Click on a common condition below to read more information.
Arthritis is usually categorized as either Osteoarthritis (OA) or Rheumatoid Arthritis (RA). RA is a connective tissue disease. As with other connective tissue diseases, onset and progression vary greatly with periods of exacerbation (flares) and remissions. Joint inflammation during flares actually erodes the protective cartilage away, causing significant pain, loss of movement and mobility.
OA is also commonly referred to as degenerative joint disease (DJD). It is a chronic and progressive degeneration of the joints in our body, often causing bony spurs or “lipping” at the joint surface. The cartilage that protects the joint surface wears away over time from either excessive major stresses or repetitive minor stresses. Pain limits active movement, which causes muscle weakness, contracture and increased pain.
Treatment for both conditions includes posture and body mechanics training, joint protection principles, energy conservation techniques, supportive or corrective devices or bracing, pain management and gentle stretching and strengthening techniques. It is important to remember that treatment varies depending on whether you are in a flare (or have acute inflammation) or a remission period. Careful coordination with your physical therapist is important to prevent exacerbation of these conditions.
Bursas are small, fluid-filled sacs that act as cushions between muscles, tendons, ligaments, and bones. Occasionally they can become inflamed if excessive repetitive motion, strain or impingement occur around the site. Some of the most common areas to get bursitis are the hip, shoulder, buttocks, groin or anterior thigh. Physical therapy treatment may include ultrasound, patient education to understand body mechanics, what movements and habits provoke symptoms, stretching and strengthening muscles to correct imbalances between opposing muscle groups and pain management techniques.
Chronic or Acute Musculoskeletal Pain
Frequently people feel aches and pains they expect will eventually resolve without taking any steps to do so. Sometimes they can remember something they did that started the pain, other times they do not know how or exactly when the pain started. It is always best to address pain directly at its onset to minimize the problems associated with compensatory tactics that help avoid pain. Acute or chronic pain can occur anywhere in the body, frequently people allow chronic problems in their back, neck, and shoulders to escalate to intolerable levels before seeking help. If you have a sudden onset of pain that does not resolve within a few days, it is best to get help from your provider of choice.
Physical therapy intervention for musculoskeletal pain could include any number of options, depending on the source of the injury. The treatments which are appropriate for these injuries could include: pain management techniques including soft tissue mobilization, trigger point release and joint mobilizations as well as modalities including ultrasound and electrical stimulation and exercises to stretch or strengthen the injured and opposing muscles. A thorough examination is necessary to determine the cause of pain, and treatment suitable to the injury will be discussed as well as other appropriate treatment options before any intervention is initiated.
Exercise Intervention for Special Populations
As more people decide they would like to enjoy the benefits of exercise, it becomes apparent that exercise guidelines considered safe for the average adult are not necessarily safe for everyone. Special populations include children, senior adults, pregnant women and obese individuals. Special considerations are necessary when developing an exercise program for these populations. For example, thermoregulation in children and senior adults is not adequate for high levels of activity, requiring modification of their exercise programming. Pregnant women release hormones that increase joint laxity, making high-impact exercise inappropriate. Your physical therapist understands these and other limitations to exercise for special populations and can design a customized program that allows safe and effective exercise for everyone.>
Foot Ankle Pain
There are 28 bones in the foot and ankle, which help provide stability as well as mobility, accommodate uneven surfaces, adapt to absorb forces and bear the weight of the body when standing, walking or running. This is a tall order, and supporting our feet and ankles is important to prevent the many injuries associated with instability. Ankle sprains, fallen arches, plantar fasciitis, shin splints and post-surgical management all require intervention that is available from a physical therapist. Intervention may include modalities, training techniques, joint mobilization, strengthening and stretching muscles and tendons, contrast baths or supportive orthotics.
Also known as adhesive capsulitis, this condition is caused by the shoulder capsule forming scar tissue that “sticks” to the bones in the joint, thus preventing full movement. Physical Therapy can help to increase your motion with adjustments applied to your shoulder, upper back, and neck. Along with progressive stretching with strengthening and home programs can often restore motion without surgery.
Hip pain can come from many different sources. Osteoarthritis in the hip joint can cause significant pain, which may respond well to physical therapy in the earlier stages, but often may require total hip replacement surgery (also referred to as total hip arthroplasty). Other sources of hip pain include sciatica nerve impingement, bursitis in the buttock, groin or side of the hip, uneven leg length, sacroiliac joint dysfunction, poor posture, obesity, stress fractures or muscle imbalances from tight hamstrings, hip flexors or other muscles. Infants and children may also have hip pain from congenital hip dislocations or slipped capital femoral epiphyseal (this is when the “ball” of the hip joint actually slides partly or completely off the shaft of the femur bone) to name just a few. A thorough examination is required to determine the cause of pain and a plan of care is developed from those findings. Interventions may include modalities such as ultrasound or electrical stimulation, stretching and/or strengthening muscles, patient education about posture and body mechanics and pain management techniques. Pain in one area may come from injury in another area, so many tests have been developed to differentiate pain from injury.
ACL (anterior cruciate ligament) tears are a common sports-related injury. We have successfully rehabilitated many athletes and non-athletes following surgery for these tears. Aggressive strengthening and range of motion restoration protocols are key to full function. Other conditions such as arthritis, meniscal tears, and patellofemoral syndrome, which produces painful “crunchiness” under the kneecap, can also respond well to our therapy techniques.
Low Back Pain
There are a number of structures which can cause low back pain including discs, nerves, muscles and facet joints. These can show up as a lumbar sprain or strain, disc bulge, protrusion or herniation and sciatica syndrome. An initial evaluation performed by a physical therapist can help to determine the cause of your pain. Soft tissue mobilization combined with rehabilitative exercises and education is the most effective approach for most patients. To treat back pain, one must have a comprehensive approach including posture training, flexibility and strengthening of the muscles of the trunk and arms and legs, and physical therapy. Inflammation must also be addressed in most cases through ice and/or modalities.
Whether it is following an automobile accident or due to work or sleep postures, neck pain is generally relieved when joint motion is restored, muscles regain their pliability, inflammation is minimized. Physical therapy to adjust posture and workstation to maintain the ideal posture for your neck. Strengthening of the supportive muscles and arm, chest and back muscles further speeds up the healing process. Muscle tension headaches often accompany neck pain and respond well to these therapies.
Osteoporosis is becoming a more recognized problem that can be managed with conservative care. Physical therapy can effectively treat osteoporosis patients with exercise, and body mechanics and postural training. If a patient has pain various treatments may be needed to reduce the pain prior to initiating a special exercise program.
Biologic tissue has the ability to repair itself with repeated loading if the load is not too great and time is allowed before the load is repeated. When we exceed these limits with inadequate rest, we cause damage to the tissues in our body. This is known by several names: overuse injury, overuse syndrome, repetitive strain injury or cumulative trauma disorder. These types of injuries may include bursitis, tendinitis, shin splints, stress fractures and muscle strain, spasm or weakness. The number one intervention for overuse injuries is rest. Depending on the affected area, other interventions may include ultrasound, stretching, muscle setting, patient education about posture and body mechanics and pain management techniques.
Rotator Cuff Tendonitis, tears and Impingement Syndrome produce pain causing difficulty using the injured arm, especially overhead. Proper strengthening, and inflammation control and soft tissue mobilization can often successfully solve these problems. Sometimes, additional treatment with an orthopedic surgeon, or physiatrist is necessary and will work most successfully with a competent therapy program.
After an athletic injury a physical therapist and/or chiropractor can design a specific treatment regimen to enhance the healing process and allow for a quicker and safe return to competition. Some treatment methods may include ultrasound, electrical stimulation, exercise training, and chiropractic adjustments. Our rehabilitation programs are comprehensive and give athletes access to state-of-the-art equipment.