Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is a common cause of knee pain in both adolescents and adults.  It is especially prevalent in runners and is sometimes called “Runner’s knee”. PFPS is typically characterized by pain at the front of the knee.

Anatomy:
b.pfsmlThe patellofemoral joint is comprised of the patella (knee cap) and the femur (thigh bone). The patella sits in a groove on the femur. When the knee bends, the patella moves along this groove. This is referred to as “patellar tracking”. A combination of dynamic (quadricep muscles and ITB)  and static (articular capsule, medial and lateral retinacula, bony structure and ligaments) stabilizers control patellar tracking.

 

Symptoms:

  • Pain around or under the patella
  • Aggravated by activities such as squatting, going down stairs, kneeling, lunging, running and prolonged periods of sitting
  • Knee may feel stiff
  • May notice clicking or grinding with knee movement
  • Minimal swelling

Causes:
There are 3 primary contributing factors that increase the risk of PFPS.

1) Muscular imbalance

  • Quadricep muscle weakness can impair patellar tracking. When the inner quadricep muscle is weak and the outer quadricep muscles and ITB are tight, the patella is pulled towards the outside, impairing its tracking. Tight hamstrings and calves can also contribute to PFPS. Furthermore, weak gluteus muscles decreases pelvic stability and increase the force placed on the knee which increases risk of PFPS.

2) Malalignment

  • Large Q-angle (wide hips), knock knees and asymmetrical kneecaps can contribute to PFPS. Additionally, over pronation (excessive rolling-in) of the feet can cause the lower leg to rotate inwards, increasing stress on the knee joint.

3) Overactivity

  • Increasing your running/training mileage, speed, intensity and hill work  too quickly without enough rest are common training errors that can cause PFPS.

Treatment:

Physiotherapy can effectively treat PFPS. The first step of treatment is identifying the cause of the problem. A treatment plan will then be created to deal with the cause and prevent injury recurrence. Initially, resting and icing the knee will be important to decrease pain and inflammation. A variety of soft tissue techniques, andjoint mobilization, as well stretching and strengthening exercises will be used to further rehabilitate the knee and surrounding structures. If necessary taping techniques, knee bracing and foot orthotics may recommended to deal with malalignment issues. It is important to note that addressing this issue early will promote faster recovery.

For more information about Kinetic Physiotherapy, visit our website:http://www.kineticphysiotherapy.ca  Contact Kinetic Physiotherapy via e-mail:info@kineticphysiotherapy.ca or phone: 905-637-1414 to set up an appointment.

Muscle cramps: Why you get them and what you can do

calf-crampMuscle cramps are involuntary muscle contractions of one or more muscles. These spasms can be quite painful lasting a couple seconds to 15 minutes or longer. A muscle cramp can recur several times before it resolves.  Muscles of the feet, calves, thighs, hands, arms and abdomen are  prone to spasm. Whether you are out for a run, in the car or  going to sleep, muscle cramps come without warning.  A common question we get at our clinic is what causes these cramps and how can you relieve them?

Potential Causes of Muscle Cramps
Injury: Following an injury, muscle cramps can occur as a protective mechanism. Muscle spasms help to minimize movement, stabilizing the injured area.

Vigorous activity: Exercise related cramps are likely caused by muscle fatigue. In normal functioning muscles, inhibitory messages are sent to the muscle to prevent it from contracting too strongly. When the muscle fatigue, this inhibitory message is decreased causing overstimulation to the muscle. This results in a muscle cramp.

Dehydration: Dehydration can occur through excessive fluid loss when sweating and/or inadequate fluid intake. Dehydration increases the likelihood of muscle cramps.

Muscle cramps can also be caused by an underlying factor:
Mineral deficiency: Low levels of calcium or magnesium in the blood causes increased excitability of the nerves and the muscles that they stimulate. Increased muscle stimulation can result in muscle cramping.

Nerve compression: Spinal nerve irritation or compression can cause cramp-like pain.
This may be accompanied by weakness or sensory changes.

Poor circulation: If blood vessels become narrow due to arteriosclerosis, blood supply to the extremities become decreased. This can result in muscle cramps that are more likely to occur when you are walking or exercising but stops with rest.

Kidney, thyroid, hormone and liver disorders: Muscle cramps can be complications of an organ disorder. For example, hypoglycemia and anemia can cause muscle cramps.

Drug side effect: Various drugs such as those used for blood pressure, Alzheimer’s disease, high cholesterol and others can cause muscle cramps.

What can you do?

Stretch: Most muscle cramps will relax if the muscle is stretched. This can sometimes be accomplished by standing up and walking around or changing positions. Stretching the specific muscle group in spasm may also be required. For instance, if your calf is in spasm, stretch is by performing these 2 stretches. CalfStretches

Massage: Gently massaging the muscle in spasm may help to relax the muscle.

Heat: Applying a heat pack to the muscle cramp or having a warm bath may also help to get the muscle to relax.

Prevent the cramp: There are a number of things you can do to prevent muscle cramps from happening in the first place:
a) Stay well hydrated
b) Ensure adequate dietary intake of nutrients and minerals
c) Stretch before and after physical activity
d) Rest: get enough sleep and allow sufficient time for muscles to rest and recover after exercise

Physical therapy: If your muscle cramp is the result of an injury, physical therapy can help to decrease muscle tone and spasm and rehabilitate underlying injuries.

Note: Cramps that are a result of organ disorders, nerve compression, poor circulation or drug complications may need further medical investigation for appropriate treatment.

For more information about Kinetic Physiotherapy, visit our website:http://www.kineticphysiotherapy.ca  Contact Kinetic Physiotherapy via e-mail:info@kineticphysiotherapy.ca or phone: 905-637-1414 to set up an appointment.

Easing Your Neck and Shoulder Tension

The neck and shoulders are often the victims of stress and pain.  Although there are multiple potential causes of neck and shoulder pain, symptoms are frequently the result of structural stress caused by our day-to-day activities. For instance, activities such as holding a phone between your shoulder and ear, doing repetitive overhead work (e.g. painting or lifting boxes), and typing at a keyboard that is too high can all cause muscle tension in the neck and shoulders. Additionally, sitting and standing in a poor posture with the head and shoulders forward and upper back slouched causes strain and tension in the muscles. Anxiety and chronic stress can also contribute to this problem as it can cause the body to adopt a self-protection posture with the shoulders raised, jaw clenched and neck jutting forward.

There are things you can do to decrease tension in your neck and shoulders:

1) Maintain good posture throughout the day. You can check out our previous post here for more information.

2) Drink plenty of water. Water is necessary for proper muscle and joint function. Try to drink at least 8, 8oz glasses of water a day.

3) See a physiotherapist. A physiotherapist can assess your neck and shoulders to determine the cause of your pain and develop a treatment plan to address any issues.

4) Stretch. Check out our newest video for an easy shoulder and neck yoga sequence that will help to decrease tension and stress.

 

4 Exercises You Can Do at Work

Many Canadians spend the majority of the work day sitting at a desk. Although sitting may not seem like a high risk activity, sedentary jobs can have a negative impact on overall health. These types of jobs contribute to obesity and can lead to various other health issues such as tendonitis and neck and back strain injuries. Fortunately, there is something you can do. Here are 5 exercises that you can do at work to help keep you active, healthy and injury free at work.

1. Stretch

Stretching regularly will help to decrease tension and tightness in your muscles. Here are 10 simple stretches you can do at your desk. Try to perform a few of these stretches, 3-4 times a day. Hold each stretch for 20-30 seconds. Stretching should be pain free. (If any of these stretches cause pain, numbness or tingling, contact a health care professional)

2. Strengthen Muscles

-Glute squeeze: while sitting at your desk, tighten your buttocks, hold for 5 seconds, then relax. Repeat 10 times

-Heel raises: if you are taking a standing break, raise up on the balls of your feet by lifting your heels off the ground. Repeat 20 times

-Chair Squat:  without using your hands stand up and sit back down in your chair. Repeat 10 times

-Leg raises: When sitting, tighten your thigh muscle and kick your leg out straight. Hold for 5 seconds, repeat 20 times.

3. Stand Up

Every 15-20 minutes, take a break and stand up. Standing helps to improve circulation and posture, relieves stress and can decrease low back pain.

4. Go for a Walk

On your lunch break, go for a walk. Walking for just 10 minutes can help to control blood sugar and cholesterol, burn fat, increase energy and decrease stress. If possible, change into walking shoes to ensure your feet are well supported.