physical therapy colorado springs

How to Avoid Foot Surgery

Bare Physical Therapy foot pain, knee pain, Manual Physical Therapy, metatarsalgia, Orthotics, plantar fasciitis, Podiatrist , , , , , , , , , , , , , , , ,

 

 

  Elective foot surgery is expensive, debilitating, time consuming, frequently unnecessary, and patients are often worse pain following surgery. Matter of fact, if you find anyone happy with an elective foot surgery you might also want to go ahead and buy yourself a lottery ticket…the odds are about the same. I always say, “there is NOTHING surgery can’t make worse”.   That is especially true in elective foot procedures.

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Has your surgeon told you that you need surgery for the following?

  •  Neuroma
  •  Bunion
  •  Hammertoe
  • Plantar fasciitis
  • or maybe because you had advanced degenerative Osteoarthritis?

Trust me, the surgery will not address the cause of any of the above pathology.  If you fuse, remove, dissect, or realign something in the foot without addressing the cause, you are just kicking the can down the road until you need surgery #2, #3, etc.

A brief bio on me to provide credibility on this subject:  I became the Army’s expert in lower extremity biomechanics and foot/ankle treatment specialist in 2000 and was honored to hold that position until my retirement in 2013.  I’ve attended 120 hours of continuing education in biomechanics and have taught courses all over the country.  I have also successfully treated thousands of patients in my career, relieving their pain and in countless circumstances, avoided the above mentioned surgeries.

The BARE NECESSITIES Do’s and Don’ts of foot pain…

The Don’ts

  1. Don’t see a podiatrist. Podiatrists are foot surgeons and they have little knowledge or inclination toward conservative treatment options.
  2. Don’t let anyone inject your foot. Cortisone injections are somewhat effective in treating foot pain, BUT they do NOTHING to address the cause of foot pain. As a result, when the steroid wears off the foot pain often returns worse than before.
  3. Don’t let anyone sell you a hard plastic arch support. Your foot was designed to bend and flex during the stance phase of gait, and it can’t perform correctly with a hard piece of plastic wedged under the arch. These “custom” arch supports are also expensive and rarely covered by health insurance.
  4. Don’t let anyone convince you that you just need to “stretch” more. Typically the most common cause of foot pain is an underlying instability… instabilities get WORSE with stretching even though it can feel a bit better short term.

The Do’s

  1. Do try a change of shoe. Many times replacing a worn out, or poorly fit shoe will be enough to start the healing process. If possible get advice on footware from a reputable shoe dealership (none of the chains) or medical professional with significant foot/shoe experience or training. If you are on your feet a lot (work, home, sports), don’t skimp on your shoes. You don’t need to spend a fortune, but the shoe market is competitive and you do get what you pay for.
  2. Do try a full length off-the-shelf shoe insert that you can usually get in a running shoe store for $40-$70. This is a semi-rigid arch support and will still allow your foot to flex and bend as it’s intended to, but will still provide some support.
  3. Do find a good manual therapist (Massage or Physical Therapist) to break up the adhesions that are likely contributing to the pain in your foot. If your therapist tries pushing “exercise” as the cornerstone of treatment and does no or very little manual therapy, go find a different provider. This condition cannot be fixed with exercise, though exercise can be a component of recovery…the main emphasis should be on manual therapy (not dry needling) to both lower extremities.
  4. If all else fails…Do find a biomechanical specialist to construct a custom biomechanical corrective orthotic (shoe insert) to address the underlying cause of your foot pain. These professionals are few and far between. I noted above how I became a specialist in this field, and here is a link to my website. You will find information on the difference between arch supports and biomechanical orthotics as well as examples of what I would need to conduct an assessment on you (video and other) if you happen to not live close to Colorado Springs.

Lastly, if you happen to find this blog AFTER you already had a surgery (or 4)…there is still hope. Follow these same do’s and don’ts and you will be amazed at your recovery!!

By LTC Tony Bare (ret), DPT, OCS, ATC

Visceral Therapy for stomach problems

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How many people do you know who take medications for their abdomen on a regular basis? Stomach medications for heart burn, reflux or indigestion, intestinal medications for ulcers, constipation, diarrhea, or general digestive problems. How many have had their gall bladders removed?? What if there were fibrotic adhesions from illness or injury that may have occurred years earlier? Adhesions that were impacting the performance of the abdominal organs and causing them to be symptomatic?

These tissue adhesions can be treated with physical therapy, specifically visceral therapy in which tissue mobility and motility can be restored and stomach or intestinal symptoms can be resolved which may eliminate the need for medications.

Come to Bare Necessities PT…There is Hope…True Healing Exists!!

Testimonial from my patient Tyler:

I had severe stomach problems from the age of 12 to 17. Severe pain, nausea, constipation, and diarrhea were all symptoms that I lived with on a daily basis. I missed so much school that I was unable to graduate on time.  I had seen several doctors and specialists and was diagnosed with IBS, possible Crones disease and even parasites.  I was prescribed several different medications and supplements, as well as changed my diet, all with little to no relief.  I was told I would have to live with this for the rest of my life. I then was introduced to Tony.  Just three visits cured my problem and I no longer suffer or have to worry about how I’m going to feel each day. It has changed my life. THANK YOU TONY!

 

The Therapeutic Value of Visceral Manipulation

Visceral Manipulation (VM) was developed by world-renowned French Osteopath and Physical Therapist Jean-Pierre Barral. Comparative studies found Visceral Manipulation beneficial for various disorders

Digestive Disorders
Bloating and Constipation
Nausea and Acid Reflux
GERD
Swallowing Dysfunctions 

Emotional Issues
Anxiety and Depression
Post-Traumatic Stress Disorder

 Pain Related to
Post-operative Scar Tissue
Post-infection Scar Tissue
Autonomic MechanismsPediatric Issues
Constipation and Gastritis
Persistent Vomiting
Vesicoureteral Reflux
Infant Colic

VM assists functional and structural imbalances throughout the body including musculoskeletal, vascular, nervous, urogenital, respiratory, digestive and lymphatic dysfunction. It evaluates and treats the dynamics of motion and suspension in relation to organs, membranes, fascia and ligaments. VM increases proprioceptive communication within the body, thereby revitalizing a person and relieving symptoms of pain, dysfunction, and poor posture.

An integrative approach to evaluation and treatment of a patient requires assessment of the structural relationships between the viscera, and their fascial or ligamentous attachments to the musculoskeletal system. Strains in the connective tissue of the viscera can result from surgical scars, adhesions, illness, posture or injury. Tension patterns form through the fascial network deep within the body, creating a cascade of effects far from their sources for which the body will have to compensate. This creates fixed, abnormal points of tension that the body must move around, and this chronic irritation gives way to functional and structural problems.

Imagine an adhesion around the lungs. It would create a modified axis that demands abnormal accommodations from nearby body structures. For example, the adhesion could alter rib motion, which could then create imbalanced forces on the vertebral column and, with time, possibly develop a dysfunctional relationship with other structures. This scenario highlights just one of hundreds of possible ramifications of a small dysfunction – magnified by thousands of repetitions each day.

There are definite links between somatic structures, such as the muscles and joints, the sympathetic nervous system, the visceral organs, the spinal cord and the brain. For example, the sinuvertebral nerves innervate the intervertebral disks and have direct connections with the sympathetic nervous system, which innervates the visceral organs. The sinuvertebral nerves and sympathetic nervous system are linked to the spinal cord, which has connections with the brain. In this way someone with chronic pain can have irritations and facilitated areas not only in the musculoskeletal system (including joints, muscles, fascia, and disks) but also the visceral organs and their connective tissues (including the liver, stomach, gallbladder, intestines and adrenal glands), the peripheral nervous system, the sympathetic nervous system and even the spinal cord and brain.

Thanks to the dedicated work of Jean-Pierre Barral, a Physiotherapist (RPT) and Osteopath (DO), healthcare practitioners today can use the rhythmic motions of the visceral system as important therapeutic tools.

Barral’s clinical work with the viscera led to his development of a form of manual therapy that focuses on the internal organs, their environment and the potential influence on many structural and physiological dysfunctions. The term he coined for this therapy was Visceral Manipulation.

Visceral Manipulation relies on the palpation of normal and abnormal forces within the body. By using specific techniques, therapists can evaluate how abnormal forces interplay, overlap and affect the normal body forces at work. The goal is to help the body’s normal forces remove abnormal effects, whatever their sources. Those effects can be global, encompassing many areas of bodily function.

How Does Visceral Manipulation Help You?

Visceral Manipulation is used to locate and solve problems throughout the body. It encourages your own natural mechanisms to improve the functioning of your organs, dissipate the negative effects of stress, enhance mobility of the musculoskeletal system through the connective tissue attachments, and influence general metabolism. Today, a wide variety of healthcare professionals perform Visceral Manipulation. Practitioners include osteopathic physicians, allopathic physicians, doctors of chiropractic, doctors of Oriental medicine, naturopathic physicians, physical therapists, occupational therapists, massage therapists and other licensed body workers.

How is Visceral Manipulation Performed?

Visceral Manipulation is based on the specific placement of soft manual forces to encourage the normal mobility, tone and motion of the viscera and their connective tissues. These gentle manipulations can potentially improve the functioning of individual organs, the systems the organs function within, and the structural integrity of the entire body.

Harmony and health exist when motion is free and excursion is full – when motion is not labored, overexcited, depressed, or conflicting with neighboring structures and their mobility. Therapists using Visceral Manipulation assess the dynamic functional actions as well as the somatic structures that perform individual activities. They also evaluate the quality of the somatic structures and their functions in relation to an overall harmonious pattern, with motion serving as the gauge for determining quality.

Due to the delicate and often highly reactive nature of the visceral tissues, gentle force precisely directed reaps the greatest results. As with other methods of manipulation that affect the body deeply, Visceral Manipulation works only to assist the forces already at work. Because of that, trained therapists can be sure of benefiting the body rather than adding further injury or disorganization.

*from the Barral Institute

hip and back pain during and after pregnancy

Bare Physical Therapy back pain, half marathon colorado springs, Manual Physical Therapy, pelvic pain , , , , , , , , , ,

 

Marnie – hip and back pain during and after pregnancy:

When I was four months pregnant, I started getting severe hip and back pain. I was as stiff as a board, no matter how much stretching I did, and I did a lot. I would get a pinched nerve near my tailbone so bad that I couldn’t lift my feet off the ground to walk. My hips felt like they were burning on fire. The mornings were the worse, when it felt like the wind got knocked out of me, my back and hips hurt so bad. I felt like I was 90 years old and there was nothing I could do about it.

I was in PT from four months pregnant until 10 months postpartum. I would feel better sometimes but it was only temporary, sometimes only half an hour, sometimes a couple of days. But nothing ever got better. Finally, a friend referred me to Tony.

Not only was Tony a kind and gentle person, he figured out what was structurally wrong with me and “fixed” it in one visit! It turns out, that during pregnancy, the hormones that let your hips open up also caused my sacrum to sort of drop down and get wedged underneath my hips and pelvis. There was no way for it to get out, until Tony and his wife teamed up and literally pulled it back out into the right place! It didn’t even hurt. I am still in shock every day that I was able to walk out of Tony’s office and not feel any pain! I will never be able to thank Tony enough for what he did for me. My life as a “90-yr old” in chronic, 24/7 pain is no longer a reality for me. I believe he works miracles!

To all the mamas out there who think that hip and back pain are just a normal part of pregnancy and giving birth, please believe me when I say, it is not normal. You can get help. You deserve to not be in so much pain!!

 

Emily: 34 Weeks Pregnant

I first came to Tony last Spring after visiting my chiropractor numerous times for my cramped neck and not feeling any relief. He was able to give me some tips and excercises that improved my neck pain in just a few visits. Because of my experience last spring I decided to go back a few weeks ago and have Tony work on my hip/ lower back area. I was 34 weeks pregnant and would cramp up so bad that I could hardly walk after laying down for a while. Again, it took just one visit to feel relief. I was amazed and slightly disappointed that I didn’t see Tony earlier in my pregnancy!! I had a chiropractor appointment scheduled for the following day. I knew I needed to explain that my hip felt much better after Tony’s adjustment. I asked that she wouldn’t adjust my hips so that it would stay in place. Unfortunately, she went right on and popped them like usual and undid the work that Tony and Amy had done. Thankfully I knew it could be fixed, so I came back to the Bare’s with the regret of seeing my chiropractor, and they were able to work their magic again. I love how they work together as a team and really truly want you to experience a pain free life. Thank you for all that you’ve done for me! I can’t express how greatful I am for your practice!

The Courses I’ve Taken and Taught on Biomechanics and Running

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I recently returned for a Continuing Education Course on biomechanics of gait, running and rehabilitation titled: Running Rehabilitation and after this weekend my total hours of continuing education on gait stands at 120!!

  • 1996 Locomotor Biomechanics (8 hrs)
  • 1997 Orthotic Reaction (22 hrs)
  • 1998 Grinders & Glue (16 hrs)
  • 1998 Landing on Your Feet (8 hrs)
  • 1998 Current Concepts in Biomechanics (22 hrs)
  • 2000 When the Foot Hits the Ground (Lv2) (15 hrs)
  • 2001 The Running Course (15 hrs)
  • 2015 Running Rehabilitation (14 hrs)
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I certainly learned a couple things from my most recent course.  First, the science of running has certainly evolved in the last 14 years but the course also validated that all the work I invested to become a Subject Matter Expert in Biomechanics has certainly paid off.  To summarize that work I thought I’d list my teaching experience…
  • 1999-2000 I re-wrote 32 hours of gait and biomechanics for the Army-Baylor Physical Therapy Program.
  • 1999 University of Texas Health Science Center, Normal Gait (4 hours)
  • 1999 Balboa Naval Medical Center (Tricare Region IX), Lower Extremity Treatment Options (15 hours)
  • 2000 Etiology of Foot Pain, Health Care Providers in Bosnia (8 hours)
  • 2000  Army Orthopedic Physical Therapy Residency, Normal Gait and Malalignments (15 hours).
  • 2002 Army Orthopedic Physical Therapy Residency, Normal Gait and Malalignments (15 hours).
  • 2002 Colorado Springs Air force and Army Cont. Ed.  Normal Gait, Malalignments and Orthotic Prescription (15 hours)
  • 2003 Hawaii APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hrs)
  • 2003 Army Sports Medicine Physical Therapy Residency, Normal Gait, Malalignments and Orthotic Prescriptions (15 hours).
  • 2005 Hawaii APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hrs)
  • 2007 Operation Iraqi Freedom Deployment Cont Ed. Foot Pain Management in a Deployed Setting. (8 hours).
  • 2009 Kentucky APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hours).
  • 2010 Texas APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hours).
  • 2011 Washington APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hours).
That is a total of just over 200 hours of teaching to hundreds Physical Therapy students, graduates and and post graduate specialists.  I don’t proclaim this accomplishment to brag about what I’ve done, but to give God glory for the opportunities He’s afforded me.  I’m also realizing I haven’t taught a course in 4 years…I need to get off my butt and put on another conference!! 🙂
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Gait Analysis for FIT4MOM Front Range Half Marathon Trainees

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Amy here!

Tony and I are getting married THREE weeks from today! Here’s an engagement photo since I love it so much View More: http://halchakphotography.pass.us/untitled-export-7

Tony and I had the honor of seeing about 35 of the FIT4MOM Front Range half marathon trainees this last month. I own the FIT4MOM Front Range franchise. We offer fitness for all stages of motherhood from Parker to Fort Collins. We have nearly 30 instructors and several hundred moms attending our classes, making up an amazing community of support, fitness and the village it takes to raise kids AND moms. Tony and I are able to combine our professions in order to serve these moms even better.

We have been offering 5K, 10K and half marathon training for the last several years with great success. In 2015 we had over 200 moms go through our running training programs. I’m a marathoner myself so this is definitely a passion of mine and since Tony is a biomechanics expert and one of only a few people in the country fabricating orthotics the way he does I wanted to make sure our moms were given the opportunity for an evaluation with him. I’m always looking for ways to improve our programs and add value so it only made sense to incorporate Tony into the program.
As part of the fall half marathon training we offered a free gait and shoe evaluation with Tony for each registered participant. Each mom that signed up got 15-20 minutes one on one (well, two on one since I was there too) with Tony. He evaluated feet, marked them, watched them walk, checked out shoes and gave recommendations. Some were as simple as ‘keep doing what you are doing’ while others needed shoes changes and some were offered a custom orthotic. We really tried to educate each mom on her mechanics, her body, her shoes and to answer any and all questions. The main goal was to reduce injury and provide them with the resources to run a successful and easy half marathon.

We spent two days in Loveland  and saw 17 Fort Collins and Greeley group moms and a day in Denver seeing another 18. It was pretty awesome to meet all these moms face to face and to hear their stories, their struggles, their progress and their goals. We are looking forward to incorporating the evaluations into each running training that we have moving forward. Tony and I really enjoyed being able to work together on something that we both are very passionate about but it was a really fun time seeing all the moms.

Thank you to all the moms that came to see us!

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Examining and marking the foot

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The two of us  watching mom walk to analyze gait

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Tracing for measurements and prescription

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BONUS! Mama Cameron was injured so she came to see us!

If you want to know more about Tony’s experience and background with orthotic fabrication go HERE

Read more about orthotics and the Fallacy of Arch Supports

My Orthotic History and Experience

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In 1996 I had been a physical therapist for 2 years and I left my assignment at Ft. Campbell, KY to attend a 2 week continuing education course at Ft Sam Houston, TX. During the course a man named Michael Cane taught 8 hours on gait, biomechanics and orthotics. It was completely over my head. I was so angry that Physical Therapy school had completely failed to teach anything useful on the subject, that I was on a mission to remedy the situation. I took a Michael Cane’s 3 day course, another 3 day course taught by a Podiatrist and another by an Orthotist. I took another 3 courses and dove into the research…in 1998 I re-wrote the curriculum of lower extremity biomechanics, gait and orthotic treatment for Baylor University. By 2001 I had become the Military’s gait and biomechanics expert (across all services) and was a guest instructor in 2 different Graduate PT programs and 2 different clinical residencies. I developed my own 3 day continuing education course and I have taught it all over the country.

IMG_2426Orthotic magic

                                               Bosnia, Camp Eagle, 2000

God provided a perfect environment for me to become the expert described above… I grew up working for my dad as a machinist, so I had a comfort level with building and machine work. The Army provided me with an endless supply of Soldiers not biomechanically designed to run or march. I had access to some of the best orthotic labs in the nation, mentoring by orthotists with decades of experience and plenty of supplies. My skills were honed and I still learn from every patient I evaluate and treat. Every patient is so very unique. I’ve made over 5000 pair of orthotics. I’ve made orthotics for patients as young as 6 and as old as 96, patients who are Olympic track and field athletes, recreational and high school athletes and patients just struggling to walk without a cane or crutches.

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Do you have pain in your back, hips, knees, shins, ankles or feet? Have you a bag full of orthotics that didn’t help your pain in the past? If I evaluate you, you will see my evaluation will be comprehensive, I will explain to you what is working and not working throughout your stride and if an orthotic can help you. I will provide a comfortable and affordable device and you will have the chance to finally turn that page in the chapter of your life.

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Want more information?
See my Fallacy of Arch Supports article

LTC Tony Bare (ret) DPT, ATC, OCS
Physical Therapist
Colorado Springs, CO

Custom Orthotics By Providing Video Gait Analysis

Bare Physical Therapy achilles tendonitis, Arch Support, bunion, foot pain, knee pain, metatarsalgia, Orthotics , , , , , , , , , , , , , , , , , , , , , , , , ,

I’ve had a lot of interest in my Bare Necessities  Custom Orthotics (arch supports or shoe inserts) from people across the country and I’ve had good success making them based off the information below. If you’ve read my post on the Fallacy of Arch Supports, you know that one of the components of my exam that makes the orthotic successful is the dynamic gait analysis, so if I’m provided the video footage I’ll have great insight into your biomechanics and if they need any help or correction.

The good news is that I’ll assess your videos FREE!! All I need is 10 second clips of you walking barefoot on the treadmill from behind and from each side.   Just do your best to walk on the treadmill at your comfortable walking pace.  Take video footage of the following angle/level  (including both sides/foot):

IMG_2421 IMG_2426

I’ll need a tracing of your foot next to a ruler. See picture below (it doesn’t have a ruler but you’ll need a ruler next to your tracing).  The tracing will let me know what size of orthotic to make and I’ll have an idea what adaptations your biomechanics have forced your foot to make and that will be even more information helping to guide my orthotic prescription.

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IMG_2431The orthotics themselves are only an average cost of $85 plus $10 shipping and handling, so send me your videos and get on the road to pain free walking or running.

Now that we are relocating to Laramie, WY please refer your Colorado Springs friends to this post.

Please email me your video and foot tracing to tony@barept.com

LTC Tony Bare (ret), DPT, ATC, OCS
Physical Therapist
Laramie, WY

Hands and Manual Therapy

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IMG_2418When was the last time a health care provider put his or her hands on you?   Even my profession of physical therapy has largely gone away from 1:1 care and what little time you get with your therapist is increasingly spent hooked up to a machine or doing exercises. There is a place for machines and for exercises but the most dramatic healings in my 20+ year career have always occurred from direct hands-on techniques. Why, if manual therapy is so effective, is my profession moving away from it? It’s largely driven by the staggering decline in insurance reimbursement. In order for clinics to stay open they have to see so many more patients that there just isn’t enough time to provide much or any hands-on care.

Fortunately, working out of my home, I’m able to charge much less and provide you an hour of experienced hands-on treatment for only $75.00, not much more than you would pay for an hour of massage!

Are you tired of hurting? Have you given up hope? Come see what my manual therapy techniques can do for you!

LTC Tony Bare (ret) DPT, ATC, OCS
Colorado Springs, CO

Cranial Therapy

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What if your head wasn’t on right? What if you weren’t right in the head? What if your head wasn’t on straight? Why do we have so many common phrases that describe cranial dysfunction? Because it REALLY does happen!!! I’ll admit that when I was in school the notion that something might not be right with the bones of the skull was openly scoffed at by my instructors. Fortunately I’ve had my eyes opened by clinical practice and my hands have become calibrated to assess the subtle changes in cranial bone alignment and movement…and then fix it!

How does it work? Well, it’s pretty simple if you picture your brain as the most important organ in your body suspended in fluid and filaments that support and lift the brain from every imaginable angle from the skull to the brain. Now imagine if one of those skull bones is twisted or flexed… imagine if it’s not able to adjust to the blood pulsing inside the brain because it’s “stuck”. What symptoms might it cause? Anxiety, sleepiness, sleeplessness, difficulty concentrating, difficulty remembering, headaches, dizziness, jaw pain (TMJ/TMD) are the more obvious ones. It could affect anything that your brain manages:  your hormones, your blood pressure, your coordination.

Please read my testimonials and if you have a toddler with sleep issues please read THIS STORY.   I’ve treated TBI, Concussions, CHI, Headaches, TMD, Sleeplessness, Dizziness, memory issues and I’ve even treated Restless Leg Syndrome! Cranial Therapy is so powerful for some particular pathologies that you will notice a great difference after only one or 2 treatments. Give it a shot, you may be able to quit buying the industrial sized bottle of pain killer or get off all your sleeping medications!!

LTC Tony Bare (ret), DPT, ATC, OCS
Physical Therapist/Owner
Colorado Springs, CO

Knee Pain

Bare Physical Therapy knee pain, Orthotics , , , , , , , , ,

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Anyone remotely athletic usually has some degree of knee pain…why? Well, putting aside traumatic injuries, there are a couple of reasons the knee is so susceptible to general non-traumatic or over-use pathologies.

  1. The knee is a the largest moving joint (surface area) in the body and
  2. It is located between the two longest levers in the body (femur and tibia)…the combination creates a great deal of potential torque through the knee-joint and caught in the middle of it is the knee cap (patella).
  3. The knee is really well designed to move forward and backward, but rotation and sideward motions create a real issue for your knee due to the leverage and torque noted above.

Now you are probably thinking…”That makes sense for basketball players who are pivoting and changing direction all the time…but I just walk for exercise…or jog…I’m just moving straight ahead…why do I have knee pain if the knee is designed to move straight ahead?”

The answer is all about biomechanics…my field of expertise. Even though you are moving forward there are subtle sideward and rotational movements that occur in your knee…this puts a lot of stress on the structures designed to control, decelerate and limit those motions (plica, pes anserine, IT band, the patellar tendon and the entire patella femoral joint).

You’ve probably heard the term pronation; well pronation doesn’t stop at your feet. Pronation in the foot is translated into rotation of the tibia and to make matters worse the femur starts rotating the opposite direction during the stance phase of gait. Now picture all those structures I listed above being pulled in both directions and you can understand why your knee hurts when all you do is walk for exercise.

Common Treatment of Knee pain:

Self-treatment: anti-inflammatory medications, ice, rest, knee sleeves, sports creams…these will all help your knee “feel” better…but will not treat the cause of your knee pain… so often times your symptoms will recur. There are a couple of things you can do to address the cause of your knee pain all yourself!! First of all, improve your walking/running surface. The more flat and level the less of those pesky accessory motions affecting your knee. Secondly, better shoes. Some biomechanical issues can be addressed with shoes alone; not a specific brand but a general type of shoe. How can you know what kind of shoe you should wear? You should receive a biomechanical evaluation…and I do that for only $20!!

Physician treatments: stronger anti-inflammatory medications, injections, more expensive braces and hopefully a physical therapy consult.

Physical therapy treatments: Modalities (ultrasound, ice, heat, LASER, electric stimulation), exercises and manual therapy (massage, myofascial release, trigger point needling, etc). You already know the modalities by themselves won’t do much better than what you could do for yourself. Please don’t ask me why every physical therapy student is taught to treat knee pain with exercises…mainly quadriceps strengthening and hamstring stretching…both those muscle groups work largely in the forward plane of movement. The knee ALREADY moves really well in that plane. The bottom line is that the body doesn’t have very many muscles that are even well designed to control lower extremity movement in sideward or rotational plane of motion and believe it or not, you probably don’t need any more strengthening of those muscles…you know why? Because they are really strong already!!! You know why? Because your biomechanics make them work extra ALL THE TIME (every single step). Because they work more than they should…and probably have for years…the muscle itself may be short circuited a bit and have fibrotic knots and ropes running throughout it. If that’s the case…those muscles would benefit from manual therapy (myofascial release) and combined with modalities and exercise you can have your dynamic pronation stabilizing muscles firing on all cylinders before you know it!! Once you combine that with a better walking surface and shoe…you may actually have resolved your knee pain!!

However, often times a shoe is not a great enough correction…or maybe you don’t want to spend the rest of your life confined to walking and running on a treadmill. In either case, please contact me…read my testimonials!! For only $20 I will do a biomechanical assessment on you and let you know if your mechanics can be improved with shoes alone…and what type of shoes you should wear. I’ll also let you know if I feel a custom orthotic would help your mechanics (please read why my orthotics are unique)…and the average cost of the custom orthotics I hand make is typically only another $80!!!

LTC Tony Bare (ret), DPT, ATC, OCS
Physical Therapist/Owner
Colorado Springs, CO