Phoenix Osteopractic Physical Therapy

09/11/2025

Interesting shoulder mobility exercises.

09/04/2025

📃Management of chronic knee pain caused by postsurgical or posttraumatic neuroma of the infrapatellar branch of the saphenous nerve

📌 Key Takeaways

-Injury to the infrapatellar branch of the saphenous nerve (IBSN) is a relatively common complication after knee surgery, which can interfere with patient satisfaction and functional outcome.

-Symptomatic IBSN injury has been reported in 55–100% of patients following Total Knee Arthroplasty (TKA) , in 37–86% following ACL reconstruction, and in up to 28% following surgical meniscectomy.

-Injury to the IBSN may also result in neuroma formation due to Wallerian degeneration and subsequent axonal growth, leading to severe and debilitating pain.

-Following surgery, 80.0% reported improvement in leg pain, 68.0% reported clinically meaningful improvement, and 68.0% reported improvement in health-related quality of life.

-Overall, 72.0% reported they were satisfied with the surgical outcome.

-Lack of postoperative improvement was significantly associated with older age, female gender, multiple prior knee surgeries, and prior resection of IBSN neuroma.

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🩺 Clinical Implications

-Neuroma of the IBSN should be suspected in patients who develop neuropathic medial knee pain following orthopedic surgery or trauma.

-IBSN neuroma as a cause of debilitating chronic knee pain is likely under-recognized, particularly in community hospitals and other institutions without a dedicated peripheral nerve surgery unit.

-In properly diagnosed and selected patients, surgical neurolysis and resection of painful IBSN neuroma provide clinically meaningful pain improvement in a majority of patients as well as improvement in health-related quality of life.

-Future research should verify risk factors for poor postsurgical outcome and optimize selection criteria for surgical intervention.

👉Link to article in the comments 👇

📌Whay about physiotherapy?(out of the article)

🏥 Role of Physical Therapy in IBSN Neuroma Management

🔹 Before Surgery (Conservative Phase)

-Pain modulation:

Desensitization techniques (gentle massage, tapping, graded exposure to textures).

-TENS or other neuromodulation methods for neuropathic pain relief.

-Edema and scar management:

Soft tissue mobilization, scar massage, silicone pads if surgical scar sensitivity is present.

-Activity modification:

Avoiding positions or activities that overstretch or compress the nerve.

-Functional maintenance:

Gentle quadriceps strengthening, ROM exercises, avoiding aggravation of neuropathic symptoms.

🔹 After Surgery (Post-Neuroma Resection / Neurolysis)

-Wound care & protection: Early phase focus on healing, avoiding excessive stretch on the medial knee.

-Gradual desensitization: Continued sensory re-education to reduce hypersensitivity.

-Strength & mobility: Restore knee ROM, quadriceps and hip strength, and gait training.

-Neuropathic pain management: TENS, graded motor imagery, mirror therapy if central sensitization develops.

-Functional rehab: Progression to ADL training, balance work, and gradual return to activity.

⚠️ Key Considerations for PT

👉If neuroma pain is severe and refractory → physiotherapy alone is usually insufficient, and surgery may be required.

👉PT is most beneficial for symptom modulation, function maintenance, and postoperative rehabilitation.

👉Collaboration with pain specialists and orthopedic/nerve surgeons is crucial for comprehensive management.

12/20/2024

This is the base program that I use to help many many guys overcome their months and years of shoulder injury neglect. But I also customize several other exercises to address the specific needs of each patient. Hit me up with a DM if you want to learn more! Or reach out to me on my website or page.

11/09/2024

This can affect knee extension, producing pain but also resulting in muscular weakness. Want to know how advanced, cutting edge treatments such as electro-dry needling and extracorporeal shockwave therapy can be effectively used to resolve this problem…?

09/08/2024

🦶 Achilles tendon rupture can occur suddenly and is often associated with certain risk factors that increase the likelihood of this injury.

📝 Key risk factors include:

Age 👵👴,
S*x ♂️♀️
Training program 🏋️‍♂️🏃‍♀️
Type of sport 🏀⚽
Prolonged use of corticosteroids 💊
Certain antibiotics 💉
Genetic factors 🧬.

✅ You can learn all about achilles tendon ruptures by watching our new lecture 'Achilles Tendon Rupture' by Dr Mathijs van Ark on Trust Me-Ed!

🔗 https://www.trustme-ed.com/lectures/achilles-tendon-rupture

08/11/2024

08/11/2024

Crossover Symmetry is the Go-To program for overhead and throwing athletes. I use it everyday in my practice.

If you are suffering from shoulder pain and just can’t seem to get rid of that nagging pain that is preventing you from improving your lifts, comment “ME!” for a Free Discovery Call and in-clinic consult. Limited in-clinic spots available!

08/02/2024

Great shoulder stabilization progression

06/22/2024

04/15/2024

I'm so grateful for Sarah Naylor of Sarah Naylor Realtor for her "Home & Heart" commitment to building community, in part through building and supporting small businesses to have had the vision and drive to create and maintain the Rockwall Area Small Business Alliance. It is a privilege to be a part of such a dynamic and exciting group of small business owners in my hometown. I appreciate the camaraderie, the support, and the servant-leadership displayed by so many of it's members. I count it an honor to be numbered among you. Wiloni Rollins Darrington Kylee Darrington Lyon Tate Farms Rockwall, Texas Marcus Edward Tamez Gerald Hendrik - Rockwall Wealth Advisors Gerald Hendrik Steven Stanford Trevor R Johnson Wiloni's Costumes Russell Lyle Darrington

04/02/2024

Thanks to all the birthday well-wishes yesterday. My wife made my favorite dinner (Bacon-wrapped Chicken) and surprised me with a Peanut-Butter Cream & Reese’s PBC pie…even though she had to hold her nose to make it (she hates peanut butter!!)

01/17/2024

Dallas Vitality — offering New Year, New You discounts! Comment “New Me!” to get a FREE personal consult! Share this with a friend for even DEEPER DISCOUNTS!!