Conditions
ACL Tear
Anterior Cruciate Ligament (ACL) tears are unfortunately common in athletes. They can be due to a sudden force such as a tackle in football, but often they are from trying to cut quickly on the field or court. The ACL is one of the ligaments responsible for holding your femur and tibia together, so surgery is often required. Rehabilitation can take a year or more following surgery, as leg strength and power must be regained after range of motion. Manual therapy early on in the healing process for range of motion gives way to exercises and return to sport activities before taking the field.
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Bursitis
Bursitis refers to inflammation of the bursa, which are a series of fluid-filled sacs throughout your body to take pressure off of the joints. There is a bursa under your patellar tendon that can be irritated and inflamed leading to pain and limited range of motion. Physical therapy involves a movement assessment to look for limitations elsewhere that may be affecting the knee, manual therapy including trigger point dry needling, cupping, and scraping to allow for greater mobility, and strength training to support the knee and decrease stress.
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Meniscus Tear
There are two menisci located in your knee, one on the inside (medial) and one on the outside (lateral), either one can be torn. The tear usually occurs from a twisting motion with your foot planted. Small tears may go away relatively quickly, while larger ones may require surgery. Physical therapy has excellent success rates with meniscus tears. It is important to decrease stress to the area by improving mobility and strength of the surrounding muscles. A gradual return to activity is essential to avoid re-occurence of symptoms. Read more in our blog here!​
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Hamstrings/Quadriceps Strain
The hamstrings and quadriceps are two of the most important muscles for walking, running, and most lower body exercises. Muscle strains occur when the muscle is under too much load or a rapid movement occurs for which the muscle is not prepared. Strains can take anywhere from a couple of weeks to months to heal depending on the severity. Trigger point dry needling can be beneficial to mobilize the affected muscle before loading it to promote healing, blood flow, and strengthening of the tissue. Physical therapy is crucial to prevent recurring strains. Read more about hamstrings strains.
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Arthritis
Arthritis refers to inflammation of the joint and the knee can be a possible location. Arthritis can be a normal part of aging and is usually accompanied by other pathologies if pain or disability are present. It is important to decrease joint stress by making sure that other joints and muscles are moving as they should along with strengthening surrounding areas. Wear and tear at one segment is typically due to other segments not taking their share of the load, and sometimes gaining mobility elsewhere is all that is needed to resolve symptoms.
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Patellar Dislocation/Subluxation
Dislocation involves the patella (kneecap) going to the side and remaining out of place. Subluxation occurs when the patella goes out of place but spontaneously returns. Dislocations are serious medical issues and should be addressed by a health professional, as nerve damage is possible. Rehabilitation from these injuries involves strengthening the surrounding tissue to hold the knee in place while decreasing compensatory muscle guarding with techniques such as cupping or scraping.
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Patellar Tendinitis
The patellar tendon connects the bottom of your kneecap to the tibia. It is crucial for most lower body exercise and activities. Unfortunately, the tendon can become irritated by repeated overuse and load for which it is not prepared. An example would be if you did not exercise all winter but went for a 5 mile run the first day of spring. The tendon would be irritated and you would either keep running and aggravating it or rest, but this would not strengthen the tendon. Strengthening and activity modification are key to build resilience and workload capacity of the tendon under controlled conditions.
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Postoperative
Knee surgery is always intimidating. Rehabilitation after surgery can also be stressful, as you want to assure that the surgery went well. We have worked with hundreds of clients after knee surgery so we are familiar with how the experience should progress. We are available to answer any questions, even when you do not have an appointment scheduled. We are also intimately familiar with healing timelines and can give you ideas of what your return to activity should look like. Read more about postoperative physical therapy in our blog.
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Osgood-Schlatter Disease
Osgood-Schlatter Disease is typically prevalent in children going through significant growth spurts. It involves irritation and pain of the patellar tendon with activity. When we are growing, our bones grow faster than our muscles and tendons. Therefore the muscles and tendons get stretched to keep up. If there is too much load on the stressed tendon, then irritation can occur which can be hard to calm down. Manual therapy can be beneficial to improve mobility and decrease muscular tension. Exercise and activity modification are also important to manage the load on the tendon. Read more about Osgood-Schlatter Disease in our blog here.