Tag Archives: Orthopedic Center

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.

Are you suffering from back pain? Are you looking to get rid from back pain?


Back pain is becoming one of the most common American health problems, affecting around 80% people at some point during their lives. It could be from minor pain, regular pain to sudden become chronic and severe pain. The pain can be acute if for few days but consider chronic if more than four to six weeks.


There are numerous complications on spine and complaints about back pain can be categories based on the spinal column curvature and understand the 33 vertebras. The neck pain (Cervical: 1-7 vertebras), upper back pain (Thoracic: 8 to 19 vertebras), lower back pain (lumbar: 20-25 vertebras) and tailbone (pelvic: 26-31 vertebras) and two (32-33) coccygeal vertebrae rarely focused.


Usually, back pain originates from the muscles, nerves, bones, joints and some time from the other structures in the human spine. Back pain can be divided into neck painupper back pain, and lower back pain. Back pain can be occur due to various reasons like muscle strain, sprain or slipped disc. There are many causes of Back Pain but one of the most common reason of back pain is doing work with which you are not used to, like carrying heavy things,  engaging in strenuous physical work and so on.

So the most common cause in back pain is wrong posture, auto or work injury and if your cause is over-weighted then back pain can be worst.


Mostly, younger people (30 to 60 year old) can suffer from back pain which originates from the disc space itself. Older adults (e.g. over 60) can suffer from Back Pain which is related to joint degeneration.


See your doctor without any delay in case of any pain in spine. Get plenty of rest and use regular an anti-inflammatory medicine to relieve pain. If your pain is severe, lost feeling see your doctor or go to the emergency room or call 9-1-1 right away. X-rays is the basic option for radio-graphic assessments for low back pain. You doctor may suggest you other diagnosis in cases in of congenital defects, trauma, metastatic cancer or bone deformity as a cause of lower back pain.

Treatment and Precautions:

There are various benefits that are provided by the physical therapy and rehabilitation for back pain and other spine related problems. The goals of physical therapy are to reduce your pain, and educate you not only in your daily and work routine but also maintain treatment program so that further recurrences can be prevented. There are many different types of treatments provided by physical therapy for back pain. Actually, the physical therapist may focus on reducing pain with passive physical therapy. These are the considered passive therapies because they are done to the patient by the therapist. In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine and restore your daily routine.

If you are suffering from Back Pain and want to get rid of this Pain then search physical therapy clinic near you and consult only professional, licensed and experienced physical therapist today.


Call 911 for an ambulance right away. Do not try to drive to the emergency room, and try to move as little as possible.


Does your hand hurt? Have you noticed symptoms of pain, discomfort, fatigue and weakness in one or both of your hands? Are your fingers locking and unable to extend, without assistance from the other hand? Have you experienced numbness and tingling that has gotten progressively worse? Does your hand feel clumsy and are you noticing that you drop things from your hand more frequently or are unable to pick up things or open containers with your hands? If so, you may be suffering from one or more of the following chronic hand and upper extremity conditions such as arthritis, tendinitis, or nerve conditions such as carpal tunnel syndrome.

Has your hand or upper extremity been affected by an accident or trauma leaving you with wounds, scars, burns, injured tendons or nerves, fractures, dislocations or amputations of your fingers, hand or arm? Have you undergone prolonged casting or underwent a surgical procedure? Are you now experiencing severe pain and limitations in motion and function, associated with your injuries?

Whether you are suffering from a chronic hand and upper extremity condition or recently experienced an acute injury, you may be a candidate for hand therapy. If your physician has not already recommended it, you should ask him for a referral so that you can expedite your recovery process.

What is hand therapy? Hand therapy is specialized therapy that focuses specifically on conditions affecting the hand and upper extremity. It can be performed by an Occupational Therapist or Physical therapist who has a high degree of specialization that requires continuing education and often advanced certification.

What can hand therapy do for me?
• Provide preventative , Non-operative or conservative treatment
• Manage acute or chronic pain
• Provide wound care to include care of open and or sutured wounds (prevention of infection and assistance in healing)
• Control hypertrophy (raised and/or swollen) scars or hypersensitive scars
• Reduce swelling
• Instruct in desensitization and sensory re-education following nerve injury or trauma
• Fabricate splints for prevention or correction of injury or to protect surgical sites or to increase movement
• Design and implement home exercise programs to increase motion, dexterity, and/or strength
• Train in the performance of daily life skills through adapted methods and equipment
• Conditioning prior to returning to work

What is a Certified Hand Therapist?
A Certified Hand Therapist (C.H.T.) is an occupational/physical therapist who specializes in the treatment of hands.
They must have a minimum of 5 years postgraduate experience with at least 4,000 hours in hand therapy and have successfully challenged the Hand Therapy Certification Commission exam in order to obtain these credentials. CHT’s are dedicated professionals who have a commitment to meet the highest standards of their profession. The hand and arm have an extremely intricate anatomy and complexity. Rehabilitation of the hand and arm requires in-depth knowledge and up-to-date techniques. Certified Hand Therapists have the highest level of competence in the rehabilitation of upper extremity injuries.
Certified Hand Therapists are able to initiate treatment immediately following surgery often while stitches are still in place. Early referral to a hand therapist is effective in preventing further surgeries and obtaining an optimal outcome.

Hopefully, this information helps you to make the right decision, when consulting your medical specialist.
“Restoring life back into your hands”