July 2012 Exercise Away Your Knee Pain It seems counterintuitive, but when it hurts to move

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1 Exercise Away Your Knee Pain It seems counterintuitive, but when it hurts to move your knee, the best thing you can do is move your knee. A 2009 study in the British Medical Journal found that supervised exercise therapy improved pain and function in people suffering from patellofemoral (front-of-the-knee) pain. A more recent study of young military recruits in the United Kingdom suggests that targeted exercises can help prevent knee injuries from occurring in the first place. If scientific evidence does not convince you, consider these practical advantages of exercise for knee pain: Movement increases the amount of lubricating synovial fluid in your joints, which helps reduce pain and stiffness. Physical activity helps you lose weight and gain muscle strength, reducing the load on your knees. The problem, of course, is performing exercises correctly so that you do not cause further damage to an already strained or injured knee. High-impact activities are to be avoided especially those that involve jumping or sudden stops and starts. Instead, knee pain sufferers should try swimming walking (on shock-absorbent surfaces like dirt roads or treadmills) using a recumbent stationary bike gentle strengthening and stretching Remember to take it slowly. A little discomfort is to be expected when you are dealing with a preexisting knee injury or condition, but if you begin experiencing more severe or frequent pain, ease off. Even gentle, nonstrenuous exercise can benefit your joints, and the goal is to reduce pain, not run a marathon. For the safest and most effective pain-reducing program, consult with us. We can ensure that you obtain the positive benefits of exercise minus the risk of incurring further damage or injury to your knee.

2 When Your Arm Pain Is a Pain in the Neck Do you experience pain when you raise your arm, but the pain decreases when the arm is raised above your head? Many times, the initial discomfort results from nerves in the neck being pinched because the shoulder blade is not positioned correctly. Raising your arm above your head takes the stretch off the nerve and provides relief, but carrying something like a bag of groceries increases the stretch on the nerve, thus escalating the pain. When these nerves become pinched (cervical radiculopathy), either due to swelling, a slipped disc or degenerative changes in the spinal column, pain can radiate down one or both arms. It is quite common for a pinched nerve to produce a tingling sensation or numbness in the arm, and if the situation is more severe, it can result in spasms or significant muscle weakness in the affected arm. Several factors can contribute to this, including poor posture, the type of job you perform (especially those that require a great deal of overhead work), hobbies and general physical health. The good news is that a pinched nerve can be treated with various modalities: Icing for 20 minutes several times a day will help reduce inflammation and pain. Your physician may recommend using a nonsteroidal anti-inflammatory medication, such as ibuprofen or naproxen, to reduce inflammation and pain. For more severe pain, your physician may prescribe a corticosteroid injection near the nerve in question. Gentle stretching exercises often will relieve pressure on the affected nerve. Massage, ultrasound therapy and electrical stimulation are some of the modalities used to treat pinched nerves and, subsequently, relieve arm pain. To strengthen your shoulder and arm, and relieve your pain, we can design an exercise program and provide you with instruction on proper body alignment, safe lifting techniques and ways to modify your daily activities to avoid pain. Our goal will be to help reduce the painful pressure on a pinched nerve.

3 Don t Let Your Achilles Tendon Become Your Achilles Heel The constant ache of chronic Achilles tendonitis can make performing daily activities uncomfortable, and treatment options are not always effective. Because this condition is believed to be degenerative and associated with impaired healing, the tendon loses the natural ability to regenerate or self-heal as time goes on. Physicians often consider administering injections into or around the tendon to improve healing, minimize pain and reduce inflammation. The most commonly used injections are corticosteroids and platelet-rich plasma (PRP). Corticosteroid injections typically involve shooting a small amount of cortisone around the affected tendon. While this type of therapy can effectively reduce inflammation and swelling, there is a significant risk of tendon rupture. PRP is a newer therapy that involves taking a small amount of the patient s blood and running it through a special machine to extract platelet cells that contain naturally occurring chemicals that stimulate a healing response in the body. These platelets are then injected into the tendon. Theoretically, PRP can help your body overcome chronic, degenerative conditions like tendonitis, but the evidence is not clear at this point. Regardless of which type of injection therapy your physician decides, it is important that you engage in a program of eccentric exercises to help strengthen the calf muscle and reduce stress on the Achilles tendon. Toe raises, balancing on your toes and heel stretches affect the Achilles, gastrocnemius and soleus muscles by contracting muscle fiber generating tension that strengthens the muscle producing less strain during ankle joint motion protecting the Achilles tendon Performing eccentric exercises in three sets of 15 repetitions on each leg two times a day for 12 weeks appears to relieve and strengthen an aching Achilles tendon. We can help you by designing an individualized program that focuses on eccentric exercise. By following the program of exercises we provide, you will gain more flexibility, resume your normal activities and shortly return to your favorite sport, pain free.

4 Back Pain and MRI Findings Surprisingly, magnetic resonance imaging (MRI) results can actually interfere with proper diagnoses of orthopedic problems. Although the MRI is sensitive, it is not very specific. In fact, a tiny percentage of MRIs show zero abnormalities in an imaged body part whether the person experiences any discomfort or not. For instance, approximately 40% of healthy patients show a bulging disc despite having no low back pain. For patients experiencing lower back (lumbar) pain, MRI findings do not necessarily correlate with the ultimate cause. MRIs of lumbar discs can be affected by the time the tests are performed discs tend to be about 20% more swollen in the morning than they are in the evening and by the position of the person s body while the image is being taken. When the patient lies prone, a swollen disc pushes down, which may lead to an MRI diagnosis of a bulging or herniated disc. Many physicians agree that in the case of back problems, careful questioning of a patient, a thorough physical examination and knowledge of the history of the discomfort can often be more helpful than an MRI in making a correct diagnosis. Along with rest, the most conservative and very often most effective course of action is a program of active back exercises based on the likely cause of discomfort rather than surgery based on MRI findings. The benefits of a regular routine of lower back exercises include distributing nutrients into the disc space and soft tissues of the back to keep the discs, muscles, ligaments and joints healthy helping patients avoid stiffness and weakness minimizing recurrences of lower back pain reducing the severity and duration of possible recurring episodes of low back pain Fortunately, most instances of lower back pain get better on their own; approximately 50% of patients experience pain relief within two weeks and 90% within three months. An exercise routine can help you maintain your current lifestyle and reduce the risk of your being sidelined in the future by recurring lower back pain.

5 Strength Training: Stronger, Not Bigger The thought of strength (weight) training may bring to mind body builders with six-pack abs and bulging biceps. As a woman, you may not aspire to that physique. You may also wonder, since women produce significantly less testosterone a hormone that helps build muscle mass than men, is there any reason to bother with the weights? Men do have greater absolute muscle mass and physical strength than women, but the sexes are equal in their capacity to increase strength relative to their different baselines. For most women, stronger not bigger is the goal, and with greater strength come other benefits, some less obvious. Among them are enhanced immune function increased bone density that reduces the risk of osteoporosis and vulnerability to fractures improvement in mood and self-esteem Strength training also shifts the balance from excess body fat to lean muscle mass, resulting in healthier weight. This beneficial trade-off occurs through enhanced coordination within the nervous system as the neurons that control muscles begin to fire in a more coordinated way. In addition, weight training increases metabolism, another boon to successful weight management. These strength-enhancing sessions need not be watered down from men s training regimens, experts report. Women are no more likely than men to be injured, provided they receive professional instruction and observe proper technique. Your workout should include free weights, resistance exercise and activities that strengthen your core. Give equal attention to both upper and lower body development. And, you need not limit your strength-building exercise to a gym or physical therapy facility. We can help you exercise at home with simple items such as dumbbells and stretch bands. Before you start a strength-training program, we can help you improve your physical skills by creating exercises tailored to your needs, goals and body composition. This way, you can be stronger, not bigger.