Welcome back to the blog!!
Today we're we're moving up the chain from the knee to the hip. We're discussing femoroacetabular impingement a.k.a. "hip impingement." Anyone familiar with that "pinching" in the front of their hip with a squat, lunge, or while running has likely dealt with a "functional hip impingement" episode. If you have experienced this over a longer period of time, you should be evaluated for hip impingement syndrome.
Hip impingement has gained notice in the sports medicine community specifically over the last 15 years as advancements in diagnostics and surgical procedures has led to increased people going under the knife. This is a syndrome that can be defined in really 2 ways; intra-articular and extra-articular impingement. Extra-articular refers to soft tissue impingement outside the joint, which could be muscular or nervous system in nature. Most commonly though, we are refereing to intra-articular issues which are further classified in to 3 sub-diagnoses; a Pincer Lesion, Cam Lesion or Mixed Lesion. In a Pincer lesion the, there is bony overgrowth of the acetabular rim (the socket) that leads to decreased available motion for femoral head (ball) and increased "pinching" at the top of the joint with flexion. In a Cam Lesion, the overgrowth is on the neck of the femur and leads to an early contact between the acetabulum and head of the femur at end range. Both of these can lead to increased shearing at the joint. They are often diagnosed both clinically with certain special tests as well as with both x-ray and MRI. However, recent studies have show that clinical tests are not as specific as we would like them to be for diagnosis, and imaging does not seem to have a direct correlation between evidence of a Cam or Pincer lesion and the presence of pain.
Welcome back everyone!
I'm finally discussing some current research on the diagnosis and treatment of a specific injury. In this week's blog, I'm discussing the current Clinical Practice Guidelines for diagnosing and treating Patellofemoral Pain Syndrome (PFP). So if you have ever had knee pain related to squatting, running, descending stairs etc.. then this should be an informative read for you, providing you some direction in your ability to address your symptoms.
PFP is commonly referred to as "Jumper's or Runner's knee." This condition involves, typically, insidious onset of pain behind or around the knee cap. This is a very common syndrome with an estimated prevalence of 25% up to 50% in the general population over their lifespan and does account for anywhere between 2-7.5% of people presenting for medical care. This syndrome most commonly affects youth athletes between the ages of 12-19 but some studies indicate a higher prevalence in the 50-59 year old age group.
Symptoms usually present with no specific injury and can come on slowly overtime. Typically there is worsening of pain with lower-limb loading (eg, squatting, prolonged sitting, ascending/descending stairs, jumping, or running, especially with hills). There is poor correlation between internal derangement of tissue or cartilage damage and symptoms, and therefore a clinical diagnosis based on a cluster of symptoms associated with pain reports during squatting, descending stairs, and knee flexion positions like prolonged sitting should be used. Your medical provider and rehab specialist should be looking at these things as the best supported way to diagnosis this condition.
Welcome back to the Blog! Hopefully you have found useful information here in the past, or if this is your first time reading my material, well then, I hope you enjoy!
Today I am discussing 3 ways to optimize your ability to lift and load weight overhead. In addition to helping you lift more in the gym, this also has major implications for maximizing your function as you age. My goal with you reading today is for you to gain a better understanding of how you move with and without weight. So let's get started with the first Key!!
1. How well do you move without weight or load??
One of the most important points. Simply put, Can you move freely and smoothly without restriction when you are not holding weight?. If you can't move smoothly, then you can't load correctly. It's equivalent to attempting squat 150lbs when you can't move from sitting to standing. It's possible to do it once with compensation, but over time it will lead to a disaster. So you first need to understand your movement without load and what you need to do to improve it. A strength and conditioning coach, movement coach, or physical therapist is a great resource here.
Dr. Luke Greenwell is a Performance Based Physical Therapist with an extensive background in treating the injured athlete. He is passionate about returning people to the sports & activities they love. He has post-doctorate certifications in Manual Spine Therapy and Functional Dry Needling. He is also a NSCA Certified Strength and Conditioning Specialist. He has extensive experience in Dartfish video gait/running analysis, concussion rehab, & functional movement screening & correction. He is the owner of CrossFit based RecoverRx Physical Therapy