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Leaps and Bounds: Performance Rehabilitation helps patients with many different conditions. Please see the diagram below for information on common conditions we treat and how physical therapy can help you.

About Knee Pain

The knee is the most complex joint in the body. It has to bear the weight of the body while moving through an incredible range of 130 degrees or more. When running the knee absorbs up to 6 times the weight of your body in force! In a lifetime, it is estimated that the average person will take over 216 million steps and walk 108,000 miles. With this amount of use, at times things can go wrong and lead to knee pain.

Most knee pain stems from the loss of what is called “accessory motions”. Accessory motions are the knee’s smaller movements that are sliding side-to-side, back and forth as well as spinning and rotating. Without consistent stretching, and especially without being very active, the tissues around the knee become tight and sore. In addition, if the muscles in the front or back of the knee become weaker, that can lead to more abnormal forces on the knee joint.

All of these problems lead to increased tissue sensitivity of the knee. The normal response is one of inflammation that can be felt as pain in and around the knee.

Knee Sprain / Strain

Sprains refer to injuries of the ligaments (connect bone to bone) and strains refer to injuries of the muscles or tendons (connect muscle to bone). Sprains and strains occur from quick over-stretching of the tissues, sometimes under contraction, causing micro-tearing and subsequent injury. Swelling begins as part of the inflammation process, causing pain and difficulty with movement.

About Meniscus Injury

The meniscus is a ring of cartilage on the lower part of the knee (the tibial plateau) that is responsible for providing cushioning and stability of the knee joint while guiding movement. It is connected on the outer edges to the thick ligaments around the knee. The inside part of knee (medial meniscus) bears more weight and often sustains more damage than the outside part (lateral meniscus).

The meniscus is supposed to be smooth to ensure good gliding of the knee when it is bending. With injuries, the meniscus can become bruised and even torn. The outside edges of the meniscus have more blood flow than the inner portions. This means, depending on the area where the damage is located, the healing process can be slow.

Many times, meniscus injuries are mild to moderate and can be rehabilitated with physical therapy. However, at times surgical intervention may be necessary to clean and shave down the torn areas of the meniscus. Physiotherapy is very important in the full recovery after this surgical procedure.

About Knee Tendonitis

The ending of the word “itis” is defined as inflammation. Therefore, tendonitis is inflammation of a tendon, which connects muscles to bones. Commonly, the tendon that connects your quadriceps muscle to the tibia bone can become inflamed, resulting in a condition also known as jumper’s knee. This structure can often become inflamed due to abnormal joint movements, improper loading, and weakness of the surrounding musculature. This causes a reaction of the tendon, resulting in pain during repetitive movement and especially with squatting or kneeling down.

About Anterior Cruciate Ligament (ACL) Tears

The anterior cruciate ligament (ACL) is an important ligament that checks the backward  sliding of the femur bone on the tibia bone in the knee, when the foot is planted. This ligament injury is often seen in sports, especially with blows to the knee from the side, while the foot is planted on the ground.

It is common to undergo an ACL repair or reconstruction surgery when the tear results in gross instability of the knee.  Physiotherapy is vital to rehabilitation, both prior to the surgery, and for months afterward. Recovery does take time and the goal is to protect the surgery site, maintaining stability, while getting back into walking, running, and other sport-specific activities.

We are starting to see some research in which people are able to rehab their ACL tear without surgery. Very exciting stuff!

About Posterior Cruciate Ligament (PCL) Tears

The posterior cruciate ligament (PCL) is an important ligament that checks the backward sliding of the tibia bone on the femur bone in the knee. This ligament injury is often seen in sports, especially with blows to the front of the knee while the foot is planted on the ground, or in falls especially when landing on a flexed knee.

PCL repair or reconstruction is not as common as ACL repair. When indicated, physiotherapy is vital to the rehabilitation both prior to the surgery, and for months afterward. Recovery does take time and the goal is to protect the surgery site, maintaining stability, while getting back into walking, running, and other sport-specific activities.

About Medial Collateral Ligament (MCL) Tears

The medial Collateral ligament (MCL) is an important ligament that checks the side to side sliding of the femur bone on the tibia bone in the knee. This ligament injury is often seen with sports or falls, especially with blows to the outside of the knee while the foot is planted on the ground. It is common for the MCL to be injured along with the medial meniscus.

When indicated, physiotherapy is vital to the rehabilitation both prior to the surgery, and for months afterward. Recovery does take time and the goal is to protect the surgery site, maintaining stability, while getting back into walking, running, and other sport-specific activities.

About Lateral Collateral Ligament (LCL) Tears

The lateral Collateral ligament (LCL) is an important ligament that checks the side to side sliding of the femur bone on the tibia bone in the knee. This ligament injury is often seen with sports or falls, especially with blows to the outside of the knee while the foot is planted on the ground.

When indicated, physiotherapy is vital to the rehabilitation both prior to the surgery, and for months afterward. Recovery does take time and the goal is to protect the surgery site, maintaining stability, while getting back into walking, running, and other sport-specific activities.

About Total Knee Replacement

A total knee replacement surgery may be needed when the knee has suffered a significant trauma or may be due to severe arthritis. In a total knee replacement surgery, the ends of the femur and tibia bones, and backside of the kneecap are replaced. With a partial knee replacement either the end of the femur bone or tibia is replaced. There have been many advances in the technology of the total knee replacement prosthesis and procedures allowing for less invasive surgery and faster recovery times.

Typically people have suffered for a while before having surgery, leading to changes in walking, muscle strength and function. Physiotherapy before surgery in general has shown to help with the speed and quality of recovery after surgery.

About Knee Post-surgery Rehab

Other types of surgeries for the knee are fracture repairs or ligament / tissue repair from trauma. The amount of force it takes to break bone means that the soft tissues around the knee are most likely significantly injured also. After surgery, due to limited movement, range of motion is lost as well as strength. Since walking is a very complex action of different muscles moving in a coordinated fashion, it can be difficult to walk after a knee surgery.

Difficulty Walking

It takes us at least 12 months as a baby to learn the fundamentals of walking. It takes even longer to learn how to walk properly and eventually run. Walking is very complex and requires good balance, the ability to know where your joints are in space (proprioception), the ability to know how your joints are moving (kinesthesia), good range of motion and strength.

When walking patterns change due to age, injury, or disease, abnormal stresses from everyday activities can be transmitted to areas it shouldn’t. This can result in pain and discomfort in the hip and other areas of the body. The good news is that if you have difficulty walking, you can be helped. Physiotherapists are the experts uniquely trained to do so.