Ask the Physical Therapist

Q: What causes leg cramps?

A: Both athletes and couch potatoes can get leg cramps. The athlete for not fully replenishing lost fluids and the sedentary individual for lack of fluids in general. Minerals such as potassium, calcium, and magnesium along with water are important in proper contraction and relaxation of muscles.
Generally re-hydration, massage and stretching of the involved muscles can be very effective. A physical therapist can instruct you in the proper ways of safely stretching tightened muscle groups.
It's important to know that poor hydration is not the only cause of cramps. Nighttime cramps in particular can be a result of poor circulation due to narrowing arteries. This can be caused by arteriosclerosis, smoking, and diabetes. See your physician if you suspect any of these conditions
Thomas Houghtalen, PT, MTC

Q: How does a Physical Therapist treat (rehab) low back pain?

A: Our approach to low back pain will require a full assessment of structure and mechanics by a Physical Therapist to identify problem areas.Treatment will then include:
1. Pain relieving modalities and manual therapy to reduce muscle tension and relieve joint stiffness.
2. A therapeutic exercise program to regain lost motion and strength. During this phase, instructions will be given of how and when to resume normal activities safely.
3. Advanced exercises are then given to help prevent further episodes.

Thomas Houghtalen, PT, MTC

Q: I have suffered from an injury to my right leg, especially the knee area. Is it possible to have the nerve that runs through & down the right leg pop? What types of physical therapy could help?

A: Your visit with physical therapy will start with an evaluation of you present problem an ddysfunction that you have.
It is possible that you may have injured any one of the following: a muscle strain, ligament sprain, overstretched nerve or even an injury to the mechanical components of the knee joint itself. Depending on what we found with the evaluation it may include stretching and strengthening to the area to allow you to have less pain and improve overall function. Visit our web page for an office that is most convenient for you.
Thomas Cooney, PT, MS

Q: After having hip replacement surgery, what type of physical therapy is common?

A: Physical therapy following total hip replacement is done in phases.
In the first two week physical therapy will consist of teaching the patient how to move and perform daily activities while protecting the surgical repair. Simple leg, hip, and abdominal exercises will also be done. This phase is usually done in the hospital, rehabilitation center, or at home.

In weeks 2-8 the patient is instructed in advanced exercises to promote strength, stability, mobility, and proper walking techniques. This will be done at an outpatient clinic of your choice.

Depending on your overall health and previous physical activity, physical therapy beyond two to three months will focus on advanced activities that will assist you in returning to work, sports, gardening, biking, hiking, etc.
Thomas Houghtalen, PT, MS

Q: What types of therapy are used for torn ligaments?

A: Ligament injuries can vary from mild to severe. A mild ligament injury is often referred to as a sprain. A sprain is a stretch injury to the ligament. It often results in swelling, pain, tenderness, weakness, and instability to the joint. A severe sprain can result in some of the ligaments being torn. This creates an unstable joint and may require surgery.
Physical therapy can speed up the healing process of a sprain or torn ligament. Because ligaments have a poor blood supply, whirlpool, ultrasound, and other treatments are used to increase the blood supply to the area, bringing in fresh nutrients to speed up the healing process. Gentle stretching and range of motion exercises are introduced next. Without motion, the ligaments will not heal properly. Motion also helps to pump fluid out of the join. Physical therapy treatment also includes strengthening exercises to help get back to full activities, including sports. Regardless of the severity of ligament injuries, physical therapy can help to speed up the healing process and get you back to the activities you need to do.
Teresa Lincoln, PT

Q: Can physical therapy help tendonitis?

A: The tendon attaches the muscles to the bone. Tendonitis occurs when it becomes irritated and inflamed. The most common sites are the shoulder elbow (tennis elbow), hip, knee (jumper's knee), and lower leg (shin splints). Tendonitis can be caused by a single injury but more commonly as a result of repetitive strain. Baseball pitchers often have shoulder tendonitis due to repetitive throwing. Keyboarding can cause tendonitis in the arm due to repetition combined with poor sitting postures.

Our physical therapist will use a variety of treatment procedures to help heal this inflammation. Overuse activities and postures are discussed and the physical therapist will educate the patient in body mechanics and home exercises to prevent further injury.
Thomas Houghtalen, PT, MTC

Q: How long does it typically take for a rotator cuff injury in an 80 year old man to fully heal?

A: Rotator cuff injuries can range from a simple strain to a complete tear of the tendon. Here are a few basic guidelines to follow after you have rested you injury for 2-3 days.
If it is moderately painful to reach fully overhead and behind your back the injury probably is relatively mild but may take 6-8 weeks for full recovery. Limitations will be in lifting, carrying, and overhead activities.
If it is too painful to complete these motions or you have a noticeable loss of power in the arm you may have a more serious injury. Short term physical therapy can determine the severity of the injury and advice can be given on either conservative management or referral to an orthopedic physician for additional tests.
Thomas Houghtalen, PT, MTC

Q: What types of physical therapy might be used for a post stroke patient?

A: The type of physical therapy a patient would receive after having a stroke would depend upon the level of involvement of the problem. Your attending physical therapist would start with an evaluation of the problem and chart a course for recovery. With a stroke there could be loss of strength, range of motion, balance, walking ability, sensation loss, and speech difficulties. Your therapist will work with you on retraining, stretching, and strengthening areas that are weak or tight to improve the function loss that occurred. The therapist would work with the patient with specific exercises to improve all those areas mentioned that have had loss of function.
Thomas Cooney, PT

Q: My back and shoulders frequently hurt if I work at my computer for long periods of time. Can you make any recommendations to help alleviate these problems?

A: Many of your jobs now require increased computer time and prolonged periods of sitting. Muscle groups in the low back and shoulders can get tight with lack of activity and poor posture at the keyboard. There are things you can do to alleviate these problems:

1. Change position frequently. Stand up every 20 minutes and stretch.
2. Evaluate your workstation. Is your chair at the correct height so that you feet are flat on the floor and supported' Is your monitor at or slightly below eye level? Are your wrists in the neutral position at the keyboard?
3. Develop a home exercise program. Doing some form of exercise everyday for at least 30 minutes will get you out of your work positions and stretch some of those tight muscle groups.

Thomas Cooney, PT

Q: What types of physical therapy treatments are used for a torn meniscus?

A: After you have been seen by your attending physician, physical therapy is often prescribed to reduce pain and swelling, and maintain mobility of the knee joint. Treatment may include ice and electrical stimulation to reduce swelling, gentle exercises to improve knee movement and instruction in exercises that you perform at home to improve functional strength and mobility.
Thomas Cooney, PT

Q: My son is going into his last year of Little League and wants to learn how to throw a curve ball. Is it safe for him to do so?

A: This is a very controversial question. Although there is not any clinically significant research which indicates that curve balls and sliders are detrimental to a little leaguer's arm, there are studies which suggest a high correlation of elbow and shoulder pain in individuals who throw curve balls and sliders before bone maturity. Current recommendations by Dr. James Andrews of the American Sports Medicine Institute, recommend no breaking pitches before the age of 14.
Brian Duquette, PT

Q: Can Physical Therapy help strengthen a tibia bone break between my knee and ankle once it heals?

A: After your bone break (fracture) has healed your attending physician may refer you to physical therapy for evaluation and treatment if required. If that is the case, your physical therapist will evaluate your needs and build a program which will enhance your recovery process. This can include pain control, stretching, strengthening, gait improvement, and return to former function. The density of our bones and our muscles that surround the fracture site both benefit from exercise. If physical therapy services have been prescribed we can be contacted at the listing above. Exercise is Medicine!
Thomas Cooney, PT

Q: What is the difference between tendonitis and bursitis?

A: The ending 'it is' means inflammation. Tendonitis means inflammation of the tendon and bursitis means inflammation of the bursa. Tendons connect muscles to bone and bursa(e) are lubricating sacs which prevent friction between muscles. Both conditions are treated similarly in physical therapy. Some of the most common tendonitis diagnoses are rotator cuff and patellar tendonitis, lateral (tennis elbow) and medial (golfer's elbow) epicondylits. Shoulder and trochanteric (hip) bursitis are common diagnoses as well.
Thomas Cooney, PT

Q: What types of therapy are effective for a sprained ankle injury?

A: When the injury first occurs the acronym RICE is the order of the day. It stands for Rest, Ice, Compression, and Elevation of the ankle. Your attending physician will evaluate the injury to rule out any possibility of broken bones. After it has been determined that the ankle has been sprained, you may be referred to physical therapy where the attending therapist will evaluate the extent and severity of the ankle sprain and eventually get you started on strengthening exercises after the swelling and pain have subsided.
At this phase effective rehabilitation exercises may include use of aquatic exercise, strengthening and balance exercises, and calf raises. If you have sustained this injury, feel free to contact your doctor regarding rehabilitation efforts.
Thomas Cooney, PT

Q: What is aquatic therapy and when is it most commonly used?

A: Aquatic therapy is an exercise program performed in the water using the buoyancy or fluid resistance of the water to either help increase movement or provide resistance to strengthen muscles. Programs, run by physical therapists, are individualized for each participant's specific medical conditions. Although any condition can benefit from aquatic therapy, it is most beneficial for these conditions: early walking and strengthening following hip/knee surgery; decreasing joint impact in arthritic or spinal conditions; decreasing pressure on pinched nerves; increasing general conditioning and core strengthening.
Geraldine Pfeiffer, PT

Q: What is the difference between arthritis and bursitis and how is it treated through physical therapy?

A: Arthritis and bursitis are both inflammatory conditions that can produce pain, swelling, and loss of movement. Arthritis is the inflammation of a joint commonly caused by trauma, degenerative joint changes, or systemic disease. Bursitis is the inflammation of a bursa sac (fluid filled sac) within soft tissue or bony structures and can develop from trauma or overuse activity. Once you have seen your physician, a referral for physical therapy may include the application of heat/cold based modalities to reduce pain and swelling, gentle therapeutic exercise to restore pain-free mobility/strength, education, and self care management
Marianne E. Vrobel, PT

Q: Are PT exercises effective in treating osteoarthritis?

A: Following a thorough evaluation and diagnosis by your family physician, you can request a referral to physical therapy. A physical therapist will prescribe gentle exercises including aerobic conditioning, specific muscle strengthening related to the joints that are involved, and education in posture and pain management techniques. Regular light exercise has been shown to minimize stiffness and also may contribute to reduction of pain associated with osteoarthritis.
Linda Van Alstyne, PT, OT

Q: How do you treat restless leg syndrome?

A: Restless leg syndrome is a sleep disorder in which a person experiences unpleasant sensations in the legs often described as creeping, crawling, tingling, pulling, or painful. A visit to your family physician will confirm the diagnosis. Once an official diagnosis has been established treatments may include medication, utilization of heating/icing modalities, massage, exercise, and monitoring of caffeine in your diet. Although physical therapy may not be the primary method of treatment, discuss the plan of care with your physician and a referral to physical therapy will occur as deemed appropriate.
Michelle Banaszewski, PT