Common Injuries

SPINE

Cervical Disc Herniation

The vertebrae that form the spine in your back are separated by cushioned discs that, when healthy, act as shock absorbers and keep the spine flexible.  As we age, our discs lose some of the fluid that helps them maintain flexibility. A herniated disc may be the result of small tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material (nucleus) inside the disc may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.  Herniated discs in the neck can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands.

Your physical therapist will evaluate your activities and biomechanics to determine the cause of the pain. Treatment will include techniques to decrease pain such as modalities, soft tissue massage, and joint mobilizations. In addition physical therapy will improve the posturing of the neck through activity modification, manual therapy techniques, and prescribed therapeutic exercises that will strengthen the muscles of the core and trunk.

Lumbar Spinal Stenosis

Lumbar spinal stenosis is a narrowing of the spinal canal that usually develops over a long period of time. As the spinal canal narrows, it can compress the spinal cord itself or irritate the nerve roots that branch out from it.  Treatment includes pain-relieving and anti-inflammatory medication, physical therapy, and in some cases, surgical treatment.

Most cases of spinal stenosis do not require surgery. Physical therapy treatment will include techniques to relieve mild to moderate symptoms of pain, numbness, and weakness in the legs.    In addition your therapist will address the biomechanics of your spine through prescribed exercises, postural modification, and manual techniques. You will be taught how to stretch and strengthen your core muscular system to allow you to safely resume your activities.

Degenerative Disc Disease

Degenerative disc disease is a term used to describe the normal changes in the spinal discs as we age. Spinal discs are soft compressible structures that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers allowing the spine to flex, bend, and twist.  As the disc degenerates the space between the vertebrae becomes smaller and the spine becomes less stable. The body reacts to this by constructing bony growths called osteophytes which can put pressure on the spinal nerve roots or spinal cord, resulting in pain and affecting nerve function.  Herniated discs in the lumbar spine can cause pain, numbness, or weakness in the back, legs, and feet.  

Physical therapy treatment will include techniques to relieve your pain such as modalities, soft tissue massage, and joint mobilization.  In addition your therapist will address the biomechanics of your spine through prescribed exercises, postural modification, and manual techniques. You will be taught how to stretch and strengthen your core muscular system to allow you to safely resume your activities.

SHOULDER

Multi-Directional Instability of the Shoulder

The shoulder joint is a complex joint that allows more motion than any other joint in the body. Because the joint is so mobile it can be prone to instability.  Multi-directional instability (MDI) occurs when the shoulder joint shifts excessively within the socket with no history of a traumatic event. People who have symptoms of MDI complain of clunking or shifting of the shoulder with overhead movements. Most people who have symptoms related to MDI participate in athletics that involve overhead movement with young women being more commonly affected than men.

Your physical therapist will evaluate your activities and biomechanics to determine the cause of your dysfunction.   Treatment will include techniques to decrease pain such as modalities, soft tissue massage, and joint mobilization. Physical therapy will improve the posturing of the shoulder through prescribed manual techniques and therapeutic exercises aimed at restoring normal scapular motion.  Our goal is your safe return to activity and preventing re-injury.

Rotator Cuff Impingement Syndrome

The shoulder is one of the largest and most complex joints in the body. The shoulder joint is formed where the humerus fits into the scapula, like a ball and socket. The rotator cuff is a group of four muscles that function as stabilizers of the shoulder joint when the upper arm moves.  Impingement occurs when there is increased pressure on the rotator cuff, commonly caused by a bone spur, tendonitis, or bursitis (inflammation of a fluid filled sac in the shoulder joint).  If inflammation is present the rotator cuff tendons are pressed against the underside of the acromion causing impingement when the arm is raised overhead, behind the back,
or across the chest.

Your physical therapist will evaluate the biomechanics of the shoulder to determine the cause of your dysfunction.  Treatment will include modalities to decrease pain and manual techniques such as soft tissue massage and joint mobilization. Physical therapy will address the posturing of the shoulder through prescribed exercises aimed at restoring normal scapular motion and strengthening
of the rotator cuff.

Adhesive Capsulitis (Frozen Shoulder)

Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff. Adhesive capsulitis is a painful and disabling condition that often causes great frustration for patients due to slow recovery. Movement of the shoulder is severely restricted and everyday tasks such as lifting, reaching and sleeping become painful and limited.

This condition, for which an exact cause is unknown, tends to be self-limiting as it usually resolves over time without surgery.  The normal course of a frozen shoulder has been described as having three stages:

Stage One:

The freezing/painful stage may last from six weeks to nine months.  As the pain worsens, the shoulder loses motion.

Stage Two:

The frozen/adhesive stage may last from four to nine months and is marked by a slow improvement in pain but the stiffness remains.

Stage Three:

The thawing/recovery stage may last from 5 to 26 months, during which time the shoulder motion slowly returns to normal.

HIP

Hip Impingement Syndrome

The hip joint is a ball-and-socket joint formed between the pelvis and the femur.  Normally, the ball glides smoothly within the socket, but a problem with the ball or socket rim can interfere with smooth motion. This problem can cause hip impingement known as femoroacetabular impingement (FAI). It is believed to be a major cause of arthritis of the hip.

You can have FAI for years and not know it because it is often not painful in its early stages.  The main symptoms are stiffness in the groin or front of the thigh and/or a loss of your hip's full range of motion.  As the condition progresses you may feel pain with more subtle activities such as sitting for a long time or walking up a hill. Pain that occurs at night or when walking on flat ground suggests that the cartilage cushioning the joint has begun to break down, a condition known as osteoarthritis.

 Your physical therapist will address the biomechanics of the hip through prescribed exercises for the lower body and trunk, postural modification, and manual techniques. Stronger muscles will help support and alleviate stress on the joints of the lower body and allow you to safely resume activities

Trochanteric Bursitis

Bursitis is an inflammation of the small sacs of fluid (bursae) that cushion and lubricate the areas between tendons and bones.  Trochanteric bursitis can be caused by an acute injury, prolonged pressure on a bursa, or activities that require rapid joint movement such as jogging or bicycling long distances.  Symptoms may include hip and buttock pain that spreads down the outside of the thigh to the knee area. Pain may be severe enough at night preventing you from lying on the affected side.

Trochanteric bursitis is often treated with rest, anti-inflammatory medications, and physical therapy. Your physical therapist will evaluate the biomechanics of the hip and prescribe exercises for the lower body and trunk, postural modification, and manual techniques.  Stronger muscles will help support and alleviate stress on the joints of the lower body and allow you to safely resume activities.

Osteoarthritis of the Hip

There are many types of arthritis, but osteoarthritis is the most common. Also known as degenerative joint disease, osteoarthritis is more likely to develop as people get older. Osteoarthritis occurs when inflammation or injury to a joint cause a breaking down of cartilage tissue. The classic sign of arthritis is joint pain and dull aching in the groin, outer thigh, or buttocks. Pain is usually worse in the morning and lessens with activity; however, vigorous activity can result in increased pain and stiffness.

Physical therapy is often prescribed to help increase the range of motion and strengthen the muscles of the lower body and core. Treatment will include techniques to decrease pain while addressing the biomechanics of the hip through prescribed exercises for the lower body and trunk, postural modification, and manual techniques.  Stronger muscles will help support and alleviate stress on the joints of the lower body while allowing you to safely resume your activities.

ELBOW

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow or lateral epicondylitis is a condition in which the outer part of the elbow becomes sore and tender. It is commonly caused by non-inflammatory, chronic degenerative changes and is most prevalent in middle age.  Symptoms associated with tennis elbow include, but are not limited to: radiating pain from the outside of the elbow to the forearm and wrist, pain during extension of wrist, weakness of the forearm, a painful weakened grip, and morning stiffness.

Physical therapy plays an important role in the treatment of lateral epicondylitis. Your therapist will utilize various techniques including modalities (ultrasound, iontophoresis, light therapy and electrical stimulation), soft tissue mobilization (deep tissue and cross friction) and ASTYM.  You will be taught proper stretching and strengthening techniques, in addition to activity modification.  Education including ergonomics and energy conservation is important to help prevent re-injury as you resume your activities.

Golfer’s Elbow (Medial Epicondylitis)

Golfer's elbow, or medial epicondylitis, is an inflammatory condition of the medial epicondyle of the elbow very similar to tennis elbow. The tendons of the forearm muscles come together in a common tendinous sheath, which is inserted into the medial epicondyle of the humerus.  In response to minor injury, or sometimes for no obvious reason at all, this point of insertion becomes inflamed.  It is also called Pitcher's Elbow, Climber's Elbow, and Little League Elbow.

Physical therapy plays an important role in the treatment of medial epicondylitis. Your therapist will utilize various techniques including modalities (ultrasound, iontophoresis, light therapy and electrical stimulation), soft tissue mobilization (deep tissue and cross friction) and ASTYM.  You will be taught proper stretching and strengthening techniques, in addition to activity modification.  Education including ergonomics and energy conservation is important to help prevent re-injury as you resume your activities.

KNEE

Osteoarthritis of the Knee

Osteoarthritis, commonly known as degenerative joint disease, is a condition in which the natural cushioning between joints (cartilage) wears away causing the bones of the joints to rub more closely against one another with less of the shock-absorbing benefits of cartilage.

Almost everyone will eventually develop some degree of osteoarthritis, however, risk factors such as weight, heredity, and repetitive stress injuries can increase the risk of developing significant arthritis at an earlier age.  Symptoms of osteoarthritis may include pain, swelling, stiffness, decreased ability to move and, sometimes, the formation of bone spurs.

Physical therapy treatment will include techniques to decrease pain while addressing the biomechanics of the knee through prescribed exercises for the lower body and trunk, postural modification, and manual techniques.  Stronger muscles will help support and alleviate stress on the joints of the lower body while allowing you to safely resume your activities.

Patellofemoral Stress Syndrome (PFSS)

Patellofemoral stress syndrome (PFSS) refers to pain in the front of the knee that can be a result of wearing down, roughening, or softening of the cartilage under the kneecap (patella).  PFSS may be caused by overuse, injury, excess weight, a patellar tracking disorder, poor body mechanics, or degenerative changes under the patella.

The main symptom of PFSS is knee pain, especially when sitting with bent knees, squatting, jumping, or climbing stairs. Symptoms can be relieved by avoiding these aggravating activities and strengthening the muscles of the lower body and trunk.

Physical therapy will include techniques to decrease pain while addressing the biomechanics of the knee through prescribed exercises for the lower body and trunk, postural modification, and manual techniques.  Stronger muscles will help support and alleviate stress on the joints of the lower body while allowing you to safely resume your activities and avoid the risk of re-injury.

Anterior Cruciate Ligament

The anterior cruciate ligament (ACL) connects the upper leg bone (femur) with the lower leg bone (tibia).  This ligament is often injured when the knee is straightened beyond its normal limits during a rapid change in direction, which commonly occurs in sports that require stop-and-go movements. ACL ruptures are on the most physically, financially, and emotionally devastating sports related injuries amongst active individuals.

Symptoms of a sudden ACL injury may include feeling or hearing a pop in the knee at the time of injury, pain, swelling, and a feeling that the knee may buckle or give out. 

Treatment for ACL injuries depends on the severity of the knee injury and a person's activity level. Treatment includes physical therapy, surgery, or both.  Your physical therapist will evaluate the biomechanics of your knee to design challenging exercises that retrain your body movement.  These prescribes exercises will focus on functional activities, agility, control, and power to help you decrease the risk of re-injury and optimize your safe return to activity.

FOOT

Achilles Tendinopathy

The Achilles tendon is one of the longest tendons in your body.   Achilles tendinitis  means inflammation of the Achilles tendon, but inflammation is rarely the cause of tendon pain. Tendinosis refers to micro tears in the tissue in and around the tendon caused by overuse. Some experts now use the term tendinopathy to include both inflammation and micro tears.

Symptoms include pain, swelling, altered joint movement, and limited performance. Chronic tendinopathy can be caused by many factors including lack of flexibility, muscle dysfunction, training on hard surfaces, and poor footwear. 

Your physical therapist will evaluate your ankle/foot biomechanics and prescribe exercises for the lower body and trunk, proprioceptive retraining, manual techniques, and proper shoe wear. Various techniques will be utilized to address your pain including modalities (ultrasound, light therapy and electrical stimulation), soft tissue mobilization and ASTYM.  Our goal is to optimize your safe return to activities while avoiding the risk of re-injury.

Plantar Fasciitis

Plantar fasciitis is inflammation of the thick, fibrous band of tissue (fascia) that reaches from the heel to the toes, supporting the muscles and arch of your foot. When the plantar fascia is overly stretched, tiny tears can occur in its surface, causing inflammation and pain. A number of factors contribute to the condition such as a sudden increase the intensity of your exercise, tight heel cords, and improper show wear. 

Your physical therapist will evaluate your ankle/foot biomechanics and prescribe exercises for the lower body and trunk.  Various techniques including modalities (ultrasound, light therapy and electrical stimulation), soft tissue mobilization and ASTYM will be utilized to address your pain.  You will be taught proper stretching techniques allowing you to safely resume your activities and avoid the risk of re-injury.

Metatarsal Fracture of the Foot

Stress fractures can form over a period of time from repeated stress on the bones.  Fractures are more common in children than in adults. In adults, bones are stronger than ligaments and tendons. However children’s ligaments and tendons are relatively stronger than bone or cartilage. As a result, injuries that may only cause a sprain in an adult may cause a broken bone in a child. Fractures of the fifth metatarsal most commonly occur in athletes such as dancers, runners, and gymnasts and are often treated by wearing a short leg walking
cast or boot.

Your physical therapist will evaluate the biomechanics of your foot and address your pain with a variety of modalities, manual therapy techniques, and activity modification. Physical therapy is aimed at regaining full range of motion, strength, and proprioceptive abilities. Your physical therapist will prescribe exercises that will help support and alleviate stress on the joints while allowing you to safely resume your activities and avoid the risk of re-injury.

ANKLE

Lateral Ankle Sprain

The ankle joint relies on ligaments for its support. Stress on these ligaments can cause them to stretch or tear when more than normal stretching force is applied to them. This happens most commonly when the foot is turned inward or inverted when awkwardly planting the foot, running, stepping up or down, or during simple tasks such as getting out of bed.

The most commonly injured ligament is the anterior talofibular ligament that connects the front part of the fibula to the talus bone and prevents the foot from sliding forward in relation to the shin. 

Conservative therapy for acute ankle sprains may be described by the acronyms RICE (rest, ice, compression, and elevation).  Protective devices including air splints and ankle braces are often used to immobilize the ankle during the healing stage.

Physical therapy is aimed at the patient regaining full range of motion, strength, and proprioceptive abilities. Your physical therapist will evaluate your biomechanics and prescribe exercises for the lower body and trunk, proprioceptive retaining, and manual techniques. Stronger muscles will help support and alleviate stress on the joints of the lower body while allowing you to safely resume your activities and avoid the risk of re-injury.

HAND

Carpal Tunnel Syndrome

Pressure on the median nerve can cause carpal tunnel syndrome resulting in tingling, numbness, weakness, or pain in the fingers, hand, or elbow. Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. Initially you may notice symptoms at night which are often treated with a splint that will keep the wrist in a neutral position relieving pressure on the median nerve.

Physical therapy plays an important role in the treatment of carpal tunnel syndrome. Your certified hand therapist will utilize various techniques including modalities (ultrasound, iontophoresis, light therapy and electrical stimulation), soft tissue mobilization (deep tissue and cross friction) and ASTYM.  You will be taught proper stretching and strengthening techniques, in addition to activity modification. Education including ergonomics and energy conservation is important to prevent re-injury as you resume your activities.