Reader Question:

I play volleyball, so will physical therapy help the patellar tendonitis in my knee?

Patellar tendonitis is the condition that arises when the tendon and the tissues that surround it become inflamed and irritated. It is a knee injury related to jumping-type sports, such as basketball and volleyball, but is also seen in running and soccer players. A combination of factors leads to patellar tendonitis, including increasing intensity and frequency of physical activity, tight leg muscles, muscular imbalance and weak leg muscles. Pain is usually sharp directly over the patellar tendon when you are active, and will persist as a dull ache at rest. Initial treatment includes rest, performing exercises in a pain free range, and ice after activities that cause pain. Your doctor may prescribe physical therapy, which can help you adjust body mechanics to distribute the forces exerted through the knee during physical activity. They can also help to stretch tight muscles, especially the quadriceps, and strengthen the patellar tendon and surrounding muscles to limit further injury. A therapist might also administer a patellar tendon strap to help distribute force away from the tendon as you return to regular activities.

Vince Frisillo, MPT
Physical Therapy & Sports Medicine
Excel Therapy Specialists

Reader Question:

My feet hurt. What can I do for plantar fasciitis?

Plantar fasciitis is an overuse injury when the tough, fibrous band of tissue that connects your heel bone to your toes becomes inflamed. Causes of plantar fasciitis include physical activ- ity overload, occupations that require increased standing or walking, being flat footed or having high arches, and
improper shoes. Symptoms of plantar fasciitis include sharp or burning pain in the heel and bottom of your foot that is worse upon waking, after long periods of standing or getting up from a seated position, and after exercise. First, try rest and ice to decrease the symptoms. If symp- toms persist, your doctor may prescribe physical therapy for exercises to stretch the plantar fascia and strengthen the ankle and foot for improved stability. Night splints help to stretch the heel while sleeping so the plantar fascia does not become contracted overnight. Once symptoms have subsided, shoe inserts, properly fitting footwear, and continuing your home exercises will help to maintain flex- ibility in the plantar fascia.

Vince Frisillo, MPT
Physical Therapy & Sports Medicine
Excel Therapy Specialists

Reader Question:

I keep hearing about the benefits of a strong “core.” What is it?

The “core” consists of many different muscles that run the length of the torso and help stabilize the spine, pelvis and shoulders. Muscles from the abdomen, hip and spine provide a solid foundation in the body’s center of gravity to help control movements, transfer energy, shift body weight
and distribute the stresses of weight bearing to protect the back. Because the core stabilizes the spine from the pelvis to the neck, they also allow the transfer of power- ful movements to the arms and legs. Often it is a weak and unbalanced core that is linked to low back pain, and training of these muscles helps to correct postural imbal- ance that can lead to injuries. Core strength training differs from some traditional weight training routines by working both the low back and abdominals in unison.

Vince Frisillo, MPT
Physical Therapy & Sports Medicine
Excel Therapy Specialists

Reader Question:

What is golfer’s elbow?

Golfer’s elbow, or medial epi- condylitis, is the inflammation of the tendon that attaches to the bony bump on the inside of your elbow. Overuse of the wrist flexor muscles causes increased stress and small tears in the tendon, leading to inflammation and scar formation, thus making the tendon weak and prone to further injury. Symptoms include pain on the inside of the elbow, elbow stiffness, and forearm and wrist weakness, and can get worse by gripping and swinging a golf club or other activities that flex your wrist towards your forearm. Initial treatment should include rest and ice until pain is gone; returning to golf early will only make symptoms worse. Physical therapy interventions include modalities to decrease inflammation and soreness, soft tissue mobilization to decrease scarring and tendon tightness, and stretching and strengthening exercises to improve tendon strength and tolerance to activity. Once the pain is gone, review your swing mechanics with an instructor and gradually return to golf, stretching and warming up before you play.

Vince Frisillo, MPT
Physical Therapy & Sports Medicine
Excel Therapy Specialists

Reader Question:

What are the benefits of aquatic therapy?

Aquatic therapy is a great way to exercise when land-based exercises are not tolerated due to soreness or limited range of motion. Aquatic therapy has four characteristics that separate it from land-based exercises. The buoyancy of the water reduces weight placed on bones and joints, al-
lowing you to move easier and progress through various levels of exercise. It is usually provided in a heated pool, which allows muscles to relax and improves joint range of motion. The hydrostatic pressure exerted by the water surrounding the body helps circulate blood from the legs to the heart, reducing the amount of swelling in the legs and feet. Finally, the water provides resistance, which helps to improve balance and strength in all muscle directions as well as increasing sensory awareness.

Vince Frisillo, MPT
Physical Therapy & Sports Medicine
Excel Therapy Specialists

Reader Question:

My running partner was diagnosed with IT band syndrome. What is it?

Iliotibial band (IT Band) syndrome is the inflammation of the thick band of fibrous tissue that begins at the hip and extends to the outer side of the shin bone just below the knee joint. The function of the iliotibial band is to provide stability to and
help flex the knee joint. When it becomes irritated, knee movement becomes painful along the outside of the knee joint and worsens with continued movement. It typically affects long distance runners and can be caused by weak hip abductors, foot pronation and running on a crowned surface. Initial conservative treatments include rest, decreasing exercise time and intensity, heat and stretching prior to exercise and icing afterwards. Physical therapy can help decrease inflammation and improve function of the iliotibial band.

Therapists can advise in training program changes and proper footwear to improve running mechanics. Treatments include exercises to help improve flexibility of the iliotibial band and gluteal muscles, strengthening of the hip abductors and knee flexors and soft tissue mobilization to lengthen the iliotibial band.

Vince Frisillo, MPT
Physical Therapy & Sports Medicine
Excel Therapy Specialists

Reader Question:

I recently heard about ASTYM. What is it?

Augmented Soft Tissue Mobiliza- tion, or ASTYM, is a treatment approach used by ASTYM-certified clinicians to help the body develop healthier tissue in areas where there is unhealthy tissue. Tendons, ligaments and muscles can develop scarring or become degenerative after trauma, surgery, immobilization or repetitive strain, and this can cause pain or limit motion. ASTYM helps to identify problematic areas and stimulates the body’s ability to decrease or remodel scar tissue and regenerate healthy tendon and ligament fibers. The ASTYM treat- ment is performed with instruments that glide along the surface of the skin. When the instruments come in contact with areas that have dysfunctional tissue, both the patient and the clinician feel “roughness.” As the instruments catch on this roughness, they initiate the body’s healing response leading to healthier tissue. Clients are encouraged to continue with work, athletic and recreational activities, and a customized exercise program is provided to help guide the healing to allow motion without pain or limitations. Clients often experience decreased pain and increased motion in just a few treatments.

Vince Frisillo, MPT
Physical Therapy & Sports Medicine
Excel Therapy Specialists

Reader Question:

My doctor says I have Ankle Tendonitis. How is this treated?

Ankle tendonitis can occur both in the inside and outside part of the ankle. Tendonitis is inflammation of a tendon. A tendon is a group of cord-like fibers that attach a muscle to a bone. Tendons can become irritated either through overuse or trauma. Ankle tendonitis usually occurs from returning to sporting activities too fast and too vigorously. Alternatively, it may occur from excessive overuse such as too much running or jumping. Trauma can also cause tendonitis. If the ankle is hit or struck, the tendons become irritated and tendonitis may result. Treatment depends on the severity of the inflammation. Your physician may prescribe anti-inflammatory medications, and rest is a primary consideration. Therapeutic modalities such as ultra-sound, electrical stimulation, heat or ice may decrease pain and inflammation. There are therapeutic exercises and stretches that can speed recovery and return you to pain-free function. If you have had multiple episodes of tendonitis in the same area over several years, you may find it takes longer to heal.

Michael Siegenthaler, DPT
Physical Therapy & Sports Medicine Excel Therapy Specialists

Reader Question:

My work place is pushing ergonomics. What is the best way for me to sit at my computer?

Ergonomics is the study of how to adapt the work place to the person. In other words, the work environment should be adapted to YOU, not the other way around. This is important
because when the workstation fits your needs, fatigue and stress decrease and your comfort increases. In the long run you are more efficient and you decrease your risk of getting a repetitive trauma disorder. Hips and knees should be at 90 degrees, feet flat on floor/foot- rest. Shoulders should be relaxed and elbows should be held at 90 degrees. Computer Monitor should be at eye level. Keyboard should be positioned so wrists are not bent up or down or twisted. A lumbar roll or sup- port should be used to provide low-back support.
If you do other types of deskwork, tilt the work up instead of lowering head and neck. Following these few suggestions can help to create a more ergonomic work environment which can in turn, keep you more healthy, happy, and productive.

Michael Siegenthaler, DPT
Physical Therapy & Sports Medicine Excel Therapy Specialists