The menisci are two C-shaped pieces of cartilage that sit in your knee between the thigh-bone (femur) and the shin-bone (tibia).  This cartilage acts as shock absorbers for your knees; they provide cushioning and also increase the stability of your knees.  A meniscal tear occurs when you get a tear in this cartilage. 
 
Meniscal tears can occur either traumatically or with degenerative changes.  Traumatic tears often happen with a sudden twist to the knee on a planted foot or by direct contact to the knee.  Degenerative meniscal tears generally occur in older people, as the cartilage weakens over time and becomes more prone to tearing. 

 

Common symptoms of meniscal tears are:
-pain in the knee joint
-inflammation and stiffness around the knee
-clicking, catching or locking of the knee
-inability to fully straighten or bend the knee    
  

Physical therapy can help to treat this condition.  Treatment may include techniques to reduce the inflammation around the knee, mobilization of the knee joint to increase range of motion, stretches and strengthening exercises for the hip, knee and ankle.  If the meniscal tear occurs in an area with good blood supply, there is potential for it to heal on its own.  However, if the tear occurs in an area with poor blood supply, there is less potential for healing and an arthroscopic surgical repair may be required.

 If you are experiencing any of these symptoms, please visit your doctor and/or physical therapist to determine the diagnosis and proper treatment plan for you.

Are you starting your day off on a painful foot?

It could be Plantar Fasciitis!

 Plantar fasciitis is a painful inflammation of the bottom of the foot between the ball of the foot and the heel.  Most people have pain when taking their first step when getting out of bed in the morning, placing their foot flat on the floor.  Some people have pain with prolonged standing and even at rest. 

 There are several possible causative factors including wearing high heels, gaining weight, and increasing the amount of time you spend standing, walking, running, or stair-climbing.  In runners, increasing the mileage or frequency of workouts, as well as changing the surface or terrain you run on, may cause inflammation of the plantar fascia.

 Treating plantar fasciitis consists of rest….which is difficult for the active individual!  Your health care provider may recommend or prescribe anti-inflammatory medication which decreases pain and inflammation.  Icing the bottom of the foot and cushioning the heel often helps ease the pain.  Orthotics are often used for those with high arches or flat feet to support the foot properly. 

 

If your pain is not relieved by the above recommendations, you may want to try physical therapy.  Physical Therapy will:

Determine the causing factor.

Stretch and strengthen the plantar fascia. 

Treat the pain and inflammation with manual techniques.

Strengthen the ankle and lower extremity.

Assist patient in returning to previous activity.

 

If you have any questions and would like to consult a physical therapist, please stop by  Joint Ventures Physical Therapy for a free injury screen with a licensed physical therapist

Ergonomic Desk Setup and Helpful Hints

 Most people spend a good amount of waking hours sitting at a desk and/or working on a computer. It is important to make adjustments to your work station to put your body in ideal alignment and prevent overuse and repetitive strain injuries. Take a minute to check out your desk set up with these helpful hints.

 1.) The computer screen should be placed directly in front of you and at one arms length away. The screen should be at eye level, or slightly below. Try to minimize glare on the screen. Large amounts of glare can set you up for poor posture at your desk.

 

2.) Your elbows should be at a 90 degree angle and your wrists should be straight while typing.  If this is not possible due to having a fixed desk height, an adjustable keyboard tray may be helpful. Do not rest your wrists on the desk while typing.

 

3.) The mouse/tracking ball should be next to you so that your arm is not extended out away from your body.

 

4.)The correct chair can make a big difference. Your back should be against the back of the chair. Adjust the seat height so that your feet are flat on the floor. Your thighs should be parallel to the floor and lower legs should be perpendicular to the floor. The thighs can be slightly elevated above the knees. If your chair is not adjustable, place an ergonomic foot rest, or a simpler solution like a small stack of books, under your feet to prevent your feet from dangling. The front of the seat should not be pressing into the back of your knees or lower legs.

 

5.) Sit with your weight evenly distributed over your buttocks and adjust the back of the chair so it supports the natural curve in back. Some ergonomic chairs have adjustable lumbar supports that can be utilized to maximize support and comfort.

 

6.) If you use a laptop daily for long periods of time, it is important to get an external keyboard and mouse. You may also want to consider getting a docking station.  If this is not possible, place the laptop on a table so that it is not in your lap.  This will help to reduce strain on the wrists, arms, and neck.

 

7.) If you are required to use the phone frequently throughout your day, get a headset or put the phone on speaker.  Resting the phone between your ear and shoulder is a recipe for neck, shoulder and upper back pain.

8.) But one of the best things you can do to minimize strain on your body from working at a computer station is to take frequent breaks!!  Taking a break every 30 minutes where you stop your work, get up and move around can help your body stay healthy and happy!!

 

 

Achilles Tendon Dysfunction  
Achilles tendon dysfunction is characterized as pain located along the heel cord (Achilles tendon) or pain located at on the heel (calcaneus) of the foot. Pain is typically worse in the morning and is usually accompanied by stiffness of the heel cord (achilles tendon). The achilles tendon is one of the largest and strongest tendons in the body.  It consists of the gastrocnemius, plantaris, and soleus muscle which come together and attach at the heel of the foot (calcaneus).  The primary function of the achilles tendon is to transfer strength and power into the calf to assist the lower leg in activities such as walking and running.

Causes
Achilles Tendon Dysfunction is caused by soft tissue irritation of the achilles tendon. This can happen for a number of reasons including repetitive movements, a recent increase in activity level, postural problems such as over pronation of the foot, running, and a tight gastrocnemius.  Certain motions of the foot done repetitively during sporting activities can also contribute to an irritation of the achilles tendon. Sporting activities with short, sharp, quick, bursts of movements in a variety of directions such as basketball, tennis, soccer and volleyball may increase your risk of developing achilles tendon dysfunction.  Other risks for developing achilles tendon dysfunction include a recent increase in activity level, running, change of shoes with less support, exercise routine that includes running hills and/or stairs and squatting.

 Physical Therapy
A physical therapist can diagnose and treat achilles tendon dysfunction. He/She will evaluate the biomechanics of the lower leg/foot, range of motion, strength of surrounding muscles and any postural problems. Treatments may include manual therapy to promote an increase in painfree range of motion, stretching to lengthen any tight musculature of the lower leg, modalities to promote healing and possible footwear change to correct for postural problems.  A physical therapist will put you through a stretching and strengthening exercise program to eliminate the pain felt by the achilles tendon dysfunction and return you to your normal everyday lifestyle without pain as quickly as possible.  Your Joint Ventures physical therapist can perform all of these treatments to assist in the recovery of achilles tendon dysfunction.

 

SNAPPING SCAPULA

Snapping scapula syndrome, also known as scapulocostal syndrome or scapulothoracic syndrome is characterized by a grating, grinding, popping or snapping sensation of the scapula (shoulder blade) onto the back side of the ribs or thoracic area of the spine. The scapula is a broad triangular bone attached to the body by strong muscles. It forms the foundation for movements of the arm. Over one third of shoulder movement occurs between the scapula and the ribcage. This movement occurs as a result of frictionless fluid-filled sacs, known as bursae. These form the articulation known as the scapulothoracic joint.

Causes

Snapping scapula is caused by problems in the soft tissues or bones of the scapula and chest wall. It can start when the tissues between the scapula and thoracic area thicken from inflammation. The inflammation is usually caused by repetitive movements. Certain motions of the shoulder done over and over again, such as the movements of pitching baseballs, swimming, or hanging wallpaper, can cause the tissues of the joint to become inflamed.

In other cases, the muscles under the scapula have shrunk (atrophied) from weakness or inactivity. The scapula bone then rides more closely to the rib cage. This means the scapula bumps or rubs on the rib bones during movement.

Changes in the alignment or contour of the bones of the scapulothoracic joint can also cause snapping scapula. When a fractured rib or scapula isn't lined up just right, it can cause a bumpy ridge that produces the characteristic grind or snap as the scapula moves over the chest wall.

Physical Therapy

A physical therapist can diagnose and treat snapping scapula.  He/she will evaluate the posture of your scapula, mechanics of how your shoulder and scapula move together, and strength of the surrounding muscles.  Treatment may include manual therapy to mobilize your shoulder and scapula to promote proper posture and alignment.  Postural stretching and strengthening will also improve the mechanics of your shoulder and scapula.  Ultimately your physical therapist will put you through a scapular stabilization exercise program strengthening muscles of your shoulder and shoulder blade to help stabilize during repetitive movements allowing you to get back to your normal everyday lifestyle without pain.

If you are experiencing any of these symptoms of shoulder pain for any reason, make an appointment with your doctor and or physical therapist for evaluation and treatment.  

There are 3 main stages of healing that occur after an acute sprain/strain injury:
 
The first stage is the inflammatory phase, where the body sends inflammatory cells to the injured site to help clot the wound and remove debris.  This phase usually lasts the first 4 days after injury.  The best treatment during this phase of injury is RICE: Rest, Ice, Compression and Elevation.  Physical therapy can assist at this phase to help reduce the swelling and provide gentle range of motion exercises.
 
The second stage is the scar formation phase, where the body lays down collagen tissue to repair the injured site and form a scar.  This phase usually lasts from Day 4 to Day 15 after injury.  Physical therapy is most effective at this stage to help promote regular tissue growth and minimize scar tissue development.  Treatment might consist of modalities, manual therapy, deep tendon frictions, stage to promote proper strengthening without re-injury to the healing tissues. massage, stretches, and gentle strengthening exercises.  At this stage the repairing collagen tissue is still weak and can be susceptible to re-injury if over-stressed.  Physical therapy can help guide exercises at this
 
The last stage of healing is the remodelling phase, where the body remodels and increases the tensile strength of the newly repaired tissue.  This phase lasts from approximately Day 15 and continues for up to 1-2 years after injury.  During this phase, physical therapy aims to minimize scar tissue build-up, encourage optimal orientation and alignment of the newly formed tissue, correct muscle imbalances, retain and maintain mobility of the joint, increase the stability of the joint, strengthen the repaired tissue with more difficult and challenging exercises, and prepare for return to sports or leisure activities.
 
If you have suffered an acute sprain/strain please consult your doctor or physical therapist to determine the appropriate treatment plan for you.

Listen to your body.

 

Know what works for you… It may not be the same as what works best for your friends, but if you have a successful run/race, you did it correctly!

 If your body hurts then rest, cross train, and or talk to a professional/coach about it.

 You don’t get strong by running; you must be strong to run!

 Your feet affect every aspect of running.  If you have pain somewhere in your body and there is no known injury to that body part, look to your feet (or better yet, have a PT/Podiatrist/MD look at them, too!)

If everything is okay with your feet (including shoe fit/wear mileage), look at your hips.  Stability through your pelvis is KEY!

 

Common Running Injuries:

(All of these may result from the biomechanical problems described below, overtraining, or a combination of factors!)

 

1)      Runner’s Knee/Chondromalcia Patella/Patellar tendonitis:

The space behind the kneecap or the tendon attaching the kneecap to the shinbone becomes irritated and painful.  Generally, the quadriceps muscle is not strong enough to handle the load/impact from each step you take, or the foot is collapsing too much and the impact is being transferred to the knee.

• Quad strength – Straight Leg Raise, Single Leg Balance, Double and single leg squats

• Glute Strength – Side lying leg raise, sidestep, BOSU/balance exercises, 4-way kick

• Custom or Over the Counter Inserts/Changing Shoes

 

2)     Stress Fractures

Although a stress fracture is not a full fledged fracture, it can sideline you!  Runners typically see them in the tibia (shinbone), but the can occur anywhere.

• Try some non-weight bearing exercises to cross train, like aqua jogging, swimming, cycling, etc

 

3)     Iliotibial Band Syndrome

Pain on the outside of hip or knee is generally caused by weakness on the inside of your quadriceps muscle and the outside of the hip/glutes.  This tendon runs from the top of your hip to the outside of your knee and is not very flexible.  When you rely on it more than the muscles in your thigh, it gets irritated!

• Stretch the ITB

• Strengthen quads and glutes as above

• Wear the appropriate shoes

 

4)     Shin Splints
Irritation of the tissue that connects the muscle in the front of your shin (anterior tibialis) to the shinbone (tibia) can result from improper footwear, or tight calves.

5)   Plantar Fascitis

The plantar fascia is very tough connective tissue that covers the bottom of your foot (arch).  Pain in the heel or arch, especially when you first get up in the AM is a hallmark sign of this problem!  Can be caused by; a loss of arch height, increase in activity, tight calves, and or improper footwear.

• Stretch the calves and bottom of your foot

• Strengthen the bottom of your foot

• Change shoes/inserts

 

6)     Achilles Tendonitis

Typically pain in the lower part of your calf, usually results from tight calves, poor mechanics at the foot, poor calf strength

• Stretch and strengthen calves

• Change shoes/inserts

 

7)     Muscle Pulls

Micro tearing of the muscle tissue, usually when you ask a muscle to do something it is not ready for.  (I.E. running without a proper warm up or sprinting across the street to avoid being hit by a car)

You need to give the tissue time to heal before stressing it with running

 

8)    Ankle Sprains

We’ve all done it! Be careful about pot holes, curbs and ice!  If you twist your ankle, keep your shoe on until you are somewhere you can get ice on it.  The shoe will help stop some swelling. RICE!

• Single leg balance, eyes open and closed, 4-way kick

• BOSU balance ex

 

9)     Dizziness/Nausea

Hydrate but don’t over hydrate!  80z fluid per 20 min of running is generally enough.  When you find a drink/water/gel combo that works for you don’t mess with it!  Some people can tolerate solid food and others can’t.  Know what works for you.

 

10) Blisters

Proper fit of shoe/insert and drywick or wool socks that don’t allow moisture to accumulate on your skin.

 

If you have any questions about any of these injuries or are experiencing any of these symptoms, please feel free to contact one of the physical therapists at Joint Ventures or your doctor.

Joint Ventures Physical Therapy and Fitness is proud to introduce the Grand Opening of their 6^th location in the Boston area. The new office is conveniently located in Kendall Square.  We have partnered with Equilibrium in the Watermark Building at 350 Third Street.  This connection continues to expand our relationship with the EQ to provide you with all around fitness and wellness. We currently have 5 individual treatment rooms offering 1-on-1 physical therapy services, massage therapy, acupuncture and spa services.

 

Joint Ventures is excited to continue to grow and offer state-of-the-art quality care and wellness services to the Cambridge community.  Please stop by our new location anytime for a tour of the facility.

 

To schedule an appointment for any of our services in Kendall Square, please contact us at 617-536-1161.

 

Joint Ventures Physical Therapy

Located at Watermark Building

350 Third Street

Cambridge, MA 02142

What is Pes Anserinus Bursitis?

The pes anserinus is made up of three tendons which include the sartorius, gracilis, and semitendinosus muscles. These muscles are primary flexors of the knee and help protect the knee from extreme valgus or lateral stress.  Combined anatomically they lie just above the medial collateral ligament.  Pes Anserinus bursitis is irritation of the bursa or fluid filled sac that helps to cushion the knee between these anatomical structures. Pes Anserinus bursitis can occur from:

1.) Acute trauma to the knee
2.) Athletic overuse
3.) Biomechanical processes.  

Pes Anserinus symptoms include pain located on the inner knee, swelling along the inner knee, and difficulty climbing up and down stairs. Athletes who develop Pes Anserinus bursitis typically participate in a sport that requires a great deal of sharp cutting movements, runners and swimmers. Treatment for Pes Anserinus bursitis is aimed to reduce the strain on the injured musculature. This may be done with stretching, heat, ultrasound, deep tissue massage, NSAIDS, and ice massage.  Pes Anserinus bursitis should begin to resolve within a few weeks.  As your symptoms begin to dissipate you may return slowly to activities that do not aggravate your knee. Your Joint Ventures Physical Therapist can perform all of these treatments to assist you in the recovery and help return you to your previous activity level. 

The patella tendon is a band of tissue that connects the patella (knee cap) to the tibia (shin bone).  It assists the knee to extend or straighten out.  Patellar tendonitis is a condition that occurs when the patella tendon gets inflamed.  This can occur from an acute traumatic injury to the tendon, but more commonly comes from overuse of the tendon especially with jumping activities (also referred to as "jumper's knee").  Symptoms include pain at the patella tendon (directly below the knee cap), tenderness on palpation of the tendon, and pain with activities such as jumping, running and prolonged walking.
 
Physical therapy can help treat this condition.  Treatment may include techniques to reduce the inflammation and scar tissue build-up around the patella tendon, patellar mobilizations, massage and stretching of the muscles in the leg, and re-strengthening to prepare for return to activity.  Other treatments may include taping, knee braces, support straps and/or orthotic recommendations.
 
If you are experiencing any of these symptoms, please visit your doctor and/or physical therapist to determining the diagnosis and proper treatment plan for you.