Often the answer or treatment plan for a person’s particular issue is not what is expected.  For example, a common complaint is shoulder pain.  Many people struggle to lift overhead properly and often have shoulder pain.  This pain is typically from what is known as shoulder impingement syndrome leading to tendonitis of the rotator cuff.

There are many “standard” treatments for this ailment depending on the medical practitioner you ask.  For example, a physician is likely to offer pain medications (and possibly an anti-inflammatory medication); advice on icing and taking it easy; and if particularly progressive, a physician may even provide a hand out regarding elastic band exercises.  Some physical therapists would likely offer similar advice, such as icing and elastic band exercises to strengthen a muscle group known as the rotator cuff muscles.  (The rotator cuff is a group of four muscles that are important in the movement and stability of the shoulder.)

Time and time again, after a thorough examination of the client, I understand why the shoulder is hurting.  The person has no thoracic mobility likely due from: years of poor posture; office work; washing dishes; taking care of children; or sitting watching TV for hours.  Maybe these activities have led to a very rigid and immobile thoracic spine.

Poor thoracic mobility is a big deal when it comes to shoulder mobility.  The shoulder joint is made up of the scapula (shoulder blade) and humerus (the arm bone to the elbow).  The shoulder blade and the thoracic spine also make a type of joint.  If the thoracic spine is stiff, the shoulder blade is unable to rotate correctly–affecting the way the ball of the humerus spins in the socket of the shoulder blade.  This leads to impingement of the rotator cuff and biceps tendon which causes pain.  If you don’t treat the lack of thoracic mobility, it will be very difficult to ever resolve the shoulder pain.

This real and all too common example of why a person develops shoulder pain is to illustrate why seeing a physical therapist is so valuable.  How would a person know the real cause of the shoulder pain if he or she didn’t ask a physical therapist?  The answer is that he or she wouldn’t know.  Unfortunately, he or she would likely go round and round from one treatment to the next without fully recovering or understanding the real reason why the pain developed in the first place.

Worse yet, as the shoulder pain worsens so does one’s ability to function and his/her quality of life.  In an older adult, this so often begins a downward spiral away from healthy aging and toward an abnormal aging process.  This same example is seen in many of the most common orthopaedic complaints from foot and ankle pain to knee or low back pain.

The dichotomy of the human body is that it is very simple and fragile, yet a complex and robust machine!  The body is truly remarkable and full of surprises.  Many of the most common aches and pains a person may have can be described in a similar scenario like mentioned above.

Physical therapy can help!  Some issues are not so black and white.  Many issues are like peeling an onion with many layers to the problem.  I believe it is crucial to have a physical therapist on your team to help you live a long, happy life performing the activities that you want for as long as you want!

Age is relative, and movement is the key to healthy living.  The goal for health aging is to improve health span, which means the length of time that a person is healthy and thriving in his or her life and not just alive.  Physical therapy can help with healthy aging by improving health span and assisting in a more successful aging process.  We are all capable of successfully aging if we are intentional about the process. 

Physical therapists can help you improve, restore or maintain your ability to move and function in your daily life.  As a physical therapist, I help people participate in life, whatever that may be for each individual.  To learn more about physical therapists, visit the American Physical Therapy Association (APTA).

How Can Physical Therapy Benefit You?

• Assist in recovery from a surgery (assisting in complete recovery and integration back into daily life or sport)
• Assist in recovery from a stroke or heart attack
• Assist in improving strength or endurance after an illness or prolonged inactivity
• Assist in improving balance and walking ability to prevent falls
• Maintain independence
• Pain management including low back pain, shoulder pain, hip or knee pain and/or arthritis pain
• Improve athletic performance by optimizing movement patterns
• Health and injury prevention in sport and in life (work or play)

Physical therapists can help guide you through any array of recovery or rehabilitation: return to work, sport, running, and CrossFit.  Whatever your desired activity may be, a physical therapist can help you get moving and “living” again!  Fundamentally, movement is life!

If you’re interested in learning more about how physical therapy can help you to age successfully and improve your health span, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

In this video, I demonstrate the proper technique for performing shoulder pendulum exercises. Shoulder pendulum exercises are frequently utilized early in the rehabilitation process to help maintain a basic amount of shoulder motion as well as to promote blood flow to aid in the healing process.  When performed correctly, these important exercises provide very little stress to the recovering structures.  Pendulum exercises help to maintain a baseline amount of motion which is critical in promoting blood flow for proper tissue healing, for pain management, and in order to avoid frozen shoulder syndrome (adhesive capsulitis).  Shoulder pendulum exercises are typically one of the first exercises allowed post-surgery or shoulder injury in conjunction with elbow, hand, and wrist exercises (depending on the injury).

In this video, I explain the basics of how to properly perform pendulum exercises. Although these exercises are basic, they are typically performed incorrectly by utilizing active motion instead of a passive motion.  Pendulum exercises are commonly utilized after rotator cuff repair, sub acromial decompression surgery, collarbone fracture and/or surgery, total shoulder replacement/total shoulder arthroplasty, and frozen shoulder (adhesive capsulitis).

Have you performed shoulder pendulum exercises before? If so, did you make these common mistakes?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

In this video, I demonstrate how to utilize over-the-door shoulder pulleys.  Shoulder pulleys are an excellent way to use active assistive motion to regain motion in the shoulder post injury or surgery.  In this video, I explain the basics of how the shoulder pulley works.  They are frequently utilized early in the rehabilitation process to not only help regain motion, but to also promote blood flow which aids in the healing process.

Shoulder pulleys are commonly utilized after rotator cuff repair, sub acromial decompression surgery, collarbone fracture and/or surgery, total shoulder replacement/total shoulder arthroplasty, and frozen shoulder (adhesive capsulitis).  I also instruct many of my clients to utilize shoulder pulleys for pain management as well as a prevention strategy for arthritis and loss of shoulder motion and function.

Have you used shoulder pulleys before? If so, what was your favorite way to utilize them?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

A.  Thanks for the question, Shawn. I’m sorry to hear about your snowboarding accident.  Fractures of the collarbone (clavicle) are actually fairly common and typically result from falling on the shoulder, the collarbone or an outstretched hand.  Collarbone injuries are also very common in toddlers, typically due to a fall out of bed or tripping when running.

The collarbone attaches the sternum to the scapula (shoulder blade). Many important structures, such as nerves and blood vessels, lie just below the clavicle. However, these vital structures are rarely injured when the clavicle breaks.  Diagnosing a clavicle fracture is typically performed via X-ray. In certain circumstances, a CT Scan may be performed for a more thorough image of the injury.

Symptoms of a Collarbone Fracture include:

• Pain in the shoulder or over the collarbone.
• Difficulty raising your arm due to pain.
• Slumping or sagging of the shoulder, typically downward and forward.
• A grinding sensation in the collarbone area when attempting to raise the arm.
• A “bump” forms over the collarbone. In severe cases, the bump will be similar to a piano key sticking up and will be mobile.
• Bruising and swelling over the collarbone area.

Surgical Intervention

Depending on the severity of the injury, surgery may or may not be indicated. In most cases, a simple fracture (where the bones are still aligned) will not require surgery.  Even in cases of minor malalignment, most people will not undergo surgery.

Surgical fixation is most common when there is a significant displacement or malalignment present. The purpose of surgical fixation is to hold the bones in place while they heal.  The physician will either utilize a metal plate and screws or small pins to hold the bones in place.  Although the surgical hardware can be removed once the bones have sufficiently healed, often it will remain throughout a person’s lifetime.

Rehabilitation post-surgery is fairly straight forward and is similar to the following nonsurgical treatment recommendations. Please follow your physician’s recommendations after surgery as each procedure can be different.  Variations in recovery and rehabilitation can occur and are dependent on: the area that was fixed; the severity of the fracture; and the stability of the bone and fixation.  These factors will determine how quickly you can progress through the rehabilitation.

Nonsurgical Treatment Recommendations

Most collarbone fractures do not require surgery (particularly, if the fractured area retains its alignment). Your physician will assess the severity of the fracture.  This will determine how quickly you can progress through the stages of treatment.

A general time frame for healing (with an initial return to function) is on average 6 weeks for adults and about 4 weeks for children. Complete bone healing, remodeling, and a full return to all activities will take longer.  This will depend on your age, health status, and the severity of the injury.

PRICE (Protect, Rest, Ice, Compression, and Elevation)

• Protect. In many cases, you will be advised to wear a sling (particularly, during your daily activities). This will help to protect the area from too much motion and activity while allowing the bone to heal in its proper place. It will also indicate to others that you have an injury, so that they may avoid knocking into you.
• Rest. Allow the arm and shoulder time to rest and recover. Do not utilize the arm for activities that cause pain. Avoid excessive motions and use. As the pain subsides, you can slowly taper up the use of the arm by starting with simple daily activities.
• Ice. Apply ice to the painful area–typically the sooner, the better. The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a gel pack style. A bag of frozen peas can be ideal. Individuals with poor circulation or impaired sensation should take particular care when icing.
• Compression. It’s not easy to apply compression in this area. In most cases, it’s not necessary. In some cases, a simple ACE wrap can be used around the shoulder and collarbone area to help reduce the pain. The wrap is typically applied to help hold the shoulder in a backward and slightly downward direction.
• Elevation. Elevation is typically not necessary unless you are experiencing excessive swelling in the affected arm and hand. You can position the arm in a slightly elevated position by using pillows while lying on your back or on the non-affected side. This would be an excellent time to apply ice, too.

Sleeping

When sleeping, try not to lie on the affected side. Hug a small pillow for comfort.  This also promotes optimal blood flow to the shoulder area.

Pain Management

Initially begin with PRICE (Protect, Rest, Ice, Compression, and Elevation).  Pain medication, such as acetaminophen, is always an option if recommended by your physician.  You may also want to consider utilizing topical agents, which can help to decrease pain and muscle spasms. The method of action varies greatly according to the product used. You may find that one product works better than another. Some of my favorite products in my medicine cabinet include: Biofreeze Pain Relieving Gel; Arnica Rub (Arnica Montana, an herbal rub); and topical magnesium.

Another option is oral magnesium. You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates. Taking additional magnesium (particularly at night) can help to reduce muscle cramps and spasming. It is also very helpful in reducing overall muscle soreness and aiding in a better night’s rest. Most people are deficient in the amount of magnesium they consume on a regular basis. I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose as needed. I would caution you that taking too much magnesium can lead to diarrhea. Mag Glycinate in its oral form is the most highly absorbable. Although not as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.

Supplements

Mt. Capra, an organic goat farm in eastern Washington State, offers superior quality products primarily utilizing goat based products. CapraFlex by Mt. Capra is the best bone and joint supplement I have found. It is a blend of natural herbs and spices along with glucosamine and chondroitin.  The herbal and spice formulation is designed to naturally decrease inflammation and support healing.  I recommend it to anyone recovering from an injury or attempting to prevent injury when performing at a very high level.  I personally use it, and in my practice, it has helped clients recover faster and prevent injury.  It can interfere with some blood thinning medication, so if you are on this type of medication, please check with your physician.

Vitamin D3, such as Viva Labs Vitamin D3, is critical to the absorption of calcium through the intestinal wall which is important for bone health.  Although calcium is a critical component of bone health, I cannot recommend extra supplementation because of the potential cardiac risks to over supplementation.  A healthy varied diet will typically supply adequate calcium levels (assuming that adequate Vitamin D3 levels are present for absorption and that you are avoiding drinking soda).  Vitamin D3 is also a critical nutrient in maintaining a healthy immune system.

Be sure to maintain a generally healthy diet. Give your body the needed nutrients to heal and recover quickly.

Range of Motion

Depending on the severity of the fracture, you will likely have to limit the range of motion (ROM) of the shoulder to less than 70-80 degrees of flexion (forward) and abduction (sideways) motion. You will also have to limit reaching behind your back. A person may typically wear a sling for 2-4 weeks while limiting the motion.

The initial treatment to maintain ROM is to perform the pendulum exercise (as demonstrated in the picture on the left down below). Bend forward at the waist, and let your injured arm hang down toward the ground. Make small circles with your hand, and let the momentum move your arm around effortlessly.  Try to make both clockwise and counterclockwise circles. For more instruction, please watch How to Properly Perform Pendulum Exercises.

Around the 2-4 weeks mark, you can begin to work on regaining full forward flexion by using an over-the-door shoulder pulley (as demonstrated in the picture on the above right). Work slowly on motion for 5-10 minutes at a time. You may push though minor discomfort, but you should never experience significant pain during this process. For more instruction, please watch How to Use Shoulder Pulleys to Regain Shoulder Motion.

As flexion improves (typically after the 4 weeks mark), then you can begin to work on all other motions of the shoulder. This includes motion out to your side (abduction) and behind your back (internal rotation). The shoulder pulley can be utilized to regain these motions as well. Otherwise, you could walk your fingers up the wall when facing forward to regain flexion and sideways to regain abduction. You could use a towel to regain the motion behind your back.

Strengthening

Initially avoid lifting anything over 5 pounds. Typically around the 4-6 weeks mark (depending on severity of injury), you can begin a gentle rotator cuff strengthening program. These exercises should always be performed pain free and initially, the resistance will be very light. For specific exercises, please refer to Rotator Cuff Exercises.

The rotator cuff is a critical component to shoulder mobility. It is made up of four different muscles whose job is to make sure that the ball of the humerus (arm bone) rotates and slides properly in the socket, which is made up of the scapula. The rotator cuff allows the other major muscles of the arm, such as the deltoid and Latissimus dorsi (lats), to properly move the arm.

When there is weakness or dysfunction, it will cause rubbing of the muscle tendon on the bone. This can lead to impingement or eventually fraying and tearing. Insuring proper strength in the rotator cuff after a collarbone injury is an important component in avoiding shoulder impingement syndrome.

Return to Full Activity

Around the 8-12 weeks mark, you will likely consult with your physician to have another X-ray taken.  Once you’re cleared by your physician, you can slowly taper back into more strenuous exercises and a return to full activity.

If your injury was severe or required surgery, it may be closer to the 16 weeks mark before you can return to full activity and be cleared to lift heavier weights.  I recommend that you slowly taper back into your prior activities.  If you are experiencing pain, then back off that particular activity and try it again at a later date.

Help from a Physical Therapist (PT)

Every injury is different. If you’re experiencing pain or difficulty regaining your strength and shoulder range of motion, please consult with a physical therapist that is an orthopaedic certified specialist (OCS). The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

Good luck, Shawn! I hope you find this information to be helpful and provide some relief from the pain you’re experiencing.

Have you broken your collarbone? What was your experience like?  Please share your best tips for recovery.

If you have a question that you would like featured in an upcoming blog post, please email contact@thephysicaltherapyadvisor.com. For additional health and lifestyle information, join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

A.  Great question, Judy! A total knee replacement is often referred to as a total knee arthroplasty (TKA).  It’s really more like a resurfacing of the knee joint.  TKA is most often used as a treatment for those suffering from moderate to severe osteoarthritis in the knee.  Other common causes for the procedure include Rheumatoid arthritis and injury.  Knee replacement is more common among women and the likelihood of replacement increases with age.

The following information on total knee arthroplasty (TKA) and rehabilitation is not meant to be all inclusive, but to serve as a starting point as to what you will likely experience during rehabilitation. Each person’s rehabilitation process is likely to vary depending on his/her particular needs.

Four basic steps are performed in a Total Knee Arthroplasty (TKA):

1. Prepare the bone. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
2. Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint.
3. Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. This is not performed with every procedure unless necessary.
4. Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.

Proper rehabilitation is a critical component to overall success with this procedure.  In most cases, a physical therapist and possibly an occupational therapist will be involved in the rehabilitation process.  I tend to classify the rehabilitation into the following four major stages.

Stage I Rehabilitation

This is the initial post-surgical recovery stage in the hospital with physical therapy (typically the same day).  The goal is for you (the patient) to be upright and walking with an assistive device, such as a walker, in order to initiate very basic motion in the knee.

Although same day procedures can be performed, you will typically spend two to three days in the hospital following this procedure.  With the new surgical techniques utilized, most patients will not have any weight bearing or other mobility precautions.

There are risks of complications with any medical procedure.  The biggest risk initially is falling either from the newly operated knee giving way or complications from medication (which can cause dizziness, lightheadedness or other symptoms).  Other possible unlikely complications include: loosening of the prosthetic within the bone; blood clots; and infection.

Prior to leaving the hospital, pain management is a priority.  In addition, you need to be able to walk at least to a bathroom (typically with some assistance to maintain safety).

Four typical options for discharge:

1. Discharge home and continue rehabilitation with in-home care.
2. Discharge home and initiate physical therapy in an outpatient clinic.
3. Discharge to a skilled nursing facility. This is typically reserved for those who are expected to need an extended recovery.
4. Discharge to a sub-acute rehabilitation facility. This is typically reserved for those who may need additional medical care, but who can tolerate a more intensive rehabilitation program.

Regardless of the discharge location, the initial treatment is very similar.  Focus on pain management.  Improve your ability to ambulate.  Initiate RICE (Rest, Ice, Compression, and Elevation).  Start with basic range of motion (ROM) exercises (as described in Stage II).  Also, please refer to Total Knee Replacement Rehabilitation Exercises for many of the most common exercises you may perform depending on your individual need.

Medication Management

A major component of the rehabilitation will be to insure proper pain management.  This is typically through pain medication (both narcotic based and/or acetaminophen).  It is important to maintain proper pain management because it allows you to perform necessary activities of daily living (ADLs) as you progress through your rehabilitation.  Additional medication management may be necessary if you’re taking blood thinning medications in order to decrease the risk of blood clots.

RICE 

• Rest. Your body has just undergone a major surgery. It will require more rest initially to properly heal and recover. Although exercise and movement will be critical to your recovery, additional rest will be needed. Limit walking on any hard surfaces, such as the flooring in grocery stores, for at least the first three to four weeks in order to minimize pain and swelling.
• Ice. Apply ice to the painful areas especially in and around the knee. The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a gel style Cold Pack. A bag of frozen peas can be ideal. Individuals with poor circulation or impaired sensation should take particular care when icing. Often, your physician will prescribe a machine known as an IceMan (or something comparable) to help with cryotherapy to reduce pain and inflammation.
• Compression helps to prevent and decrease swelling. Swelling can cause increased pain and slow the healing response, so limit it as much as possible. You may utilize a common ACE wrap or your physician may recommend wearing TED hose which helps with swelling and decreases the risk of blood clots.
• Elevation. When resting, keep the leg as straight as possible and elevated above the level of your heart to help reduce swelling (edema). Try not to prop anything under the knee because it would cause flexion (bending). You want the knee to move straight into full extension.

Stage II Rehabilitation

Stage II typically starts on about day three to five.  It can last up to six to eight weeks depending on your recovery.  Continue to progress with pain management, edema management, gait/ambulation training, RICE, and range of motion as initiated in Stage I.

Movement 

Regaining range of motion (ROM) is one of the primary goals with TKA rehabilitation.  Knee extension (straightening) and knee flexion (bending) must be regained as quickly as possible.  There is a limited window of time that ROM must be restored.  Aim for full recovery of ROM within the first six to eight weeks (if not sooner).

Regaining both full knee extension and flexion are critical to long term success.  Once you regain full ROM, you must maintain it throughout the process.  Movement helps tissues receive the needed nutrients and can help with pain management.  Movement, including frequent toe tapping and ankle motion along with knee ROM, can also help to reduce swelling and prevents blood clots.

If the patient doesn’t regain adequate motion through the rehabilitation process, I find that knee pain usually remains a long term issue along with poor mobility.  The goal for TKA ROM is usually 0-120 degrees of motion.  (Zero meaning that the knee is perfectly straight.  The 120 degrees is how far backward you can bend the knee.)  For a point of reference, touching your heel to your buttock is usually about 150 degrees of motion.  Your knee will not have the same available ROM as a healthy knee joint, but it will be functional for most tasks.

Restoring full ROM can be accomplished in many ways.  The gentlest way is to perform heel slides by lying on your back and sliding your heel toward your buttock (as demonstrated in Total Knee Replacement Rehabilitation Exercises).  A stationary bicycle is also very helpful.  These exercises should be performed within a mild to moderate amount of pain and discomfort.  Although ROM exercises can be a little painful, they don’t damage the new joint and ultimately, the ROM will help to decrease pain.

Ambulation

In most cases, your initial ambulation will require an assistive device such as a front wheeled walker (FWW), crutches or a cane for safety and pain relief. Initially, the knee motion will be limited. Pain and swelling will affect the strength of the leg. This means that the leg could have a tendency to give way or be unsteady. This should improve quickly over the first several days, but I always recommend an assistive device initially.

Walking with an assistive device also gives you the opportunity to walk with a normal gait pattern which will help improve your knee’s range of motion and aid in your recovery. Your physical therapist will work with you to help restore as normal and safe a gait pattern as possible. It is common to feel or even hear clicking during ambulation and movement due to the plastic and metal components. This is normal (particularly, early in your rehabilitation when the knee is swollen and ROM remains restricted).

Strengthening

Increasing your leg strength is an important part of your recovery, but it will not necessarily be an initial focus of your recovery. The primary goals for rehabilitation initially involve proper ambulation, reducing the swelling, pain relief, and range of motion for your knee.   Adequate strength throughout the lower extremity is important. The primary focus will be on quadriceps strengthening and hip abduction (gluteus medius) strengthening. These two muscle groups tend to be the most important in regaining full functional mobility after TKA.

Stage III Rehabilitation

Similar to Stage II, rehabilitation in Stage III continues to focus on range of motion (ROM).  At this point, you would typically ride a stationary bike regularly while working to maintain full ROM (0-120 degrees).  Movement helps tissues receive the needed nutrients and can help with pain management.  Movement also reduces swelling and prevents blood clots.  This stage is typically eight to twelve weeks after the operation.

The Stage III exercise program (as demonstrated in Total Knee Replacement Rehabilitation Exercises) is designed to improve strength of the entire lower extremity while still focusing on quadriceps and gluteus medius (hip abduction) strength.  Balance and gait drills are typically introduced.  The goal is to ambulate without any noticeable abnormalities from the TKA and to reduce the risk of falls (particularly if you’re no longer using an assistive device).

During Stage III rehabilitation, I would generally expect that you have proper pain management without the use of narcotic medications.  Mobility for basic daily tasks is usually quite good and the intensity of the rehabilitation has increased.  In this stage, you’re working hard on self-rehabilitation and may be continuing formal rehabilitation in an outpatient physical therapy clinic.

Stage IV Rehabilitation

Stage IV usually occurs four to nine months after the operation.  Exercises should be designed to help maximize your mobility and desired mobility outcome/goal.  Increased exercise intensity and more dynamic balance training are introduced.  A return to full functional mobility is the desired outcome.  In this stage, a majority of the exercises are performed independently.  You may intermittently consult with a physical therapist to progress in rehabilitation to insure that you’re meeting your goals.

Each person’s rehabilitation process is likely to vary depending on his/her particular needs. Always be open and honest with the medical professionals who are assisting you. If you feel as though something is not quite right, don’t hesitate in discussing the issue.

During your recovery, don’t forget the basics! Proper hydration and consuming nutrient dense food is critical to providing your body with the necessary building blocks to optimize your recovery. Proper hydration is critical in reducing your risk of blood clots.  It also helps the body to deliver much needed hydration and nutrients to your healing tissues.

Physical therapy will be an important component to your recovery and rehabilitation.  If you don’t already have a physical therapist that you are comfortable working with, The American Physical Therapy Association offers a wonderful resource to help find one in your area.  Depending on how you progress during your rehabilitation, you will likely work with multiple physical therapists while at the acute care or rehabilitation hospital, during in-home care, and/or at an outpatient clinic.

Thank you, Judy, for your question.  Good luck with your procedure!  I hope your rehabilitation for your knee goes smoothly and that you recover quickly!

Have you undergone a total knee arthroplasty (TKA)?  What was your experience like?  Please share your best tips for recovery.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice.  No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

Health care costs in the United States continue to outpace almost any other sector for inflation. Unfortunately, this increase in cost has not shown any actual positive change in health status.  It is imperative that we all take a leadership role in our own health care by continuing to be proactive.

The Physical Therapy Advisor will continue to the lead the way in providing useful and practical types of “how to” information, including methods to safely self-treat and manage common physical therapy related conditions. My desire is to help you address the aspects of optimizing your life while promoting well-being in order to manage pain, improve mobility, and to age well.My Top 3 Posts on How to Age Well: 

1. How to Age Successfully
2. My Top 10 Anti-Aging Tips
3. Why Walking is Critical for Your Health

The American Physical Therapy Association (APTA) has designated October as National Physical Therapy Month. This October, the content focuses on how physical therapy can help you to age well. You can also find local physical therapists (PTs) in your area as well as search for general advice on many physical therapy related conditions at MoveForward.

What does aging well mean to you? How can I help you in this endeavor?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Muscle spasms and cramps can be terribly painful.  They tend to occur at the most inopportune time and place.  In a pinch, many household items can be used to assist in eliminating muscle spasms, cramps, tightness, and pain.  When available, my first choice is almost always the foam roller.  It is versatile and can be used to mobilize tissue as well as boney articulations.  The foam roller also works great to increase spinal extension mobility.  For more information on foam rolling, please refer to Foam Rolling for Rehabilitation and 5 Ways to Improve Range-of-Motion (ROM).

My Top 3 Household Items for Self-Mobilization:

1. PVC Pipe – This works great for sore forearms (including “tennis elbow”) as well as tight hamstrings or shin splints. You can use one hand or both to press or rub the PVC pipe over sore or tender areas. The amount of pressure shouldn’t be painful. Avoid pressing on especially boney areas.

2. Tennis Ball* – This is perfect to pinpoint those hard to reach places on the back or in the buttock region. Hold pressure over the sore area or spasming muscle until the spasm releases. This could take a couple of minutes depending on the severity of the spasm. (*A tennis ball may be substituted with another firmer and smaller rubber ball as shown below.)

3. Racquetball – This is perfect for self-foot mobilization or if you need to provide more pressure using a firmer ball. If you suffer from plantar fasciitis or poor mobility in your feet, I highly recommend performing this daily for a couple of minutes on each foot. Be sure to work the entire foot, not just the arch.

Muscle spasms, cramps, tightness, and muscle soreness are often quite painful!  These three common household items can be used to help mobilize, minimize, and/or eliminate muscle pain.  For more helpful ideas, please refer to Muscle Cramping & Spasms – Treatment Options, in which I discuss specific treatment options for managing pain including: massage, self-mobilization tools, topical agents, and supplements.

What are your top household items for dealing with muscle cramping and spasms?  Please post your comments below as we could all use a few more tricks to eliminate pain!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!