Excel PT: Effective Hip and Knee Pain Relief

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EFFECTIVE HIP AND KNEE PAIN RELIEF

Knee or hip pain is a common complaint for individuals across all ages and genders. There are many causes for hip and knee pain. Some of these issues such as osteoarthritis, hip impingement syndrome, patellofemoral (kneecap) pain syndrome, bursitis, and tendinopathies can be due to overuse. In addition, there are always sources of pain that can be due to trauma, such as muscle strains/tears and fractures.

By Joseph Bertucci, PT, DPT

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INSIDE : • Effective Hip And Knee Pain Relief • Relieving Your Hip And Knee Pain

• Exercise Of The Month • Featured PT

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Many of these painful diagnoses can be traced back to less than optimal movement patterns which are due to weakness in the hips and leg muscles. Over time, these movements can irritate or cause breakdown of muscles and joints. Suboptimal movement patterns can also predispose individuals to traumatic injury. These movement patterns occur countless times a day, whether we realize it or not. Squatting down to pick up your child, or climbing stairs to get to the laundry are some examples of motions that, if done repeatedly with poor form, can be a cause of pain. The motion at the hip and knee are closely related. The knee joint moves very well in bending straight and extending. However, people do not move in one straight plane at all times. Whenever people turn, pivot, cut, or simply stand on one leg, there is an element of imbalance for which our muscles must account. A lot of that control actually comes from the hip. Picture trying to squat to the floor to pick up a quarter you dropped. Try doing it with your toes pointed away from each other like a ballerina. Then, try performing the same task with your toes pointed towards each other. The motions and stresses put on your body are vastly different, and all you did was rotate your hips a few degrees. Now imagine having to perform that squat with your toes pointed towards each other 500 times. While this is an extreme example, it can help to INSIDE : • Relieving Your Hip And Knee Pain • Featured PT By Joseph Bertucci, PT, DPT EFFECTIVE HIP AND KNEE PAIN RELIEF (continued from outside)

• Exercise Of The Month • Patient Success Spotlight

illustrate how an abnormal movement over time can cause pain. At Excel, we have skilled therapists who can help to identify abnormal movements and find its source. Whether there is a strength, mobility, stability deficit or some combination of each, physical therapy has been shown to reduce hip and knee pain for various diagnoses. Research has shown that for individuals that have patellar (kneecap) pain, there is a significant improvement in symptoms when hip exercises are performed regularly compared to just quad strengthening (Bloomer & Durall, 2015). In addition to helping knee pain, general strengthening is shown to decrease pain associated with hip osteoarthritis. The benefits of exercise were such that those who were expecting to require a hip replacement were able to wait 40% longer with the same quality of life before having their hip replaced (Svege, et al. 2013). Regular exercise and strengthening of hip musculature is an effective way to decrease pain and avoid repetitive stresses than can lead to further injury in both the hip and knee joints. If you are currently experiencing mild hip or knee pain, it is a good idea to see one of the skilled therapists at Excel to get a comprehensive evaluation to better understand your pain. Sources: Bloomer BA, Durall CJ. Does the Addition of Hip Strengthening to a Knee-Focused Exercise Program Improve Outcomes in PatientswithPatellofemoralPainSyndrome?JournalofSportRehabilitation.2015;24(4):428-433.doi:10.1123/jsr.2014-0184. Svege I, Nordsletten L, Fernandes L, Risberg MA. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomised trial. Annals of the Rheumatic Diseases. 2013;74(1):164-169. doi:10.1136/annrheumdis-2013-203628.

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Justine Prestifilippo, PT, DPT Justine is a therapist at our Lafayette Hill clinic location. Read her full profile here: FEATURED PT

Relieving Your Hip And Knee Pain

1. How did you decide to become a physical therapist and what motivates you to work with patients? I decided that I wanted to become a PT after having years of PT as an injured dancer. I had one amazing PT who, for lack of better words, helped me get my life back and I realized I wanted to be that amazing PT in someone else’s life. This is

Your hips, knees and lower legs are tough—but injuries happen. Your hips and knees are your largest joints which support the body’s weight. They work in close coordination, giving us mobility. However, due to injuries, age and arthritis, pain can flare up. What Causes Hip and Knee Pain? Hip and knee pain are surprisingly common. Thus, their source can occur due to a variety of causes. If you are experiencing pain in any part of your leg, pinpointing the exact spot can also help determine the cause. The Mayo Clinic has detailed several leading causes of hip and knee pain. While many causes exist, the most likely are:

also what motivates me. She had such an impact on not only my rehab and returning me to my usual activities, but also on my mood. I strive to do the same thing for all of my patients.

2. In your words, what makes Excel Physical Therapy different from other physical therapy clinics? Excel stands out because they truly value the importance of one on one time. This allows us to actually spend time working with, and getting to know our patients, ensuring their program is exactly what they need to achieve goals that are meaningful to them. Excel also values continuing education, which is so important as there is always something new to be learned to ensure we are providing the best care possible. 3. What was your most memorable patient experience? I worked with one patient during a clinical rotation while in PT school who was a young ballerina. She will always stand out to me because she was the first dancer patient I got to work with and I saw a lot of myself in her. I was able to use my past experience to help tailor her rehab to her ballet needs and get her back to performing.

• Arthritis • Dislocation • Hip fracture • Sprains and strains

• Tendonitis • Pinched nerves • Osteoporosis • Cancer

While some causes are more severe than others, a physician can help in identifying each. As the body ages, joints can become inflamed. Cartilage may wear down, reducing the “buffer” between bones. In some cases, limited blood flow may cause bone tissue death, or necrosis. If you are experiencing redness, inflammation and stiffened joints, the condition may be severe. What Are the Symptoms? While leg pain is noticeable by a slew of symptoms, several are prevalent. Aching or stiffness around the hip, groin, back or thigh may be a sign of deeper problems. A decreased range of motion, too, is a sign of deeper problems which may later result in hip or knee pain. Sometimes, inactivity can contribute to immobility—and later pain. If you are limping, lurching or are experiencing bad balance, contact a physician. While some hip and knee pain does go away, those lasting longer than several months may be hinting at a deeper issue. If you are suffering with hip or knee pain, call us today to learn how we can eliminate your pain and put a spring back in your step!

4. If you could be any animal, what would it be and why? I think I’d like to be a dog. That would be the best life; getting to lay around all day in the sun or run around a yard…

5. If you could describe yourself in one word what would it be and why? This is a hard question! I guess hungry? Hungry to keep learning more, doing more, to become my best, but also just usually hungry.

6. What do you like to do in your off time, outside the clinic? I like spending time with my husband, family, and friends, experimenting with new foods, and trying not to let weeds completely overtake my yard.

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“When I was referred to Excel for help, I wasn’t exactly coming in with an open mind. I am a natural skeptic and previously had a negative physical therapy experience elsewhere. However, from the first day I walked in, I was greeted with smiles and support. My therapists listened, adjusted, and explained everything to me, before and after my ACL reconstruction. As my goals changed, so did their plan for me. I always felt like we were a team, working together so I could accomplish everything I had my mind set to do. I’m so thankful to have had their help (along with Fern’s smiling face greeting me every visit). If you have a chance to come here, do it! You might be surprised at what you’re capable of accomplishing, and the Excel team will do everything possible to ensure you succeed.” - Karen M. (Royersford) Don’t delay we can help you! Contact us: Downtown Philadelphia & South Jersey, Northeast Philadelphia and Lower Bucks County, Montgomery County, The Main Line, Delaware County, Chester County, Allentown, Lancaster: www.excelphysicaltherapy.com/contact-us Begin by lying on your side with your legs straight. First, lift your top leg to just about a 45 degree angle off of the table. Second, lift your bottom leg up to meet the top leg. Return lower leg to table, repeat 5-10 times per side. Side-Lying Hip Adduction EXERCISE OF THE MONTH “If you have a chance to come here, do it! You might be surprised at what you’re capable of accomplishing...”

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