Arthritis is a condition that affects the joints, causing pain, stiffness, and inflammation. Many people with arthritis find that their symptoms can worsen as the autumn and winter seasons approach due to the cold and damp weather. Here's some information about arthritis during this time of year and what you can do to feel better:

How Autumn and Winter Affect Arthritis:

1. Cold Temperature: The drop in temperature can lead to increased joint stiffness and pain for individuals with arthritis. Cold weather can cause the muscles, tendons, and ligaments around the joints to tighten, making movement more difficult and painful.

2. Dampness: Increased humidity and dampness in the air can also exacerbate arthritis symptoms. The changes in atmospheric pressure can affect the synovial fluid in the joints, leading to discomfort.

3. Reduced Physical Activity: As the weather gets colder and days become shorter, people often engage in less physical activity. This reduced movement can lead to muscle weakness and joint stiffness, further worsening arthritis symptoms.

Tips for Managing Arthritis in Autumn and Winter:

1. Stay Warm: Dress in warm, layered clothing to maintain body temperature. Keep joints covered to minimize exposure to the cold.

2. Heat Therapy: Apply heat to affected joints using heating pads, warm baths, or hot packs. Heat can help relax muscles and reduce pain.

3. Stay Active: Engage in regular, gentle exercise to keep your joints moving. Activities like swimming, walking, or indoor exercises can help maintain joint flexibility and strength.

4. Diet and Nutrition: Maintain a healthy diet rich in anti-inflammatory foods, such as fruits, vegetables, and omega-3 fatty acids found in fish. Some people also find relief through dietary supplements like glucosamine and chondroitin but consult a healthcare professional before using them.

5. Medications: If over-the-counter pain relievers are insufficient to manage your arthritis symptoms, consult your healthcare provider for prescription medications or injections that can help alleviate pain and inflammation.

6. Physical Therapy: Consult with a physical therapist who can develop a personalized exercise and stretching program to manage arthritis symptoms. They can also teach you techniques for joint protection.

7. Maintain a Healthy Weight: Excess body weight puts added stress on the joints, exacerbating arthritis symptoms. If needed, work on achieving and maintaining a healthy weight through diet and exercise.

8. Manage Stress: Stress can worsen arthritis symptoms, so practice relaxation techniques like deep breathing, meditation, or yoga to help manage stress.

9. Stay Hydrated: Proper hydration can help maintain the lubrication of joints. Drink enough water throughout the day.

10. Consult a Healthcare Provider: If your arthritis symptoms worsen during the autumn and winter seasons, don't hesitate to seek advice from your healthcare provider. They can adjust your treatment plan and recommend appropriate therapies or medications.

It's important to note that the impact of weather on arthritis can vary from person to person, and what works best for one individual may not work as effectively for another. Therefore, it's essential to work closely with healthcare professionals to develop a comprehensive plan for managing arthritis and reducing its impact during the colder months.

Here are some additional ways you can learn more about arthritis and its management.

1. Arthritis Foundation Website

2. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

3. Consulting Healthcare Professionals: For personalized advice and treatment, it's crucial to consult with healthcare professionals, including rheumatologists and physical therapists, who can provide guidance tailored to your specific condition.

Every year countless people strain their backs doing yard work, and are stuck in pain for days or weeks. Before you start raking and hauling the leaves off the lawn, here are a few tips to avoid common yard work injuries:

• Warm-up: It is very important to participate in light warm-up and cool-down exercises. This will help loosen your muscles and has been shown to decrease the likelihood of injury.
• Reduce strain on your back by using gravity to your advantage when raking.
  • Rake downhill. Leaves individually are not heavy, however together they can become tasking. In addition, it is important to tighten your core and to avoid twisting or turning movements.
  • Always use a tarp. Raking leaves onto a tarp allows you to avoid bending down and bagging the leaves every minute or two. Which in turn takes a great deal of stress off of your back. When the tarp gets full, drag the tarp over to where you are planning on dumping them.
  • Don't overdo it! The #1 reason we see people in our clinic is due to overuse injuries. Do not try to rake all the leaves in your yard in one day. Divide the yard into sections and handle a couple sections a day. Raking is a repetitive movement that can lead to overuse of muscles and cause pain. Take plenty of breaks, drink lots of water, and listen to your body. If your back is screaming at you then listen and rest for the remainder of the day.

I hope this helps you stay pain free. With any questions you may have please contact us through the Chat Bot

What is my TMJ?

Pain with chewing can be caused by dysfunction of the temporomandibular joint (TMJ). The TMJ is formed by the mandible (highlighted in blue in the picture below) and the mandibular fossa. The mandibular fossa is a depression in the temporal bone of the skull in which the jaw bone inserts (circled in red below). If there is a dysfunction of this joint, it can lead to a plethora of symptoms including ringing or fullness in the ears, headaches, neck pain, and pain with chewing. 

Pain from the joint 

If there is dysfunction inside the TMJ itself, this can cause pain with chewing. When you open your mouth, the portion of your jaw that inserts into your skull must roll and glide forward. There is a disc inside the joint to lubricate this motion. Sometimes the jaw will slip forward too much in the joint when you open your mouth and slide right off the disc. This causes a popping or clunking sound and is often painful. 

Pain from the muscles 

The muscles of mastication (the muscles you use to chew) can also cause pain when chewing or eating. There are four muscles of mastication: the temporalis, masseter, lateral pterygoid, and medial pterygoid. All these muscles help to either open or close your mouth. These muscles can become painful with TMJ dysfunction or if they are overused such as when grinding your teeth at night. If these muscles are overused they can cause joint restrictions and headaches. 

How can physical therapy help?

Physical therapy can help TMJ pain by addressing both the muscular and internal joint components of this problem through joint mobilizations and soft tissue work. 

This may be the most frequently asked question I get: My low back hurts, what should I do about it? The answer is clear: it depends! There are any number of different anatomical structures and disease processes in the low back that can be the cause of your pain. And sometimes there are no clear causes from any particular structures! We call this non-specific low back pain, and it occurs quite frequently.

However for our purposes we will group back pain into 3 categories:

1. The Annoying Ache

2. The Sharp, Stabbing “I Can Barely Get Out of Bed” Pain

3. The Serious “I Need To Go To The Hospital” Pain

We will deal with number 2 and 3 today. The first thing to cover is the red flags, meaning warning signs that you should head to the ER. Here is a basic list of the most important:

1) Bowel and Bladder Changes: meaning either urinary retention (being unable to urinate), or bowel incontinence (being unable to hold back a bowel movement), although any changes in your bathroom habits should prompt a discussion with your doctor.

2) Saddle Sign: If you have numbness or tingling in the area between your legs or buttocks (anywhere that would be covered by a bicycle seat) then you should also skip straight to the ER. If you want a picture of what this means, find the Wikipedia page for Cauda Equina Syndrome.

3) Significant Neurological Signs: If you are noticing significant weakness, your foot is dropping, your legs are collapsing under you, or both legs are painful, numb, or tingling then you should seek direct attention.

Obviously if your pain is so great that you cannot stand it, then by all means go to the ER. But just pain is likely not indicative of something that needs urgent surgical treatment.

So with those exceptions out of the way, what do I do when I have sharp, stabbing back pain that is keeping me from moving? Here are 3 principles:

1. Total Bed Rest is NOT best: You likely will have to take it easier and modify or stop many of your normal activities that cause an aggravation of your symptoms, but you should not just lay in bed and not move at all.

2. Pay attention to what aggravates your pain: If you know what brought the pain on, that is great. But whether you do or not you should try to take note of things that make the back feel better or worse so you can share this with your PT. For example, “I tend to notice that my pain increases with sitting for a long time or with bending down to tie my shoes, but it feels better when I stand and walk around.”

3. Gentle movements that reduce pain are beneficial. Try things like lying on your back and bringing one, or both knees up to your chest. You can also try lying on your back with your knees bent up, then letting your knees and legs rock back and forth gently from side to side. If you are able to, you can assume a cat/cow or Child’s pose position, or even try a Cobra. All of these depend on if you are able to tolerate the position and movement without aggravation of your pain. Again, gentle movement helps calm the back down, too aggressive and you can re-irritate the back. Your therapist will help you find this balance when you are able to come to your session, in the meantime, try your best and err on the side of caution.

Make sure to check back next time for what to do with that annoying aching pain!

If you are having achy pain in your knees or specifically around your patella (kneecap) with prolonged running, sitting, or with stairs and squatting you may have a condition called Patellofemoral Pain Syndrome (PFPS). This syndrome is caused by irritation and inflammation of the articular cartilage on the underside of the patella (Chondromalacia Patellae) and can be due to various anatomical or biomechanical faults. This does not, however, have to be a lifelong struggle with pain as there are many ways to address the improper movement patterns around the knee that be used to return you to your optimal function. 

 

So what is PFPS? 

When the knee is working properly, the patella will glide smoothly between the femoral condyles in the trochlear groove (see image) during knee flexion and extension. With PFPS, this is not the case and can be due to multiple factors. If you have decreased mobility and/or muscular control at the hip and ankle, this will lead to an improper positioning and tracking of the patellofemoral joint especially during weightbearing activities. This causes an increase in the irritation of the cartilage beneath the patella. Weakness in the quadriceps muscle can also affect the pulley-like mechanics of the patella and play a direct role in patellar movement. Tightness of the connective tissue surrounding the patella (retinaculum) can be another big factor in improper patellar positioning. If the lateral retinaculum is too tight, it can pull the patella out of alignment during knee movements. When someone is suffering from PFPS, they may have one, two, or all of these impairments that contribute to their knee pain. 

What is the treatment for PFPS?

Physical Therapy can be used to alleviate the symptoms of PFPS by addressing the improper biomechanics at not only the knee, but also at the hip and ankle. A Physical Therapist will utilize various tests and measures in their examination to determine the cause of your specific knee pain and the impairments that need to be addressed. These impairments may be limitations in joint mobility, problems with muscular control around the hip knee and ankle, or simply weakness surrounding the joints of your involved leg. While PFPS is not limited to runners, a majority of knee pain with running can be attributed to the patellofemoral joint. If you are a runner, your Physical Therapist can utilize a running gait analysis to better understand what increased stresses are being put on your patellofemoral joint, and at what portion of your gait cycle they are occurring. Regardless of your activity level, your physical therapy treatment will be specifically tailored to your needs in order to get you back to an active lifestyle without being limited by knee pain. 

 

What contributes to my balance?

Balance is essentially made up of three components: your vision, vestibular system, and proprioception. We will break these down further! 

 

Vision and balance:

Vision is one of the major contributors to balance. Looking at your surroundings provides input as to where your body is in relation to the wall, the floor, etc. For example, your brain registers that the wall is vertical in front of you and that keeps your balance in check. If vision is impaired or eliminated it will have significant effects, try to stand on one leg with your eyes closed! 

 

Proprioception and balance: 

Proprioception is knowing where your body is in space. Proprioception is accomplished through the joint receptors in your muscles, tendons, and ligaments. For example, this is how you would know if your finger is bent or straight while closing your eyes. If the muscle, ligaments, and tendons are not doing a proper job with this task, then the input to your brain will be decreased and balance will subsequently be decreased. Ways to challenge proprioception are standing on foam or an uneven surface. 

 

Vestibular system and balance: 

The vestibular system is housed in the inner ear inside your head. This system provides input to your brain about which way your head is turned and if your head is accelerating or decelerating. If the vestibular system lags behind, it can affect your balance during quick movements of the head. Examples are turning your head when you hear an unexpected noise while walking, or looking up to see an airplane. If the vestibular system is lagging, it can also affect eye movement which crosses over into the “vision and balance” portion of this blog. Lagging of eye movement when quickly moving your head can cause imbalance.

 

Other things that might affect balance:

One other thing that may affect your balance is medications. If you have had a recent medication change or change in dosage that could likely be causing light-headedness. This can especially happen with medications for high blood pressure.

Orthostatic hypotension is another condition that can cause light-headedness when going from laying down to sitting/standing, or from sitting to standing. During these positional changes, your blood pressure drops then has to rise back up to where it was. If the blood pressure takes too long to return to normal you will feel light-headed. Those high blood pressure medications are one of the things that can cause this process as they decrease the amount of fluid in your blood. The solution to this problem is to stay hydrated and move slowly when getting up! 

We can help!

If you are experiencing any or all of these conditions, we can help! Same-day/Next-day Appointments are available. Please visit www.frederickpt.com or call (301) 663-7898 for more information.

Many patients that come into the clinic often ask whether they should use ice or heat at home to help with injury, pain, and soreness. Ice and heat are both beneficial when used appropriately to aid in the healing process and help with stiffness or soreness. Cryotherapy and thermotherapy used in isolation without any other intervention is not as effective if it were coupled with exercise or stretching, but can still give temporary relief. It is important to know when to use Ice vs heat to get the best therapeutic results necessary for pain relief. In this blog post, we will discuss the benefits of using thermotherapy(heat) and cryotherapy(ice) for post treatment relief.

Benefits of using Thermotherapy

Thermotherapy is typically a common choice for patients when they begin to feel any soreness, stiffness, or even pain because it is more comfortable and feels better than ice. In some cases, heat can do more damage than good if not used not used appropriately. For example, if there is swelling or inflammation in the area heat may exacerbate symptoms. Heat is most used to relive chronic pain and subdue muscle stiffness or soreness. Listed below are some Benefits of using heat for relief.

• Improves circulation – increases blood flow to affected area
• Relaxes and soothes sore or stiff muscles
• Soothes chronic pain such as arthritis
• Increases blood flow – aids in healing damaged tissue
• Helps to reduce muscle spasms

Benefits of using Cryotherapy

While ice is generally not as popular of a choice, it still has many therapeutic benefits to aid in the healing process. Ice is used for acute injuries, acute pain, or swelling and inflammation. Ice is not indicated if you have impaired circulation, cold hypersensitivity, and impaired sensation. These are just a few reasons to choose another option for pain relief due to risk of further injury. Below are some of the therapeutic benefits of cryotherapy:

• Decreases inflammation
• Reduces swelling
• Decreases blood flow – decreases inflammation and swelling
• Slows nerve conduction – assists with pain relief (short duration)

Summary

Aa a General rule ice is best used for acute injuries, acute pain or to reduce swelling and inflammation, while heat is most effective when used for chronic pain or to relive soreness and stiffness in the body. Heat should not be use when swelling or inflammation are present as it can worsen these symptoms. Cryotherapy and thermotherapy are most effective when used for 15 to 20 minutes at a time. Generally, 20 minutes on and 20 minutes off every hour is optimal to reduce symptoms. If you find yourself with pain or discomfort and the use of ice or heat are not resolving symptoms, stop in to Purcellville Orthopedic Physical Therapy or call us at (540) 751-1970 and we would be happy to get you scheduled for an initial evaluation to get rid of the pain and discomfort you may be feeling. If you have any questions regarding whether it is best to use ice or heat please don’t hesitate to give us a call!

Raise your hand if you have ever sprained your ankle! You likely have your hand raised right now, because most people will experience this injury in their lives. This article will help you know the steps to take when this happens. Ankle sprains happen when the foot rolls inward (most commonly) or outward. The motion goes beyond what the joints can safely handle and often results in a sprain or tear of the ligaments on the outside of the ankle. Many people do not handle these well afterward, falling into the trap of over-protecting or the lure of over-aggressiveness. The key is to thread the needle between these which you can do with the acronym ARMS (yes, ARMS for an ankle sprain, its just weird enough that you'll remember it)

Avoid Aggravation or Additional Injury

1. If a certain movement or activity causes moderate to severe pain or starts off with minimal pain but begins getting worse, then AVOID the activity for the time being.
2. If an activity will place you at high risk for re-injury (playing basketball, hiking really uneven surfaces, jumping on a trampoline) then AVOID this activity.

Rule out a fracture

1. If you are unable to bear weight on the leg, have a large amount of swelling and bruising, or have a lot of tenderness on your ankle bones then you will want to get an x-ray to rule out a fracture.

Maintain Motion:

1. Do not keep your ankle in one position without moving it, unless your doctor or physical therapist expressly tell you to. Make circles with your foot, spell the alphabet, move your foot up and down, all keeping with rule A and not moving into range of motion that aggravates pain.
2. Keep walking, trying to use a normal gait pattern if possible. Still follow rule A.
3. Place your injured foot flat on a step or box and while holding onto a surface with your hands, rock forward letting your knee come over your toes. Go as far as you are able to without pain.

Strengthen/stabilize:

1. Before returning to sport or other activity it is important to get the ankle back to full strength, motion and stability, otherwise re-injury or compensations can occur.
2. This can be done through "4-way ankle" exercises, basic balance training, and stretching.
3. Talk to your physical therapist about an individualized program to return you to your normal activities.

I never thought I would live through something like this. These are surely unprecedented times. Most folks are now working from home and our activity levels are a fraction of what they were a couple of months ago. The combination of sitting at home all day on the computer, the inability to exercise at the gym, the inability to participate in school/sports teams, the inability to run errands, and the refrigerator that is constantly calling our names is a recipe for disaster.

Are your neck, shoulders, or back hurting? It is probably from poor posture, body mechanics, and ergonomics, particularly while sitting at your computer. Or, like most of us you need to take a break to take in some fresh air and do some Spring cleaning and yard work. Are your knees, back, elbows, and wrists sore? It’s all about how we move, how we carry our bodies when performing various tasks and activities, what positions we’re holding ourselves in, and for how long.

Here’s an experiment: take your index finger and pull it back toward the back of your hand. Now, hold it for 10 seconds or so. It’s most likely starting to hurt right? That is because you were putting abnormal stress on normal tissues. This same thing happens when sitting, standing, bending, or crouching for long periods of time—especially if you’re not used to it.

Here Are 5 Tips to Try at Home to Reduce Posture-Related Pain:

1. Schedule a TelePT Appointment!

Did you know that Superior can help you with these things while you’re stuck at home? Yep! Via our new TelePT appointments, we can evaluate your posture and movement patterns during the COVID-19 pandemic and beyond—even if you can’t physically come to our clinic. Using our encrypted, secure, and HIPPA-compliant platform, we can watch how you walk, how you transition to and from sitting to standing, how you sit at your desk or use your computer, bend, lift, rake, garden, and more, right in your own home. In fact, it’s actually an advantage as we can really see how you’re performing your daily activities in the comfort of your own home!

Want to give it a try, or want to learn more about our TelePT option? Give us a call us at our Thomas Johnson or Spring Ridge office, or simply click here to visit our TelePT page. We are here to help and will get through this together!

2. Hydrate!

Our bodies are comprised of at least 70% water. Muscles, nerves, discs, joint structures, and fascial tissues need water to function effectively and efficiently. Drink at least 8-10 8-oz glasses of water a day, preferably spring water (they contain better electrolytes!). A bonus? Filling up on water especially before meals will help you eat less and lose weight as well without thinking about it too much. Talk about a score!

3. Move!

Movement and changing your position frequently helps to redistribute weight-bearing forces on your joints and provides nutrition to your discs and meniscus. The result? A decrease in stiffness and posture-related pain. Get out of your chair often—at least every 40 minutes. A versa desk (an elevating desk) is a wonderful tool to have so you can change from sitting to standing often.

4. Position Yourself in the Optimal Sitting Posture

Make sure you are sitting at a 90-degree angle (a right angle) at your elbows, hips, knees, and ankles, and/or have good support under your feet if you are shorter in stature. Your back should be upright, your low back being supported by a small pillow, thighs should be level with your chair, eyes should be level with your computer, and your mouse should be close so your arm isn’t extended. If you have a large gym ball, you could sit on that as well. Since you can’t slouch on the ball, you’ll need to activate your core muscles and legs to stay on it. It’s a great simple exercise!

5. Spring Cleaning/Yard Work Body Mechanics

We’ll talk more about this in the next blog, but for now, suffice it to say that sprucing up your yard and tidying up your home is an incredibly beneficial activity while being stuck at home.

Just because you’re stuck in and around the house doesn’t mean you have to suffer from the new posture-related pain and aching that comes with it! Give these different tips a try, and definitely schedule a TelePT Appointment! We’d be honored to help you through it.