvic floor), the sacrum itself does not move in isolation, and it is heavily impacted by muscles attaching in and around the pelvis.

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SpikeBall

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SpikeBall


Summer is here, which means change is upon us. Whether you spend this time of year gardening, spring cleaning, or taking in the sunshine doing yard work, these kinds of activities require a lot of lifting which could cause a low back strain. I recently moved and I could not help but notice my back feeling sore the next week or so. I was humbly reminded that I am no longer in my early twenties– gone are the days of lifting and carrying with pure strength and little care for form. I quickly learned that if I want to continue being helpful for future moving days, I have to maximize proper movement strategies to minimize all those aches and pains. As your local physical therapist, I wanted to highlight good lifting mechanics and provide some helpful tips that will limit your chance of injury for your next moving day.

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Moving Day

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Moving Day


Summer is here, which means change is upon us. Whether you spend this time of year gardening, spring cleaning, or taking in the sunshine doing yard work, these kinds of activities require a lot of lifting which could cause a low back strain. I recently moved and I could not help but notice my back feeling sore the next week or so. I was humbly reminded that I am no longer in my early twenties– gone are the days of lifting and carrying with pure strength and little care for form. I quickly learned that if I want to continue being helpful for future moving days, I have to maximize proper movement strategies to minimize all those aches and pains. As your local physical therapist, I wanted to highlight good lifting mechanics and provide some helpful tips that will limit your chance of injury for your next moving day.

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Spondylolysis and Spondylolisthesis

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Spondylolysis and Spondylolisthesis

Spondylolysis is estimated to occur as much as 25-60% in athletic populations The most common age group for occurrence is 11-18 years old, with higher likelihoods of injury occurring during puberty and growth spurts. Adolescents today typically play multiple sports throughout the year, often overlapping with minimal to no rest between seasons. Sports involving high impact and spine loading, as well as trunk rotation and extension, have a higher incidence of spondylolysis. Research shows football, gymnastics, power lifting, diving, baseball, softball, hockey, basketball, and soccer tend to have an increased risk for this injury……