Kevin Durant reportedly suffered a hyperextended knee less than a minute into last night’s contest against the Wizards in D.C. and exited the court shortly thereafter. An MRI is scheduled. The injury occurred when Washington Center, Marcin Gortat made contact with Golden State’s Zaza Pachulia who then stumbled, landing on Durant’s left leg.
Though the MRI may not reveal any significant injury beyond a mild sprain, there is a range of diagnoses possible in this situation.
What is the significance of a hyperextended knee?
Ligaments – which attach bone to bone – provide stability by restraining excessive movement in our joints. When a joint goes beyond its normal range of motion, the integrity of certain ligaments becomes compromised, resulting in a sprain. In the case of the knee, forceful or traumatic hyperextension into a bowed position stresses the anterior cruciate ligament (ACL) – which is the primary stabilizer of the joint – and may also impact other secondary stabilizers. Worst-case scenario for Durant would have been a Grade 3 sprain, otherwise known as an ACL tear. A Grade 3 sprain is actually a complete rupture. Best case would be a Grade 1 sprain, with only mild tweaking of the ligament.
When the knee hyperextends, the tibia (the larger bone in the lower leg) glides forward excessively on the femur (the thigh bone) at the knee joint. This abnormal movement, whether caused by trauma or a non-contact situation, can also result in a bone bruise, or contusion. As with a sprain, the extent of the contusion would be proportional to the degree of hyperextension that occurred and whether trauma played a role. Another factor is the athlete’s baseline – or normal – range of motion.
A prior history of ligament sprain that results in persistent joint laxity predisposes an athlete to excessive joint mobility. This may set the stage for a non-contact injury. Many people – particularly ballet dancers and gymnasts – have hypermobile knees, enabling extension beyond a level plane and into a hyperextended position. This expanded range of motion is their “normal”. For a hyperextension injury to occur in these populations, the tibia would have to glide that much further forward, still stressing its restraints.
It is important for an athlete or dancer to have exceptional muscle strength, particularly in those muscles surrounding a less than stable joint. It is also vital that strength is optimized at the end-ranges of motion. The hamstrings become particularly vital in the case of the knee, for in their role as knee flexors. In addition to bending the knee, the hamstrings also act to extend the hip. However, as knee flexors they provide a degree of dynamic restraint to limit hyperextension of the joint.
In recent years it has become more apparent that any impact to the human body, whether a fall or a bicycle accident, can have more lasting effects than previously thought. Concussions are among the many injuries resulting from trauma that are not physically apparent and are not easily recognized by victims and those around them. Concussion recognition during football, from the little leagues to the professional level, has gained media attention in the past decade. However concussions can also result from accidents, falls, and other types of impact sports. Soccer, hockey, volleyball, and basketball are just a few sports where aggressive play and bodily contact can lead to biomechanical brain injury. Coaches and health practitioners have the ability to help preserve athletic participation and future brain function by recognizing symptoms and by taking the appropriate action to help with healing.
Concussions are often difficult to diagnose without the proper tools and individuals may be reluctant to voice their symptoms. Competitive conditions make players fearful of being sidelined while workers or students may not want to delay projects at hand. Many others underreport or fail to report their symptoms because they lack the knowledge to recognize a true concussion. Players, coaches, and caregivers need to be educated in concussion symptom recognition and how to support these individuals.
Doctors of Physical Therapy are musculoskeletal specialists who can guide individuals and athletes recovering from concussion in a safe transition to daily activities, exercise, and sports. Besides increased risk of a second more severe concussion, there exist other post-concussive risks that can be detrimental to a person’s well-being. Recent studies by Herman et al. (2016) and Gilbert et al (2016), have demonstrated a relationship between concussion history and lower extremity injuries in athletes. One concussion can disrupt a person’s balance and equilibrium as well as their strength and mobility. When this is paired with subsequent lower extremity injury, a repeating cycle is created where rest, muscle atrophy, and decreased mobility contribute to re-injury and further physical decline. Physical Therapy eliminates this cycle by targeting strength, endurance, and balance deficits in the core, hips, knees, and ankles that persist after concussion. With an individualized rehabilitation program provided by a trained Physical Therapist, a patient recovering from concussion can return to function and return to their sport with confidence and decreased risk of future injury.
Elizabeth Lamontagne PT, DPT, SCS, CKTP
Staff Physical Therapist at Recovery Physical Therapy
Herman, D.C. Jones, D. Harrison, A., Moser, M., Tillman, S., Farmer, K., …Chmielewski, T. L. (2016). Concussion May Increase the Risk of Subsequent Lower Extremity Musculoskeletal Injury in Collegiate Athletes. Sports Medicine. Doi: 10.1007/s40279-016-0607-9.
Gilbert, F.C., Burdette, G.T., Joyner, A.B., Llewellyn, T.A., Buckley, T.A. Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes. Sports Health: A Multidisciplinary Approach. 2016;8(6):561-567. Doi: 10.1177/1941738116666509.
Myofascial Release is a highly effective technique developed by John Barnes, an icon in the physical therapy world. The technique emphasizes gentle prolonged sustained stretching of the fascial system and myofascial elements to release restrictions that may be causing symptoms throughout the body. Fascia is continuous throughout the human body, so a restriction in one location may cause symptoms elsewhere. Fascial restrictions do not show up on MRIs or other diagnostic imaging, so the therapist performs a comprehensive evaluation, starting with posture to determine where fascial restrictions may lie.
Myofascial Release is used to treat all types of diagnoses ranging from low back pain, neck pain, TMJ, patella-femoral issues, tennis elbow, headaches, to name a few. It is estimated that the fascial system can create pressures up to 2000 lbs of pressure per square inch, thus causing pain, numbness, tingling, edema, and decreased strength. Myofascial release is a safe, gentle treatment which consistently produces lasting results.
Dr. Robert Kotraba, PT, DPT, OCS utilizes Myofascial Release at our Rockefeller Center location. For more information, please call 646-562-0617.
TAPING FOR NYC MARATHON RUNNERS
When: Saturday, November 5th, 2016
Where: Recovery Physical Therapy Upper East Side Location
157 East 86th street 2nd floor, New York, NY 10028
(Entrance next to Steve Madden Shoe store)
What: 30-minute kinesio taping by a licensed Physical Therapist to enhance performance and decrease pain for those running the NYC marathon.
Who: If you have neck, shoulder, back, hip, knee, foot, or ankle pain, there are taping techniques that can help with pain and enhance performance.
Cost: The cost includes a 30-minute session where the therapist will evaluate taping needs and administer the tape (tape will be provided by Recovery Physical Therapy.) $50 self-pay fee.
There will be no massage, stretching, joint mobilizations or manipulations, or any other modalities/treatments. If you feel you do need any of these services before or after the marathon, please contact us at (212) 831-3315 to schedule an appointment.
Contact: Please feel free to contact us at (212)831-3315 or come in to make an appointment!
Though water is still the best, this antioxidant-rich liquid has been an answer to pain, inflammation, swelling, and sleeplessness. Tart cherry not only has important nutrients but also contains many antioxidants and anti-inflammatory agents. It aids in cancer prevention, heart health, and as an anti-inflammatory, which can help alleviate a variety of ailments like asthma symptoms, arthritis pain, and regulate metabolism.
Cherry juice concentrate:
- Soothes pain, prevents muscle damage and fastens recovery
Runners, here is something useful for you. Cherries could be the solution to post-run muscle soreness. It is naturally high in potassium, which conducts electrical impulses throughout the body. This mineral also helps maintain blood pressure, hydration, muscle recovery, nerve impulses, digestion, heart rate, and pH balance. Cherries contain about 330 mg of potassium per cup, which is almost 10 percent of how much you need each day.
- Treats insomnia.
Let this juice help you get a good night sleep. A lot of healing takes place when you sleep .The fruit is naturally rich in melatonin which is responsible for sleepiness and regulates your body’s internal clock and tryptophan, an amino acid the body uses to create even more melatonin. Also, a class of pigments called anthocyanins found in the fruit is able to slow the breakdown of tryptophan, thereby lengthening its sleep-inducing effects.
- Prevents gout, fight inflammation and arthritis
Research shows that the antioxidants in tart cherry juice can reduce pain and inflammation from osteoarthritis- gout. The fruit lowers the levels of uric acid—the chemical that causes gout in high concentrations—and c-reactive protein, a biomarker of inflammation. Researchers give credit again to anthocyanins, which also give the fruit its dark red hue.
- Boosts Immunity
Cherry concentrate and cherries pack a powerful antioxidant and anti-viral punch. Flavonoids, a type of antioxidant in cherry juice, are made by plants to fight infection and have a significant impact on immune system function.
But wait, the potential side-effects of tart cherry juice include abdominal discomfort and diarrhea. While studies show that anthocyanins act against the development of obesity and can help reduce abdominal fat, and lower the risk of metabolic syndrome, the 140-calorie per 8-ounce serving juice may also affect your weight. If you’re looking to lose some fat, stick to eating the fruit rather than drinking the juice.
Ekta Lund, PT, MSPT, CSCS, CKTP – Co-Director, Upper East Side location
Concussion diagnosis and treatment has been an important topic of discussion recently as new research points to the potential long term effects of concussion. Concussion and Post-Concussion syndrome prevention have been all over the news; and schools, athletic organizations, as well as professional leagues are all creating new rules and guidelines to help prevent and treat concussion.
At Recovery Physical Therapy’s Upper West Side location we are proud to announce our new Concussion Management Program.
A concussion is defined by the Centers for Disease Control as “a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain.”
Any type of head trauma can cause concussion; from falls, to motor vehicle accidents, bicycle accidents or sports collisions to name a few.
While the majority of people who sustain a concussion have relief of symptoms in about two weeks, for some the symptoms can persist for weeks or even months post-concussion.
As Physical Therapists we can assist in relieving the symptoms of concussion including headache, loss of balance, dizziness, visual problems, vestibular problems, and exercise intolerance.
Physical therapists can provide a vital service to promote healing, a return to work or school and a safe return to physical activity and athletics as soon as possible.
Once a referral to our specially trained physical therapists has been made by the doctor or health care practitioner, patients will receive a detailed initial evaluation. An individualized treatment plan will be created based on the patient’s symptoms, impairments and specific goals.
We will work together so that you, or your patient, can return to everyday activities, school, work, and safely return to athletics after a concussion.
If you would like to learn more about our concussion program, or to make a referral or appointment please call, 212-874-1550 or email us at
We are looking for a NY State licensed physical therapist for our Wall Street location. Candidate must be experienced with orthopaedic and sports related injuries. Patient care is important to us, so candidate must have excellent interpersonal skills.
We offer a comprehensive benefits package which includes continuing education reimbursement.
Please submit cover letter and resume to:
Keep Those Hips Healthy! Easy everyday hip mobility exercise to keep your body in shape during the workweek…Check out today’s exercise to help you improve your swing, courtesy of our friends at the Titleist Performance Institute.
Do you have any of these swing faults? Come find out with a TPI Golf Fitness test and Swing Analysis at RPT’s Golf Improvement Program on the Upper West Side! For more information, please contact Brett Weiss, PT, DPT, TPI at bweiss@ recoverypt.com or 212-874-1550.
Congratulations are in order to the following physical therapists who recently passed the Orthopaedic Specialist (OCS) and Sports Certified Specialist (SCS) examinations.
The American Board of Physical Therapy Specialties (ABPTS) has certified more than 16,000 individuals who have demonstrated advanced clinical knowledge and skills in physical therapy specialty areas.
Currently, the ABPTS offers board-certification in eight specialty areas of physical therapy: Cardiovascular and Pulmonary, Clinical Electrophysiology, Geriatrics, Neurology, Orthopaedics, Pediatrics, Sports, and Women’s Health.
Sports Certified Specialist:
Jerry Desmond, PT, DPT, OCS, SCS – Director, Grand Central Facility
Elizabeth Lamongagne, PT, DPT, SCS, CKTP – Upper West Side
Nicole Listas, PT, DPT, ATC, OCS – Director, Rockefeller Center
Robert Kotraba, PT, DPT, OCS – Rockefeller Center
Kristen D’Aloia Gerst, PT, DPT, OCS – Grand Central
Sheldon Nakashima, PT, DPT, OCS – Grand Central
Katherine Spencer, PT, DPT, OCS – Grand Central