Runner’s Knee Treatment in Visalia and Hanford


We hear it all of the time.  I didn’t know that PT is an excellent option for runner’s knee treatment in Visalia and Hanford.  It’s true…yes, active individuals are at a higher risk for runner’s knee, but also true that physical therapy can address symptoms before they get worse.

If you run or participate in other sports that involve lots of running on a regular basis, you’re putting yourself in a good position health-wise to maintain adequate fitness.  Unfortunately, you’re also placing yourself at an increased for a number of running-related injuries, and a condition called patellofemoral pain syndrome (PFPS) is high on that list.  PFPS can truly dampen your ability to keep staying active, but help is on the way in the form of physical therapy.

The knee consists of two major joints: the tibiofemoral joint, which connects the shinbone (tibia) to the thighbone (femur), and the patellofemoral joint, which connects the kneecap (patella) to the femur.  PFPS—also known as runner’s knee—is essentially an umbrella term used to describe any type of pain that arises from this patellofemoral joint or the area directly surrounding it.  Another way of explaining it is pain at the front of the knee, in and around the patella.

Runner’s knee is regarded as an overuse injury, which means it usually develops due to excessive or repetitive movements that require the use of the knee.  This is why the condition is most common in individuals who are physically active with running or other sports, especially when someone suddenly increases the amount or type of training in their routine.  Other contributing factors include weakness, tightness or stiffness in the muscles around the knee, or an abnormality in the way the lower leg lines up with the hip, knee or foot.

Together, these conditions can interfere with the ability of the patella to glide smoothly on the femur during movement, and this increased friction is what is responsible for the pain and other symptoms associated with runner’s knee.  Patients with runner’s knee typically report feeling pain in or around the patella when walking up or down stairs/hills, after long periods of activity or sitting, or when spending time on uneven surfaces.

These symptoms can certainly make it difficult to keep active or even get through the day without issue, and many patients with runner’s knee have to take time away from their routine as a result.  But physical therapy can actually address these symptoms as soon as they begin and help patients recover before their condition gets any worse.  A typical physical therapy program will include the following:

  • Strengthening exercises
  • Stretching exercises
  • Sport-specific training
  • Taping or bracing if necessary
  • Cross-training guidance to avoid too much time in one sport

Results from a recent review of several studies illustrate just how effective a physical therapy program can be for patients with PFPS:

The studies indicated that manual therapy combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles.

So if you’re an active individual and you’ve recently noticed some pain developing around your patella, it could be runner’s knee, and the best way to prevent it from getting any worse is to see a physical therapist right away.


Physical Therapy for Chronic Ankle Sprains – Why You Should Consider It


The lower the location of a joint in the body, the more weight it’s responsible for supporting.  The ankles, then, have the tall task of supporting the entire body, and this is one of the main reasons they are injured so frequently.  Ankle sprains are the most common injury seen in the athletic population, and they have the power to throw a wrench in the spokes of any active person’s training.  They can also lead to a long-term cycle of re-injury, but all this can be avoided with a physical therapy program.

If you play sports, there’s a fairly strong chance you will sprain your ankle at some point.  Ankle sprains account for up to 45% of all sports injuries, and approximately 25,000 people sprain their ankle every day in the U.S.  The sport you play will also affect your odds, as the majority of sprains (41%) occur in basketball, followed by football and then soccer.  This mainly has to do with the movements that are common in each sport, and lots of jumping and cutting significantly increases the risk for ankle sprains.

Ankle sprains involve the ligaments of the ankle joint, which are flexible bands of tissue that connect one bone to another.  Ligaments are elastic and can be stretched to a certain length and then return to their original position, but they have a limit.  When any of the ligaments in the ankle is stretched beyond its maximum range of motion, damage will occur and result in an ankle sprain.  Symptoms will vary depending on the severity of the sprain, but usually include some—or all—of the following:

  • Pain
  • Swelling
  • Tenderness
  • Stiffness
  • Instability

If you do experience an ankle sprain, the prognosis is usually quite good, and most people can get back to sports or training within about 4-6 weeks; however, the risk of a condition called chronic ankle instability (CAI) increases significantly after the first sprain.  This is why proper treatment from a physical therapist is necessary for a full recovery and to reduce your chances of experiencing another ankle sprain in the future.  Treatment programs are always individualized, but typically consist of RICE (rest, ice, compression and elevation), stretching and strengthening exercises, and balance and functional training.

Physical therapy is recommended for both initial ankle sprains and for patients that continue to sprain their ankles repeatedly, and research has shown that it’s effective in both cases.  The effectiveness of physical therapy and exercises was supported in a recent review of studies that concluded as follows:

For the treatment of acute ankle sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilization, with moderate evidence supporting exercise and manual therapy techniques, for pain, swelling and function. Exercise therapy and bracing are supported in the prevention of CAI.

While it might sound like a single ankle sprain means a long-term series of problems, this is more likely to be the case if the injury is not managed properly from the start.  This is why you should see a physical therapist first and fast after your first ankle sprain to reduce your chances of future injury.


Identifying Low Back Pain Causes…an Exercise in Futility for Most

Identifying the cause of your low back pain is usually difficult, but physical therapy is a universal solution to address most cases

When it comes to low back pain, there is an abundance of alarming statistics available that can help put the massive size of the problem in perspective. Here are a few key examples:

  • Low back pain is currently the number one cause of disability in the world
  • Every year, about 37% of the world’s population will experience low back pain
  • At any given point in time, about 540 million people are affected by low back pain globally
  • The amount of years of disability caused by low back pain since 1990 has increased by 54%

No One is Really Immune to Lower Back Pain

Research has also suggested that very few people are completely immune to the impact of low back pain. The number of individuals affected by it is actually highest in high-income countries, but rates are rapidly increasing in low- and middle-income countries throughout Asia, Africa and the Middle East as well. And although low back pain is more common in women and older individuals than in other groups, it can affect just about anyone of any age. In fact, one study showed that 40% of 9-18-year olds throughout the world report having had low back pain.

But despite the incredibly high number of people with low back pain and all that’s known about it, this next fact may surprise you more than anything else: in the vast majority of patients, the actual cause of the pain cannot be identified. In some patients, problems like spine fractures, inflammation disorders, infection and cancer may be responsible, but for everyone else, the cause is not known, and they are classified as having “nonspecific low back pain.”

Additional Factors that Impact the Perception of Back Pain

For these individuals, there are several factors that might play a part in the development of their low back pain. These include:

  • Psychological factors like depression and anxiety,
  • Social factors like income and education levels, and
  • Inherited genetic factors.

People with chronic conditions like:

  • Asthma,
  • Headaches,
  • Diabetes,
  • Smokers, and
  • Individuals with Previous Episodes of Back Pain…

…are also more likely to experience low back pain than those who are in good health.

This may sound overwhelming and perhaps even dampen your spirits if you’re currently dealing with low back pain, but as physical therapists, we’d like you to know that the cause of your pain is not as important as you may think. Many people get hung up on the specific diagnosis of their pain and go on to have tests to determine the source of their problem. But as you can see, getting an accurate diagnosis is rare, and these tests may lead to unnecessary treatments like surgery for some.

Don’t Focus on the Cause of Lower Back Pain When It Can Rarely be Determined

Rather than focusing too much time on the diagnosis, physical therapy concentrates on addressing the problem starting with your very first session. Throughout movement-based therapies and exercises individualized according to your abilities and goals, we will work with you on a one-on-one basis and target your pain from many angles. We believe that movement is a key ingredient for reducing low back pain, and this is why we promote a more active lifestyle along with your treatment program from the get-go.

Current research is continuing to support physical therapy as an effective means to alleviate back pain, no matter the cause. In one recent study that reviewed current guidelines on the best treatments for low back pain, researchers recommended the following:

For many patients with nonspecific low back pain, simple first line care (advice, reassurance and self-management) and a review at 1-2 weeks is all that is required. If patients need second line care, non-pharmacological treatments like physical therapy should be tried before pharmacological therapies.

So if you’re dealing with low back pain, don’t waste your time worrying about what might be causing it. Instead, take action and see your physical therapist now for an evaluation and treatment plan that will address your issues and get you back to moving pain-free once again.

Take-home Messages:

  1. The cause of lower back pain can rarely be determined.
  2. 99% of lower back pain does NOT require surgery.
  4. The faster you start physical therapy, the better your outcome in almost all cases.

What are you waiting for?  The clinical research is clear and our expert clinicians here in Visalia and Hanford are ready to help.

Contact us today.

Fall Prevention Program in Visalia

Lifestyle modifications and physical therapy can reduce your risk of falling later in life

If you happen to be over the age of 65 or have a loved one in that age group, you are probably aware of the risk of falls and the damage that can be done if one occurs. Awareness is essential for preventing falls, but all the information out there can be overwhelming and lead to a greater fear of falling, which can actually have a negative effect. With that in mind, we’d like to explain some basic steps that can reduce not only your risk, but your fear of falling as well. Falls are the leading cause of injury for older Americans, and approximately one-third of adults aged 65 and over falls each year. When one falls, there’s a good chance bones will be broken. The femur (the thigh bone that meets with the socket in the pelvis) is often fractured as a result of these falls.  Other common fractures include the spine, forearm, leg and ankle. Falls can occur for any number of reasons, but they are usually due to a combination of internal and external factors. Poor vision and/or balance in an environment with bad lighting, bad footing or slippery surfaces can all be a recipe for a fall. If a fall does occur, many individuals go on to develop an even greater fear of falling, even if they don’t get injured. This can cause them to limit their activities, which leads to reduced mobility and loss of physical fitness. Worst of all, this process can become a vicious cycle that actually increases the risk for falling.

Overcome the Fear of Falling & Improve Your Physical Fitness

What’s most important to realize is that falling should not be seen as an inevitable part of aging. By being aware of your risk and making lifestyle adjustments both in and out of your home, you can significantly reduce your risk of falling. Below are some fall-prevention tips to help you stay on your feet and injury-free:
  • Stay physically active, since good fitness can help prevent falls
  • Wear shoes with nonskid soles, and consider getting Velcro or spyrolaces
  • Conduct a walkthrough of your home (with someone else if you’re uncertain) to identify possible problems that may lead to a fall, then make necessary changes
  • Install handrails on both sides of stairways, avoid clutter and items on the floor
  • Get your eyes checked once a year, and get adequate calcium and vitamin D
  • If you’re taking numerous medications, learn the side effects and if there are any interactions that can increase your risk of falling
  • Take your time, be patient and ask others for help with difficult, risky tasks

Beyond Eduction & Lifestyle Modifications, Our Balance Program Can Really Help

Aside from making these important lifestyle adjustments, physical therapy is another positive means to reduce your risk for falls. A physical therapy program will help to improve your strength, flexibility, balance and overall fitness, all of which will make you more capable of navigating your daily life with a lower fall risk. To highlight how physical therapy can help prevent falls in older adults, a recent study compared resistance (strengthening) exercises to aerobic exercises, both of which are commonly prescribed by physical therapists. Researchers concluded with the following:
Adding resistance exercise to aerobic exercise improves factors associated with an increased risk of falls. However, both exercise regimes, combined or aerobic alone, are more effective than no exercise in the reduction of fall risk factors. Reference:
So if you’re concerned with your risk for falling later in life, contact us for a consultation and find out how we can help you keep your fall risk at a minimum. NOTE: We have more information about our Balance Program if you click here.

MRI for Lower Back Pain in Visalia – Why You Might Want to Avoid It

Seeing a Physical Therapist First and Avoiding an MRI  for Work-Related Lower Back Pain Will Often Lead to Better Outcomes

Of all regions of the body, the spine is associated with a much higher amount of pain than anywhere else. In fact, low back pain ranks second only behind the common cold for reasons to visit a doctor. Up to 80% of the general population will experience at least one episode of low back pain in their lives, so if your back is bothering you right now, you’re far from alone.  If you’ve experienced a work-related injury, and are looking want an MRI for lower back pain in Visalia, read on.  We think you will find this information valuable.

Lower Back Pain is a Common Work-Related Injury

For the majority of individuals with a history of low back pain, it’s easy to attest to the fact that the pain usually makes it more difficult to complete everyday tasks that you normally complete without even thinking about. It’s for this reason—and particularly when the pain is more intense—that low back pain is also one of the leading reasons that people miss work due to disability.

Low back pain can develop over time in a gradual manner or it may come about suddenly. For some, this leads to symptoms on a nearly constant basis, while for others, symptoms only arise every so often. Symptoms vary in each individual, but typically include the following: pain, tenderness and/or stiffness in the lower back, difficulty bending, lifting or twisting, weak or tired legs, difficulty sitting or standing for extended periods, and pain that spreads to the buttocks or legs.

False Positives with MRI’s are Common…Don’t Get Labelled as Having a Problem When It Doesn’t Exist

When an episode of low back pain first strikes, it’s categorized as acute, which is what most individuals experience.  Of those who experience a work-related back injury, many decide to seek out treatment for this pain… many go straight to their doctor for an evaluation and advice on what to do next. Unfortunately, this decision can prove to have some consequences that you might not expect. Some doctors will order additional tests like an MRI to better visualize what may be affecting your spine. But often times, the results from these tests will not help to improve the quality of treatment, and can instead lead to risky interventions like surgery.

To illustrate what may happen if you see a doctor first, one study investigated the effect of having an MRI on patients with work-related low back pain. Some of their key findings included:

  • A high percentage of people studied THAT WERE PAIN FREE, had a positive MRI
  • Reference here
  • Having an MRI was associated with a worse outcome in all patients who had one
  • Patients who had an MRI spent between $12,948-$13,816 more on medical costs than those who did not
  • Click here for the Reference

Costs are generally higher in patients who have an MRI because not only is the test itself expensive, but these patients are also more likely to be instructed to have treatments like surgery based on their results, which comes with its own set of risks. But there’s a much easier way of avoiding all of these costs in the first place: see a physical therapist first.

MRI Results Alone, Do Not Indicate the Cause of Lower Back Pain

In most cases, a physical therapist won’t send you to have an MRI for low back pain unless they think it’s completely necessary, which is rare. Instead of wasting time, needlessly suffering, waiting for results and being told to have potentially risky treatments first, you should try conservative, natural care first.  Our physical therapist will start treatment during your first visit and immediately work towards addressing your problem and alleviating your pain. So for any low back pain that’s hindering your enjoyment of life, see one of our physical therapists for the fastest and safest path to a full recovery of your abilities.

Call Us to Learn More.  Click here to visit our contact page.

Shoulder Specialist in Visalia – What Rotator Cuff Patients Need to Know

If you are looking for a shoulder specialist in Visalia, because of a rotator cuff injury (a common cause of shoulder pain), seeing a physical therapist first can help you avoid unnecessary treatments like surgery.  This article provides common sense reasoning as to why we can help.

What’s the Rotator Cuff ?

You’ve probably at least heard of the rotator cuff—especially if you play or watch sports—but what you may not know is just how important of a structure it is. The rotator cuff is a group of muscles and tendons in the shoulder joint that allows the arm to lift and rotate.  In addition to permitting movement, it also stabilizes the shoulder and helps the joint maintain good alignment and posture during many daily activities.  So any time you experience one of the countless displays of flexibility in your shoulder, you have your rotator cuff to thank.

Because the rotator cuff serves such an important role and is used so frequently, it’s also a common site of injury.  Injuries to the rotator cuff most often occur in people who repeatedly perform overhead motions in their profession or recreational activities. Some examples of those affected by rotator cuff injuries include painters, carpenters and athletes involved in tennis, baseball—especially pitchers—and swimming.

Repeated Overhead Activity Leads to Injury Which Might Mean You Need to See a Rotator Cuff Rehab Specialist

When these activities are performed regularly for a long period of time—or through the aging process—the rotator cuff tendons eventually become inflamed from over-stretching or repetitive stress, which can lead to pain or injury.  The most common injuries seen are rotator cuff tendinitis (or shoulder impingement), shoulder bursitis and rotator cuff tears.  The primary symptoms of a rotator cuff injury is a dull ache deep in the shoulder that makes it difficult to reach behind the back or lift the arm.

To investigate just how many people in the general population have rotator cuff injuries, one study (click for the reference) examined the shoulders of 683 individuals, some of which had shoulder pain and others who did not. This is what they found:

  • Overall, 20.7% of participants had a rotator cuff tear
  • 36% of participants with shoulder symptoms had a rotator cuff tear
  • 16.9% of participants without shoulder symptoms had a rotator cuff tear
  • The risk factors for a rotator cuff tear were trauma to the arm and older age

This study shows that rotator cuff tears are very common, and in many cases, a tear may exist even if the individual does not have should pain or other symptoms. Unfortunately, if you have a rotator cuff injury and go to a doctor first for an evaluation, there’s a chance that you may be instructed to have unnecessary treatments like an injection or surgery if they find a tear. But as you can see, tears are present in many people who aren’t even in pain, and surgery is rarely needed to treat it. Surgery is also very risky and expensive.

Why Seeing a Physical Therapist First Makes Perfect Sense…

On the other hand, if you see a physical therapist for your rotator cuff injury first, in most cases they will treat you right away regardless of whether or not you have a tear. As a result, you can begin your path to recovery through various exercises, manual treatments and other interventions during your first session, while avoiding expensive and potentially dangerous treatments in the process.

So if your shoulder is bothering you and preventing you from functioning normally, make the smart choice of seeing a physical therapist first for the best possible outcome.

Click here to visit our Contact Page, then give us a call to learn more about how we can help.

Visalia Headache Specialist Near Me


Overcome your frustrating headaches with the help of a Visalia headache specialists … one of our expert trained physical therapists here at Bacci & Glinn Physical Therapy.

Frequent headaches can sure throw a wrench in your spokes, and most of us know how they can interfere with our ability to function normally.  But for the 45 million Americans with chronic headaches, this inconvenience doesn’t just come and go every so often.  Instead, headaches are a regular occurrence that can strike them any time.

Over 100 different types of headaches have been classified, but they are all generally categorized as either primary or secondary.  A primary headache simply means the headache itself is the disorder, while secondary headaches result from other conditions like a neck strain, TMJ muscle disorder, stroke, infection or head injury.

Most headaches are caused by a combination of factors, and different triggers can set off headaches in different people.  Some of the more common causes of primary headaches include stress, anxiety, lack of physical activity, bad sleeping habits, certain medications, poor diet and bad posture.  In every case, it’s important to determine the type of headache first before attempting to treat it.

Headaches Often Respond Favorably to Physical Therapist Directed Treatment

No single treatment exists that’s capable of eliminating all headaches, but all types are treatable.  While many people reach for pain-relieving medications like ibuprofen or acetaminophen when a headache hits, these drugs don’t offer a long-term solution to the problem and may not even work for some individuals.  Physical therapy, on the other hand, is designed to identify the problem that’s causing the headache and then address it with a variety of interventions.

A physical therapy treatment program for chronic headaches will usually include some of the following components:

  • Soft tissue mobilization: rhythmic soft-tissue stretching of the neck and upper back muscles
  • LightForce™ laser therapy: the 15 Watt therapeutic laser facilitates pain relief
  • Neck mobilization: manual technique to gently move joints of the neck
  • Strengthening exercises: to increase strength of the muscles that stabilize the upper back and neck
  • Stretching exercises: to increase range of motion to tight muscles in the neck, chest, and upper back
  • Posture education: making slight modifications to the home or office to improve overall spinal posture, reduce stress and increase body awareness

Clinically Proven Headache Treatment for Visalia Residents

Research has shown that physical therapy can be effective for helping patients with headaches to improve, like this recent study, which concludes:

Compared with usual care, participants receiving physiotherapy reported significant reductions in headache frequency immediately after treatment (mean difference -1.6 days, 95% confidence interval [CI] -2.5 to -0.6), at 6-month follow-up (-1.7 days, 95% CI -2.6 to -0.8), and at 9-month follow-up (-2.4 days, 95% CI -3.2 to -1.5), and significant improvements in all secondary outcomes immediately posttreatment and at 6- and 9-month follow-ups, (p<.05 for all). No adverse events were reported.

CONCLUSIONS:Physiotherapy treatment provided benefits over usual care for seniors with recurrent headache associated with neck pain and dysfunction.  Reference:

Headaches may be nuisance to your daily life, but it doesn’t have to be this way.  Contact our physical therapy team for a complete evaluation of your condition and a personalized treatment program that will address your issues and reduce the occurrence of these bothersome episodes.  Click here to for contact information that’s right on our home page.


Looking for Shoulder Pain Treatment in Visalia?

When you are looking for shoulder pain treatment in Visalia, physical therapy is your best bet to help you bounce back!

The shoulder is the most flexible joint in the body, and it allows the arm to move in wide range of directions so that we can perform many of the dexterous tasks needed in daily life.  Unfortunately, this extreme flexibility comes at a price, as certain movements, postures and habits can cause damage to the shoulder and result in pain.

The shoulder is not actually a single joint, but a ball-and-socket made up of two joints, which combine with other structures in the region to allow the arm to move as it does.  Just about every movement that requires the use of our arms also involves the shoulder in some way, and it’s particularly important for reaching tasks and overhead activities.

Shoulder pain includes any pain that arises in or around the shoulder.  It may originate in the joints themselves or from any of the surrounding muscles, ligaments or tendons that make up the shoulder.  Most shoulder problems that result in pain are due to a tear or inflammation of a tendon, instability, arthritis or a fracture.  One of the most common causes of shoulder pain is when the tendons of the rotator cuff—an important structure that keeps the shoulder in place—become trapped under a bony area of the shoulder, which is called rotator cuff tendinitis.  Other conditions that can cause shoulder pain include shoulder impingement syndrome, frozen shoulder, tendinitis and bursitis.

NOTE: Quick Reference Guide to Shoulder Conditions We Treat

People who perform lots of overhead activities on a regular basis like painters, carpenters swimmers and baseball players are all at an increased risk for developing shoulder pain, and bad posture can lead to its development as well.  Most shoulder pain will dissipate within a few weeks with some rest and avoidance of activities that may aggravate it, but for pain that’s more severe or lingers for awhile, physical therapy may be necessary.  Physical therapy is one of the most proven effective methods to treat all types of shoulder pain, and treatment typically consists of the following:

  • Heat, ice, massage and other pain-relieving remedies
  • Stretching exercises to improve flexibility
  • Strengthening exercises to build back strength
  • Posture training for sitting and standing
  • Activity modification to help you avoid movements that make the pain worse

The use of physical therapy to treat shoulder pain is also supported in the medical literature as an effective way to foster improvements.  In one recent study on subacromial pain syndrome, another term for shoulder impingement syndrome, the conclusion states:

Exercise therapy should be the first-line treatment to improve pain, function and range of motion. The addition of mobilizations to exercises may accelerate reduction of pain in the short term.

Shoulder pain can be a real inconvenience, especially if it prevents you from participating in sports, but we are here to help.  Contact us to find out how we can address your shoulder pain and get you back to full strength as quickly and safely as possible.