There are many health and fitness benefits to resistance training. Not only does it enhance muscular strength, it improves fundamental movement skills, increases bone mineral density, improves cardiorespiratory function, helps in weight management and body composition, and reduces injury risk in sport. Despite the established benefits of resistance training, many health care professionals, teachers, coaches and parents have been led to believe that it is inappropriate to implement at the youth level. Probably the...
Check out our interview by sports anchor Jeh Jeh Pruitt with Fox 6 WBRC! We are proud to sponsor this weekend’s Alabama Speedgolf Open benefitting the Ronald McDonald House! For more information, check out https://www.speedgolfusa.com.
Over the last several weeks I have received a number of inquiries pertaining to cash-based physical therapy, given that our clinic functions under this payment model. For those that have asked, and for others that may be curious, let me clarify what this payment system is and what it means for you. In the most simplistic terms, a cash-based practice is one in which the clinicians do not accept insurance payments, accepting only direct payments...
Let me state the obvious: It is HOT outside! REALLY HOT! This week I’ve been providing medical coverage for a local youth soccer camp. While I do not anticipate (and certainly do not wish to see) any significant injuries, my biggest concern has been the development of a heat-related illness in an athlete. The prevention, recognition and treatment of exertional heat illnesses are major focuses of the on-field sports medicine team at all levels of...
One of the main priorities of rehabilitation after anterior cruciate ligament (ACL) reconstruction is the restoration of quadriceps strength. While there is certainly considerable pain, swelling, temporary loss of motion and reduced function associated with the surgical procedure, it has been estimated that approximately 30% of patients demonstrate quadriceps strength deficits up to 12 months after surgery, and those deficits can be as high as 30% years after the procedure. This is important, as these...
The off-season is a critical time for any athlete, particularly those participating in overhead or throwing sports. Given the progressive loads to both the neuromuscular and cognitive systems throughout the regular season, it is imperative that restoration takes place. Specifically for baseball players, the cumulative stress on the dynamic (muscle) and static (ligament/tendon) stabilizers of both the upper and lower extremities leads to a variety of changes over the course of a competitive season. ...
Check out some photos of our clinic, taken by the amazingly talented Amy Dummier! Please feel free to stop in for a visit and/or to schedule an appointment for any of our services...
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Arthrofibrosis (AF) is abnormal internal scarring inside the knee joint and surrounding structures. It may begin with sticky adhesions that can gum up the surfaces that are close to one another, such as the suprapatellar pouch above the patella, the anterior interval behind the patellar tendon, the area around the cruciate ligaments and the capsular ‘gutters’ at the side of the joint.
The abnormal ‘gumminess’ of these normally mobile tissues leads to painful knee stiffness. Attempts to bend the knee result in sickening pain above the knee in the region of the suprapatellar pouch. Aggressive physiotherapy tends to make the knee hot, swollen, red and painful, and instead of mobility improving it tends to worsen. Lack of understanding about the arthrofibrotic process may lead to doctor and physiotherapist berating the patient for not trying hard enough, and the patient may feel demoralized and angry.
Manipulation Under Anesthesia
The objective of manipulation under anesthesia (MUA) for the knee is to break sticky adhesions gumming surfaces together before these adhesions turn into proper scar tissue. To this end, the procedure should be done early once it is appreciated that physiotherapy is no longer improving range of motion (ROM) or that ROM is getting worse. During the procedure the patient needs to be fully anaesthetized and under the influence of true muscle relaxants. The hip should be bent to 90 degrees and the surgeon hold the thigh near the knee and apply a gentle rocking motion of the lower limb through flexion and extension while observing improvement.
Not every practitioner will perform the manipulation in exactly the same way. By having the patient under anesthetic or deep sedation, the clinician is able to gently but firmly take the knee through as much of a range of motion as possible in order to free any adhesions. A danger of course is that the inexperienced practitioner may be too rough and cause damage to the tissues.
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