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Ask a Therapist

Pop & Pain in Leg

About ten months ago, I was stretching after warming up and I was doing the scorpion pose (I’m a dancer, so I need to constantly stretch). I started to pull my leg up and I heard a pop in my base leg (left leg). There was a sharp pain, and I lost so much flexibility. The weird thing is, there was never any bruising or swelling, and I never limped. I had no visible symptoms of pulling my hamstring, but I’m pretty sure I did. I never compressed or iced it, but I stopped stretching for about 3 months, and after that, I only rolled it out with a foam roller/tennis ball. About 4 months ago, I started stretching again, and though I have gained back some of my former flexibility, the stretching will sometimes make it hurt more. It will ache all through my hip, and I can’t straighten my leg sometimes due to pain. I don’t know what to do.

There are so many potential possibilities of what you’ve done and what to do to help it that I can’t give you clear advice. I’d encourage you to get a physical therapist to check you out. I will say that you could have strained one of many ligaments around your hip, pelvis, or back. You could have injured your hamstring also. You have had enough time for the tissue to heal, but very often you lose some mobility while you are recovering. I would say you should have a good chance at making a full recovery, but you will likely need some help to find the way there.

Pain in Shoulder

I have had pain in my shoulder for a few months, primarily when raising my arm. There is also some weakness and instability. I’m very active both in sports and my job, and I’m concerned that I am making it worse. However, complete rest isn’t an option. Without complete rest, will my shoulder ever heal? I have been avoiding upper body exercises at the gym, but are there any exercises for the shoulder that I could be doing? Or should I avoid any strength training until there is no pain? Should I be stretching? I’m concerned that because of my lifestyle, this will just continue to worsen. I’m avoiding seeing a physical therapist just due to budget right now, hoping that I can find a solution on my own. Thanks for any advice you can offer.

Unfortunately there are so many things that could be causing and influencing your pain that it is very hard to give you specific advice that can help you. I can say that if you help your sore arm lift up with your other one, and it makes it a lot easier, you could be dealing with a rotator cuff problem. If it’s the same whether you help or not, it might be something more like the joint capsule.

Complete rest is often counter-productive, but there is some sense in avoiding painful activities, such as overhead lifting, until you can tolerate it. The complexity here is that when you have pain in your shoulder, your body reacts. Your muscles tend to switch off a little, certain muscles tighten up, the neck and thoracic spine stiffen, and the way the shoulder and shoulder blade move compensate due to pain. All these things are barriers to recovery and happen in different doses in different people. Often the underlying issues are not that severe, despite the amount of pain and disruption to your life.

In general, you should work on thoracic mobility (extending and twisting mobility), your shoulder blade position (scapular squeezes), and careful rotator cuff strengthening. Technique and exercise dosing is very important, and it often needs some skilled eyes and advice to ensure this.

I know you don’t have PT in your budget right now; I will say it is the best bet for establishing what you have and finding a way to recovery. Having a painful shoulder can come at a cost to your quality of life and potential problems down the line. Good PT is worth it.

Work Conditioning Program

Do you do Work Conditioning programs? I have herniated discs at L4, L5, and S1. I have completed a physical therapy program and my physician has prescribed a work conditioning program. I am trying to find a PHYSICAL THERAPY location near me, and Results came highly recommended by my Fire Chief.

We do offer work conditioning in our clinics. We would be glad to accommodate you. The way it works in the workers compensation world is that the insurance company and or physician decides where they send you based on contracts, convenience, and relationships.

You may be able to influence where you are sent by discussing it with your doctor. Our website has a listing of our clinics that will take great care of you. Let us know if we can be of any more help to you in finding you a clinic or PT.

Throbbing Pain in Knees

I have not worked out in years, and tonight I had my first kickboxing class. Since then, I have been in horrible throbbing pain from my knees up to my hips. Both legs are also hot to the touch. Is this normal or okay from a workout, or should I worry?

Most likely, you are experiencing normal post exercise muscle soreness, and this will be worse with extreme and unusual activity. I’m guessing you weren’t actually getting kicked or struck in your upper legs, so it’s likely from the muscle activity.

Delayed onset muscle soreness will usually take a few days to resolve and should improve day to day. There’s not much to be done to help it other than time. Keeping gently active, avoiding anything extreme, and stretching gently will help you recover more predictably.

The only precautions about what you’re experiencing could be if you did have a heavy fall or were struck, if there are other symptoms that are coming with it (numbness in your legs, inability to weight-bear, dark brown/red urine, kidney pain), or if you are not improving or getting worse over the next couple of days. Any serious condition is quite unlikely, but if you have concerns I would suggest visiting your physician or a walk-in clinic.

Exercise Program

I have high cholesterol, but I am an otherwise healthy 22 year old female. My doctor said to focus on strength training and cardiovascular exercises. He specified that I go to a gym for 30 minutes every day. What exercise program can you recommend for me?

Thanks for your question. The best exercise program for you is quite an individualized thing- the good news is that there are a number of ways you can be successful at improving your health through exercise. Something that is convenient, achievable, sustainable and enjoyable will always tend to stick. After all, these are the habits of a lifetime.

There are some guidelines for what is likely necessary to keep healthy. Cardio exercise is key to having a normal cholesterol level.That can include walking, jogging, bike riding, swimming, elliptical, rowing machine. If you have any injuries or have problems that require you to increase your body strength and control, you need to ease into exercise gradually, cross train, or avoid some exercises all together.

Strengthening exercise may not burn through the same amount of calories as intense cardio, but it can be invaluable in preventing injury and is great for your system. The best suggestion is to do a combination of cardio and strength training.

A trainer at a gym may be able to guide you and find you a balanced program. To work with a personal trainer, group exercise, or with a friend or partner can be very motivating. If you are having any physical trouble getting started, seeing a physical therapist is a great idea. Our goal is to arm you with the knowledge and strength to achieve your goals.

Wound Vac Removed

I just had my wound vac removed from my ankle. I was non weight-bearing on that ankle for 7 weeks. Can I resume weight baring status, or do I have to ease into it?

Your ability to resume weight bearing is going to be dependent on many things, some of them being the type and extent of the original injury, the amount of healing that has occurred, your tolerance to weight bearing, etc. With that being said, there is no straight forward answer that we can provide through this forum. Your best resource to get this answered would be the physician who placed and removed the wound vac. If he or she says you can resume WB but you are having difficulties with it or returning to your previous level of function, because of pain, weakness, range of motion limitations, a Physical Therapist would be the perfect person to help with that. Likely this is something you should see a PT for after discussing further with your Medical Doctor.

Correcting Bowlegs

I just have to know- are there any hopes of correcting bowlegs without surgery?

Typically “bow legged” is a structural thing that will not change without surgery. However, if you are not having pain or limitations in activities, and it is just a cosmetic thing, there would likely be no need to have surgery. Of course, consult with your medical provider about this. If you are having pain or limitations in activities, you could try conservative actions first, such as physical therapy. Despite not being able change the look and shape of the legs, physical therapy should be able to help with improving pain and function.

Neuroma Pain

For about 3 years now I have a neuroma on my left lateral femoral cutaneous nerve just before it traverses the anterior superior iliac spine. A block of the nerve stopped the pain for a few hours. I have tried steroid injections and radio frequency ablation, which hasn’t helped at all. As I seek solutions, one of the things I would like to understand better are the physical activities that cause this neuroma to get worse. If I squat for a minute or two, I will have increased pain for weeks. If I bend at the waist to pick something up, I can have increased pain for 1-7 days. I can usually sit in any seat for 15 minutes without pain but any longer than that will start to bring discomfort. Vertical seats like airplane seats bring greater discomfort quicker, while more reclined seats with lumbar support are comfortable for longer. If I sit in an uncomfortable seat for 30 minutes, I will usually have escalated pain for a few hours. If I sit in an uncomfortable seat for an hour or more, the pain can be escalated for a couple of days. I am looking for any information which may help me answer the following questions. Why do these activities aggravate my neuroma? Is the nerve being stretched or compressed? Is there a certain way to position myself that would allow me to squat, bend, or sit for longer periods of time with less discomfort? Are there muscles that can be strengthened that might reduce the stress on the nerve? I largely try to avoid doing any of the activities that aggravate the nerve for a few years now but, as time goes on, this neuroma has only gotten worse. Any help is appreciated.

Sorry to hear about your neuroma. It sounds like your symptoms are aggravated when you are compressing the nerve. It is quite close to the surface of your skin, and when your thigh comes up towards your abdomen, it is compressing it. The nerve also gets irritated by clothes, tight waist band, or belts.

In terms of what you can do to help it, getting strong in your gluteals and back extensors may help. Getting looser in your hip flexors, thigh muscles, and lower abdominals may be helpful too. There are exercises to get the nerve tissue more mobile. Research femoral nerve glide or ‘flossing’ exercises. They might temporarily aggravate your symptoms.

Getting your symptoms under control can be a process. I suggest getting a good PT to guide you through this. If you can locate someone with manual therapy or orthopedic specialization, they should be equipped to help you.

Stretching Broken Finger

I have a broken finger (middle phalanx ring finger). It’s been splinted for 4 weeks, and seems to have healed enough to remove the splint. I can only move it slightly. I’ve seen many videos on stretching exercises. I’m 40 and relatively healthy. Throughout the healing, I’ve focused heavily on my diet, including protein, whole foods, vitamins, and amino acid supplements. About how long will it take to get flexibility back in my finger? I’m uninsured, so I can’t afford an orthopedist.

Most people recover from a finger fracture with normal hand function. The fracture usually heals pretty reliably over 3-4 weeks, but some are problematic. If the fracture extends into a finger joint or if a joint got injured in the same episode, it can complicate the recovery. Stiffness after immobilization is expected, and the recovery timeframes depends on so many variables that it is not possible for me to give you clear guidelines.

I would advocate for you to have a PT or a hand therapist check you out, It comes with some expense, but regaining the use of your hand is important. Seeing a professional will allow you to understand what specific exercises to perform and get a more accurate understanding of your prognosis. It’s true that most of the hard work will be done by you independently, and it will likely involve self-mobilization techniques targeting the 3 finger joints individually and working on your ability to grip and open your hand. If one of the joints is being persistently painful, thickened/swollen, and not progressing, this can be a sign your recovery is getting a little more complicated.

PT for Broken Foot

Do you provide physical therapy for someone who is recovering from a broken foot?

We sure do! We are very used to dealing with the effects of pain, disuse, and immobilization on a healed or healing fracture. Even after the bone(s) have healed, there is the potential for on-going issues if proper gait, strength, and mobility are not restored. We have a number of clinics in your area. I have full faith and expectation you would be very well looked after.

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