Experiencing knee pain can limit your tolerance to walking.

Osteoarthritis (OA) of the knee is one of the leading causes of functional limitations. The knee pain caused by OA frequently leads to the need for a total knee replacement.

Walking, however, can be a non-pharmacological knee injury treatment for those with knee osteoarthritis.

Exercise can help improve range of motion and the strength of the knee. Walking vigorously for 5-10 minutes is now being recommended as a treatment for knee osteoarthritis and may limit the need for a joint replacement.

Walking is an activity that does not require any equipment and can help reduce stiffness and inflammation in the knee joints. Since there is no blood supply in the knee joint, this area relies on the movement of the joint to move fluid. This fluid helps to provide nutrition to the joint. Walking is a weight-bearing exercise that also helps to improve bone health.

Walking vigorously has been found to delay the need for a knee replacement for those at risk of developing functional limitations as a result of knee arthritis. There was a decrease in the incidence of knee replacement for those that participate in a regular walking program than those that did not.

Starting a Walking Program for Knee Health

To maintain the health of your knee joints, it is recommended to walk a range of 3,000-6,000 steps per day, or 5-10 minutes of moderate to vigorous walking.

If you are starting a walking program, take it easy at first. Start at a pace that is comfortable for you. You can either start by walking for five minutes or, if you received a new step tracker over the holidays, try for around 3,000 steps. As your strength and endurance improve, you can walk up to 10 minutes a day or around 6,000 steps.

A good pair of shoes will also help support your knees. Walking on a track or asphalt will have a slight decrease to the impact on the knees. If this is still too much, walking in a pool is an excellent form of exercise that limits the impact to the joints.

The important take away is just to get moving.

With more than 600,000 knee replacements performed every year, many people were unsure if walking would have any effect on increasing or decreasing the need for knee replacement.

When taking into account the intensity and duration of walking, there was not an increase in structural damage to worsen knee pain. The decrease in knee replacement frequency was most noted between those that walked and those that did not participate in any physical activity.

If you do have knee pain, physical therapy is a great place to start to get you moving again. You will be provided a knee injury treatment plan with safe exercises that focus on improving function and minimizing the effects of knee arthritis. Start by requesting an appointment.

Falls can be problematic for anyone. However, in the elderly population, this can be a bigger concern. Falls can lead to injury or be indicative of other health issues. If someone you know has fallen, or if you are concerned that they are a fall risk, then there are several things to consider and multiple ways movement therapy can help.

Falls can be the sign of medical conditions. An individual can become weaker due to medical conditions that can lead to a fall. Once an individual has fallen, they are at a higher risk for future falls. It is important for these individuals and their caregivers to seek out what could have led to their fall.

After a fall, a follow up with the physician may be in order. The doctor can investigate if there are other conditions that led to the fall. These can include dehydration, anemia, atrial fibrillation, among others. Additionally, their blood pressure should be checked. This should be checked in both the seated and standing positions to determine if this is a contributing factor. The doctor can also determine if any of their medications could contribute to changes in function. It may also be beneficial to have their vision re-checked, or if any home modifications should be made.

Physical therapy can further investigate gait abnormalities and imbalance issues. Once other medical concerns have been addressed, movement therapy can help to improve strength and balance. A physical therapist can assess gait abnormalities and determine a treatment program to best improve gait mechanics. Physical therapy will also focus on any strength deficits that an individual may present with. If there are any pain issues or limitations in flexibility, a physical therapist will be able to address these issues as well.

A physical therapy evaluation will usually include a gait speed assessment, as gait speed is indicative of fall risk. Gait speed has been called “the sixth vital sign.” Again, the ability to be able to ambulate at a safe speed can prevent falls. When an individual has difficulty maintaining a normal gait speed, they will have difficulty making the proper reactions when their balance is challenged. Physical therapy can focus on improving step height and stride length to avoid shuffling while walking. Therapy can also help improve endurance to tolerance to daily activities such as household chores.

Finally, physical therapy can help to improve the quality of life for an individual after a fall or to prevent a fall from occurring. Falls can contribute to injuries and decline in function. However, this does not have to be the case. Physical therapy will assist in maintaining and improving function and life.

If you or a loved one has experienced a fall, contact us to schedule an appointment. One of our physical therapists will assist you through movement therapy.

If you have chronic pain symptoms and are a smoker, there may be a correlation between the two. Chronic pain affects many aspects of life, including sleeping, immune function, and vision. Smoking has a detrimental effect overall health, but studies have shown there is an increased dependence on tobacco due to chronic pain. The team at Foothills Sports Medicine can show you physical therapy benefits and how to fight both chronic pain and smoking.


Smokers make up twice the number of people who experience pain when compared to the general public. Approximately 42% of the population who experienced chronic pain last year were smokers. They are also more likely to be less active, rely on pain medication, and report increased stress in their lives. Unfortunately, smokers with this chronic pain may seek out other treatments that include alcohol or illicit drugs. This can worsen depression, which is common in high levels among smokers.


The most likely correlation between smoking and pain is carboxyhemoglobin induced anoxia or vascular disease; this can lead to disc degeneration in the spine. Smoking brings in a variety of toxic substances that damage the interior lining of blood vessels, which impedes their ability to carry oxygen, leading to tissue starvation, and degeneration. Medication efficiency is also affected because a smoker’s metabolism is much higher.


There are indications that smoking can cause a slight analgesic effect as it makes the pain receptors hypersensitive to pain, thus increasing the desire to smoke. Chronic exposure to nicotine sensitizes pain receptors, decreases pain tolerance, and increases pain awareness, resulting in greater need for analgesic agents.


Individuals who seek cigarettes for pain relief describe their pain as more constant, and use cigarettes to modulate pain and stress, which increases their likelihood of smoking again. When smokers are suffering pain, they also tend to smoke more frequently. They falsely believe that smoking helps their pain by alleviating anxiety, depression, anger, and frustration.


Starting to smoke begins a dangerous downward cycle of degradative health effects. Seeking treatment from a therapist from Foothills Sports Medicine and learning about physical therapy benefits can teach an individual to control their pain symptoms without the need of nicotine. Exercise can help by increasing activity level and improving one’s health. Improving activity and decreasing pain will positively affect your quality of life, so don’t wait.

We have all heard the benefits of exercise; it can help improve strength, cardiovascular function, and quality of life. However, finding time to exercise can be difficult. So how much activity do we need to perform in order to have an improvement in our health?

The surgeon general reports that most people begin to see increased health benefits when performing at least 30 minutes of moderate activity on most, if not all, days of the week. This specific amount of activity maximizes the improvement of cardiovascular fitness and bone health, the ability to perform daily activities, and it lowers the likelihood of developing back pain and disability. Improvement of one’s health also minimizes the cost of health care.

This recommendation does allow for a cumulative amount of activity, but it also permits a less continuous flow of activity, than say, three 10-minute sessions throughout the day. This could include activities such as using the stairs, going for a short walk on your lunch break, or performing a home exercise program designed by your physical therapist.

In one recent study from McMaster University in Hamilton, Ontario, the researchers examined the effects of interval training on improved fitness. The researchers separated men into three groups. The first the control group, was told not to change anything about their diet or sedentary lifestyle. The second group rode a stationary bicycle for 45 minutes at a moderate pace. The final group rode the stationary bicycle for a total of 10 minutes, while performing interval training. They were instructed to warm of up for 2 minutes, then pedal as hard as they could for 20 seconds, return to a slow pace for 2 minutes, sprint again for 20 seconds, recover at a slow pace for another 2 minutes, sprint for one last interval of 20 seconds, and then cool down for three minutes. This workout lasted ten minutes with only one minute of strenuous activity. Both exercise groups completed three sessions a week for 12 weeks.

Re-examining the participants of this study, the researchers found that both exercise groups had similar gains. The subjects demonstrated increased endurance by almost 20%, significant improvements in insulin resistance, and changes to the muscles that improved both energy production and oxygen consumption.

So what does this mean for the average person? If you have the time for a 30-45 minute workout each day, you will enjoy the added health benefits of exercise. However, this data also indicates that you can still reap the benefits from only a few minutes of exercise. If working out for long periods of time, most days of the week seems too daunting, on your body or schedule, you can still have improvements from a shortened workout. Of course, the most important step is getting started.



Gillen JB, Martin BJ, MacInnis MJ, Skelly LE, Tarnopolsky MA, Gibala MJ (2016) Twelve Weeks of Sprint Interval Training Improves Indices of Cardiometabolic Health Similar to Traditional Endurance Training despite a Five-Fold Lower Exercise Volume and Time Commitment. PLoS ONE 11(4): e0154075. doi:10.1371/journal.pone.0154075

Janene Alcantar, PT, DPT, is an AZ physical therapy expert located at our Surprise, AZ facility. She is here to explain what deep core muscles are and how to engage them in order to help support a healthy body:

What does it mean for your physical therapist to engage your deep core? Though frequently taught, the concept is often misunderstood by professionals throughout the industry.

The deep core involves the diaphragm, pelvic floor, transverse abdominis, and multifidus muscle. These muscles work together to provide support for your entire body. If one is overactive or underactive, engaged incorrectly, or engaged at the wrong time, dysfunction can result.

If you have pain trying to maintain correct posture throughout the course of the day, you may have dysfunction in your core muscles. For example, sitting with poor posture at a desk for extended periods of time can reduce your core muscle strength. Repetitive movements performed incorrectly throughout the day, or no use of the muscles at all, can cause major problems.

Over time, people may lose the ability to engage their deep core muscles, which is essential for proper back function. Fortunately, trained physical therapists can help patients return function to these muscles.

The first crucial step in joining a core strengthening program is proper assessment. Your physical therapist will address your individual needs and implement a personalized program. Rehabilitating the core muscles requires training since they need to not only engage correctly but improve their endurance.

Women and men quickly lose strength in these muscles as our movement patterns change, but patients can always be taught lifting mechanics and are encouraged to maintain an upright posture for strengthening.

As a trained professional, I can help you rehabilitate weak core muscles. I also know where issues can arise. Engaging deep core muscles does not mean tightening them as hard as possible. You shouldn’t feel tension in your ribs or into the gluteal region at any point. Even though the diaphragm is involved in exercises, you should still be able to speak and breathe as deep core muscles are activated.

For example, one of the best positions for core strengthening involves lying on your back with your knees bent. Next, place your fingers towards the middle on the anterior superior iliac spine (ASIS), and as you breathe out perform a Kegel contraction. You can feel a Kegel contraction by squeezing the muscles of the pelvic floor as if you were stopping a flow of pee. You should feel the lower abdominal region become tight. Relax after holding the position for five seconds.

It can be tricky and the Kegel exercise can be performed incorrectly. The key is to pull the muscles up. Many will bear down to feel a contraction in this region. Additionally, patients have to pull their bellies in, rather than out, when engaging the transverse abdominis muscle. A physical therapist can teach you many core strengthening exercises that can be incorporated into an individualized exercise program.

Many have never properly engaged their deep core muscles, or have lost control, either due to pregnancy or poor awareness. With the assistance of a trained professional, you could see your posture and overall core stamina increase with physical therapy.

Our experts at Foothills Sports Medicine Physical Therapy know how to help you! If you have questions about chronic back pain, your posture or deep core-strengthening, make an appointment today! To learn more about AZ physical therapy at Foothills Sports Medicine Physical Therapy, and what our certified specialists can do for you, check out the Foothills blog.