Got knee pain? The knee is an interesting joint and I'm finding that the more knees I treat, the less I focus on the knee itself. In my other blogs I had mentioned how the hip influences the low back, well it also plays a major role in knee health. The knee likes to bend forward and back, flexion and extension, and would like to avoid the rotational component. It seems that those with knee pain lack what we call, proximal stability, quite often. The hip is weak and causes the knee to want to drift inward especially during single leg stance. Try this, stand on one leg only and try to lower yourself down in a mini-squat. Does your knee want to cave inward towards the midline of your body? If so, that is hip/glute weakness. If it does not, we may look into the ankle and other factors, but in most cases this is pretty common. That weakness may not be exposed through low level activities, but may create problems when performing repetitive activities, i.e. running, and load bearing activities, i.e., stairs. Research is also coming out now stating that physical therapy is just as effective as arthroscopic knee surgery to correct meniscus tears (the cushion between your knee joint). This was featured on Dr. Oz on 04/25/14 with exercise demonstration. The exercises on the video are a conservative start, but I would encourage you to try the resisted side step exercise I described in my previous blog Piriformis/Sciatic Pain? Do This Exercise. It is great because it does not stress the knee so you can perform it without irritating your knee pain and indirectly make your knee stronger. Just balancing on one leg alone is also very important because it gives us a good idea how the hip is performing. If you try and you're struggling to stay upright, your hip is weak and makes you more susceptible to knee injury. For any questions you may have about knee pain, contact me at srusincscs@yahoo.com Otherwise, please "share" so that we may all BeneFIT!! www.ScottRusin.com
2 Comments
For those of you who don't know, 850 is the area code for which I reside in. It is the Destin, FL area which is a major hub for stand up paddle boarding (SUP) and the location of BOTE, YOLO and GUSU boards. You can't live here and not notice their presence in the area. At first, I didn't see the excitement in them. I'd sit on the beach and watch people float by and wonder how that was seen as enjoyable. Next thing you know, I had to have one! I rented one first to test it out and was amazed by how much fun I had. It is a great form of exercise and it puts you out in nature where you can see a different world below you. It is not at all like riding in a boat, you're right on the water and in full control. Imagine having dolphin swim by and seeing different fish while exercising and staying fit. The board is great because it forces you to use your lumbo-pelvic stabilizing muscles, your core, and using your entire body to paddle. We sit at work and spend most of our days in a slouched position, paddle boarding forces you to use your postural muscles which is great for your overall health. They even have Yoga classes on the boards and races are becoming very popular. Not to mention, the great cardio workout and metabolism boost. You can travel pretty far on a paddle board and venture to remote areas, turn it into a camping trip and just be outside! We all have gone to the beach and parked our butts in one spot, sort of like at work except better surroundings! Why not get up, paddle, enjoy nature, all while exercising and staying in shape?!! So get off your butt and go paddle! Please share so that we can all BeneFIT! www.ScottRusin.com Also, check out Stand up Paddle Board Review and Tower Paddle Boards I recently read a post on Runner's World about what to do for piriformis syndrome and I felt like they had left something out. From working with piriformis and "sciatic" pain on a daily basis, I'd thought I'd share a little info on an exercise that has done wonders for my clients. Often, runners and triathletes neglect frontal and transverse plane movements, meaning that they do not perform any exercises going side to side or with a rotational component because all of their movement is in forward, backward flexion and extension. Some runners choose not to do resistance exercises at all because of the idea of carrying too much muscle mass which, I think, is a mistake. You can train to be strong and avoid the bulk while making yourself a more balanced and efficient runner. Your hip/glutes are vital in controlling rotational forces of the lower extremity and protecting the back from accessory movement. It's like driving on tires that are not balanced, they wear faster just like your joints. Your glutes are part of your "core", much more important than the 6 pack abs (they just look good). If you are already flexible, stretching the piriformis will provide you with little benefit other than temporary relief. The glutes and piriformis need strength to accept your body weight when landing on one leg while running. Strengthening the glutes may help with your knee pain as well believe it or not (We had an Ironman solve his knee pain within days of performing this exercise I'm about to describe). Your knee does not want to rotate, it wants to flex and extend. If the upper leg rotates inward because of weak glutes, it puts strain on the knee joint and IT Band. So, once again, you can try to stretch the IT all that you want, but the strength in the glutes will most likely provide the greatest benefit. I am a huge fan of an exercise that we call resisted side step because of how effective it is in targeting your butt muscles. The only equipment you need is a theraband with good resistance. You can tie one around your ankles or purchase one in the 850HealthStore through Amazon. Blue or green would be your best bet, blue being more difficult. The continuous loop band seems to provide better resistance (12 inches). Now, walk sideways with it around your ankles while keeping your toes pointed a tad inward and avoid pointing outward because it will engage your hip flexor instead of the muscles we're going after. Also, avoid leaning sideways and keep your midsection tight. You can walk sideways for approx. 20 feet then walk back without turning around. Do 3 sets and you will feel it! Give it 2 weeks of performing most days of the week and you will be a better athlete! Please share so that we can all BeneFIT!! www.ScottRusin.com Let me begin by saying that this new technology called the Piezo Wave 2, has provided our physical therapy clinic with amazing results in the first couple weeks of treatment. It is nothing like we have ever experienced in the treatment of musculoskeletal pain. The Piezo Wave 2 is described as Myofascial Acoustic Compression Therapy (MyACT). There slogan is "Not all modalities are created equal" and I tend to agree. Our clinic has "experimented" on numerous clients with a variety of orthopedic issues from post-op patella fracture to chronic neck and low back pain and have received unexpected, yet very positive results. The only mistake we've made is not documenting client's responses after treatment. So, what is it? Piezo Wave 2 was developed by Richard Wolf and a company called ELvation out of Germany. Richard Wolf was a leader in the development of endoscopes. MyACT delivers mechanical energy in the form of sound waves to the target tissue which includes tenocytes in tendons, fibroblasts in ligaments and skin, osteocytes in bone, chondrocytes in articular cartilage and endothelial cells in blood vessels which are all highly responsive to mechanical energy. What is great about MyACT is that you can also vary the depth of the treatment by changing the adapter on the sound head from 5mm to 30mm. I like to describe it as a metal detector for unhealthy tissue and trigger points. Please see my post for further explanation of trigger points. This device has pin-point delivery in targeting unhealthy tissue through a mechanical stimulus resulting in cellular changes that promote increased circulation and pain relief. You cannot feel the treatment around healthy tissue which also helps us as therapists to more accurately address our client's pain when we come across the discomfort of a trigger point. It is comparable to having a deep tissue massage in a fraction of the time and we suggest you drink plenty of water after the treatment just as you would after a massage. We are more than excited to offer this treatment at Sandestin Physical Therapy Services as part of the Sandestin Executive Health & Wellness Center. Your first session is FREE because we believe you have to experience the results. This is no gimmick, it really is showing amazing results! Stop by or call (850)267-6755. www.ScottRusin.com What's with the "X" in the new logo? Surprisingly, "X" has several meanings going way back in time despite the fact that it appears so simple. I am so thankful for everyone's support in pursuing this website! It means the world, literally. We continue to share these messages and everyone is benefitting from it! I was asked what is the meaning? X is the Greek letter “chi,” the first letter in the word Χριστός, which means “Christ.” X has been an acceptable representation of the word “Christ” for hundreds of years despite the fact that everyone says, "don't take Christ out of Christmas" when using the shorthand, Xmas. X is also the 24th letter in the alphabet and represents the Roman Numeral, 10. It is also used in multiplication and can be said to represent the unknown. Maps leading to hidden treasure often denote the treasure with an X and hopefully, you'll visit my site and discover something that you find valuable! Thank you again and I hope you find the information here of some value! I've been hearing more and more about this NuVal Nutritional Scoring System, so I had to learn a little about it. If you haven't heard, NuVal is a nutritional rating score given to food in the grocery store that allows you to make better choices when you go grocery shopping. It was developed by nutrition and medical experts that are independent from the food industry. I think this is amazing and will help consumers make better choices and hopefully create competition within the food industry. Foods are rated on a scale of 1-100 with 100 being the most valuable to your health. Not many grocery stores have this system in place, but I did see Tops Friendly Markets on the list (grew up shopping there) and this list should grow with time. To find out which grocery stores have NuVal, click here. To see a sample of the scoring, click here. You may be surprised by some of the foods you are buying now! Please share so that we can all BeneFIT! www.ScottRusin.com Your job demands long hours and most of it is sitting behind a desk or sitting at meetings. Not to mention, you had to sit in your car and drive to and from work to later go home and sit down to eat dinner. You're exhausted after and give in to any thought of exercise. Let me help. First of all, your health is at risk. "Alpa Patel's 2010 study, published in the American Journal of Epidemiology (Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults), which found a common link between physical inactivity and cardiovascular disease mortality even after adjusting for smoking, body mass index, and other factors." (MoveForwardPT.com) Got your attention?! Yes, sitting at a desk all day is now being compared to the mortality rates of those who smoke. Not to mention, the harmful effects on your posture which leads to muscle imbalance and later back, neck and shoulder pain. The computer has provided us physical therapists with job security because of the amount of people affected. What do we do? There are several things we can do, most of which won't get you fired. You obviously will have a difficult time getting your boss to buy you a treadmill desk, so a cheaper alternative would be the DeskCycle Desk Exercise Bike Pedal Exerciser By DeskCycle (the long way of saying bike that fits under your desk, or just the pedals). It is on Amazon for $150, small price to pay for your health and if you don't have a gym membership, there you go. Other options include taking short breaks and walking the staircase a couple times, going for a walk at lunch, doing cardio exercises in place (jumping jacks, jogging, mini-squats, etc.), just close your office door! Posture is also important. Prolonged sitting causes atrophy of your postural muscles and tightness of the large muscle groups that round your shoulders and tilt your pelvis forward, both of which are major contributors to upper and lower back pain. To improve neck and shoulder discomfort, step into your door frame of your office, put your elbows on the frame at shoulder height, gently lean in and feel a stretch in your shoulders and chest (don't stick your head out like E.T. either), hold for 30 seconds at least 3 times, a couple times during the day. Grab a thera-band palms up with both hands at shoulder width and rotate your arms outward maintaining a 90 degree bend at your elbow while squeezing your shoulder blades together. Do not use your upper traps (shrug) to compensate, squeeze your shoulder blades down and back for high repetitions greater than 30. Also, follow the link about shoulder pain to help with your posture at 850health.com. Thera-bands are great for your office because they do not take up any space and can give you varying resistance to be effective with several exercises. No thera-band? Sit back against the wall with your knees at 90 degrees and just hold for as long as you can or just simply sit and stand from your chair until you fatigue. It is easy to give in to the long hours, but you will find yourself more efficient at your job and at life if you get active! Take care of your body, it's the only one we get! For more exercises, email me at srusincscs@yahoo.com or stop by our office at Sandestin Executive Health and Wellness Center! Otherwise, please share so that we can all BeneFIT! www.ScottRusin.com Contemplating a total joint replacement? Hopefully, I can help in your decision. After teaching joint replacement classes, the pre and post op, I've made several observations while doing so, but I would like to start by saying that pain will change your decision making and some tolerate it better than others. Sometimes, it will drive you into the quickest pain reducing decision which is understandable. I think we can all agree that keeping your original "parts" is always the best option and exhausting all of the conservative treatments prior to surgery should be recommended by your physician. One of those treatments should be physical therapy. I've spoken about mechanics in the past and how they influence the wear and tear on your joints like the tires on your car. If they are not balanced properly, you will get less life out of them. The hip musculature is often overlooked in knee rehab and is crucial in knee health because it controls the rotational forces at the knee. Ever stand up from a chair and feel like your knees want to move inward? That's glute weakness - yes, your butt is weak! Your knees, of course, do not want to move in that direction and it will cause stress on the structures surrounding the knee. Strength of the lower extremity will also help to distract the knee joint providing increased joint space. Just because your x-ray shows decreased joint space, that does not mean it is the source of your pain. If I had a dollar for everyone who said they had "bone on bone" in their joints, I would have my student loans paid off! You could x-ray the entire population of those over 55 and find poor joint space on x-ray, but it does make a good selling point. In health care, we need to start treating the patient first and not the imaging. There are several structures that surround the hip and knee joints that can mimic your pain and believe it or not, your physical therapist is trained to figure that out! I'm not here to discourage you from having a joint replacement, I just want to educate you on your options. You have to go through the extensive rehab after and you will benefit greatly from doing some strengthening before, so why not try therapy and possibly avoid the surgery altogether?! Thank you for reading and please share so that we can all BeneFIT!!! www.ScottRusin.com Another ingredient to avoid when purchasing supplements is magnesium stearate. Manufacturers like to add this ingredient into the development process because it prevents substances from sticking together or to the machine doing the processing. So, if you could imagine, saving money is always priority over consumer health. Magnesium stearate is also used to bind sugar in hard candies like mints, and is a common ingredient in baby formulas. Magnesium stearate is not a source of magnesium and has no benefits, but may have a detrimental effect on your immune function as stearic acid has been linked to suppression of T cells. The filler also stimulates your gut to form a biofilm, which can prevent proper absorption of nutrients in your digestive tract! It seems to be pretty common. After this was brought to my attention, I started to skim the supplement isles and found it to be included in almost everything. If you do not know where to look, every supplement should have an ingredient list somewhere on the bottle. Stay healthy people! Please share so that we can all BeneFIT! |
Categories
All
850HealthStore
iPerformanceCenter www.ScottRusin.com 850Health Facebook Page Dr. Mark Giovanini Neurosurgeon AuthorScott Rusin is the Director of Physical Therapy at the Sandestin Executive Health & Wellness Center in Sandestin Resort, Miramar Beach, FL. He has a degree in Physical Therapy, is a Certified Strength & Conditioning Specialist (CSCS) and Nike Golf NG360 Performance Specialist Powered by the Gray Institute. Archives
November 2015
|