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Overcoming Knee Pain: Causes and Treatment Options

Knee pain is a common issue affecting people of all ages. Whether it’s a sudden injury or a long-term condition, knee pain can impact your daily activities and affect your quality of life. Understanding the underlying causes of knee pain and the available treatment options can help you overcome knee pain and get back to your daily activities.

Common Causes of Knee Pain:

1. Arthritis: Arthritis is a condition that causes inflammation in the joints, including the knees.
2. Sprains and Strains: Sprains and strains are common causes of knee pain, especially among athletes and physically active individuals.
3. Overuse Injuries: Overuse injuries, such as runner’s knee, occur when the knee is repeatedly subjected to stress and strain.
4. Bursitis: Bursitis is an inflammation of the fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles near the joints.
5. Tendinitis: Tendinitis is an inflammation of the tendons that connect the muscles to the bones.

Effective Treatment Options:

1. Physical Therapy: Physical therapy can help you strengthen the muscles around your knee and improve your joint’s range of motion.
2. Medications: Over-the-counter pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve knee pain.
3. Ice and Heat Therapy: Applying ice or heat to the affected area can help reduce swelling and relieve pain.
4. Braces and Supports: Wearing braces and supports can help reduce the stress on your knee and provide support during physical activities.
5. Injections: Corticosteroid injections can help reduce inflammation and relieve pain in the knee.
6. Surgery: In severe cases, surgery may be necessary to repair damaged tissues or replace the affected joint.

Conclusion: Knee pain can be a debilitating condition, but there are effective treatment options available. Understanding the underlying causes of knee pain and seeking appropriate treatment can help you overcome knee pain and get back to your daily activities. If you are struggling with knee pain, it’s important to consult with a healthcare professional to determine the best course of action for your individual needs. With the right treatment and a proactive approach, you can overcome knee pain and enjoy a more active and pain-free life.

Find out more about how we can help you treat knee pain by contacting our Foothill Ranch Physical Therapy, Placentia Physical Therapy, Mission Viejo Physical Therapy, or Lake Forest Physical Therapy locations.

The Connection Between Physical Therapy and Mental Health

How Movement Can Improve Your Mood

Physical therapy and mental health may seem like two unrelated fields, but there is a strong connection between the two. Movement, in particular, has been shown to have a positive impact on mental health.

Physical therapy is a healthcare profession that focuses on the diagnosis and treatment of musculoskeletal conditions. This includes injuries, chronic pain, and other conditions that affect the movement and function of the body. Physical therapists use a variety of techniques, such as exercise, manual therapy, and education, to help their patients improve their physical abilities and reduce pain.

Mental health, on the other hand, is an often-overlooked aspect of overall health and wellness. Mental health includes a person’s emotional, psychological, and social well-being. Mental health conditions, such as depression and anxiety, are becoming increasingly common and can have a significant impact on a person’s quality of life.

Despite being in different fields, physical therapy and mental health are connected in several ways. Movement, in particular, has been shown to have a positive impact on mental health. Exercise, for example, has been shown to reduce symptoms of depression and anxiety, as well as improve overall mood. Physical activity releases endorphins, which are chemicals in the brain that act as natural painkillers and mood elevators. In addition, exercise can also help improve sleep and reduce stress, both of which can have a positive impact on mental health.

Physical therapy can also help individuals with mental health conditions by addressing physical limitations that may be contributing to their condition. For example, if a person is experiencing chronic pain, this can lead to feelings of depression and anxiety. By treating the physical condition, a physical therapist can help reduce the emotional symptoms as well.

Another way physical therapy can help with mental health is by teaching individuals new movement patterns and ways to improve their physical abilities. This can help boost self-confidence and self-esteem, which can have a positive impact on mental health. Physical therapy can also help individuals with mental health conditions by providing them with a safe and supportive environment to work on their physical abilities.

Overall, the connection between physical therapy and mental health is a strong one. Movement, in particular, has been shown to have a positive impact on mental health. By addressing physical limitations, promoting physical activity, and providing a supportive environment, physical therapy can help individuals improve their physical and mental health. If you are experiencing symptoms of mental health conditions or chronic pain, it is important to talk to your healthcare provider about how physical therapy can help.

Find out more by contacting our Foothill Ranch Physical Therapy, Placentia Physical Therapy, Mission Viejo Physical Therapy, or Lake Forest Physical Therapy locations.

Tips for Finding the Right Physical Therapist and Making the Most of Physical Therapy Sessions

When it comes to physical therapy, finding the right therapist is just as important as the therapy itself. A physical therapist who understands your specific needs and goals can make all the difference in your recovery and overall well-being. Here are some tips for finding the right physical therapist and making the most of your therapy sessions.

1. Look for a therapist with the right qualifications: Physical therapists should have a degree from an accredited physical therapy program and be licensed to practice in your state. In addition, some therapists may have additional certifications or specializations in specific areas, such as sports medicine or geriatric physical therapy. Make sure to look for a therapist who has the qualifications that align with your specific needs.
2. Check for experience and reputation: Look for a therapist who has experience treating conditions similar to yours and ask for references or testimonials from previous patients. You can also check online reviews or ratings to get a sense of the therapist’s reputation.
3. Consider location and office hours: Physical therapy often requires multiple visits, so it’s important to find a therapist who is conveniently located and has office hours that work for your schedule. OC Sports and Rehab has Physical Therapy locations in Lake Forest, CA, Foothill Ranch, Placentia, and Mission Viejo.
4. Look for a therapist who listens and communicates effectively: Finding a therapist who listens to your concerns and goals and communicates clearly is vital for a successful therapy experience.
5. Ask about the therapist’s approach: Different therapists may have different approaches to therapy. Some may use manual therapy techniques, while others may focus on exercises or modalities such as ultrasound or electrical stimulation. It’s important to find a therapist whose approach aligns with your preferences and goals.

Once you have found the right therapist, it’s important to make the most of your therapy sessions. Here are a few tips for maximizing the benefits of physical therapy:

1. Be honest and open with your therapist: Share any concerns or questions you have, and provide your therapist with detailed information about your symptoms and medical history.
2. Follow your therapist’s instructions: Your therapist will give you specific exercises and stretches to do at home. It’s important to follow these instructions to get the most out of your therapy.
3. Attend all scheduled sessions: Missing therapy sessions can impede your recovery and slow down your progress. Be sure to attend all scheduled sessions, and let your therapist know if you need to reschedule.
4. Ask questions: If you don’t understand something your therapist is saying or doing, ask for clarification. It’s important to be an active participant in your therapy and understand what’s happening during each session.

Physical therapy can be a powerful tool for managing pain and improving function, but it’s important to find the right therapist and make the most of your therapy sessions. By following these tips, you can find a therapist who understands your specific needs and goals, and make the most of your therapy to achieve the best possible outcome.

Which Exercises Help You Improve Muscle Strength and Overall Fitness

If you’re looking to improve your muscle strength and overall fitness, you may be focusing on popular exercises like bicep curls and squats. However, there are a few overlooked muscle groups that are equally important to target in your workouts.

First, let’s talk about the transverse abdominis. This muscle, located in the lower abdomen, helps support your spine and keep your core stable. To exercise the transverse abdominis, try the plank exercise. Start in a push-up position with your arms straight and hands shoulder-width apart. Hold this position for 30 seconds, then rest for 30 seconds and repeat. You can also try the bicycle exercise, which involves alternating between lifting your right elbow to your left knee and your left elbow to your right knee while lying on your back.

Next, we have the rotator cuff muscles. These muscles, located in the shoulder, help with shoulder rotation and stability. To exercise the rotator cuff muscles, try using a resistance band. Sit on a chair and hold the resistance band in both hands, with your arms extended straight out to the sides. Slowly rotate your arms inward, then outward, against the resistance of the band. You can also try the side-lying external rotation exercise, which involves lying on your side with a weight or resistance band in your top hand and your elbow bent at a 90-degree angle. Slowly lift the weight or resistance band up, keeping your elbow pressed against your side.

Finally, don’t forget about the gluteus medius muscles. These muscles, located in the hips, help with lateral movement and stability. To exercise the gluteus medius muscles, try the side-lying hip abduction exercise. Lie on your side with your legs stacked on top of each other. Lift the top leg up, then lower it back down. You can also try the side-step exercise, which involves using a resistance band or mini-band around your legs just above your knees. Stand with your feet hip-width apart and step to the side, keeping your feet together as you move.

Incorporating exercises for these overlooked muscle groups into your routine can help improve your overall muscle strength and stability. Always be sure to consult with a healthcare professional before starting any new exercise program.

Find out more about key exercises to improve your overall fitness by contacting our Foothill Ranch Physical Therapy, Placentia Physical Therapy, Mission Viejo Physical Therapy, or Lake Forest Physical Therapy locations.

Maximizing Your Physical Therapy Sessions: Tips and Tricks for Faster Progress

If you’re currently undergoing physical therapy, you’re likely eager to make progress and see improvement as quickly as possible. While the rate of progress can vary depending on a number of factors, there are some things you can do to maximize your physical therapy sessions and potentially speed up the healing process.

First and foremost, it’s important to follow your physical therapist’s recommendations and instructions. This includes doing any prescribed exercises or stretches at home, as well as any other self-care techniques they may have recommended. Adhering to the treatment plan can help ensure that you’re making the most of each physical therapy session.

In addition to following your treatment plan, there are a few other things you can do to maximize your physical therapy sessions:

1. Communicate openly with your physical therapist: Let your therapist know about any pain or discomfort you’re experiencing, as well as any changes you’ve noticed in your condition. This can help them adjust your treatment plan as needed and ensure that you’re getting the most out of each session.
2. Stay hydrated: Proper hydration is important for overall health, and it can also help with physical therapy. Make sure to drink plenty of water before and after your sessions to help flush out toxins and reduce muscle soreness.
3. Wear comfortable clothing: Wear clothes that are comfortable and easy to move in to your physical therapy sessions. This can help you feel more at ease and allow you to focus on your therapy.
4. Stretch before and after sessions: Stretching before and after physical therapy sessions can help improve flexibility and reduce muscle soreness. Talk to your therapist about which stretches would be most beneficial for you.
5. Stay positive: It’s normal to have ups and downs during the physical therapy process, but it’s important to stay positive and keep a good attitude. This can help you stay motivated and focused on your progress.

By following these tips and tricks, you can make the most of your physical therapy services and potentially speed up the healing process. Remember to always listen to your therapist’s recommendations and trust in the process – with time and dedication, you’ll be on your way to reaching your therapy goals.

5 Causes of TMJ Discomfort or TMD

The temporomandibular joint, or TMJ, joins your skull to one side of your mandible (lower jaw). The general term for what occurs when the joint and/or muscles used for chewing become inflamed, stuck, or painful is temporomandibular disorder (TMD).

TMD typically affects people between the ages of 20 and 40 who have a history of clenching and grinding their teeth (bruxism), dental work, trauma to the jaw or face, increased anxiety or stress, or poor posture. TMD affects more women than men and is more common in women than in men.

Pain in the jaw, ears, face, neck, and upper back are among the symptoms. When yawning, talking, or eating, some patients may experience difficulty opening or closing their mouths, abnormal jaw movement, or popping, clicking, or grinding sounds in the joint.

Daily, social, or occupational activities might be restricted by a symptomatic TMJ. Following are some examples of lifestyle choices that may be linked to TMD or TMJ discomfort:

• Increased anxiety and stress – One of the main causes of TMD pain is increased stress, which frequently results in jaw clenching or teeth grinding. You might want to think about getting more sleep, practicing diaphragmatic breathing for 5 to 10 minutes several times a day, working out, taking a yoga class, or just taking a brief break to walk around the office and write down your stress-inducing situations.
• Slouched posture – Because the neck and jaw are closely related, slouching while working at a desk or using a mobile device can put undue strain on the neck’s musculature and cervical spine, which in turn can change how the mandible sits. The condyles of the jaw bone may sink deeper into their joint sockets when the shoulders are rounded, which is frequently the case when the head is positioned forward. The masticatory muscles that help open and close the mouth may have a different length-tension relationship as a result of poor posture. Muscle imbalances and joint misalignment may cause increased joint compression, which could be the cause of pain. Placing a beach towel or handkerchief in the small of your back while you drive or sit at a desk is one way to improve posture. You should take this as a cue to sit up straight and adjust your neck and shoulder alignment.
• Oral habits – A few habits that can cause the TMJ muscles to be overworked and cause microtrauma to the joint or the soft tissues (such as the ligaments, tendons, and muscles) that surround and support the joint include chewing on gum or writing implements, biting nails and lips, and clenching and grinding teeth. Try using a mouth guard at night if you grind your teeth, or try sucking on candy mints instead of chewing gum.
• Diet – Optimal TMJ function depends on healthy eating habits in addition to weight management and proper nutrition. Steak, nuts, stringy vegetables (like celery), and some breads are examples of foods that, despite being healthy, may overstrain or exert excessive compression forces on the TMJ. Large bites that require a wide opening of the mouth can also add strain. Smaller bites or softer food portions may help to lessen discomfort from TMJ overuse.
• Excessive mouth opening –  Your mouth should be able to open at least 40 centimeters, or three finger widths. However, yawning, singing, or even laughing can cause excessive mouth opening. Use three fingers’ worth of space or put your fist between your chin and breastbone before opening your mouth to help lessen excessive mouth movement.

OC Sports and Therapy are TMJ Treatment specialists treating patients at our Foothill Ranch, Lake Forest, Mission Viejo, or Placential locations. Give us a call 949.716.5050 to learn more!

How Physical Therapy Can Help You with Your Ankle Injury

No matter the type of injury, there are two main goals of physical therapy: restoring mobility and restoring strength.

Some fundamental exercises a physical therapist will probably have the patient perform in order to restore mobility include:

“Ankle Alphabet”  – The patient reads the alphabet while forming each letter with their foot in “Ankle Alphabet.” This not only keeps the ankle mobile and reduces swelling, but it also helps the physical therapist identify the specific areas of the foot or ankle that are painful or stiff. The therapist will note which letters the patient finds difficult and which muscles were employed to produce those movements.

Ankle Pumps and Ankle Circles – Simple strengthening exercises called “ankle pumps” and “ankle circles” involve the patient pointing and flexing their toes while moving their ankle in a circular motion.

4-Way Theraband Ankle Movements – The patient moves their ankles in all four directions while wearing a resistance band called a Theraband (pointing toes, flexing toes, moving toes to the right, and moving toes to the left).

After an ankle injury, and particularly after an Achilles tendon rupture, patients frequently experience muscle loss in their calf muscles and decreased strength throughout the entire back side of the leg. A physical therapist may perform the following fundamental exercises to regain strength, particularly in the lower leg’s back:

Seated Calf Raises – Raising your legs while seated will work your soleus muscle. The patient can begin without a kettlebell and progress to using one once their strength starts to increase so they can add more weighted resistance.

Rocker-board or “BAPs Board” –   The patient must adjust their stance depending on the position because the bottom of this wooden or plastic board has an uneven surface. This makes the muscles that move the ankle more powerful (pointing toes, flexing toes, inversion, and eversion). It can be done with two legs or, for a greater challenge, standing on one leg. As the patient improves, different difficulty levels can be introduced.

Leg Press – The patient will perform either a single or double leg press, concentrating on flexing the toes and maintaining a static hold at the motion’s extremes.

Heel Raises/Toe Raises – Heel raises and toe raises will be performed by the patient to strengthen the muscles that cause the toes to point and flex, respectively.

TRX Single Leg Squats – With the aid of the TRX, a patient will perform single leg squats that will aid in the restoration of single leg strength and balance, which are essential for running and walking as well as for future injury prevention.

To learn more visit our ankle physical therapy videos page or contact one of our expert Orange County physical therapists.

Why Daily Movement to Offset Sitting is Important

About a third of a person’s life is spent sleeping. How much of the other two-thirds is spent off their feet? Even sitting isn’t fun, and its bad effects are sometimes compared to those of smoking. Sitting is not only not fun, but has been shown to make people die younger.

The question is how much (or how little) movement is needed to counteract the bad effects of sitting. Researchers have looked into how different amounts of sitting, how often you move, and how long you move affect your health. They are starting to get clear answers about how to move every day to make up for time spent sitting.

One study found that sitting for more than 30 minutes raises the risk of death, while any amount of exercise, whether light or intense, lowers that risk by at least 17 percent. This study, which was published in the American Journal of Epidemiology, looked at data from a previous survey about nearly 8,000 adults 45 years or older.

Researchers from New York, Michigan, Arizona, and Alabama looked at the differences between 30 minutes of light exercise (like walking at a normal pace) and 30 minutes of moderate-to-vigorous exercise (e.g., jogging or running). They also looked at how the results changed when the total time spent sitting was broken up into several shorter sessions instead of one long one.

The results showed that the risk of dying went down when people moved for 30 minutes instead of sitting for 30 minutes. A half-hour of light exercise cut the risk by 17%, while a half-hour of moderate-to-vigorous exercise cut the risk by 34%.

The risk goes down with how much you move, but even one minute of exercise cuts down on how much you sit.

WHAT MAKES IT A HACK

Muscles keep us moving, and they also help control how much sugar and fat are in the blood. If we don’t move around after eating, the blood sugar won’t be used by the muscles and will instead be stored. In the same way, muscles that don’t get regular exercise aren’t as good at getting rid of fat from the blood. Also, if you sit too much, your muscle mass and strength can go down.

When people sit for a long time, blood pools in their feet. Because of this, pressure builds up in the lower legs, which hurts the blood vessels and can cause permanent damage. This is also a problem with standing desks, which work the leg muscles but don’t improve blood flow like walking does.

Even if someone works out in the morning, sitting all day will still be bad for them. The key is to spend less time sitting. Even moving for one minute every half hour can help. These small movement breaks don’t have to be a full Zumba class; they could be a few minutes of cleaning or vacuuming. These exercise snacks help keep the muscles working well and the blood moving all over the body by keeping them active.

HOW IT CHANGES HOW LONG YOU LIVE

The key, say the two researchers, is to move more and spend less time sitting. Sitting too much is bad for the body right away and in the long run.

Sitting all day can also put pressure on the discs in your spine, which can speed up their degeneration and cause chronic back pain, which can make you feel bad and affect your health.

Getting up and moving around more and sitting less seems to be important.

In the end, any kind of regular movement during a day of sitting is good for your health. Even if you just stand up for a second or flex and point your feet, that’s a start.

Find out more about the importance of daily movement by contacting our Foothill Ranch Physical Therapy, Placentia Physical Therapy, Mission Viejo Physical Therapy, or Lake Forest Physical Therapy locations.

The Benefits of Physical Therapy in Preventing Heart Disease

There are many types of heart disease, including hypertension (high blood pressure), coronary heart disease (heart attack), and cerebrovascular disease (stroke), but the most important number is 610,000 – the number of Americans who die of heart disease every year. That’s 1 out of every 4 deaths.

The good news is that most forms of heart disease are preventable by making lifestyle changes, including quitting smoking, practicing good nutrition habits and reducing stress in your everyday life.

Still, one of the easiest and most effective ways to reduce your risk of heart disease is by getting active.

How Cardio Helps Strengthen Your Heart

While the word “cardio” might invoke horror in some, cardiovascular or aerobic activity is important for (surprise, surprise) cardiovascular health. Here are a few important things to know about your cardio health:

• The American Heart Association recommends five 30-minute moderate exercise sessions each week.
• The benefits of regular cardio include strengthening your heart and blood vessels, improving the flow of oxygen throughout your body, lowering your blood pressure and cholesterol, and reducing your risk of heart disease, as well as diabetes, Alzheimer’s disease, stroke, and even some kinds of cancer.
• If you’re not sure where to start, don’t feel overwhelmed – cardiovascular activity includes a wide range of activities that get your heart pumping, such as walking, jogging, biking, swimming, and dancing.

The Importance of Strength Training

Along with cardio, strength training can decrease the risk of heart disease and improve your overall health – here’s how:

• Strength training can speed up the body’s metabolic rate, which can decrease fatty tissue on the body.
• It can also decrease the amount of visceral fat, or belly fat that sits around vital organs, including the heart. Storing excess visceral fat can cause a lot of health problems, including heart disease.
• Studies have shown that strength training twice a week, especially combined with regular cardiovascular activity, can have profoundly positive effects on heart health and overall health.

Physical Therapy Can Get You Moving Again and Keep You Active

Most of us know that exercising regularly is good for our health, but getting started (or restarted) can often be intimidating, and even more so if you’re experiencing pain or recurring injury. It’s not uncommon that pain in the back, neck, knee, shoulder, or other joints and muscles sidelines a person for an extended period of time – and in many cases that periodic injury can slip into permanent inactivity.

Physical therapists are musculoskeletal experts who are trained to get your body healthy enough to start exercising or get back into a routine without pain, as well as create and support an appropriate exercise program for people of all ability levels. Physical therapy services can help get you moving again by:

• Assessing and diagnosing the root causes of pain and injury
• Treating problem areas with customized plans of care that can include a wide range of modern clinical approaches, including manual (hand-on) therapy, exercises and stretches, dry-needling and more.
• Teaching correct form and posture to ensure that you’re performing exercises correctly to prevent future injuries.

Whatever your goals are, don’t let pain stop you from achieving them, especially when it comes to your heart health. Getting back into a routine of cardio and strength training can be a vital part of preventing heart disease down the road, and physical therapy can get you back into action and keep you moving.

If you’re decreasing or avoiding activity because of pain, know that in most cases you can see a physical therapist without a doctor’s referral. OC Sports and Rehab can assess your symptoms and let you know if PT is right for you, or if there are other avenues to moving pain-free again.

Physical Therapists Recommend Doing These 5 Exercises

If you’re one of the many people who made a resolution to get fit and active this year, you may be struggling to find the time and energy to stick to a workout plan. It can be hard to find time to be active when you have to work and take care of your family. Worse, even if you have the time, it can be hard to sort through all of the articles, tips, and routines online that are supposed to be from “experts.” Where do you even begin?

Physical therapists are the real experts when it comes to muscles and bones, so we asked some of our PTs what their favorite effective and efficient home exercises were. We want to take the guesswork out of exercise so you can get the most out of your time and workouts.

1. Squat your age a day
   Squats are one of the best exercises because they work so many different muscles at the same time. If you do a good squat the right way, it can work your quads, hamstrings, glutes, abs, calves, hip abductors, and more! Start with your feet slightly wider than your shoulders and imagine you’re sitting back in a chair. To keep good form, keep your hips and buttocks low and your chest up. You can make the workout harder over time by squatting lower, doing more reps, and maybe even adding weight.
2. Get stronger by doing pushups
   One of the easiest and best exercises for strengthening and toning the upper body, pushups work the triceps, pectoral muscles, shoulders, and abdominal muscles. If you’re just starting a new fitness routine, you might have to start on your knees, but if you keep at it, you should be able to do pushups from your toes in no time. By increasing the number of pushups you can do at once, your strength will steadily improve. Also, pushups are versatile because you can change where your hands and feet are to make them harder and work different muscles. Try the seal pushup, the diamond pushup, and staggered hand pushups once you’ve mastered the regular pushup.
3. Be grateful for planks
   Planks are one of the best exercises for your abs, even better than crunches and sit-ups because they put less pressure on your back. Planks not only work your abs, but they also strengthen your whole core and lower back. This makes you more stable, lowers your risk of injury, and keeps you mobile. Planks come in a lot of different forms, just like pushups. There are low planks, high planks, side planks, shoulder taps, and more. Google different modifications and try holding for 30 seconds to a minute at a time, 3–5 times a day. You’ll see and feel the benefits in no time.
4. Bridge with arms overhead
   Bridges are another great exercise for your lower body and core. They also work your lower back. Start by lying on your back with your feet on the ground evenly. Make a fist with your arms up and punch the ground with it as you lift your hips and squeeze your glutes. This works the long muscles in the neck and chest that are needed for good posture. Keep your knees wide and push your heels into the ground to get the most out of your glutes. Hold the movement at the top and take a few breaths to use the diaphragm. Like the squat, the bridge uses a lot of different leg muscles, which makes it a good and useful exercise.
5. Don’t underestimate jumping jacks
   Boxers, athletes, and people in the military do jumping jacks as part of their workouts because they are one of the easiest ways to do cardio from anywhere. Jumping jacks are a type of plyometrics, also called “jump training,” which is a good way to combine aerobic and strength training. Your heart rate goes up, and you work out your whole body, especially your glutes, quadriceps, and hip flexors. When you lift your arms over your head, you also stretch out your shoulders and use your abdominal muscles to stay balanced. You can change things up to make it more difficult, but sticking to the basics is a good way to burn calories, get your heart rate up, and work muscles all over your body.

Find out what exercises and movements are optimal for getting in shape by contacting our Foothill Ranch Physical Therapy, Placentia Physical Therapy, Mission Viejo Physical Therapy, or Lake Forest Physical Therapy locations.