Preventing Knee Pain

There are various causes of knee pain, but here are a few tips to help prevent or reduce the incidence of pain. 

 Gradually Increase Training Intensity

Jumping into a training program too quickly is one of the primary causes of sports injuries. Runners who up their mileage too quickly often experience knee pain. To avoid this problem follow a program of gradual increase. 10 percent per week increase is a good rule.  That pertains to any training parameter, i.e.: time, mileage, load, etc.

 Strengthening Program

One of the first things, as a physical therapist, that I check when evaluating knee pain is muscle strength/imbalance. In addition to building up specific knee muscles (quadriceps, hamstrings, etc.) addressing core strength is important for overall stability and helping to reduce the risk of injury.


Maintaining appropriate flexibility through a regular stretching program is important in minimizing injury. This is especially important for those athletes involved in sports that require stop and go as well as cutting and turning activities.

 Sports Specific Skills Training

In order to minimize knee injuries, it is important to address exercise/activities that correlate directly to the sport an athlete is participating in.

One of the best programs for preventing knee injuries, especially ACL injuries in women, is the Santa Monica Sports Medicine ACL Injury Prevention Program. This program, which is evidence based, includes very specific exercises and skills training. Even though it was developed for female soccer players, the concepts pertain to all sports and activities.

 Appropriate Foot/Ankle Support

Use of appropriate footwear, to include custom orthotics, which addresses ankle instability (pronation and supination), will also help minimize injuries.

Always remember to get proper clearance from a medical professional before beginning any exercise routine and choose activities that you enjoy.

Alan Crothers, PT, SCS

Board Certified Sports Clinical Specialist

Downtown Site Manager


Urinary Incontinence

Women’s Health

Do you have urinary leakage when you cough, sneeze, laugh, or exercise?  If so, you are in a large sisterhood of women who suffer in silence.  A common misconception is that Urinary Incontinence(UI) is natural part of aging and nothing but surgery can be done about it.  This is far from the truth.  Actually, there are several non-invasive treatments.  One is the simple Kegel exercise.  If you are doing it correctly, no one can tell.  You can do this waiting in line, in the car, or while talking on the phone.  There also may be certain foods/fluids in your diet that are irritating your bladder.  If  you try limiting coffee intake and note a change in your symptoms, this could be a sign of an overactive bladder that is also responsive to Physical Therapy treatment and Kegel exercises.
The most important thing to know is that no one can help you if they don’t know that you are suffering.  Talk to your healthcare provider to make sure it is not something more serious.  Then consider a regimen of Kegel exercises.  The Women’s Health Section of the American Physical Therapy Association has an informative site for information and finding clinicians.

Andrea Goldberger, PT
Women’s Health Lead Therapist

Shoulder Injuries & Skiing/Snowboarding

With snowboarding season well under way many people are injuring their shoulders. This seems to happen in snowboarders more often than skiers, because skiers tend to land in a different position due to their poles. Some of the most common injuries that come into the emergency department include collar bone fractures, acromioclavicular (AC) separations and shoulder dislocations. These happen most often from landing on outstretched arms after catching edge or missing a jump over two feet high. Symptoms include pain and possibly a deformity of the shoulder. While most minor collar bone fractures and AC separations heal themselves with immobilization, shoulder dislocations may require more involved rehabilitation. This is because many of the muscles (rotator cuff) and ligaments around the shoulder get either sprained or torn. Torn muscles and ligaments can cause just as much pain as a broken bone and often times take longer to heal.  Shoulder injuries are particularly aggravating because of people’s tendency to use them before they are completely healed, which can lead to secondary complications.

            Prevention is the best way to avoid all of these problems.  It is a good idea to learn how to fall if you plan on learning how to snowboard or if you are interested in terrain parks.  Deprogramming your brain is the first step – you must get used to the idea that using your arms to break you fall is a bad idea.  Next, you must practice; if you are just learning how to snowboard falling should come naturally.

            In the event you do injure your shoulder seek professional medical attention to determine the severity and to receive proper treatment. And remember to beware the famous last words, “hey, watch this!”

Tyler Jepson, DPT

Emergency Department Physical Therapist

Arthritis and Weather

For those of you with arthritis- have you ever noticed how the weather affects how you feel? Have you been able to predict rain or snow with amazing accuracy? Have you ever wondered how the rainy weather where you are traveling to might effect what you feel like when you get there?There is a fun web site endorsed by the Arthritis Foundation that may help. Go to, on the home page on the top left is a box that asks for your city, state or zip code. The local forcast will come up and at the bottom of the page is a section on weather for your health. They have an Arthritis Index measure. They take into consideration changes in atmospheric pressure, temperature and humidity and predict if symptoms will be mild to severe. To get this measure for another day, say later in the week or the following week choose the 1-5 day forcast. Pick the day you are curious about and click on forcast details, this will bring up an Arthritis Index measure for that day for morning and evening.It can be fun and useful. Try it for a while and see if in fact their index matches how you feel. There are many factors that influence how you feel. How active you have been, a sudden increase or decrease in activity, viruses, how you have slept and your stress level to name a few. The idea is to be prepared, maybe plan less on days you think will be more painful. Have cold or heat handy to help with any increase in pain.

By the way AccuWeather also has a Frizz Advisory to help you avoid bad hair days.

Susan Gordon PT

Arthritis Program Lead Therapist