Leg Injuries in Happy Valley

Our average lifestyles are more sedentary now than ever before. Most of us don’t get the recommended amount of vigorous activity recommended by health professionals, not even close. Not to make excuses, but many people have desk jobs. And while there is nothing inherently wrong with that. Being seated for the majority of our day can do a real number on our bodies. Problems with circulation, muscle length imbalances, and weakness begin to creep up.

Our muscles require stimulation to sustain their or improve their functionality. With sedentary lifestyles, we simply aren’t giving ourselves enough stimulation to maintain a healthy baseline. This can become problematic when we get that spontaneous itch to go have some recreational fun, but our bodies aren’t equipped for the seemingly enjoyable outing and can lead to injury. Our muscles provide support, structural stability, and influence the mechanics of our joints. They are the guy wires to our ships. With weak or under prepared muscles trying to preserve our whipping sails while at play, sometimes, something has to give.

We’ve compiled a list of the most prevalent leg injuries treated at Ascent Physical Therapy.

Treatment of Hamstring Injuries

Injuries to the hamstrings typically occur from running activities such as during a sports game or for training. The two types of injuries that can result are a tendonitis or a strain/tear.

Tendonitis situations occur from overuse and inadequate recovery between bouts of activity. A common situation is increasing the volume of running or exercise too quickly. Many runners follow a “10% rule”, where their weekly distances don’t increase by more than 10% consistently. So, if you ran 10 miles one week, it would be considered safe to run 11 miles the next week without risking an overuse injury, whereas, going from 10 to 15 miles may result (not guaranteed though) in an injury.

A hamstring strain or tear results from a sudden heavy increase in tension such as trying to turn and sprint, or from over striding – your step length increased too far – while running. These are also called muscle pulls or the phrase “I pulled my hammy”. Characteristically, there is moderate-large sudden onset of pain, possible bruising, loss of motion, weakness, and a distinct limp while walking/running. It will be quite painful during the “swing through” phase of gait where your lower leg swings past your standing leg. This occurs because your hamstrings act as the brakes so your lower leg doesn’t snap into full knee extension while moving.

The time for recovery depends on the severity and duration (how long you’ve had) of the injury and the treatments implemented for recovery. Use of crutches is appropriate if your injury is causing a limp.  Hamstring injuries are important to rehab correctly because the risk of re-injury is quite high with premature return to sport/training. Beginning a treatment program sooner than later will result in quicker return to play and reduced risk of re-injury.

Treatment of IT Band Syndrome (Iliotibial band syndrome or ITB syndrome)

IT Band Syndrome is the inflammation of the muscle near your front pant pocket. The inflammation can occur up near the top of the hip but can also occur down on the outside of the knee. Both are usually associated as an overuse injury. Onset is more frequent in cyclists and runners. Irritation at the hip level is from muscular straining from overtraining. Irritation at the knee is from friction of the IT band against the outer surface of the knee, likely from tightness. A third, less common reason this develops – particularly in runners – is from always running on the same side of a road or cambered (sloped) surface, which leads to uneven strain through the lateral hip & knee.

A lot of people will gravitate toward a foam roller as a first line of treatment for IT Band Syndrome. A foam roller can be a great tool for loosening up commonly found tension along the outside of your thigh. Unfortunately, it doesn’t address the “Why?”. Why is my IT Band getting so tight? Am I running weird? Am I training too much? Do I have muscle imbalances? These are the questions you’ll want answered if you’re looking for long term relief and prevention of your symptoms now and down the road.

Due to the nature of the condition being inflammation based, you don’t want to try and run through your symptoms. Seeking help earlier is better, but it’s never too late to get a nagging IT Band treated!

Treatment of Knee Pain

Knee pain is one of the most common orthopedic reasons people go to their primary care provider. The underlying cause of your knee pain could be as simple as you fell on it, to a much more complex presentation involving the internal mechanics, hip strength, ankle mobility, and training style. Identification of why your knee is hurting is the first thing to find out for establishing a targeted treatment program.

The mechanics of your knee are driven predominantly from your hip, thigh, and ankle. If you stand and shift your knee side to side, that motion is actually coming from your hip. The thigh and ankle have more influence over the flexing and extending of your knee. A dysfunction up or down the chain can lead to problems at the knee itself. Ensuring proper muscle group strength and flexibility balances are important for maintaining appropriate stresses through your knee. For example, a commonly held ratio of strength for the thigh is 3:2, quadriceps: hamstrings. So, your quadriceps should be able to approximately push 3# for every 2# your hamstrings can pull.

Learn more about how we fix knee pain at Ascent Physical Therapy.

Treatment for Total Knee Replacement (Arthroplasty)

Knee replacement surgeries are one of the most prevalent and fastest growing orthopedic surgeries in the US. Our Baby Boomer generation has been noted with active lifestyles with no signs of wanting to slow down, and that’s awesome! The problem is, sometimes, the wear and tear on our knees from a lifelong journey of activity can become a barrier from continued participation in the things we love with the people we love. Knee replacements used to be recommended as a last resort when your pain was so bad you literally couldn’t stand it. New research is encouraging people to not wait till it gets that bad anymore. If we look at long term outcomes and activity levels, people who have their total knee replacement earlier have more mobility and less discomfort.

It should be noted that while most people experience significant improvement in function after a total knee replacement with physical therapy, you should expect pain for weeks following your surgery. This is important to note because the first 12 weeks after your total knee replacement is the most critical for achieving the best potential outcomes from your surgery. Prior to your surgery, it is becoming more commonplace to work on improving strength and mobility as much as possible to maximize the surgical results while speeding up recovery times. Following the instructions of your surgeon and your physical therapist will get you the most out of your health investment. In addition to maximizing your recovery after surgery, we will closely monitor and communicate with your surgeon for any risks such as infection or hardware failure.

We had a surgical knee patient in 2015 that we suspected had acquired an infection. After a call to their surgeon they were able to be seen that same day and ended up in emergency surgery in under 24 hours. Your post-operative care is important. Make sure your provider is always vigilant for your health!

Treatment of Meniscus Injury

Your meniscus acts like a rubber washer in your knee. It provides increased stability and cushioning in your knee. Injuries can happen from a single trauma – typically during twisting with your foot planted – or from repeated wear and tear over time. The mechanism of your injury will indicate a likelihood to the type of injury to your meniscus. The acute sudden onset style is related more to tears (several types) of various severity. The common symptoms related to this include popping, clicking, swelling, catching, and locking in your knee during movement. A slow, wear and tear mechanism, onset will be associated with degenerative fraying. People will usually feel more of an ache to sharpness that gets worse with prolonged bending or increased exertion.

Conservative treatment with physical therapy of small to moderate meniscus tears has been shown to be as effective as surgery in long term outcome studies. Altering your movement mechanics to reduce strain in your knee while increasing the strength of your hips & thighs can result in full recoveries! Large tears typically require a surgical correction to regain full function. In either scenario, if left untreated could result in further damage to the meniscus, in addition to, an acceleration of degenerative arthritic changes.

This is a common condition we treat at Ascent Physical Therapy and we’d be glad to assist you in making a full recovery!

Treatment of Shin Splints

Shin splints is a painful condition that is typically associated as an overuse injury. This is the most common among people just beginning a new running or walking program, especially if over areas with lots of hills. It can also happen to seasoned runners who made sudden or large changes to their training program before their bodies could adapt appropriately. In essence, you’re experiencing a prolonged muscle strain.

Conservative treatment with physical therapy is quite successful with resolution of shin splints. The tibial musculature requires prescriptive strengthening and inflammation reduction techniques to restore normal mechanics and prevent future flare ups.

A thorough evaluation by one of our doctors of physical therapy can help identify: why your symptoms started and confirm what the problem is while screening for more serious complications such as – stress fractures or compartment syndrome.

Treatment of Ankle Sprains & Injuries

Ankle sprains are incredibly common but notoriously under treated. Recent studies indicated that only about 50% of people who sprain their ankle see their primary care, and up to 60% of people who had an ankle sprain still have symptoms up to 18 months later. The downplayed seriousness of ankle injuries is commonplace but the after effects can haunt people long after the original incident. Most ankle sprains involve an “inversion sprain”, or when your foot rolls in and the tissues on the outside of your shin/ankle are damaged. A “high ankle sprain” is particularly damaging and can lead to recovery times longer than ankle fractures sometimes!

Immediately after an ankle sprain you should implement the following:

  • Protect the injured area from further damage
  • Elevate ankle above the heart
  • Use a cold pack – not directly on skin, 20 minutes on for each hour
  • Use a light compression wrap to limit swelling

If you can’t bear weight on your foot after 24 hours you should consult with your primary care to check for a fracture.

After an ankle sprain, your ligaments and muscles endured a stretch larger than they should have. This can leave lasting negative changes in their ability to sense when your ankle is beginning to roll in the future. This is why it is common for people who have sprained their ankle in the past to suffer from more sprains in the future. It creates a slippery slope if not treated and can lead to permanent damage. The good news is, with physical therapy the receptors that communicate your ankle’s position can be tuned back up with targeted prescriptive activities! In the interim, or during intense levels of dynamic activity, we recommend getting a Badger Brace for protection. They have a built in orthotic and were designed by a physical therapist with a profound background in foot & ankle injuries.