It is that time of year where many people are hitting the pavement and trails ramping up for races or just general fitness goals. Some may have gutted out the wintry weather and tried to sneak in runs during breaks in the rain or indoors on the always reliable treadmill. With an increase in volume of running, we often see repetitive stress injuries that can come with inadequate attenuation of forces. If you’ve been running long enough, chances are you know someone or have a running partner who dealt with a recalcitrant tendon issue, whether involving the Achilles tendon, peroneal tendon or patellar tendon. Or maybe you had to deal with it yourself. If so, hopefully you’ve packed your patience as the process can be frustrating. If you have ever had these injuries sideline you then you know how it can hinder your ability to compete in athletic activities. It’s helpful to understand the physiology of what is happening to the tendon in order to know how best to treat it, ideally while working alongside a physical therapist familiar with running and jumping 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.
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.
Victor Kollar, PT takes you through the areas to think about as you get ready for your annual turkey bowl football game.
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.
Right now, I am 1.5 years post ACL surgery, but 3.5 years post ACL injury. I will be recalling my experience starting at the time of injury all the way through my individual Physical Therapy experience. This will be a multi-part series that tells my story, plus various research facts and personal details along the way.
Falls have become the leading cause of injury for older adults. 27.5% of individuals 65 years and older have reported at least one fall in the past year.1 These falls can lead to serious injuries that involve broken bones or head trauma. Each year over 800,000 people in this age group are hospitalized due to a fall injury and 95% of hip fractures are caused by a fall.2 However, falls are preventable. Working to recognize the modifiable risk factors in our lives can help reduce the chance of fall and injury.
Right now, I am 1.5 years post ACL surgery, but 3.5 years post ACL injury. I will be recalling my experience starting at the time of injury all the way through my individual Physical Therapy experience. This will be a multi-part series that tells my story, plus various research facts and personal details along the way.
Osteoarthritis is one of the most common orthopedic conditions among physical therapy patients. Osteoarthritis (OA) describes degeneration of cartilage and, eventually, bone in a moving joint. The development of OA can be the result of a previous injury or specific joint condition but is most often idiopathic in nature.1 Knees, hips, and thumbs are notorious for developing OA as a result of the large, repetitive forces these joints have to absorb over the course of a lifetime.2 The term OA refers to a wide spectrum of joint degeneration and can sometimes be used to describe a joint that appears damaged on an X-ray but doesn’t hurt or cause a decline in function (asymptomatic osteoarthritis). Various studies of the general population in the U.S. estimate that 20-28% of adults aged 60+ have evidence of hip OA on an X-ray, yet only 4-10% of this population have pain or poor function due to hip OA.3,4 Although an X-ray may show hip joint degenerative changes, treatment generally does not occur until someone begins to have symptoms.
What to know about getting back into activity following a diagnosis of COVID
With the most recent spread of Covid across the country, The Journal of the American Medical Association has recently released guidelines on the safest way to return to exercise following all levels of Covid infection. As physical therapists, we are responsible to help our patients return to safe exercise, and should be taking responsibility for returning our patients safely to exercise following Covid. Here are some things to consider for best practice when returning to activity following a COVID diagnosis depending on severity of symptoms.
Right now, I am 1.5 years post ACL surgery, but 3.5 years post ACL injury. I will be recalling my experience starting at the time of injury all the way through my individual Physical Therapy experience. This will be a multi-part series that tells my story, plus various research facts and personal details along the way.
Before I explain why, lets briefly get on the same page with a definition for Early Sport Specialization (ESS). Typically ESS refers to year-round (for at least 8 months) intensive training or competition in an organized sport by young athletes (<12 years of age) while excluding all other sports.
Injury Risk
One of the most studied problems with early specialization is increased injury risk compared to peers. The biggest factor contributing to this increased risk was participation in any individual sport for greater than 8 months of the year3. This is especially true in baseball pitchers where pitching for more than 8 months per year was correlated with a 500% increase in risk for Tommy John surgery. (I discuss this and other risk factors for UCL injury in my blog “Minimizing the Risk for UCL Injuries in Throwers” *hyperlink). Across all sports there is an increased injury risk of 1.81 times in highly specialized athletes compared to their multi-sport peers5.
Does Running Cause Knee Arthritis?
In my practice, I frequently have the opportunity to interact with runners. Running is a repetitive activity that certainly has injury risk. I do frequently come across runners and people who have quit running saying something like: “I know running will give me arthritis, but I just love to do it.” or “I quit running because I was afraid of developing arthritis in my knees.” Common thought continues to be that the impact of running does lead to arthritis.
Examining the Evidence
Do our perceptions meet reality? Let’s look at the research to find out.
The annual prevalence of patellofemoral pain in the general population has been found to be over 22%! Anterior knee pain is not just a problem for young adults and adolescents. In this article, I’d like to provide you with several key tests you can use to help determine if you may have patellofemoral pain and then outline how a physical therapist can successfully help you recover.
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.
The annual prevalence of patellofemoral pain in the general population has been found to be over 22%! Anterior knee pain is not just a problem for young adults and adolescents. In this article, I’d like to provide you with several key tests you can use to help determine if you may have patellofemoral pain and then outline how a physical therapist can successfully help you recover.
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.
To learn more about pickleball and shoulder injuries, I decided to ask a local, avid pickleballer who also happens to be an expert shoulder surgeon, Dr. Samuel Koo. Dr. Koo practices at ProOrtho in Kirkland, WA where he specializes in the prevention, diagnosis, and treatment of a variety of shoulder injuries. When Dr. Koo isn’t helping the community with their shoulder injuries, you can often find him on a nearby pickleball court. Dr. Koo first found pickleball about 3 years ago after he was introduced to the game by a friend. His current pickleball addiction is fueled by his history of playing tennis and ping pong.
When asked to compare tennis and pickleball, Dr. Koo says “The biggest difference between pickleball and tennis is that tennis places a premium on the overhead shot—mainly serves and overheads at the net—while pickleball is mostly a game played below your waist.” Given the underhand nature of the game of pickleball, one would expect a lower occurrence of shoulder injuries than in tennis where overhand serving is a major component of the sport.
If you have ever played or watched a game of pickleball, this distinct difference is easy to appreciate. The shorter paddle, slower ball speed, lower net, and smaller court does not place the same demands on the shoulder, or body in general, as in tennis. With the shoulder moving through lower, quick paddle swings near the body, there tends to be less demand into the end ranges of shoulder motion which can reduce the stress on muscles and ligaments surrounding the shoulder joint. Conversely, when the arm quickly accelerates and decelerates through an overhead swing, there are greater demands on the dynamic stability of the shoulder. In pickleball, this type of racquet activity is less common.
What kind of office chair should I get?
With work from home here to stay, patients are asking this question more than ever. The kitchen chair or couch has lost it’s novelty long ago, and your neck and back are telling you it is time. Looking at how patients are sitting in chairs throughout my career, I have noticed common pitfalls in office chair buying. In this blog I’ll share three things that are often overlooked when shopping for a chair.
The seat pan: This is the length of the seat from back to front. If this is too long, the patient ends up perching on the edge of the chair to avoid the back of the knees getting compressed. To test if it is too long, see if you can fit 4 fingers between the chair and the back of your knee. If there isn’t much room for your fingers, it is too long. To avoid this problem, you can look for a chair with adjustable seat depth.
Adjustable lumbar support: Very often, the curve in the chair does not line up with the inward curve of the lower back. Well positioned lumbar support is important to adequately support the spine when you are sitting. There are different mechanisms for this, such as the backrest sliding up and down.
Try out your chair in person before you buy. It is possible that your thighs are long enough and your back is curved just right so that you only need basic adjustability. But most of us don’t match up that well, so looking for these extra features could save you the headache and pain in the butt, literally. For more tips on seating, computer and desk ergonomics, visit your Lake Washington Physical Therapy clinic! Or, come by and see what office chairs we landed on at our new location in West Seattle. #Ducky’s #local business
Laura Bouma, PT, DPT, OCS, CMPT
The Biomechanics of the baseball throw:
Baseball fans thrive on interesting facts and statistics, but out of all of these facts, the science behind throwing a baseball has to be the most fascinating. The way that an elite athlete’s body can act as a coiled spring, transmitting the necessary forces to turn a baseball into an eye-blur is truly awe-inspiring. During the throw the elbow functions as a hinge joint, going through rapid extension at about 2400°/s for a professional pitcher. (Which is the equivalent of saying that in 1 second the arm could whip around 360° nearly 7 times). Accelerating to this incredible speed places a force on the Ulnar Collateral Ligament (UCL) of your elbow reaching 64Nm (nearly 50lbs).4 Not surprisingly, there is some fallout over time due to the transmission of this high force.
On February 23, 2021 golf made national news after Tiger Woods got into a single car accident while driving to the golf tournament that he was hosting in Pacific Palisades, California. He was extracted from the car and headed straight into surgery sending the golf world into a frenzy. Would the superstar return to golf? How long until we get the “Big Cat” back on tour? Will he even come back after recovery? Although most of those questions are up in the air, lets take a dive into the injuries that Tiger sustained to get a better understanding of the tough road ahead.
is an overuse injury that causes pain at the front of the shin with exercise. MTSS is an early stress injury along a spectrum that includes tibial stress fractures. It is most common in runners, jumping athletes, and military personnel-- individuals which undergo recurrent impact exercise.
Differential diagnosis of MTSS requires clinicians to distinguish MTSS from tibial stress fractures, exertional compartment syndrome, peripheral vascular disease or popliteal artery entrapment, and other less common causes of exertional pain in the lower extremities, including muscle or fascia involvement or nerve entrapment syndromes.
IT Band Syndrome
What is it?
Iliotibial band syndrome (ITBS) is a common overuse injury characterized by pain at the outside of the knee. It’s particularly prevalent in endurance athletes such as runners and cyclists-- those who undergo repetitive back-and-forth knee movements. In fact, ITBS is the leading cause of lateral knee pain and the second leading cause of overall knee pain in this population.
Physical Therapy Goal Setting:
As the world is facing uncertainty with the COVID-19 pandemic, here are some tips on setting goals to provide stability.
As physical therapists, we set goals for all of our patients to ensure we are working towards activities and daily living tasks that are important to you! We use a common strategy of SMART goals. What are SMART goals?
“Speed kills” is a phrase often heard in the athletic world to emphasize the idea that the faster the athlete is, the more successful he or she will be. As a health professional and a performance coach, it is important to teach athletes that being fast does not always have to rely on genetic background. There are plenty of specific mechanics that can turn speed into a skill.
What is Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome (PFPS), also known as “runner’s knee”, is a broad term that describes pain in the front of the knee and around the kneecap. It’s one of the most common overuse injuries of the knee. Although it’s more common in individuals that participate in sports with lots of running or jumping, it can occur in nonathletes as well.
