Exercises for Knee Pain

Exercises for Knee Pain at Range of Motion Physical Therapy Dublin
Last year I wrote a short blog on Patellafemoral Pain Syndrome PFPS here, in this follow up article I will expand on some more information on some exercises that are proven to help PFPS with strengthen quads and glutes, while not causing excess load on the patella.

The cause of PFPS can be put down to quite a large number of factors, muscle weakness (Glutes & Quads), poor motor control (incl. core strength and proprioception), altered biomechanics (such as ankle pronation) and soft tissue issues (tight ITB / Psoas / Hamstrings etc..)

The key to managing PFPS is a graded exercise programme without aggravating symptoms. The best types of exercises prescribed are Open & Closed Chain exercises.

Open Chain Exercises: are when your foot is free to move during an open chain exercise. These types of movements tend to isolate a single muscle group and a single joint. For example, the one joint involved during a leg extension is the knee and the muscle group it isolates is the quads. Other examples of open chain exercises include leg curls, clams and leg flexion and extensions.

Closed Chain Exercises: these are the opposite to open chain exercises in that your foot is in a fixed position, normally with the ground. Closed chain exercises work multiple joints and multiple muscle groups at once. For example, a squat involves the knee, hip and ankle joints, and multiple muscles groups (quads, hamstrings, hip flexors, calves and glutes).

Closed chain exercises can be done with body weight alone and progressed with added weight, bands etc.. Other examples of closed chain exercises include step ups / step downs, mini squats, single leg squats and lunges.

The angle of the knee is a very important factor when carrying out exercises to help reduce knee pain. There are varying degrees of knee flexion which help ensure minimum load on the knee joint while recruiting as much muscle strength. Ideal ranges for Closed Chain exercises are 0 – 45° of knee flexion, working lower as a progression.

For Open Chain exercise it is best to work 0 – 20° for the likes of quad sets or straight leg raises and 45 – 90° for leg extensions.

An exercise programme for this injury is based on a comprehensive assessment and gradual progressions, pain is the key indicator for the exercise progressions, in that there should be little or no pain when carrying out the exercises.

Contact us here should you wish to learn more or book in for an assessment.

- See more at: http://www.romphysicaltherapy.ie/index.php/exercises-for-knee-pain-open-chain-okc-and-closed-chain-ckc-exercises/#sthash.FJLM2fDA.dpuf


Off the Shelf Orthotics

This month at Range of Motion Physical Therapy Dublin, I attended a workshop/sales conference on a new custom made off the shelf orthotic. How could there be an off the shelf custom made orthotic, I hear you say…. well I asked myself the same question when I got the invite to attend, so I decided to see for myself.

There are generally two schools of thought when it comes to orthotics, one camp says you should be able to strengthen the weak arches in the foot to prevent a foot pronating. Then there is the camp who recommend the use of a custom made orthotic to support the foot and problem solved…at costs of normally around €200 – €250. In addition there are people with genetically flat feet that have been passed down from their parents and no amount of exercise will help correct that.

To be honest I think I sit in both camps, as in, when I see client with a arch issue that maybe contributing to their hip or knee pain I will often recommend they purchase an off the shelf pair of othotics, normally in the region of €35. I will ask them to wear them while we work on strengthening the intrinsic muscles in the foot. Admittedly the off the shelf orthotics you get in your local chemist can be of poor quality in terms of durability and support, they will do a job on a short term basis.

However, having attend the Quadrastep conference I was very impressed with their product and how it would be perfect for elderly clients and those who do not respond to arch strengthening exercises.

The Quardrastep System was designed by Roberta Nole a Poditratis and Physical Therapist with 20 years experience. Through her research she designed 6 custom made orthotics based on what she feels are 6 generic foot types, they also come in a narrow or wide versions and variety of sizes.

With this product there is no need for casting, foot impressions, foot scans, instead I can asses your foot type by specific foot landmarks, asses your walking gait and the wear patterns on your foot (hard skin). Based on this I will choose the correct orthotic from the choice of 12 and supply you with them immediately!

One of the best things about this product is the cost, they are a fraction of the cost of the custom orthotic and offer the same support and durability as a custom made made orthotic.

Please contact me should you wish to learn more or make an appointment for an assessment.

 


Othotics

Range of Motion Physical Therapy July Newsletter 13

Off the Shelf Orthotics:

There are generally two schools of thought when it comes to orthotics, one camp says you should be able to strengthen the weak arches in the foot to prevent a foot pronating and then there is the camp who recommend the use of a custom made orthotic to support the foot and problem solved…at costs of normally around €200 – €250.

To be honest I am still not convinced by either, bearing in mind there are people with genetically flat feet and no amount of exercise will help correct that.

So when I see client with a fallen arch that could be contributing to their hip or knee pain I will often recommend they purchase an off the shelf pair of othotics, normally in the region of €35 – €40. In the interim we work on strengthening the intrinsic muscles in the foot.

Admittedly, the off the shelf orthotics you get in your local chemist can be of poor quality in terms of durability and support, they will do a job on a short term basis.

However, having attend the Quadrastepconference I was very impressed with their product and how it would be perfect for elderly clients and those who do not respond to arch strengthening exercises.

The Quardrastep System was designed by Roberta Nole a Podiatrist and Physical Therapist with 20 years experience. Through her research she designed 6 custom made orthotics based on what she feels are 6 foot types, they also come in a narrow or wide versions and on variety of sizes.

The fact these orthotics are off the shelf but specifically designed to 6 foot types, means they can be produced and sold at a fraction of the cost of the custom orthotic and offer the same support and durability as a custom made orthotic.

Check out the Orthotics on my website should you wish to learn more or contact me if you wish to make an appointment for an assessment.