Focus on The Knee — Patellofemoral Pain

What is Patellofemoral Pain?

Patellofemoral pain is pain arising from the kneecap (patella) or the supporting tissues around the kneecap. It is one of the top 3 causes of knee pain we see in our practice and occurs when the patella is not moving or working correctly. Sometimes, there may be early arthritis of the patella, and often there is swelling or fluid in the front of the knee. If you have a weak hip, poor gait pattern, or a particular foot shape, this can make things worse.

How do I know if I have Patellofemoral Pain?

A diagnosis of patellofemoral pain is made based on your medical history, the location of your symptoms, and pain that is reproduced with certain physical tests versus others. An x-ray is not necessary to make a diagnosis.

What Can I do to Help Myself?

As mentioned above, often patients with patellofemoral pain have extra fluid in the front of the knee. This stops your leg muscles from working properly. Once the fluid has been addressed, we can start training your leg muscles, a very important step to getting rid of your pain.

Can Physical Therapy Help?

Patellofemoral Pain is very treatable, and the majority of patients are able to get rid of their pain and return to their normal activities after a few sessions with a physical therapist. Physical therapy sessions may include strengthening the hip and knee muscles and examining the foot to see if it is contributing to the problem. Remember: your exercises must be matched not only to your problem but also your stage of recovery and your functional goals. 

Relieve Muscle Pain, Migraines and more…with Dry Needling

Dry Needling is considered to be an extremely effective technique in reducing muscle tension and pain, increasing motion, and promoting increased function within muscles.

This technique is just one of many physical therapy treatments and modalities that is used to relive pain associated with muscle spasms, tendonitis, migraines, and so much more. Dry needling is a treatment that involves the use of a very thin needle through the skin to stimulate a trigger point. Dry Needling is used to release tight muscle bands that are associated with trigger points, or hard “knots” within a muscle that can cause pain over a large area. Sometimes these trigger points or muscle spasms can make it difficult to perform everyday tasks due to the pain every time the area is touched. This pain can even radiate to nearby areas of the body. The needle is used to deeply treat muscles and “deactivate” or “shut down” a painful knotted area or trigger point within muscles. When someone has muscle pain or tightness, it can lead to irritation and compression of the nerves. Irritated nerves send out a protective spasm to all of the muscles to which they are connected. This can lead to decreased mobility and pain in the area. Many of us have areas in our body that constantly feel tense or have what feels like a hard ball within the muscle. This type of treatment involves inserting fine needles into the tight areas, which elicits a brief contraction or “twitch response” followed by an immediate and long-lasting feeling of relaxation. This deep treatment can help patients achieve amazing pain relief they never thought possible.

“Before I started physical therapy at Fast-Track, I had been treated at various clinics for the last 9 months and was still incapable of doing basic things without a lot of pain in my back and shoulders. Within weeks of working with Brian and Bridgette, my pain went from a constant 7 to an intermittent 3. Today, after 3 months of treatment, my pain has virtually dispersed, and it is all thanks to this team and their knowledge in the dry needling technique. Thank you so much for helping me get back to where I was before the accident.” -Evan L.

What is Dry Needling able to treat?

· Neck pain

· Migraines and TMJ

· Back pain

· Tendonitis, shoulder and elbow pain

· Joint pain and dysfunction

· Plantar fasciitis

Benefits of Dry Needling:

· Pain relief

· Reduces muscle tension

· Restores / Increases motion and function

· Speeds up recovery

Will Dry Needling help me?

If you like the results of massage therapy but are disappointed when your discomfort returns, Dry Needling may be a great way for you to receive more long-lasting relief. Unlike other types of manual therapy, Dry Needling can treat nearly any muscle in the body, and at depths other treatments are unable to reach. Dry Needling is a great technique to complement your physical therapy treatments because it allows us to get rid of the deep knots and tension points that are unreachable during a massage.

“After trying massage for pain for 20 years, I Googled Dry Needling and Fast Track Physical Therapy came up. I was having issues with my shoulder range of motion, plus my neck and upper back. I started with Brian and moved to Bridgette when he was out of town for training. The dry needling was very helpful for my recovery, and I would highly recommend it as a tool to fixing the problem. Bridgette was very thorough in her treatments and always took the time to listen to my concerns. The techs were all very caring and always made me feel very comfortable. The office staff communicated well. They always greeted me and helped with any issue I had. I am so grateful for all the care I received from Fast Track and will miss seeing my “friends” each week.” -Kimberly C.

If you are newly injured, swollen, and have acute pain, Dry Needling is not appropriate. Additionally, patients with excessively loose joints may not be appropriate candidates for this type of treatment. An evaluation will help determine if you are a good candidate for Dry Needling.

Does the needle hurt?

The needles are very fine and solid compared to a hollow injection needle, which means they do not hurt as much. Patients report sensations of soreness, pressure, releasing, and deep aching. The needle is left in just long enough to relax your muscle, which is a short period of time. In order to return the muscle to its normal, relaxed state, the procedure is repeated in different areas. There is some discomfort because we treat sensitive areas. However, it is well worth tolerating considering the long-term relief Dry Needling treatment provides.

How will I feel after Dry Needling?

After receiving dry needle treatments your muscles may feel fatigued. Soreness can last from a few hours to 1 to 3 days, but it should not interfere with your everyday activities. We encourage you to drink lots of water and be active during this time to keep the soreness to a minimum. Applying heat to your sore muscles may help to minimize soreness. You may experience less pain and tightness after a day or so.

When used in conjunction with other physical therapy techniques, dry needling is most effective. Dry needling is another treatment tool, just like therapeutic exercise, spinal traction, other manual therapy techniques, and various modalities. It is often useful early in treatment to help break the pain cycle.

“This is a great treatment option. I have been doing Dry Needling since 2013, and Fast Track probably has the most experienced and the most certified therapists in Dry Needling in Indiana. All of our physical therapists are certified in dry needling here at Fast Track, and it has been an excellent resource to have in addition to many other certifications and techniques we use.”

Brian Horner PT, Owner of Fast Track Physical Therapy

Variety for Less Injuries…

Practice makes perfect… but when it comes to kids’ sports, variety may be the key to great success and less injuries.

Sports are a great way to keep your kids active, fit, and is good for teaching them teamwork and discipline. Sports are great, but there could be injuries that come along with it. In physical therapy, we see many kids and young adults with sports injuries.

The American Academy of Pediatrics reports that at least 50% of athletic injuries – mostly sprains, strains, and stress fractures- are from simple overuse. It is also possible some may have more serious injuries, such as concussions, meniscus tears, or broken collar bones. Research shows kids benefit most from exposure to multiple sports and forms of activity at a young age.

In an era of specialization, traveling teams, and year-round sports, it is easy to get caught up into focusing on just one sport. Professional athletes played a variety of sports when they were younger and believe being a multi-sport athlete contributed to their success later. Lebron James played football in his youth, and Michael Jordan played baseball and golf. 90% of first round picks in a recent NFL draft were multisport athletes in high school, and 224 of the 253 total picks were multisport athletes.

When kids are 8 or 10 years old and you give them options of sports to play, their body can get exposed to several demands as they are still growing. It is not just good for them physically, but mentally as well. Once kids reach their late teen years, then they can decide which sport to more focus on.

While variety is best for growing muscles, it is also important to rest. 1-2 days off for rest each week with at least 2-3 months off of an individual sport each year is good for your health.

Focus on skills development rather than structured competition. Less injury risk, because the body is moving/training in different ways, reduces the risk for overuse injuries. Developing fundamental skills early increases success and ultimately a love for sports.

At Fast Track Physical Therapy, we encourage parents to pay close attention to your young athlete’s complaints about aches and pains. While they could be simple growing pains, they could also be precursors of those over-use injuries.

Exercise and Education Are Key to Preventing Low Back Pain

Four out of five Americans will experience back pain at some point in their lives.

Today, back pain management often includes the overuse of treatments like surgeries, MRI, x-rays and medications. And it’s an expensive prospect: The annual tally on low back and neck pain treatment in the U.S. is at least $87 billion, according to a study in the Journal of American Medical Association. As it turns out, experts are testing less expensive solutions that aim to prevent occurrences of back pain in the first place, and the results are encouraging.

A study called “Prevention of Low Back Pain,” investigated the effectiveness of interventions like education and exercise in preventing low back pain. The key, according to the study, is the combination of exercise and education. Exercise alone is thought to make a difference, but when used in conjunction, exercise and education pack the most powerful punch. The best avenue is to see a healthcare professional like a physical therapist who is trained to prevent and treat pain through movement and exercise, hands-on care and patient education. These movement specialists perform evaluations to assess muscular, postural and skeletal limitations, and other factors that could one day contribute to back pain.

You probably equate physical therapists with exercise, but did you know that patient education is also a cornerstone of the physical therapy profession? Relying on formal education and practice experience, PTs can provide insights and interventions that reduce excess body mass, improve health status and reduce associated chronic disease risk by increasing physical activity. Not only is it easy to find physical therapists that lead evidence-based prevention and wellness programs right in your community, but once you’ve made an appointment, you’ll benefit from personalized one-on-one care and easy access.

You can expect the PT to begin treatment by gathering pertinent information about your movement patterns, limitations, posture and other factors that might contribute to back pain. Once the physical therapist has observed as you perform a series of exercises and gathered an account of your daily activity level and environmental factors like working at a desk 40 hours a week, they can teach you a few strategies to prevent back pain. And with 8 in 10 people experiencing back pain at some point in their lives, preventing incidences would not only take a huge chunk out of the staggering annual costs associated with treatments like medications and surgeries, but also ensure that people are on the road to better health!


Physical Therapy and New Year’s Resolutions

Physical Therapy and New Year’s Resolutions

Here’s a look at some of the similarities between physical therapy and new year’s resolutions, and how to overcome some of the difficulties of following through with each.

  1. It’s Not Easy–It is not easy to follow through with your resolutions, and oftentimes the same can be said about your physical therapy routine. It’s going to take hard work to see each through to the end. Acknowledging and accepting this will make it easier to follow through on your commitment each and every day.
  2. Developing A New Routine–Both physical therapy and new year’s resolutions force you to develop a new routine. For some, that means waking up before work in order to go for a run, while for others it means waking up early to do their physical therapy routine. Getting in the daily habit of following through with a new routine is the basis for success for both physical therapy and your resolutions.
  3. Your Diet Plays A Big Part–The most common new year’s resolution is to lose weight or become healthier, and oftentimes our diet is at the center of this change. Your diet also plays a key role in following through with physical therapy. The foods you eat help give you energy to exercise or do your therapy routine, and similarly, poor food choices can leave us feeling lethargic and less likely to be active. Improving your diet will help with both your resolutions and your ability to follow through with physical therapy.
  4. It’s Ok To Ask For Help–If you run into trouble with any aspect of your physical therapy or sticking to your new year’s resolutions, it’s okay to ask for help. In fact, it’s encouraged, because it will help you stay on track. See if a friend wants to take on your resolution with you or consult with your physical therapist if you have questions about a condition or an exercise. Lean on the resources you have, because they will help ensure your success.
  5. Recognize Small Achievements–Your leg fracture isn’t going to heal in a week, just like you’re not going to drop 30 pounds over the course of a few days. Instead of only looking at your progress as it pertains to your end goal, focus on the small wins along the way. Maybe you’re doing more reps, lifting heavier weights or down a couple pounds from the week before. When you recognize that you’re heading in the right direction, you’re more likely to continue along your path. Conversely, if you’re mad with your lack of progress compared to your end goal, it can prove to be a roadblock to success.
  6. It’ll Be Worth It–Finally, with both physical therapy and your New Year’s resolutions, know that it will be worth it in the long run. It will be hard work, it won’t always be easy, but the payoff will make it all worth it. Whenever you run into a moment of doubt or are questioning if you should give up, know that the hard work will pay off in the form of a renewed sense of health and physical function.

Jaw Pain? Pain in the jaw could be TMD…

Good news is you can manage and get relief without resorting to expensive mouth pieces or surgery.

Temporomandibular disorder (TMD), is a term that describes an entire group of disorders involving the temporomandibular joint or joints (TMJ).

The TMJs are the jaw joints. There is one on each side of your head just in front of your ear canals. Like many other joints in the body, they consist of:

  • Muscles that control joint movement
  • Ligaments that hold the bones together
  • Cartilage that provides a smooth surface for the bones to move on
  • A disc that helps with proper movement of the joints
  • Elastic tissue that helps hold the disc in place

One or more of the above tissues can cause symptoms. In fact, studies suggest that one third of the population at any one-time experiences TMJ symptoms such as pain with chewing, yawning, or jaw opening. Women seem to have TMJ problems much more often than men. There are a variety of temporomandibular disorders. The muscles (myogenous), joints (arthrogenous), or a combination of the two may cause pain. Try home remedies like an ice pack or if teeth grinding is an issue, try a mouth guard at night while you sleep.

Since physical therapists treat muscle and joint problems, they are ideally suited to address a TMD. A majority of patients diagnosed with TMD also have associated neck pain and headaches. Both respond well to treatment provided by a physical therapist. No other healthcare practitioner is better suited to address both TMD, neck pain and headaches.

Dry needling and other techniques are a great option to treat TMD.

TMD may appear to be a complex condition and it shouldn’t be. When a physical therapist performs the examination, they will be able to classify you as having one or more of the following:

  1. An inflammatory condition
  2. Limited jaw range of motion
  3. Excessive jaw range of motion
  4. Arthrogenous Disc Displacement
  5. Jaw muscle pain
  6. Neck pain causing related headaches (sometimes mistaken as TMD)

Whether the condition is mild or serious, professional advice is always essential for ruling out any other underlying issues and finding the best treatment for TMJ disorders.


Headaches…Do You Suffer in Silence? There is relief!

Pain of any type that occurs in the head is called a headache. There are also many different types of headaches, with just as many causes.

Here are the different categories of headaches:

· Tension-type

· Cervicogenic headaches

· Migraine or cluster

· Secondary headaches from an underlying condition; such as fever, infectious disease, sinus disorder, or in rare cases, a tumor or more serious illness

· Cranial neuralgia, facial pain, and other headaches

Most headaches are harmless and resolve on their own, although severe headaches that recur frequently can affect your ability to do daily activities and can reduce your quality of life. There are effective treatments for most types of headaches. Physical therapists can help determine the type of headache you are experiencing and are experts in managing pain from tension-type headaches and cervicogenic headaches.

Tension-type headaches, (also called muscle-spasm headaches), are the most common types of headaches in adults. They can also be the result of a neck or jaw problem, poor posture, fatigue, or stress.

A problem in the neck, head, or jaw can lead to tension in the muscles at the base of the head and also lead to increased pressure on the nerves to the face and head. Poor posture can also cause these muscles to become overworked, which can trigger a headache and there are treatments other than medications that can help.

Management of migraines, tension, or cervicogenic headaches may include education, deep tissue massage and other manual therapy techniques such as gentle joint mobilizations, soft tissue mobilization/myofascial release and dry needling.

Dry Needling is an excellent treatment technique for Migraines and Headaches. Dry needling involves inserting fine filament needles deep into the trigger points or knotted parts of the muscles, temples, and or other areas. Dry needling alleviates the tension without inflicting additional pain or discomfort that can be experienced with deep tissue or remedial massage.

The active trigger points refer pain that mimic the symptoms experienced with headaches and migraines. These trigger points can also cause headaches and migraines to occur. The most common muscles affected are the upper trapezius, sternocleidomastoid, levator scapulae, temporalis, and masseters. The proper treatment depends on several factors including the type and frequency of the headache and its cause, although not all headaches require medical attention.

Physical therapy will address posture, range of motion and joint mobility and strength. If, after a thorough evaluation of the patient by a physician, it is determined that physical therapy is a viable conservative treatment option, the patient can expect his or her treatment to include:

  • Skilled mobilization of the cervical spine
  • Education about job or lifestyle modifications
  • Postural correction exercises
  • Soft tissue manual therapy
  • Co-management with other health care providers

Physical therapy will address posture, range of motion, joint mobility and strength to get you feeling better, faster!

Dogs and Your Health

Who doesn’t love a cute, soft puppy? Did you know that dogs can be a benefit to your health? Well I know that first-hand how good dogs can be for you. My husband and I have two dogs, and one of them is Bella, a Canine Good Citizen Therapy dog. She comes to work with us every day at Fast Track Physical Therapy. She gives patients comfort and brings a smile to their faces even when they are in pain.

There are different types of dogs that can help both physical and emotional needs of people. So, what is the difference between a therapy dog, service dog and emotional support dogs?

A service dog is trained to help people with disabilities such as visual impairments, diabetes, seizure disorders etc. Service dogs are working animals, not pets. They have been specifically trained to perform tasks related to the disabled person’s specific disabilities.

A therapy dog has been obedience trained and is trained to provide comfort and affection to people in hospitals, nursing homes, retirement homes, schools and physical therapy clinics like ours. Therapy dogs provide mental health and physical benefits to people who spend time with them. Spending time with a therapy dog has been shown to lower blood pressure and heart rate, reduce anxiety, and increase endorphins and oxytocin. I know that our patients enjoy time with Bella.

Emotional support dogs provide their owners therapeutic benefits through companionship and love. Emotional support dogs comfort those with mental and emotional conditions such as anxiety, depression, mood disorders etc.

Now, not everyone needs a service or therapy dog, a family pet can be more than just a pet. Studies have shown real health benefits for those living with pets, including, lower cholesterol, lower blood pressure, reduced stress levels, lower triglyceride, better mental health and help you heal faster from injury or illness. Studies have found that the very act of petting an animal, such as a therapy dog, yields a relaxation response that can help alleviate the need for medication in those who require it for their physical ailments. Just getting out to walk your dog in the neighborhood is getting you up and moving too which is good for your health.

Just a few more reasons to love dogs…:)

Do You Know Your Movement Vital Signs?

Most people think of heart rate or blood pressure when they think of vital signs. It is common to use numbers to quantify health and risk of disease. The American Heart Association encourages people to “know their numbers” referring to blood pressure, blood cholesterol, blood glucose, and weight. However, research is now showing the importance of moving properly for health. Let’s take a look at some of the numbers you can use to quantify your movement health:

Walking Speed

Walking speed has been called the “sixth vital sign” in medical literature recently. It is easy to measure, and takes into account strength, balance, coordination, confidence, cardiovascular fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be predictive of future hospitalizations, functional decline, and overall mortality. Normal walking speed is considered to be 1.2 to 1.4 meters per second.

Push Ups

Push ups are popular to build strength, but a recent study found that they can show us a lot about your heart too. Researchers found that men who could do 40 or more consecutive push ups were at a 96% lower risk for cardiovascular disease than were men who could do less than 10. The push up test was also more useful in predicting future cardiovascular disease than aerobic capacity measured on a treadmill.

Grip Strength

Hand grip strength has been shown to be strongly correlated with health. The stronger your hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease, COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26 kg for men and <16 kg for women. Grip strength below these numbers was highly correlated with an increase in disease.

Standing From the Floor

If you can’t easily get down on the floor and back up your health might be in trouble, according to a study that looked at more than 2,000 people. The study asked people to go from standing to sitting on the floor and back up with as little support as needed. They found that if you need to use more than one hand to get up and down from the floor that you were 2 to 5 times more likely to die in the next 7 years than someone who can do it with just one hand, or even better, no hands at all.

Moving well is obviously important to overall health and longer life. These tests can give a snapshot of how you’re doing. If you’re having trouble with any of them, considering seeing a movement specialist – your physical therapist.

Physical therapy can help you with vertigo naturally without medication…

Dizziness, Vertigo, and Imbalance…

Dizziness is the second most common complaint heard in doctors offices. Statistics reported by The National Institute of Health indicate that dizziness will occur in 90 million of the nation’s population at some time in their lives. Dizziness is the #1 complaint for individuals over age 70. Although very common, acute or chronic problems with equilibrium may limit a person’s everyday living.

Benign paroxysmal positional vertigo (BPPV)

BPPV causes intense, brief episodes of vertigo immediately following a change in the position of your head, often when you turn over in bed or sit up in the morning. BPPV is the most common cause of vertigo.

Inflammation in the inner ear

Signs and symptoms of inflammation of your inner ear (acute vestibular neuritis) include the spontaneous onset of intense, constant vertigo that may persist for several days, along with nausea, vomiting and imbalance. It can be incapacitating, requiring bed rest. When associated with sudden hearing loss, this condition is referred to as labyrinthitis. Fortunately, vestibular neuritis generally subsides and clears up on its own.

Meniere’s disease

This disease involves the excessive buildup of fluid in your inner ear. It is an uncommon condition that may affect adults at any age and is characterized by sudden episodes of vertigo lasting 30 minutes to several hours and hearing loss.

Migrainous vertigo

Migraine is more than a headache disorder. Just as some people experience a visual “aura” with their migraines, others can get vertigo episodes and have other types of dizziness between migraines.

Acoustic neuroma

An acoustic neuroma (vestibular schwannoma) is a noncancerous (benign) growth on the vestibular nerve, which connects the inner ear to your brain. Symptoms of an acoustic neuroma generally include progressive hearing loss and tinnitus on one side accompanied by dizziness or imbalance.

If you have vertigo, dizziness, or imbalance, a vestibular physical therapist can perform a series of simple movements, such as the Epley maneuver, that can help dislodge the otoconia (calcium crystals) from the semicircular canal of the ear. In many cases, one session works; other people need the procedure several times to relieve their dizziness. Physical therapy can help you with vertigo naturally without medication.