Knee Pain? A Must Read!

Do you have knee pain?

Then, this is a must read patient success story, with notes from one of our therapists, Joseph R. Maccio, DPT, Dip. MDT

How to Avoid Unnecessary Surgery 

“I suffered a sports injury, and was first told by a doctor that it will get better over time. Nine months later, my knee was still in pain and I couldn’t get through the day without wearing a brace and icing at night. I went to an orthopedist who eventually performed a surgery to clean up my knee, but 3 months later the pain was still prevalent. I got a second opinion and this doctor sent me to physical therapy. I was skeptical, as I had already worked on strengthening my muscles. Nothing seemed to have helped and I simply wanted to function, to exercise and to play sports without a brace and pain. After a completely new diagnosis, at Maccio Physical Therapy, of referred pain from my spine and corrective movements my pain began to go away. Within about 2 months, I was brace-free, ice-free and able to exercise and play sports again without pain. It felt good to finally have a reason behind the pain and to not have another surgery and to be hopeful for my future!”

-Beth

Clinical Commentary

This patient is an unfortunate example of what happens when the spine is not properly screened. We have been increasingly seeing patients who have a surgical procedure and 6 months to a year later still have the same or worse pain. In our 2018 study, Directional preference of the extremity: a preliminary investigation, we found that by using a MDT assessment, almost half, (45.9%) of patients with isolated peripheral pain, actually had pain referred from the spine and got fully better from treatment of the spine. This finding was echoed in a Japanese study which found 44.6% of patients with the medical diagnosis of knee OA, with pain referred exclusively pain from the spine.

Contact Maccio Physical Therapy, the Capital Regions only certified MDT clinic, to make sure your knee pain isn’t referred from your spine to avoid unnecessary surgery and treatment.

Joseph R. Maccio DPT Dip. MDT

Maccio Physical Therapy

518-273-2121

jmaccio@macciophysicaltherapy.com 

"Right from the start, I could tell that the McKenzie approach was totally different..."

Do you suffer from Hip or Knee Pain? 

Do you know someone who does? 

Read about how Maccio Physical Therapy helped Andres reduce his Hip Pain 

and get back to living his life to the fullest!

Then, don't forget to sign up (or refer a friend) to our FREE Hip and Knee Pain Workshop! 

Call us: (518) 273-2121

E-mail us: marketing@macciophysicaltherapy.com

"Maccio Physical Therapy was my last resort after countless orthopedists, chiropractors, other physical therapists and even a surgery on my right hip. Right from the start, I could tell that the McKenzie approach was totally different from anything I had experienced previously. Sam and Joe worked with me closely to identify exercises that reduced my symptoms and I hit those exercises HARD. This treatment plan was infinitely better than the treatment plans I had experienced at precious clinics, which consisted of repeating minimally effective exercises over and over, and then wondering why the patient wasn’t getting better. I have never felt as personally cared for as I did at Maccio Physical Therapy. Even if someday my symptoms return and I have to come back, I am confident that their therapists will be able to get me back on my feet swiftly. Thank you Maccio Physical Therapy for giving me my life back."

"I feel like even though I'm done with treatment I am able to mitigate symptoms myself..."

Before coming to Maccio Physical Therapy, I was experiencing a lot of frustration/pain in my lower back. The professionals here helped me understand what was going on and what the goal of treatment was. Slowly, but steadily, I got better through their direction and attention to what I was experiencing. Before I didn’t know what to do on my own to manage/make the condition better but now I feel like even though I am done with treatment, I am able to mitigate symptoms myself and care for my back myself as well. Seeking treatment with Maccio Physical Therapy was a good decision, in the short term and for the long run.

Crossfit Athlete 

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Sciatica pain in lower back is gone!!!

“I was having bad Sciatica pain in my lower back. I learned how to properly move, sit and stand by recommendations from the physical therapist, which helped my balance as well. Also, I learned that sitting on the bed with no support wasn’t helping my back and it was making my Sciatica pain even worse. The therapist was very nice and patient with me. I would recommend anyone to the Maccio Physical Therapy, it has helped me work through my pain without prescription pain medicine or taking Tylenol. By going to Maccio Physical Therapy, I am back to the work and doing my normal activities.”

- Maccio Physical Therapy

16 months of pain gone… with one move! Unbelievable!

I was in constant pain for about 16 months and it was getting progressively worse. My lower back hurt when sitting down, lying down, and when walking. I had to do things in small intervals of time before the pain got to be too much to handle. I couldn’t get through washing dishes and I would have to take a break and take pain pills. Until one day I couldn’t lift my leg to walk without excruciating pain and I had to go to urgent care. They discovered I had a slipped disk. I was frightened because to me that meant surgery. They recommended physical therapy and my doctor told me about Maccio Physical Therapy. I made an appointment and it was life changing. 

Dr. Maccio was very kind and understanding, he explained what can be done to help. I was in his office crying because of the pain and by this time I would try anything. I’m so glad I did. I couldn’t believe how much the pain was holding me back from my every day routine. My quality of life has much improved. I am now pain free. Thank you Dr. Maccio and his staff.

Another Reason Why MDT Assessments is More Revealing Than X-Rays

"I had been experiencing severe pain and tenderness in my knee. When I went to my orthopedist, I was told there wasn’t much I could do and that I should take Motrin and lose weight. He pointed out that I didn’t have a great deal of cartilage left in my knee and that a knee replacement was something that I would have to face at some point. He told me to avoid walking and taking stairs but the pain continued for another two weeks so I went to see Joe Maccio. He did an assessment and gave me one very easy exercise and I felt better after the first visit. By the following week I had virtually no pain and was able to resume my exercise routine. He is a miracle worker!"

Wow, another reason why you don't want to rely on X-rays. Knee derangements are very common and typically respond very quickly regardless of an X-ray finding. The patient was seen for her initial visit, given the corrective exercises for the positive response, and seen for one follow up. She is now back in the gym doing what she wants to do!

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Good Things Happen to Those Who Wait- Except in the Case of Acute Back Pain!

For the past 31 years we have been seeing acute back pain patients the same day of injury. The outcomes are quite impressive and the risk minimal as there are rarely medications, X-Rays, MRI’s, or consultations needed.

When patients are in acute pain, there needs to be a process to get them to PT immediately. If services are not available during that critical time then outcomes can certainly take a different route. In light of the ongoing opioid problem, there has never been a more important time where same day evaluation and treatment needs to be the gold standard. Here is a success story from a patient seen as a same day referral:

“I got up from my desk at work on a Monday and suddenly experienced back pain. I have never had back issues in the past. On Wednesday, when the pain did not dissipate I decided to see my primary care physician. They evaluated me and felt I had a disc issue in my vertebrae. They recommended I start physical therapy ASAP. I called a PT office affiliated with local hospital and was told they could fit me in 5 days later. I then called Maccio PT and was seen later that day. Lindsay clearly explained the mechanics behind the issue and what I would learn to counter the issue and ultimately resolve the pain. I returned several times over 2 weeks and am thrilled to say that I can comfortably walk out today with relatively no pain just slight achiness that I now have the tools to know how to continue and improve and to be able to avoid future issues.” -Anonymous

 

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Back on the Slope Faster than Ever!

"When I walked into the building for my first session I could barely sit in the chair for more than 20 minutes. The pain made me pretty much useless. I couldn’t be the active happy person I usually was. Walking and working out was an issue, and I had to discontinue one of my favorite sports (slalom skiing).  

            After a few weeks of coming here I could feel the relief in my back. I could work out again and doing my school work wasn’t an issue anymore. I had gone to physical therapy before for a torn muscle and these sessions would be close to 2 hours long and were extremely painful. Every time I came here, the sessions were only about half an hour and I would walk out feeling stronger and more confident.

            I had never heard of the McKenzie Method before coming here. I had only heard of and experienced painful physical therapy. The McKenzie Method was faster, less painful, and more effective. I am truly grateful that I came here instead of somewhere else. They got me back on my feet faster than I imagined." -Chase

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Worth the Trip

"I am an active person who values mobility dearly. For the past few years I have struggled with pain in my back and hips. Many times the pain has kept me from work and my favorite activities. I sought treatment through the conventional establishment and found I was caught up in a pro-drug and pro-surgery mindset. I found Maccio Physical Therapy through a nurse practitioner who had success here. After meeting Joe and listening to his knowledge of the McKenzie method, I began the exercises. From the beginning when I started the exercises I noticed dramatic improvement. Joe analyzed my motion and taught me the proper exercises for my pain. I am now back to full mobility and my pain is gone. The best part of it all is that I now have the skills to keep myself pain free without drugs or surgery. Thank you so much Joe and crew." -Michael

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Looking Good

"As a younger patient, finding a drug-free way to deal with the pain I was experiencing was extremely important. I was in severe back pain, neck pain and had extreme loss of strength in my left arm. I felt better after the first week! After 2 months, I’m working out again and feel better than I’ve ever felt. These practices are lifetime adjustments that will benefit one’s life immensely. The practices here are priceless as is the amazing staff!" -Kenneth

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

The Application of Mechanical Diagnosis and Therapy to the Ankle-Foot Complex: A Case Series

The Application of Mechanical Diagnosis and Therapy to the Ankle-Foot Complex: A Case Series

Lindsay Carlton, Joseph R. Maccio, Joseph G. Maccio, Andrew Braga, Elizabeth Tomanio and Anastasia Belikov

Maccio Physical Therapy, Troy, NY, USA

Background: Pain at the ankle-foot complex is a common musculoskeletal condition that can lead to dysfunction. Mechanical Diagnosis and Therapy [MDT] is an orthopedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained movement. There has been no investigation of the association between MDT and patients diagnosed with ankle-foot complex pain.

Case Description: This report presents four patients with a primary complaint of pain in the ankle-foot complex. Three patients had a medical diagnosis while the other was self-referred through direct access. All received classification and treatment by clinicians trained in MDT solely utilizing MDT principles.

Outcomes: Short- and long-term (4-12 months) outcomes were excellent, demonstrating rapid abolishment of symptoms and return to prior levels of function in an average of 6 visits over 21 days (4-8 visits over 14-33 days) without the use of modalities, strength, or proprioceptive training. The patients demonstrated the ability to prevent and manage re-occurrence of symptoms independently without seeking further healthcare at long-term follow-up.

Discussion: The rapid speed of recovery and return to functional activities demonstrated in this case series, raises questions about whether or not the pathologies traditionally associated with the etiology of the ankle-foot complex are actually at fault or understood. Moreover, it demonstrates that specific movements can rapidly worsen or improve symptoms challenging the current generalized rehabilitation protocols. This report provides preliminary evidence that MDT may be capable of providing more effective short-term outcomes in the management of ankle-foot complex injuries. Level of Evidence: 4.

*Keywords: Mechanical Diagnosis and Therapy; McKenzie; Classification; Ankle Sprain; Derangement; Lumbar Spine; Posterior Tibialis Tendonitis; Plantar Fasciitis

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Shoulder or Neck?

"I came into Maccio PT with what I thought was a shoulder injury. Joe was incredibly nice and made it easy to explain what was going on. He recognized it as a neck problem within the first appointment. After starting the exercises I started getting better very quickly. Along the way he made sure to explain everything which was very reassuring. He provided handouts to remind me when to do each exercise and checked in to make sure everything was working. After treatment, I am now completely pain free and have a prevention plan to avoid similar problems in the future." -Morgan

"This patient was referred with a Medical Diagnosis of Shoulder strain and isolated shoulder pain only with shoulder movement. Her pain rapidly improved exclusively through corrective neck exercise. There has been increasing research finding that isolated shoulder pain can be referred exclusively from the neck, even without neck pain and stiffness.

If this was not identified this patient would have undergone multiple treatments to the shoulder which would not have resolved her pain. When this happens patients are often then referred back to a specialist where they receive unnecessary and ineffective injection or surgery, or never improve. 

Using the MDT screening process has been shown to be more reliable and effective and is the reason this patient had such a great result."

-Joseph R. Maccio, DPT, Dip. MDT

Menon A, May S. Shoulder pain: Differential diagnosis with mechanical diagnosis and therapy extremity assessment - a case report. Man Ther. 2012;18(4):4-7. doi:10.1016/j.math.2012.06.011.
Abady AH, Rosedale R, Chesworth BM, Rotondi MA, Overend TJ.

Application of the McKenzie system of Mechanical Diagnosis and Therapy (MDT) in patients with shoulder pain; a prospective longitudinal study. J Man Manip Ther. 2017;9817(May):1-9. doi:10.1080/10669817.2017.1313929.

Takasaki H, Okuyama K, Rosedale R. Inter-examiner classification reliability of Mechanical Diagnosis and Therapy for extremity problems – systematic review. Musculoskelet Sci Pract. 2017;27:78-84. doi:10.1016/j.msksp.2016.12.016.

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Sometimes It's Good to Go Downhill

"The pain in my knee was so bad that sitting hurt, walking hurt, going upstairs hurt and even sleeping hurt. I was so frustrated that I couldn’t do the things that I enjoyed. No skiing. No running. No hiking. But now, my pain is basically gone. I’m back in the gym and back on the slope and I’m a lot happier for it. Maccio PT fixed the pain and lingering issues that I have had since high school. I couldn’t be more grateful." -Haley

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Ultimate Success

"For the last couple of years I’ve had to limit my exercise and sports activity due to what I thought was regular wear and tear on my knee and feet. Coming here for therapy has made me realize that my pain was fully treatable through a variety of stretching and movement exercises. Since beginning treatment I’ve been able to exercise extensively and get into the best shape I’ve been in years without the pain I had become used to. My experience with Maccio PT has been both very helpful and enjoyable." -Casimir

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

Nice to Find an Easy Way Out

"I’ve had an excellent experience with Maccio Physical Therapy. Dr. Lindsay Carlton was great to work with. After tearing a tendon in my shoulder on July 4th- in November, I resigned to having
surgery. In early December, a friend recommended that I see Lindsay, at Maccio. I experienced improved function after the first visit and prescribed exercise, and continued to improve- following Lindsay’s direction. It’s now about three months after my first visit, and I have full use of the shoulder, and have sound instructions on how to continue to build strength. I’ve saved time, pain and expense. I wholeheartedly recommend Maccio Physical Therapy." -Tom

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

MDT Perspective: Chemicals Won't Fix a Mechanical Problem!

"I have had back issues for a number of years which had gotten to the point that I could no longer even make it through the market without terrible back and leg pain. I had numerous injections in my back to help alleviate the problems. This would work for a few months then it was a shorter time frame that the injections would do any pain relief. At first the doctor recommended physical therapy, but in my head it made no sense to pursue it. How could I do all kinds of exercises when I couldn’t even walk without pain? After a few years of feeling that life was not good or enjoyable because I was so uncomfortable I decided to give physical therapy a try. Well, I am shocked at what a difference it has made. After just a few visits I noticed relief!! My physical therapist also noticed that I had another issue that the doctor never picked up on. I am retired and planning a trip to the beach where I will be happy to walk the beach and pick up seashells without pain. I can now enjoy life and make it through the market again thanks to Maccio PT!" -Sharon

"This patient had over 6 injections and was prescribed Gabapentine and TENS, which had no effect on pain or function. Once a McKenzie (MDT) evaluation was performed it became clear that this patient's pain was mechanical in nature, not chemical, and when the corrective movement was prescribed the patient improved rapidly despite a 4 year worsening history. This is a common presentation that we see far too often and one of the most important reasons to consult with a skilled MDT clinician before pursuing long term pain management. We find 80% of chronic neck and back pain is fixable once properly understood." - Joseph R. Maccio, DPT, Dip. MDT

Hefford C. McKenzie classification of mechanical spinal pain: Profile of syndromes and directions of preference. Manual Therapy 2008; 13: 75-81.

May S, Aina A. Centralization and directional preference: a systematic review. Manual Therapy 2012;17: 497-506.

Maccio Physical Therapy, PLLC

The Capital Regions ONLY Certified

McKenzie Spine and Extremity Clinic

1 New Hampshire Ave, Troy, NY 12180

(518) 273-2121 www.macciophysicaltherapy.com

THE POWER TO CONTROL PAIN

MDT and Golf: Staying Focused One Step at a Time

"The Maccio Physical Therapy Clinic is a success story in itself. It’s more than a clinic, it’s a warm and inviting atmosphere where you almost begin to heal when you first walk in. The reception area is friendly and efficient and the therapists are capable, efficient and considerate. They care and that is part of my success story. I was a whole clinical work case in one person. I walked in with leg problems, developed back issues, a shoulder problem and then a hip problem. Each issue was handled caringly and relief ensured. Despite treatment progressing for each different problem, the original issues were never forgotten and I was treated as a whole person.

Thanks to the care and professionalism of Samantha Woitkoski, I am functioning in all the above areas in a normal life enhancing fashion. Sam is a great therapist and the Maccio team all part of a wonderful therapeutic environment." -William

MDT Slam Dunk!

"I started to suffer the worst pain over one year ago when I was playing basketball. It’s been a tough time because I couldn’t walk, stand or sit. The doctors in my hometown told me that I couldn’t play basketball anymore, which was a disaster to me.

At Maccio Physical Therapy, my therapists taught me how to get over the pain and how to get rid of the tightness along my leg. They brought my life back to normal. Most importantly, I went back to the basketball court! Now I am as good as before and I started to go to the gym and try to keep a healthy body. Thanks for healing me and helping me! Thanks for bringing basketball back to my life!" -Chen

Rapidly Reducing Pregnancy Pain with MDT

"At 24 weeks pregnant, I was referred to Maccio Physical Therapy by my midwife after experiencing intense pain from my pubic symphosis. My pain was unbearable consistently a level ten. I felt there was no hope and the next 16 weeks would be the same. It was hard to get in the car, dress myself, walk and even sit. After my first visit and one simple physical therapy movement, I felt better already. I continued my movement and the results were amazing. My pain lessened, my walk pattern improved and I gained more control back. I am very happy with my experience here at Maccio. My physical therapists were very kind, listening and supportive. Thank you so much!" -Amy

"This patient presented with pelvic girdle pain and low back pain due to pregnancy. As a physical therapy student, we were taught in school to work on strengthening, stretching, and stabilizing exercises for pregnancy patients with back pain which could take 10+ weeks to improve the patient's symptoms. This being my first time treating pregnancy pain, I was expecting this to be a long slow progress of relieving the patient’s symptoms. At the initial evaluation and a thorough MDT assessment, a single movement direction was determined to help treat this patient’s symptoms and I was amazed at how rapid the patient’s pain decreased on day one! If the patient’s pain was treated with traditional physical therapy, treatment most likely would be a longer slower process to minimize the patient’s symptoms. It is very encouraging, as a future physical therapist, to know through MDT, I can help my patients find a way to decrease their symptoms and get back to their life in no time!"

                                             -Leanne Egan, sDPT (student physical therapist)

"Over the last several years Maccio Physical Therapy, a Certified McKenzie Clinic, has had the opportunity to work closely with our local Mid-Wife clinics, that began referring women with pregnancy related lower back and pelvic pain. This opportunity has led to a very successful relationship and an 80% success rate in pregnancy related pain, which has previously been dismissed as non-treatable leading to very painful and stressful pregnancy. The use of MDT has been found to be safe and successful in the research and within our patient sample often rapidly effective, causing significant reduction in pain in just 24 hours."

                                             -Joseph R. Maccio DPT, Dip. MDT

Olusola A, Arinola S, Olusegun O. Effects of the McKenzie protocol on pregnancy-related back pain, Journal of Experimental and Integrative Medicine, 6,3, 2016

Murphy DR, Hurwitz EL, McGovern EE. Outcome of pregnancy-related lumbopelvic pain treated according to a diagnosis-based decision rule: a prospective observational cohort study, Journal of Manipulative and Physiological Therapeutics, 32,8, 2009