physiquality blog: will I have arthritis after my knee injury?

As a person who has had five knee surgeries now, this is a very personal subject. One particular pre-op appointment comes to mind. I was living in Los Angeles, and I was preparing for a cartilage implant. After years and years of dance (many on tile floors), I’ve shredded my cartilage, and the doctors agreed this would help to repair the hole in my right knee’s cartilage.

So I go to see my GP for blood work the week before surgery. He looks at what is supposed to be done, looks up at me, and asks when I’m going to have my knee replaced. I dunno doc, can I get through this surgery (that’s supposed to delay a knee replacement) first?

In my own estimation, I was doomed from the beginning. I had arthritis in my right knee at 14. My left knee started sounding like Rice Krispies in my 30s. But I know that if I don’t remain active, I’ll simply put on more weight, and I’ll be more at risk for arthritis, as well as lots of other things. So it’s better to be as active as I can, with the hopes of postponing these other issues and surgeries as long as possible.

Will I have arthritis after my knee injury?

with advice from Mitch Kaye, PT

Unfortunately, if you have a traumatic injury to the knee like an ACL tear, a meniscus tear or even certain types of fractures, your chance of developing osteoarthritis increases significantly.

Osteoarthritis, which is the wearing away of cartilage, can occur normally with years of use, but it can also occur more readily after trauma around the knee. The Arthritis Foundation estimates that 700,000 knee injuries a year account for 12.5% of post-traumatic arthritis cases in the U.S., and they warn that younger athletes with ACL injuries are at risk of developing arthritis before they are 40 years old, often within 10 years of the original injury.

If you’re an athlete who has had one of these types of injuries, it’s not something you probably wanted to hear.

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physiquality blog: four signs you should STOP working out

When a new year begins, it’s a natural time to start new habits, particularly ones related to your health. You may or may not have eaten or drank your way through the holidays, and the lack of social events in January is a good time to start eating better, drinking less (alcohol) and moving more.

However, at any fitness level, there are ways your body is telling you that your activity is too much and that you need to stop. Immediately. (I know this from personal experience — I’ve had to walk out of two different dance classes due to a sharp, stabbing pain that eventually led to joint repairs and orthopedic surgery.) These are not signs to “rub some dirt on it” and get back to exercising. They are your body’s way of telling you to sit down and possibly call your doctor or physical therapist to see what is causing the symptom.

Four signs you should STOP working out

with advice from Mitch Kaye, PT

January often brings resolutions of better health and exercising more. After a month (or 6 weeks) of indulging, hectic holiday plans, and falling off the wellness wagon, it makes sense to try to improve your health through exercise. But there are times when you should listen to your body and stop exercising.

Despite the mantra “no pain, no gain,” if your body hurts, it’s trying to tell you something. Here are four things to be aware of when working out.

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physiquality blog: how to lace your running shoes

I have mentioned before that I am not a runner. But I can appreciate how your shoes affect your sport. As a dancer, whenever I wear shoes, they have to be anchored to my feet securely, no matter what kind of shoes I’m wearing or what I’m doing. So this running post made more sense to me than most.

How to lace your running shoes

with advice from Orthopedic Rehabilitation Specialists

For most of us, when we purchase a new pair of sneakers, we keep the laces the way they are when we tried them on. We might have a preference on how they are laced, but it’s primarily aesthetic — do you want the lace at your toes to be outside the grommets or inside?

But when it comes to running shoes, lacing is one of many aspects that becomes strategic. There are particular ways to lace your shoes for arch support, wide feet, numb toes… The list is longer than most people’s daily runs.

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physiquality blog: how to play hockey safely

The title of this month’s blog post may sound like an oxymoron, but it is possible to reduce injuries in hockey, the only sport where some players still fight to play without a helmet. Smart players and athletes know that it is better to think about your body for the long term, and making sure to wear appropriate gear and include the proper strengthening in one’s regimen are easy ways to reduce the chances of injury in a sport where, eventually, one hopes that players won’t trumpet a lack of teeth as something to brag about.

How to play hockey safely

with advice from Mark Salandra, CSCS

Hockey may not initially inspire thoughts of the world’s safest sport. With a reputation for brawls on the ice and toothless grins, parents may be understandably cautious about signing up their kids for the community hockey league.

However, with the proper precautions (and protective gear), the game can be played safely while those on the ice reduce their chance of injury.

Hockey is a unique sport, says Mark Salandra, a certified strength and conditioning specialist and the founder of (a Physiquality partner program). “It incorporates speed, agility and strength in ways that no other sport tests the body,” he explains. As with any sport, injuries can be caused by a variety of factors, including the level of participation, player position, protective equipment, violent behavior, and personal susceptibility due to pre-existing injuries and style of play.

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physiquality blog: running away from injury

I might have mentioned before… I’m not a runner. Even when I’m being chased. It’s just not my thing — I’m too accident- and injury-prone to consider it.

But if you do run, there are many way to reduce your chance of injury. Our experts had several important points about what to do before, during and after you run to make sure you return to your house injury-free.

Running away from injury

with advice from Lori Francoeur, PT, MSPT, CSCS,
Jeff Rothstein, MS, CSCS, TSAC-F, CES, USAW and Polar

Running is a common way to stay fit — in theory, all you require is a good pair of running shoes. But running can also lead to a variety of injuries. Our experts talked to us about the most common running injuries and how to avoid them.

According to Jeff Rothstein, the Director of Sports Enhancement for the PT Center for Sports Medicine, a Physiquality clinic in Akron, Ohio, the most common running injuries are to the foot, knee and back. Jeff notes that having the right running shoes is essential for avoiding injury.

Lori Francoeur, a physical therapist at Foothills Sports Medicine Physical Therapy Center in Arizona, agrees. She explains that runners should wear a “good supportive shoe that will provide adequate support and cushioning for your arch and heel.”

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physiquality blog: how will rehabilitation therapy help me get better?

It’s always a pleasure when my clients’ worlds collide. Right as I’ve been working with one client to expand from continuing education for physical therapy to include occupational therapy and speech-language pathology, this post came up for another client. So while I was happy to get the source materials from our members, it wasn’t difficult to understand the subtle differences between these practitioners.

How will rehabilitation therapy help me get better?

with advice from Randy Gustafson, PT, MS, MOMT, OCS,
Michelle Kessell, OTR/L, CHT,
and Jan C. Key, MA, CCC/SLP

The goal of rehabilitation therapy is to improve a patient’s health and wellbeing after an injury or illness. It’s a broad umbrella term that covers a variety of therapies. At PTPN, the parent company of Physiquality, therapists fall into three categories: physical therapy, occupational therapy, and speech/language pathology, sometimes referred to as speech therapy.

Physical therapy

Physical therapists are experts in biomechanics and the musculoskeletal and neuromuscular systems. In other words, says Randy Gustafson, the owner and director of Mesa Physical Therapy (a Physiquality network member in San Diego, California), “Their advanced degree focuses on learning everything about how the body moves.” Physical therapy incorporates specific exercises to strengthen muscles and improve function. Therapists utilize an integrated approach that includes modalities and manual therapy, he adds.

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physiquality blog: preventing baseball injuries

With professional baseball season in full swing, here’s a reminder for baseball parents that perhaps year-round baseball isn’t such a good idea. As I’ve written about in the past for Physiquality, playing multiple sports throughout the year strengthens athletes’ skill sets and lets stressed muscles from one sport rest while another set is tested. That’s why I was astonished to hear that in the South, it’s not uncommon for a young boy of 8 or 9 years to be on THREE different baseball teams that play in the spring, summer and fall. Given my own overuse injuries, I’m hoping that we can encourage our own son to diversify and enjoy a variety of sports and activities.

(And yes, this Cardinals fan managed to fit in a dig at the Cubs in her opening paragraph. Old rivalries die hard.)

Preventing baseball injuries

with advice from Mark Salandra, CSCS

Spring training is over and baseball season has begun. And while most sports injuries are as unexpected as the Cubs leading the American League at the beginning of June, there are a few things that parents and coaches — and baseball players — should know about preventing injuries during the sport.

Mark Salandra educates and trains athletes young and old in strength and conditioning, with the goals of better fitness and lower rates of injury. A certified strength and conditioning specialist, and the founder of, a Physiquality partner program, he points out five common injuries and conditions that players should be aware of.

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physiquality blog: the benefits of cold and compression therapy

When I originally spoke with these new partners for Physiquality in January, I was quite curious about their product. (I still am, actually.) Their wraps function in a very similar way to the Game Ready machines I had to rent after my knee surgeries. It was an expensive — and difficult to fill — machine, but the cold circulation and compression did wonders for my swelling post-surgery.

When I told the vendor of my five knee surgeries and continued activity, they joked that I should become a spokesperson for their company. Does that mean I can get a knee wrap for free? Still waiting to hear an answer; until then, this is a combination of their research and what I could round up on the definite benefits of using cold therapy in conjunction with compression.

The benefits of cold and compression therapy

with advice from PowerPlay

If you’ve ever sprained your ankle or injured your elbow, you probably know that it’s been standard practice for decades to apply ice after injury to decrease swelling and pain. Dr. Gabe Mirkin coined the acronym “R.I.C.E.” in 1978 (Rest, Ice, Compression, Elevation), and this concept became the standard in treatment of acute injuries and post-surgical patients.

While there has been some debate about whether cold therapy should be used for all musculoskeletal injuries, most healthcare practitioners would agree that proper use of ice or cold therapy can reduce swelling and pain. Here are a few reminders about using cold therapy:

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physiquality blog: why are younger athletes burning out of sports?

My family lived in the South for four years. Being Midwesterners, certain things made us remember that we weren’t from around there. The use of a plural you (as in, “you all”). The prevalence of pimento cheese. The obsession with SEC football.

But one thing caught me off guard — the number of baseball teams for younger athletes. A friend’s son was in elementary school, aged nine or ten, and it was common to play on one baseball team in the fall and a second in the spring. And many of those boys played on a third team in the summer. I thought about the statistics for Tommy John surgeries and how pitchers even in high school are having the surgery. I wondered if the parents were thinking about the physical repercussions of so much repetitive motion at such a young age. And the mental effects.

I’m not immune here. By high school, I was dancing 12 hours a week, and I had my first knee surgery at the age of 16. (And while I tried my hand — or foot — at sports, I was not very good.) But I hope that parents and coaches think about the advice of our experts below and consider the short- and long-term consequences of limiting kids to one sport at such a young age.

Why are younger athletes burning out of sports?

with advice from Jeff Rothstein, MS, CSCS
and Mark Salandra, CSCS

There are many reasons to sign your kids up for sports teams. They’ll build strong muscles and bones by being active, make friends and learn how to get along with others, and become more confident as they improve on the field. But many kids burn out and quit playing before they graduate from high school. Why?

“Parents and coaches need to remember that the primary goals of playing sports when younger are to improve motor skills while learning how to be a part of a team,” says Mark Salandra. A certified strength and conditioning coach who works with many student athletes as the founder of (a Physiquality partner vendor), Mark often sees parents (and coaches) that emphasize competition over fun.

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physiquality blog: injury prevention for dancers

As a dancer who has had multiple knee surgeries after 30+ years of training, this is a subject that is near and dear to my heart. I have spoken with physical therapists in the past about whether I would have tried some of these techniques to reduce my chance of injury, but thinking back to my 16-year-old self, I don’t know that I would have. And as my problems stemmed from a combination of nature and nurture — genetically misaligned knees that couldn’t handle the years of dance training with a turnout — there’s a part of me that doubts any additional exercises could have averted the surgical procedures.

But there are many other dancers that could avert serious injury by listening to their bodies and strengthening the muscles that oppose those used in dance. For more, read on for the advice from our physical therapist and trainers who work with dancers.

Injury prevention for dancers

with advice from Elisabeth Wheeler, PT, DPT
Ann Cowlin, MA, CSM, CCE,
Mark Salandra, CSCS,
and Wayne Seeto, OT, MSPT

Most dancers know that one of the challenges of the performing arts is to make it look easy, effortless – and painless. According to Elisabeth Wheeler, a physical therapist who works with dancers at Allegheny Chesapeake Physical Therapy in Pennsylvania, up to 90% of dancers will have an injury at some point during their training. So whether you are a professional dancer in a company, or one who takes classes for physical (and mental) activity, it is important to pay attention to your body in order to avoid injury.

Elisabeth notes that dancers can have a variety of injuries throughout the body:

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