Most of us have heard of shin splints, but I’ll bet than many don’t really understand what shin splints are. Typically if a patient describes pain in the front of the lower leg, it will be diagnosed as shin splints. Let’s talk about the causes and treatment of this condition.
This condition is common in people who do a lot of running, as well as with people who have jobs that involve excessive standing or walking. The pain is typically felt in the front of the lower leg bone, the tibia. It is often described as a throbbing pain, or a deep ache, but also can produce sharp pain as well. The interesting thing is that although the pain feels as if it is coming from the bone, it is typically produced by the soft tissues that attach to the bone. This includes the tibialis posterior muscle, which is attached on the posterior (back) side of the tibia bone. This muscle is active whenever we are bearing weight on our leg. It helps to keep the arch of our foot from collapsing during weight bearing. People who have flat feet/arches would be more prone to developing this condition, as the tibialis posterior muscle will work hard to try to support the collapsing arch.
In terms of treatment, there are a couple of things to consider. First, a precautionary X-Ray or bone scan is often a good idea, as repetitive stress on the shin (especially in long distance runners) can lead to a stress fracture. If this is ruled out, then we treat the soft tissue problem. As always, we want to identify the cause of the problem, not just treat the symptoms. Patients can take anti-inflammatory meds, or ice the painful area, but these will only provide temporary relief and will not address the cause of the pain. We first need to look at the lower leg and foot alignment to see if an orthotic is indicated. If a patient has poor foot structure (especially flat arches, but sometimes excessively high arches), a shoe insert to support the arch can relieve stress from the lower leg muscles (tibialis posterior) that have to work excessively to support the arch. We also want to make sure that the patient has full range of motion and flexibility in the lower leg/ankle/foot region, as well as good muscle strength in the lower leg/ankle/foot region. A gait evaluation and possibly a running assessment are also indicated to identify abnormalities which may be contributing to the condition.
If you have been dealing with shin pain, please give us a call so that we can help you! This can be a difficult condition to treat, but it is treatable, especially with the help of an excellent physical therapist.
By: Mason Riegel, PT
1. What is osteoporosis?
Osteoporosis is a term many people are familiar with – it’s when one’s bones become weak and brittle from losing too much bone (becoming too “porous” – hence the term osteoporosis), or from making too little bone. It is dangerous because weak bones are more susceptible to breaking from falls, bumps, and accidents. Also, it can affect vertebrae and lead to hunched posture, often resulting in pain. Osteoporosis is especially prevalent in women and older populations.
There are MANY causes of osteoporosis, and it can occur in conjunction with dozens of different medical conditions and medications. This is an important conversation to have with your primary care physician to see if you are putting your bone health at risk.
2. How is it treated, and how is it prevented?
Half of women over 50 who have osteoporosis will break a bone. If you know you do have osteoporosis, is your condition hopeless or is there something you can do to take care of your bones?
Osteoporosis cannot be “cured”, but there are measures one can take to treat it. Doctors sometimes prescribe medications (bisphosphonates, prolia, forteo, estrogen-like drugs, fortical, and more) that work either by preventing the breaking down of bone or by increasing the building of bone, but all come with side effects. Depending on the severity of your osteoporosis, a medication treatment may be worth discussing with your doctor. Each person is unique, and a different treatment may work better for one person than another
Nutrition is another key component of treating (and preventing) osteoporosis! Calcium is the “building block of bone”, and your body needs vitamin D to help absorb the calcium. Daily multi-vitamins are one way to ensure you’re getting enough calcium and vitamin D, but here are some foods that are calcium-rich and vitamin D-rich (and don’t forget good old sunshine!) Most adults should aim for 1000-1200 mg of calcium, and 400-1000 IU of vitamin D daily.
Lastly, exercise is key for keeping your bones strong. Proper and consistent exercise not only strengthen your bone density but also will strengthen the muscles and tendons that connect to and support your bones, relieving pressure from your joints. Exercise for treatment and prevention of osteoporosis should include two types of exercise: weight-bearing exercise, and muscle-strengthening exercise.
Weight-bearing exercise puts stress on your bones - "good stress". This stress increases production of bone - increasing your bone density and mass or reducing the loss of bone mass. (If you want to learn more about how bone production and loss work check out this video on bone remodeling!) To exercise and use this "good stress" on your bones, do activities like running, walking, tennis, dancing, or anything repetitive on your feet. The impact on your bones actually makes them stronger. HOWEVER, if you suffer severe osteoporosis, you should consult your doctor about what exercises are safe for you to participate in. Running may not be the best exercise for someone with severe osteoporosis who is at a high risk of breaking a bone.
Muscle-strengthening exercise (“resistance” exercise), should be done for the whole body. If you’re just going to do a little bit, focus on complex movements and large muscle groups. Strengthening the legs, hips, and glutes are going to give you the support you need and this lower body strength may help prevent falls! Core and upper body strengthening are also important. If you already have osteoporosis, consider adding some fall-prevention exercises to your day, like balancing on one foot.
If you do not have osteoporosis now, remember that the best solution is prevention!
By: Lisa Bartz, C-EP
National Osteoporosis Foundation: What is Osteoporosis and What Causes It? 2018;
The American Society for Bone and Mineral Research: Response to New England Journal of Medicine Study: “Biphosphonates: Where Do We Go From Here?” 2012;
Endocrine Web: The Role of Calcium and Vitamin D in Bone Health: Nutrients for Osteoporosis Prevention, P. Camacho, MD, D. Toft MD, PhD
WebMD: Osteoporosis: Diagnosis and Treatment, 2017
Unfortunately, knee pain is common. The good news is, many cases of knee pain can be prevented, treated, and reduced or eliminated with proper treatment and exercise!
Here are a few tips for dealing with you knee pain. Remember, knee pain has many causes, and if you’re dealing with acute pain, severe pain, or knee pain from trauma, you should see your doctor or physical therapist to find the cause of your knee pain.
Air squats Backward lunges
Glute bridges Single leg balance
Calf raises Donkey kicks
Calf stretch 1 Calf stretch 2
Quad stretch Hamstring stretch
When should you see a doctor? If your pain is new, very painful, or persistent, it is a good idea to see a doctor or physical therapist right away and get advice on what treatment you may require or what your next steps should be.
By: Lisa Bartz, Certified Exercise Physiologist (C-EP)
One of the common conditions that we treat here at Hudsonville Physical Therapy is muscle tension headaches. Headaches can be a very complex condition, with many different contributing factors. However, when it is determined that the headaches are “muscular” in nature, physical therapy is a very effective solution.
One of the most common causes of muscle tension headaches is poor posture. When we sit or stand with correct posture, our head is centered over our torso, and is in a balanced position. However, many people do not sit or stand with proper posture. Our typical posture is what we refer to as a “forward head” posture, where our head is out in front of our torso. Heads are quite heavy (14-16 pounds on average), and when the head is in front of the torso, gravity is pushing it downward. So in order to keep our head up, the muscles in the back of our neck and shoulders have to continually hold our heavy head up. Over time, this causes the muscles to fatigue and get tense, leading to muscle tightness and pain.
Another cause of muscle tension headaches is stress. People tend to carry their stress through their neck and shoulders, leading to abnormal amounts of tension and lack of rest for the muscles. Over time this takes its toll and leads to chronic muscle tension and headaches.
Most people will begin taking some type of medication (pain relievers or anti-inflammatories) to treat their headache. This can provide short term benefit, but unfortunately is not a long term solution because medication does not treat the cause of the pain, only the symptoms. However, physical therapy gets to the root cause of the problem and provides a long term solution!
So what is this solution to muscle tension headaches? Typically it involves several of the following interventions:
1. Postural Education. It is essential to teach our patients proper posture so that they can eliminate the strain on their muscles caused by faulty posture. If we do not do this, the headaches will likely return. This includes identifying potential posture problem areas including use of laptop computers or cell phones.
2. Identifying stress and the body’s response to it. People often know why they are stressed, but have difficulty eliminating the effect of the stress on the body. One effective technique is by teaching correct breathing. When stressed, people often breathe with their “accessory muscles” through the neck and shoulders. This leads to shallow, quicker breathing and increased tension through the neck and shoulders. The diaphragm is supposed to be our main breathing muscle, and the diaphragm is located in the abdomen. When we breathe correctly, we use our diaphragm (abdomen) to breathe, which results in deeper, more efficient breathing. This breathing provides more oxygen to our body, which it needs. Diaphragmatic breathing also eliminates tension in the neck and shoulder muscles and helps our body to relax.
3. Soft tissue massage. When muscles have been tense for a long period of time, it’s almost as if they don’t know how to relax anymore. A skilled physical therapist is able to work on these tight muscles and release this chronic muscle tension, which can be extremely helpful in eliminating symptoms.
4. Stretching and mobility exercise. Tight muscles lose flexibility, resulting in reduced range of motion in the neck. PT can help to stretch these tight muscles and restore full range of motion in the neck, which enables the body to move without compensation.
5. Exercise. We need to identify the proper muscles to strengthen, so that the muscle tension problems do not return due to having weak muscles. This includes strengthening the deep cervical flexor muscles (front of the neck) as well as the scapular and shoulder girdle muscles. Maintaining a good exercise routine often makes the difference between having chronic headaches and being headache free.
Those are just some of the treatment interventions used by physical therapists. In all cases, it is important to have a thorough physical therapy evaluation to determine your specific needs. If you have been struggling with tension headaches, give us a try. You’ll likely wonder why you didn’t do it sooner!
By: Mason Riegel, PT
What is frozen shoulder and why do so many people over 40 develop it?
Adhesive Capsulitis, otherwise known as “Frozen Shoulder”, is a condition where your shoulder joint becomes stiff and painful. There are typically three stages to Frozen Shoulder:
The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. (Mayo Clinic) Doctors are not sure of the exact cause why this happens to people but it is more likely to happen to people who have had to immobilize their shoulder for a long period of time, like after a surgery or injury.
Keep moving! There are many exercises and stretches you can do to keep your shoulder mobile:
1. Pendulum stretch
2. Finger walk
3. Cross-body reach
Call us at Hudsonville Physical Therapy if you are experiencing shoulder pain or stiffness! 616-662-0990
By: Becca Popma
Do you know someone who has had a total knee or total hip replacement? Often times these individuals will be very excited to share the success they have had from their surgery in reducing their long-standing pain. However, what most people conveniently forget is the initial discomfort and pain they had rehabilitating their new joint immediately after surgery.
Many of our patients discuss their current (mid-rehab) condition with those that have gone before them and feel like they should be progressing faster than their current status. A total knee replacement is a major surgery where the surgeon cuts through bone and soft tissue, and then inserts a new prosthetic joint. This trauma alone can take 6 to 8 weeks to heal, and causes pain, swelling, soreness, stiffness, and weakness. Swelling alone can cause significant pain and stiffness in a joint until it begins to diminish.
It is critical to be patient and focus on the small improvements that you'll see day-to-day during the rehabilitation phase of your recovery. Most people notice slight reductions in swelling, slight improvements in their range of motion or ability to perform various functional activities such as transferring from a chair, squatting to the toilet, or dressing.
It is important to communicate to your physical therapist whether you're seeing the slight imporvements or if things are worseing. This helps give him or her clues as to how to best progress you with your rehab program.
Remember, the new "bionic part" that was inserted requires you to adapt and adjust to it as it heals!
Call us if you have any questions about total joint replacements and post-operative rehab: 616-662-0990.
By: Steve Bartz, PT
When elbow pain strikes, what do you do? First, let’s take a look at what causes elbow pain. There are many different types of injuries related to the elbow. Today, I want to touch on two of the most common. They are easy to diagnose, easy to treat but can be difficult to totally get rid of the pain.
The two most common diagnoses are “Tennis elbow” and “Golfer’s elbow”. Tennis elbow’s clinical name is Lateral Epicondylitis. It is the inflammation of the common extensor tendon of the forearm and is located on the outside of the elbow.
Golfer’s elbow’s clinical name is Medial Epicondylitis. It is inflammation of the common flexor tendon of the forearm and is located on the inside of the elbow.
For the non athlete, there are many things that can cause or bring on these conditions. The two most common are 1) A strenuous or aggressive activity, like swinging a heavy hammer or lifting something very heavy, or 2) A repetitive or overuse activity, such as factory line work or keyboarding.
The good news is they are easy to treat!
1. REST. Avoid any activity that causes pain.
2. ICE. I feel that an ice massage for 5 minutes is most effective.
3. STRETCH the affected area. This is done by putting arm straight out in front. Pull wrist up to stretch the flexors for Golfer’s elbow or wrist down for Tennis elbow. Hold stretches for 10 sec for about 5 reps.
4. Lastly, you can purchase a STRAP to wear around your forearm about an inch below your elbow to give you some relief.
Now, as I mentioned earlier, although these conditions are easy to treat they can be hard to totally get rid of. Give it a month or so, and if it does not improve with these 4 tips, let your local Physical Therapist give you a hand. One last thing to remember: don’t let this condition go, the longer you wait the tougher these conditions are to treat.
By: Brian Colvin, PT
People often have pain in their bodies that they hope will just heal on its own. Many go for days, weeks, and even months, but see no change and get discouraged.
If you are one of those wondering if getting physical therapy will help, we have a free, no-strings-attached option for you.
At Hudsonville Physical Therapy you can set up a completely free consultation with one of our licensed physical therapists.
They will sit down with you and evaluate whether PT is a good option for you. They will give an honest opinion on if they think we can help, and if so, explain what physical therapy for your condition would look like, and how they can help you.
This first step has helped many people make an informed decision on whether to move forward with this type of treatment.
Make a decision today to take a hold of your health and start feeling better! Our staff is available and committed to serving you in any way we can.
To set up a free 15-min consultation just call our office at 616-662-0090.
By: Sherri Prins
A frequent complaint is people cannot sleep at night because of back pain.
Often this is due to sleeping with a broken down, old mattress. Typically after about 10 years mattresses tend sag more do not offer the right amount of support. If this is your mattress consider purchasing a new mattress. According to Consumer Reports, conventional inner-spring mattresses, foam mattresses and air mattresses like Select Comfort mattresses all can provide good and adequate support. Their findings show that the key to long-term success of a mattress, is how much time you spend in the show room testing the mattress you eventually purchase. The more time you put into selecting a mattress in the showroom, the better likely you will satisfied with that purchase.
Another consideration is in what position you sleep at night. Specific sleeping positions will react differently to various problems people have in their backs.
For example, elderly people with arthritis in the spine often do not tolerate lying on their stomachs because it tends to extend their back. If that is the only way you can typically sleep, you may want to place a pillow under your abdomen to try to reduce the amount of arch your back.
Some people will have pain lying on their backs. These individuals could try placing a pillow under their knees to try to take some pressure off of their spine.
Side sleepers will often try putting a pillow between their knees to relieve their symptoms.
If these don’t work, you can try to sleep on a recliner chair. The amount of reclining can be adjusted by the position of the chair or propping pillows in various places to adjust for optimal comfort.
Finally consider the pillow you’re using. Too high or too low for pillow can put your spine in a compromise position affecting a good night sleep. Experiment with not only the height of the pillow but the amount of support put through your neck. Often rolling up a small towel and placing it in your pillowcase with the roll nearest your neck and away from your head can give support for your neck when in side-lying or laying on your back. Many stores sell orthopedic pillows, which provide an extra amount of neck support.
If all else fails, see a physical therapist or your physician for ideas or options available to you to rehabilitate your situation.
By: Steve Bartz, PT
What do you do when you get a "Charlie Horse" in your leg? How can you prevent them?
Typically, Charlie Horses are muscle spasms of either the hamstring or calf muscles. They occur when the muscle is suddenly contracted after being in a shortened state (like waking up in bed with a sharp cramp) or when over-exerting the muscle such as when sprinting.
To prevent these it is important to gently stretch the muscle regularly to train it to handle the stretch without going into a spasm. Calf and hamstring stretching can help with this. Long slow repetitive stretches can reduce the chances of the spams, especially before bed. Good diet and hydration may help also.
So what do you do in the middle of a Charlie Horse to try to get relief? A very effective but tricky way to reduce a spasm in your calf while in bed would be to immediately role over onto your stomach and let the bed hold your foot in a position that points your toes down (away from you). It is important you do not actively try to point your toes down while getting into this position. By taking the stretch off the muscle, it can relax quicker.
The same is true for the hamstring. Try to pull your knee into a more flexed position using your hand and NOT flex your knee with your leg muscles. Relax and wait for the muscle to relax.
Most people to quickly LENGTHEN the muscle, but this can put the muscle into a sharper spasm. Here, we are trying to shorten the muscle further without contracting it.
By: Steve Bartz, PT
Steve Bartz, PT