Category Archives: Physical Therapy Clinic

Physical Therapy: Post Below- Knee Amputation

Below-knee amputation or lower–knee amputation is a surgical process conducted to remove a limb damaged due to any injury, trauma or disease. The process of amputation can be performed at any age, but is more prevalent among the age group of 65 years and older.

What do we mean by Beow-Knee Amputation?

Below-Knee Amputation or BKA is a surgical process to remove the damaged or diseased limb. The main reason behind BKA (Below-Knee Amputation) is peripheral vascular disease or poor circulation in the lower limb. Due to poor circulation; immune or healing responses to injury limit and foot or leg ulcers may form that do not heal. These damaging ulcers may develop infection spreading to bones. Amputation is conducted to remove these diseased tissues and to prevent further infection.

During  BKA, an orthopedic or vascular surgeon removes the diseased limb while saving as much of healthy bone and tissue as possible. The remaining limb is then shaped up, so that it can be used for a prosthetic leg.

How can a Physical Therapist help?

Below-knee Amputation is a very difficult and challenging phase, both emotionally and physically. More energy and strength is required to walk with a prosthesis than normal walking. Your physical therapist can  develop an individualized exercising regime which will not only increase your overall strength, range of motion and flexibility, but will also expedite your recovery and reduce time between amputation and first step with a prosthesis.

Post Amputation Rehabilitation:

Physical Therapist will start your routine as soon as your condition stabilizes and doctor clears you. Your initial treatment may include:

  • Range-of motion and gentle stretching exercises
  • Instructions to roll on the bed, sit on the bedside and safely moving to the chair
  • Educating about the proper positioning of limb to prevent contractures
  • Educating to move about in a wheel chair and to walk and stand with a supportive device.

 Preventing Contractures:

Contractures mean the development of tightness of the soft-tissues which further limits the mobility and motion of the joint. After BKA,  the most common contracture that follows is, at the knee when it becomes flexed and it is difficult to straighten it. If these contracturers are not dealt with, they make it difficult for you to walk properly or wear prosthesis and as well increase the need of supportive device like a walker. Your physical therapist will help you to:

  • Maintain normal  posture and range of motion at your knee and hip
  • Position your limb properly and prevent developing contracture
  • Maintain normal range of motion through stretching and positioning exercises.


Experiencing post-operative swelling is normal. Compression will be maintained by the therapist in order to protect your residual limb and to lessen and control your swelling. The physical therapist will accomplish compression by:

  • Wrapping the limb with elastic bandages
  • Making you wear elastic Shrinker sock.

This also helps to shape the limb in order to prepare it to fit it in prosthetic leg. Your physical therapist will monitor the fit of these devices and as well educate you to use them properly.

Managing Pain:

Your physical therapist will also help you to manage pain in several ways involving:

  • TENS and electrical stimulation may be used where pain is relieved by blocking nerve signals.
  • Manual therapy; involving joint manipulation and massages may be used to improvise circulation and joint motion.
  • Stump management is instructed which includes skin care and stump sock use.

  Other Management Techniques:

  • Your Physical therapist will work with prosthetist in order to prescribe best fit prosthesis for you. Initially, you will receive a temporary prosthesis while your residual limb is healing; thereafter, it will be modified according to your need & requirement
  • Your physical therepist will help you to master using wheel chair and walking with a supportive device like cruthes or walker.
  • Therapist will educate you about using your prosthetic limb successfully and will also make you learn how to take care of your resideual limb with regular skin and hygiene checks, exercising and correct positioning.
  • Therapist will also educate you how to put new prosthesis and take it off.
  • Therapist will also help you to build up tolerance for wearing your prosthetics for longer times while protecting skin intergrity of residual limb.
  • Prosthetic training takes time and physical therapist make you learn to stand, balnce and walk with a prosthetic limb. You may progress gradually and eventually learn to walk independently, without using any supportive device.
  • Your therapist will also continue with stretching and strengthening exercises unless you achieve your fullest potential and become able to perform the activities you used to before amputation.

Contact Alliance Physical Therapy for thorough and agile post below knee amputation rehabilitation. Our professional physical threrapists are experienced at treating patients with amputation conditions. Our dedicated therapists have advance knowledge and are experienced at providing prosthetic training.

Physical Therapy Treatments for Running & Jogging Injuries

Running seems simpler and easier to everybody as all of us start running as toddlers and many of us continue with this activity throughout either for play, sports or exercise. But if the correct form is not maintained, this simple act can lead to serious injuries.

What causes running injuries?

When you start running for fitness, you particularly become prone to running injuries. There are certain stages at which you become more vulnerable to running injuries, like:

  • During the initial 4 to 6 months of running
  • Returning to running after injury
  • Increase in distance of running
  • Increase in speed

But the fact is, during these vulnerable stages, most of the injuries occur due to the training errors. Apart from these, there are several other factors that also contribute towards the running injuries. These are the factors that runners can avoid or prevent:

Training Errors: The most common cause of running injuries is the erroneous training regime. Inadequate stretching, frequent changes in mileage, heightened hill training, interval training and inadequate rest between training sessions all together make up for training errors.

Defective Running Shoe: An athlete should always select the footwear that fits comfortably and can accommodate his particular foot anatomy. You should replace your shoes after its mileage exceeds 500-600 miles.

Surfaces for running: The surface on which you run needs to be smooth, flat, soft and adaptable. Try to avoid concrete or rough road surfaces. Moreover, try to avoid hills initially as they place stress on knees and ankles.

What are the Common Running Injuries?

Most of the running injuries cause by applying repeated force over a long period of time. Whether you are a newbie or vet; sudden changes in training volume can cause any of the following injuries:

Runner’s Knee: When you experience a consistent tender pain around or behind the kneecap; it is a sure sign of patella femoral pain syndrome or runner’s knee. The repetitive force, downhill running, muscular imbalance and weak hips putting stress on the knee cap can cause the condition.

Achilles Tendinitis: The swelling of tissues connecting your heel to lover-leg muscles is known as Achilles Tendinitis. Rapid increase in mileage, improper footwear, tight calf muscles and flat foot contribute towards the condition.

Plantar Fasciitis: Inflammation, irritation or tearing of plantar fascia; tissue on the bottom of the foot is known as plantar fasciitis. Runners experience extreme stiffness or pain in the arch of the foot due to the condition.

Shin Splints: When the muscles and tendons covering the shinbone become inflamed and runners experience stabbing sensations in the shin; the condition is called shin splints.

Stress Fracture: Stress Fractures are the tiny cracks in the bones that occur due to repeatedly applying the greater force than the legs can bear.

Patellar Tendinitis: It is an overuse injury which leads to tiny tears in patellar tendon that connects kneecap to the shin bone.

Pulled Muscles: When due to overuse or inflexibility, a muscle is overstretched, it can tear fibers and tendons causing pulled muscles

Side stitches: Awful pain on the side of the stomach formally known as exercise-related transient abdominal pain (EJAP) caused due to diaphragm spasm because of overwork or poor running posture

Bursitis: Bursitis of hip develops because of the inflammation of a bursa between the hip and the tendon.

What are the Physical Therapy treatments suggested for Running Injuries?

A physical therapist begins treating an injured runner by conducting physical evaluation and asking questions about his running habits, regime, equipments and techniques. The therapists usually begin by suggesting patients to take rest and modifying his/her running habits. In order to prevent recurring injuries; physical therapists develop pre-and post-workout routines for them with strength work, warm-ups, stretches and cool-downs. Other specific treatments may include:

For knees: Physical therapists may suggest stretching and strengthening of hamstring, quadriceps and hip musculature along with cold therapy. Modalities like ultrasound and supportive or corrective taping techniques may also be applied.

For ankle pain and sprains: Physical therapists may suggest strengthening exercises to enhance stability. Foot orthotics may be suggested. Moreover physical therapists may also suggest massage, ice, ultrasound or electrical stimulation for tissue healing.

For Achilles Tendon Pain: Most of the times, therapists suggest rest and limited use as these are best to treat the problem. Apart from this, a therapist may also suggest heat and cold therapy, ultrasound and massage therapy to reduce swelling.

For Foot: Special shoe inserts or foot orthotics and other modification are suggested so that shoe fits properly. Therapeutic exercises accompanied by modalities like manual treatment techniques and ultrasound may also be suggested.

For Shin Splints: Deep tissue massage may be used to reduce inflammation. Supportive taping may also be applied to alleviate stress within the affected region.

For Plantar Fasciitis: Arch supports, soft-tissue massage are used to alleviate pain. Calf stretches before and after workouts may also help.

For Bursitis: Therapists will suggest stretches to restore full hip motion and to reduce friction.

Contact Alliance Physical Therapy for the expert diagnosis and state of art treatment of your pain and injuries. Our diligent team of physical therapists use patient-proven techniques and state-of-art technologies to make you as healthy and fit as before.

Physical Therapy Treatment for Spinal Stenosis

According to a study made, as many as 75% of us suffer from back pain or neck pain at some point of our lifetime. Spinal Stenosis is also one of such causes of back pain that affects the bones of your back by narrowing the openings within the bones.

What do we mean by Spinal Stenosis?

Spinal Stenosis is a condition causing the narrowing of spinal canal which in turn puts too much pressure either on the spinal cord or the nerve roots. Staying active and exercising regularly is the most efficient way to treat Spinal Stenosis. This condition can occur both in the neck or the lower back.

What are the most common causes of Spinal Stenosis?

Most of the major causes of Spinal Stenosis are related with the ageing process of spine. It may occur due to:

  • Gradual degenerative ageing process of spine
  • Thickening and calcifying of spinal ligaments
  • Bone spurs due to the enlargement of bones and joints that occurs due bone stress
  • Dehydration of spinal discs between the vertebrae due to age
  • Spinal osteoarthritis that is accompanied by the overgrowth of bone formation or bone spurs
  • Flattening of discs due to normal ageing and wear and tear
  • Spinal injuries, tumors and bone diseases like (Paget Disease) may also lead to Spinal Stenosis

What are the signs and symptoms of Spinal Stenosis?

Spinal Stenosis may cause the following symptoms including:

  • Weakness, pain, tingling or numbness in the arms, legs, trunk or shoulders
  • Muscle weakness
  • Diminished reflex cramping in the arms or legs
  • If your Lumbar Spine is stenotic, you may feel pain radiating from the low back and into the buttocks and legs
  • If a nerve root is being pushed on due to the narrowing of space within the spine, you may feel pain radiating to nerve which reduces with sitting

What are the Physical Therapy treatment options opted to treat Spinal Stenosis?

Your physical therapist will design treatment program for you depending upon the evaluations’ and your personal goals as well. He will suggest a treatment program that will be a combination of different exercises:

  • Stretching exercises may be suggested to eliminate stress on joints and to improve flexibility as well
  • Work ergonomics to improve your posture at work
  • Strengthening exercises may be recommended to support your spinal joints for strong arms’ and legs’ muscle
  • Manual therapy may be administered to improvise joint mobility
  • Deep tissue massage therapy may be used to release tension in the soft tissues
  • Hot and cold therapies may be applied alternatively to eliminate inflammation, muscle spasms, pain and swelling
  • TENS and Ultrasound therapy may be used to treat muscle cramping, stiffness and pain
  • Aquatic exercises may be suggested to help your body to exercise without putting pressure on the spine

Contact Alliance Physical Therapy for the state-of-art and efficient treatment of any of your musculoskeletal problems or diseases. Our professional and diligent Physical Therapists use patient-proven methods and top-notch techniques to treat your problems and help you to get back to your work as early as possible.

Piriformis Syndrome: Causes, Symptoms and Treatment

Piriformis muscle is a flat and band like muscle that is located in buttocks near the top of the hip joint. This muscle helps in the movement of the lower body as it makes the hip joint stable and as well lifts and rotates the thigh.

What do we mean by Piriformis Syndrome?

Piriformis Syndrome is an uncommon neuromuscular pathology which occurs when the sciatic nerve is compressed by the piriformis muscle. This compression causes pain, tingling and numbness in the buttocks and along the sciatic nerve path going down the thigh into the leg.

What are the potential signs and symptoms of Piriformis Syndrome?

  • Pain in lower back or buttocks
  • Painful to sit on the affected buttock
  • Pain or tingling sensation down the back of legs
  • Pain down the back of calf & foot
  • Pain while mounting and inclining stairs
  • Pain increases with prolonged sitting
  • Reduced range of motion of the hip joint

What are causes of Piriformis Syndrome?

Piriformis Syndrome usually develops in the athletes who are engaged in forward-moving activities like runners or bicyclists. This syndrome generally occurs due to:

  • combination of weak abductors with the tight abductors
  • Stiffness or hypo-mobility of the sacroiliac joints
  • Overporonation of the foot
  • Overworking of Piriformis muscle
  • Dysfunctioning of the adjacent SIJ or hip joints
  • Work hip stability muscles

What are the Physical Therapy treatments suggested to cure Piriformis Syndrome?

Depending upon the severity of condition, pain and other symptoms, number of physical therapy treatments may be suggested:

  • Stretching exercises are prescribed to relieve sciatic nerve irritation.
  • Heat treatment is suggested to relax the piriformis muscle.
  • Ultrasound treatment is advised for the deep heating in buttock area.
  • Hands-on treatment like deep-tissue massage or soft-tissue mobilization is administered to relax nerve signals to the piriformis.
  • Strengthening of abductors and abductor muscles may be suggested.
  • Myofascial release and thrust techniques may be suggested to address the somatic dysfunction in the patients.
  • Osteopathic manipulative treatment (OMT) may be advised to restore patients’ normal range of motion.
  • Pelvic and spine re-alignment techniques are suggested.
  • Foot orthotics or exercises are advised to restore foot and lower extremity alignment.

Contact Alliance Physical Therapy for the state-of-art and efficient treatment of any of your neuromusculoskeletal problems or deformities. We use patient proven methods and techniques to get you back to your daily routine as soon as possible and make you as sturdy and healthy as before.

Foot Drop: Causes, Symptoms and Treatments

What do you understand by Foot Drop?

Foot Drop, also referred to as ‘drop foot’ is a gait abnormality, where person is unable to lift his/her forefoot and hence walking becomes challenging for such persons. Foot drop is not a disease in itself but rather a sign of underlying foot disorder that can be neurological, muscular or anatomical. Foot Drop can affect one or both the feet and as well be temporary or permanent depending upon its cause.

Under this condition, patient loses partial or total control over the foot. The toes of such patients either point towards floor when they lift up the foot from the ground or they tend to drag the foot along the ground while walking.

What conditions give rise to Foot Drop?

Generally, foot drop occurs due to the weakness or paralysis of the muscles lifting the foot. Apart from this, there may be some other causes including the following:

  • Muscular Disorders
  • Nerve injury
  • Brain or Spinal disorders
  • Injury to peroneal nerve
  • Sports injuries
  • Diabetes, hip or knee replacement surgery
  • Sitting cross-legged or squatting for sustained hours
  • Neurological conditions like; stroke, multiple sclerosis, cerebral palsy
  • Muscular dystrophy, polio
  • Tear of the anterior tibialis tendon
  • Anterior compartment syndrome

What are the signs and symptoms of Foot Drop?

Foot drop is debilitating for the patients as it affects their mobility to a greater degree. The persons suffering from foot drop may exhibit the below mentioned signs and symptoms:

  • Difficulty in lifting the forefoot or toes off the floor
  • Pain, weakness & numbness in the foot
  • Slap foot on the floor while walking
  • Drag the foot while ambulating
  • Raise the leg while walking

What are the physical therapy interventions employed to treat Foot Drop?

Physical Therapy is the most effective treatment for the foot drop, as most of patients regain significant function and mobility after observing a regular physical therapy regime. Physical therapists use the following techniques to manage foot drop:

  • Strengthening exercises are practised to strengthen and stretch foot and to mobilize the ankle.
  • Stretching exercises are administered to help stretch the calf and foot muscles
  • Leg flexes and toe curls are advised and practised to stimulate the muscles
  • Treatment regime including electrical stimulations of nerve and muscle fibres’ may be advised to enhance the tone and contractility.
  • Gait training is recommended to help the patients walk more efficiently and to improve their stability
  • Use of ‘AFO’ (Ankle-Foot-Orthosis) braces may be recommended to support the ankle and foot function
  • Manual Therapeutic techniques including; soft tissue massage, deep friction massage, manual stretching and joint mobilization is employed by therapists to help patients regain range of motion
  • Neuromuscular Re-education including; movement techniques and mechanics is provided to restore stability and retain lower extremity in daily chores
  • Home program including; strengthening, stretching and stabilization exercises and instructions is designed to help patients to perform daily tasks.

Contact Alliance Physical Therapy for the efficient treatment of your neurological and muscular disorders. Our dedicated and diligent physical therapist will help you walk the road to recovery.

How to Avoid Back Pain during Gardening Season?

Back Pain Physical Therapy

Back Pain Physical Therapy

Warming up of weather and occasional glimpses of yellow orb in the sky excites most of us to get out in our gardens and make preparations for the spring time. Gardening is an excellent and vigorous outdoor and therapeutic activity but it also sends many of us to the doctors and physical therapistsBack Pain is the most common symptom among the people with gardening habits.

Gardening can be compared to athletic activities which involve lot of twisting, lifting and bending. So before getting your hands into plants warm-up properly, follow these easy quick tips and get ready for the day in dirt:

  • Warm up with light movements and go for a brisk walk to increase your flexibility.
  • Do not bend repeatedly. Try to do your work by kneeling or sitting.
  • Lift the gardening tools and equipments carefully. Instead of putting pressure on your back and hips, let your arms, leg and thighs carry the load by bending properly at your knees.
  • Make use of long-handled tools for proper grip and to eliminate back strain.
  • Practice proper and good body mechanics i.e. do not work in the similar position or posture for long time.
  • Keep your back in the proper alignment to reduce unnecessary strain.
  • Use stools and upside down buckets to sit comfortably and use pad to kneel to avoid knee pain.
  • Take frequent breaks, Stand up and walk around in-between the gardening activities.
  • Never bend and twist your back at the same time.
  • Stand up like you are getting out of the chair, i.e. keeping your back straight.
  • If you feel pain in certain area, apply ice or cold pack to the affected area and do not resume the activity till the pain subsides.
  • Concentrate on your legs and core while lifting heavy bags of soil, digging with a shovel and carrying water hoses.
  • To lift heavy items like; dirt bags, garden tools or planting material, use garden cart or wheel barrel
  • Use joint friendly tools so that you can stand straighter and can easily grip the handles as well

Contact Alliance Physical Therapy for the expert diagnosis and state of art treatment of your pain and injuries. Our diligent team of physical therapists use patient-proven techniques and state-of-art technologies to make you as healthy and fit as before.

Anterior Knee Pain

Chondromalacia Patellae: Causes, Symptoms and Treatment


Chondromalacia Patellae

Chondromalacia Patellae, also known as ‘runner’s knee’ is the most common cause of chronic knee pain. It often affects the young athleticsbut may also happen to-older people with arthritis and females as well, as they have less muscle mass than males.

What do we mean by Chondromalacia Patellae?

Chondromalacia Patellae is a condition, where the cartilage under your patella or knee cap softens and wears away or deteriorates. Poor alignment or overuse of knee cap or patella wears down the cartilage and as a result, knee cap begins to rub against the thigh bone which further leads to grinding sensations and chronic pain in the front of the knee.

What are factors leading to Chondromalacia Patellae?

When you bend your knee; the backside of your knee cap slides over the femur (thigh bone). But when the knee cap does not move properly it begins to rub with the thigh bone leading to swelling and pain. Many factors including the following lead to the improper movement of knee cap which ultimately results in Chondromalacia Patellae:

  • Weak hamstrings and quadriceps (back and front thigh muscles)
  • Imbalance between the adductors and abductors (the muscles on the outside and inside of your thigh)
  • Improper tracking of knee cap
  • Trauma to knee cap like; Dislocation or Fracture
  •  Repetitive stress on knee joint due to activities like; running, jumping, twisting, skiing and playing soccer
  •  Over-weight
  •  Knock-knees or Flat foot
  •   Unusual or improper shaped patella under surface
  •   Arthritis

What are the signs and symptoms associated with Chondromalacia Patellae?

  • Chondromalacia Patellae generally leads to a vague discomfort in the front of the knee, generally known as patellofemoral pain. This pain worsens with the activities like; sitting, bending, standing for longer periods and exercising
  • Feeling of tightness in the knee area
  •  Reduction in thigh muscle mass
  • Minor swelling in the knee area
  • Loss of thigh muscle strength
  • Grinding or cracking sensation when knee is extended
  • Pain increases with kneeling down and squatting
  • You may feel trouble moving your knee joint past a certain point

What are the treatment options available to treat Chondromalacia Patellae?

Non-surgical treatment techniques are generally adopted to treat Chondromalacia Patellae. The most effective treatment technique is to adhere to a well-organised Physical Therapy treatment program. A Physical Therapy treatment program comprises of a complete rehabilitation program improving your muscle function and flexibility while relieving you from pain and swelling. Following treatment techniques are adopted under a complete Physical Therapy Rehabilitation Program:

Initially for the management of pain and swelling, physical therapists may recommend:

  • Resting your knee
  • Avoiding activities that irritate your knee cap
  • Icing your knee
  • Knee braces or arch supports to protect your knee joint  and to improve the alignment as well
  • Special shoes inserts and support devices (orthotics) for flat feet

Once the pain and swelling subsides below mentioned treatment techniques are employed by the Physical Therapists to help the patients to regain pain-free functioning and activity:

  • Selective strengthening exercises are recommended to strengthen the inner portion of thigh muscles
  • Stationary bicycling, pool running or swimming are advised to maintain cardiovascular conditioning
  •  Isometric exercises involving the tightening and releasing of muscles are recommended to maintain muscle mass
  • Taping of knee is recommended to reduce pain and as well to enhance the exercising ability
  • Specific exercises to correct the misalignment and muscle imbalance are recommended

Contact Alliance Physical Therapy

Contact Alliance Physical Therapy for the efficient and state-of-art treatment and quick relieve from any of your musculoskeletal pains. Our compassionate physical therapists make use of minimum invasive diagnostic and treatment techniques to save you from further pain and suffering and assist you to lead an active and healthy life.