Hip, Knee & Leg EBook - US

Table of Contents

02 Why Does My Knee or Hip Hurt?

04 Step 1: Improve Your Stride

06 Step 2: Enhance Your Flexibility

08 Step 3: Improve Your Joint Stability

10 Step 4: Enhance Your Joint Strength

12 Step 5: Lasting Results With Balance

14 Why Physical Therapy Is The Right Choice

*medical disclaimer

Always consult your physical therapist before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional todesignanappropriateexerciseprescription. If you experience any pain or difficulty with these tips, stop and consult your healthcare provider.

Why Does My Knee Or Hip Hurt?

Pain is a symptom of the underlying mechanical problem. The vast majority of kneeor hippain is causedby poormechanicalmovement. This occurs from poor posture, alignment, flexibility, balance, coordination, or weakness of the leg muscles. Many people turn to over-the-counter medications, see their doctor for prescription medications, and even have expensive MRI’s, without achieving any long-lasting results. The reason for this is that most of the focus is on the symptom, instead of treating the root cause. As physical therapists, we get results, because we are the mechanics of the body, treating the root mechanical problems of knee or hip pain. In this book, we are going to teach you what we do to alleviate joint pain, so you can improve the health of your knee and hips, and return to the activities you enjoy. According to leading researchers, the number of total knee and hip replacement surgeries is going to sky rocket to over 4 million by 2030 (1) . However, if you try physical therapy first, you probably won’t have to be one of them. If you are careful about bending, walking or kneeling, because your knee or hip hurts, then this book is for you!

Knee or hip pain is a mechanical problem, therefore it must be treated as such. Here are the main categories that most knee and hip problems fall under: • Poor walking quality • Lack of flexibility • Poor joint stability • Inadequate leg or core muscle strength • Lack of coordination and balance • Injuries

Getting To The Root Of The Problem

Kneeor hippaincanbeacute, suchas after an injury, or chronic.Whichever pain experience, your body is telling you that something is wrong and if you don’t fix it, there will be more serious consequences in the future. Many chronic problems, such as arthritis, can be dramatically helped with the right treatment. The sooner you address the problem, the lesser the risk for long-term damage to your hip or knee joints. Take time to read and implement the pain relief strategies in this book. Your joints will thank you! If you want to know more about how we can help you alleviate your hip or knee pain for good, call us today to speak with one of our specialists. About physical therapy Physical therapists typically have doctorate degrees in medical science. Licensed by the state, they evaluate orthopedic and neurological conditions that effectmovement. Many years of training go into a physical therapy evaluation of your joints, muscles, coordination, walking, and balance. This allows us to pinpoint the exact mechanical problems of your knee and hip joints. Physical therapists are experts in hands-on treatments such as massage, joint mobilization, soft tissuemobilization andmuchmore. In addition to gentle hands on therapy, a physical therapy session also involves specific exercises that target affected areas, rebuilding flexibility, strength and coordination. Finally, a physical therapist teaches you how to take care of your body with an exercise plan, walking or running techniques, and body mechanics for long-lasting results.

Step 1: Improve Your Stride

Do you sit for long periods at work or at home? Do you find yourself slightly limping when you first start walking? Prolonged sitting actually changes the way that you walk. Areas of your hips, pelvis and spine lose their strength and flexibility. This changes the way your hips and spine move when you walk, increasing the load on your knees. Furthermore, with sitting, your quadriceps muscles weaken, leading to poor tracking of the patella (kneecap). Finally, your knee and hip cartilage health relies on a squeezing pressure from walking. With less walking in the day, the joint fluid does not circulate properly leading to a decrease in lubrication of the joints. How to walk better Walking is often the best medicine. Learning towalk properly is a big part of the rehabilitation of knee and hip pain. Here are some simple tips to help you improve your gait (the way you walk), and decrease the strain on your joints: 1.Whenwalking, try tomaintain a tall posture. This brings your spine and center of gravity into a natural position that allows your joints tomove more freely. Imagine a string gently pulling you upwards through the top of your head. 3.Avoid sitting for long periods. Get up and move around during the day at work or at home. Try to move out of a seated position at least every 30 minutes. 4.Be aware of how your hips are moving when you walk. Do you notice if one or both of your hips are slightly dipping? This is a sign of hip weakness. 5.Wear supportive shoes that provide adequate cushion to the instep. Avoid wearing shoes without ankle support such as sandals or high heels. 2.Whenwalking, focus on taking a larger, but natural stride length. Imagine hitting the ground more with your heel.

Step 1: Improve Your Stride (cont.)

6. Try to walk daily for at least 20-30 minutes. Avoid surfaces that have an incline to one side, such as roads with a large camber.

7. Speedupyourwalkingwhenyouareexercising. Speedingupyourwalking changes your stride length and forces you to utilize your muscles in a different way. 8. Swing your arms when you walk. Surprisingly, many people limit their armswing with casual walking. Whenwalking for exercise, you can focus on increasing your natural armswing. This increases the use of the trunk muscles, which are important for your spine and hip coordination. Posture helps your joints heal The strain of sitting and daily tasks causes inflammation deep in the tissues of the spine, pelvis and hips. This in turn irritates nerve endings, causing aches and pains. Proper posture helps to align the hips and knees throughout the day, reducing the build up of inflammation. Physical therapists are the experts in evaluating alignment of the body and walking patterns. Our well-trained physical therapists have years of medical training to spot deviations in your walking patterns and body alignment, due to compensation and underlying problems. Often the painful area is compensating for poor posture and alignment in other areas. By working on these other problemareas, better walking stride and posture can be restored, allowing your body to function normally and move through a pain free range. How physical therapy helps your stride

Step 2: Enhance Your Flexibility

We are creatures of movement. Our body systems rely on movement to function properly. Studies show that even for young people, 2 weeks of physical inactivity leads to 30% loss of muscle mass(2). In turn this also leads to loss of flexibility within the joints of the body. Your hip, knee and ankle joints work together to allow you to walk freely. When one of these areas becomes tighter, it can double or triple the load on the other joints.

Did you know...

Your hip joints and pelvis need to be flexible. The majority ofmovement when you squat or benddownduring the day comes from your hips. When your hips lose their flexibility, the strain is transferred to your spine and knees, causing abnormal wear and tear.

Step 2: Enhance Your Flexibility (cont.)

How to improve the flexibility of your joints It is never good to stretch into pain. Stretch your muscles and joints within a comfortable range and gradually ease into deeper stretches. Depending on your age, you should stretch more frequently. The older you get, the longer andmore frequent your stretching routine should be. This is because our tissues become less inelastic as we age. Yoga, Tai Chi and Pilates can be great ways to stretch. However, make sure you start at a basic level, listen to the instructors and stay within your limits. Dynamic stretching is a very beneficial way to improve your flexibility and coordination of the joints. The goal is to stretch while going through a series of movements. This re-educates the body on the propermovement patterns to restore proper flexibility. How physical therapy helps your flexibility One of the core principles of physical therapy is restoring correct movement. A physical therapist improves the mobility of your joints with advanced, but gentle hands on manual techniques. These gentle techniques specifically improve the flexibility andmultiple ways your hip and knee joints spin, rotate and glide. This takes many years of training and skill to be able to correctly evaluate and treat. Physical therapists then focus on teaching you how to prevent your problem from returning through specific exercises, designed to retain your flexibility. Start with gentle stretches for the whole body. Focus on your hips, low back and legs.

Step 2: Enhance Your Flexibility (cont.)

Try these exercises to improve your joint flexibility Always consult your physical therapist or physicianbeforestartingexercises you are unsure of doing. Clams In Side Lying Lie on one side hips bent to 45 degrees, feet in line with hips. Slowly raise top knee up while keeping feet touching and pelvis still. Return to start position with same speed. Repeat 10 times on both sides.

Piriformis Stretch - Modified While lying on your back, hold your knee with your opposite hand and draw your knee up and over towards your opposite shoulder.

Exercises copyright of


Step 3: Improve Your Joint Stability

Knee instability is a big problem for many people, especially after an injury or surgery. The knee is one of the most complex joints in the body. This requires a complicated ballet of precision balance andmovement of the muscles in the leg and pelvis. With injury, or if you have a sedentary lifestyle, the coordination of the muscles surrounding the joints can become unbalanced. This places an enormous amount of pressure on key spots in the knee and hip joints, increasing inflammation and pain. A large area of instability in the knee is found on the inside aspect of the joint. This is due to the angle of the femur bone and dependent on how strong your hips are. In some people, this angle is excessive causing a large amount of force to be placed on the inside aspect of the knee. If left unchecked for years, this can actually cause ligament and cartilage damage leading to severe instability of the joint and cartilage damage increasing the likelihood of arthritis. The hip and knee joints also depend on the strength and stability of the gluteal muscles. They maintain the correct alignment and stability of the pelvis and hips. With injury and inactivity, thesemuscles weaken, causing a sagging of the pelvis when walking. This is especially noted when a person is tired, or standing for a prolonged period. After injury to the knee or hip areas, muscles weaken dramatically, and if not properly rehabilitated, may not fully recover their strength. This can cause long-term strain. Seeing a physical therapist after a sports or other type of injury is essential to long-term health of your hip and knee joints.

Step 3: Improve Your Joint Stability (cont.)

How physical therapy helps your joint stability Physical therapists are experts in treating hip and knee problems. They have years of medical training in examining how the body moves. By evaluating your joint movement, muscle strength, coordination and stability, we can pinpoint the root cause of your problem. For example, discovering that you have a weakness around the outer hip muscles, we can thenmake a plan to performspecific hands on therapy and exercises to target that problem area. As a result, your body’s natural movements are restored, alleviating pain and improving your ability to performdaily activities. How to improve your joint stability • Work on simple exercises to increase the strength and stamina of your leg and hip muscles. These include exercises to strengthen your abdominals, hip, pelvic, thigh and calf muscles. A physical therapist can teach you the proper exercises to do for your particular condition. • Practice going up and down on your tip toes while gently holding on for support. This helps to strengthen the calf muscles and works on your balance at the same time. • Keep your knees lined up behind your torso when you bend or squat. This will help to use your proper legmuscles and reduce strain on your knees. • Performexercises that involvemultiple joints at one time. For example, instead of just performing exercises to extend your knee, try step ups, lunges or squats within your comfort range. • Improve your balance. Performing balance exercises increases your ability to engage your knee and hip muscles properly.

Step 3: Improve Your Joint Stability (cont.)

Try this exercise to improve your joint stability Always consult your physical therapist or physician before starting exercises you are unsure of doing.

SINGLE LEG STANCE FORWARD SLS Stand on one leg and maintain your balance. Next, hold your leg out in front of your body. Then return to original position. Maintain a slightly bent knee on the stance side.

There are approximately 640muscles in your body that help youmove on a daily basis. Your knee joints rely heavily on themuscle support tomake them function properly. Weakness in any one area produces a cascade of problems in other areas, even further up the leg in the hip or back.

Step 4: Enhance Your Joint Strength

When you sit for prolonged periods in the day, your muscles atrophy or become weak. In addition, with repetitive strain or injuries, certain muscles around the knee and hip can be injured. Injuries weaken all the muscles around the affected area, especially the smaller muscles that control the intricate movements of these joints. By strengthening specific muscles, your body can restore control to the knee or hip joints. This in turn decreases strain and daily inflammation, resulting in long-term pain relief.

Step 4: Enhance Your Joint Strength (cont.)

How to improve your joint strength Strengthcomes fromperformingtherightexerciseswiththerightamountof control. You are far better off doing small, specific strengthening exercises, than trying tomove large weights. It is safer and you will achieve a better result. A lot of strengthening actually involves restoring your brain’s ability to connect with the right muscle groups again. This develops the neural pathways and activates the right muscles at the right time. When you performexercises, suchas squats, do themslowly and focus your thoughts on tightening your gluteal and thighmuscles, controlling themovement. The pelvic and hip muscles are an important part of strengthening your whole lower extremities. Weak hip abductor muscles fail to take the load when walking, change your posture and knee mechanics, resulting in more strain on the knee, hip, and spine. Performing leg lifts out to the side and back help to strengthen the hip musculature. Perform coordinated strengthen exercises. For example, doing mini- squats while keeping your abdomen tight helps to engage the core, pelvic and leg muscles together. How physical therapy helps your joint strength Physical therapists have years of training in kinesiology, which is the study of human movement. Through proper evaluation of what muscles are weak in your legs, we canpinpoint the exact area that needs strengthening. We then teach you specific exercises that target these particular muscle groups. We help you naturally progress from very simple exercises to more complex coordinated exercises as your muscles heal and begin to work together. You are empowered with the knowledge of how to keep your body strong and healthy.

Step 5: Lasting Results With Balance

Our goal is to not only quickly relieve your pain, but tomake sure your hips and knees stay healthy for the long run. One of themost important features of healthy joints is the ability to balance and coordinate themuscles. This provides for long-term joint health and the capability to handle strenuous motions. Your lower extremity movement is complex with many muscles that have to move at the right time and right place. As we age and after injury our normal nerve feedback from the ankles and knees is especially affected. This will effect the way you walk, and result in abnormal strain to your joints. Mostpeoplearenot awareof theirdifficultywithbalanceuntil theychallenge it. For example, can you stand on one leg comfortably without swaying or having to compensate much with your arms? The good news is that, with the right exercises and treatment, coordination and balance can be vastly improved. This leads to the ability to be more active, reduce the risk of injury and prevent arthritic wear and tear.

Step 5: Lasting Results With Balance (cont.)

How to improve your balance 1.Work on your whole balance. While holding onto a steady surface, try to balance on one leg at a time. Tighten your abdominal muscles while you do this and don’t let your hip / pelvis sink down.

2.Perform calf raises while holding onto a steady surface. Try this also with your eyes closed to provide extra feedback to your legs.

3.Walk! This simple action makes you use your muscles and nerves, improving your balance. Walk for 20-30 minutes each day and wear proper supportive footwear, such as a good pair of new sneakers.

4.Perform core exercises such as modified planks.

How physical therapy helps your balance A physical therapist can pinpoint your exact problem through the examination of your flexibility, strength and coordination. You are put through specific movement patterns that show where your balance is challenged. With this knowledge, a comprehensive plan is designed to restore your balance to a natural condition, so you can return to pain free walking and running.

Why Physical Therapy Is The Right Choice

With physical therapy, there is no cracking or popping, no injections, no pushing through pain. Physical therapy evaluates how your joints move and function. Our evaluation process easily pinpoints the root cause of your problem. Then, through an individualized plan of specific, gentle hands on techniques and therapeutic exercises, we restore your joint flexibility, strength, posture and coordination. Imagine, your soremuscles soothed, your joints moving freely, walking easily, and feeling strong. Imagine being able to easily bend down, stand or walk comfortably, without fear of your knee or hip hurting. All this can happen with trying physical therapy first.

You should always try physical therapy first with a certified physical therapist, before trying other aggressive medical procedures. Many studies point to the fact that trying physical therapy first, achieves much higher results and costs significantly less than other forms of treatment. In the rare instances that more invasive procedures are required, physical therapy is an important part of your recovery and helps you return to work, play and living a pain-free life.

Call us today or schedule a free phone consult with one of our expert physical therapists. Discover simple actions that you can take, to relieve your pain quickly and naturally. Your joints will be glad that you did.

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