Achilles tendinopathy is an irritation of the Achilles tendon, a thick band of tissue along the back of the lower leg that connects the calf muscles to the heel. The term tendinopathy refers to any problem with a tendon, either short or long term. The Achilles tendon helps to balance forces in the leg and assists with movement of the leg and the ankle joint. Achilles tendinopathy results when the demand placed on the Achilles tendon is greater than its ability to function. This can occur after 1 episode (acute injury) or after repetitive irritation or “microtrauma” (chronic injury).
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle). It can be caused by a traumatic event, such as a fall directly on the outside of the shoulder, or by repetitive overuse. AC joint injuries are most common in individuals younger than 35 years of age, with males sustaining 5 times more traumatic AC joint injuries than females. Because younger athletes are most likely to participate in high-risk and collision activities, such as football, biking, snow sports, hockey, and rugby traumatic AC joint injuries occur most often in this population. AC joint injuries can be identified and effectively treated by a physical therapist, often avoiding the need for surgery.
An ankle fracture occurs when a bone on 1 or both sides of the ankle is partially or completely broken. Most ankle fractures are caused by twisting injuries and falls, or injuries experienced during sports or play. Under the age of 50, most ankle fractures occur in men. Over the age of 50, women experience more ankle fractures. The type of fracture varies from simple to complex, and can involve 1 or all 3 bones that make up the ankle joint. It is important to seek treatment after an ankle injury to determine if you have a fracture. Physical therapy shares an important role in your treatment and recovery from an ankle fracture, for a return to normal activity.
On a given day, more than 25,000 people will sprain their ankle. It can happen when you land the wrong way while you’re playing sports or participating in other physical activities, or even when you step on an uneven surface while walking. It can happen to athletes, non-athletes, children, and adults.
Ankylosing spondylitis (AS) is an inflammatory disease that causes pain and stiffness in the spine, pelvis, and other joints, like the hips, knees, feet, and shoulders. AS is a chronic (lifelong) disease, and it is hereditary. Although a majority of people who have AS carry a gene called HLA-B27, about 80% of people who have inherited the gene from a parent with AS do not develop the disease. The onset of AS is usually diagnosed in individuals between 17 and 45 years of age. Males are diagnosed 2 to 3 times more often than females, and tend to have more severe disease symptoms than females. Physical therapists help people with AS maintain productive lives by working with them to increase their strength, muscle flexibility, and joint mobility, and to improve their posture.
An anterior cruciate ligament (ACL) tear is an injury to the knee commonly affecting soccer players, basketball players, skiers, gymnasts, and other athletes. About 70% of ACL tears are the result of non-contact injuries; 30% are the result of direct contact (player-to-player, player-to-object). Women are 4-6 times more likely than men to experience an ACL tear.
Balance problems make it difficult for people to maintain stable and upright positions when standing, walking, and even sitting. Older people are at a higher risk of having balance problems; 75% of Americans older than 70 years are diagnosed as having “abnormal” balance. Older women are more likely than older men to develop balance problems, although the difference between the genders is small. Balance problems increase by almost 30% in people aged 80 years or more. Mexican-Americans have the highest rate of balance problems among all Americans. Physical therapists develop individualized physical activity plans to help improve the strength, stability, and mobility of people with balance problems.
Every year, millions of people in the United States develop vertigo, a spinning sensation in your head that can be very disturbing. Benign paroxysmal positional vertigo (BPPV) is one of the most common types of vertigo. If you’ve been diagnosed with BPPV, you’re not alone, it’s estimated to affect at least 9 out of every 100 older adults. The good news is that BPPV is treatable. Your physical therapist will use special exercises and maneuvers to help.
Biceps tendinitis is a common cause of shoulder pain, often developing in people who perform repetitive, overhead movements. Biceps tendinitis develops over time, with pain located at the front of the shoulder, and usually worsens with continued activity. When treating biceps tendinitis, physical therapists work to determine the exact source of the pain by assessing the entire shoulder, and typically prescribe a program of activity modification, stretching, and strengthening to resolve pain and return individuals to their desired activities.
A bunion (hallux valgus) is a large bump on the side of the foot that develops at the base of the big toe. It is common for a bunion to become inflamed and swollen, causing foot pain. Although anyone can develop a bunion, the condition most often occurs in women and older adults. Over time, the joint may enlarge and become stiff and painful, causing problems with shoe fit, pain, and difficulty walking. Physical therapists help people with bunions improve the angle of the big toe, improve their muscle strength and walking ability, and reduce their pain.
A calf strain is an injury to the muscles in the calf area (the back of the lower leg below the knee). The calf muscle is actually composed of up to 9 separate muscles, any of which can be injured individually or together. Calf strains can occur during hi-speed motions like running and jumping, or from any type of forceful or uncoordinated movement. Calf strains are a well-known problem for runners, soccer and basketball players, gymnasts, and dancers. Although global statistics are sparse, one 8-year study of professional soccer players revealed a 13% calf-strain injury rate. Advancing age can increase the vulnerability of the calf to injury and strain with less forceful movements. Physical therapists treat individuals with calf strains by reducing pain, restoring muscle strength and flexibility, and increasing their recovery speed.
Carpal tunnel syndrome (CTS) is a common condition of the wrist and hand that can affect the use of the whole arm. It is caused by pressure on the nerve at the base of the palm (median nerve). Because of the demands that people place on their hands and wrists, CTS is a common condition affecting 1 out of 20 Americans. Surgery for this condition is commonly performed on the wrist and hand. Fortunately for most people who develop CTS, physical therapy treatment can often relieve pain and numbness and restore normal use of the hand, wrist, and arm without the need for surgery.
Cervical radiculopathy is often referred to as a pinched nerve in the neck. It is characterized by radiating pain from the neck to the shoulder, shoulder blade, arm, or hand. Weakness and lack of coordination in the arm and hand can also occur. The condition affects an average of 85 out of 100,000 people most often individuals in their 50s. Athletes, heavy laborers, and workers who use vibrating machinery are commonly affected. People who sit for long periods of time, or individuals with arthritis in the cervical (neck) region can also be affected. Conservative care, including physical therapy, can help reduce symptoms. A physical therapist can help alleviate the acute neck and arm symptoms that result from the condition, as well as improve general strength and function. Most cases of cervical radiculopathy are resolved with physical therapy and do not require surgery.
Chronic pain is a condition that occurs when the brain concludes there is a threat to a person’s well-being based on the many signals it receives from the body. This condition can and often does occur independently of any actual body tissue damage (due to injury or illness), and beyond normal tissue healing time.
The clavicle, or collarbone, connects the arm to the body, helping to stabilize the shoulder and arm as they move. Clavicle fracture is a common shoulder injury, making up 4% of all fracture types and 35% of all shoulder injuries. The injury is most often caused by trauma, such as a direct blow to the shoulder or a fall, and is most often diagnosed in people under the age of 20. It is seen most often in young men, as a result of sports injuries. As people age, it is more likely to occur with a fall. It also becomes more common for women to fracture their collarbones with age, and less likely for men.
Compartment syndrome is a serious medical condition that occurs when there is increased pressure in the muscular compartment of the limbs. When this pressure builds, there is restricted blood flow to the involved area that can compromise the health of the muscles and nerves. Compartment syndrome is classified as either acute or chronic. Acute compartment syndrome is a medical emergency, usually due to a traumatic injury, and must be addressed immediately to avoid irreversible consequences, such as limb loss. Chronic compartment syndrome develops over time, usually due to excessive or inefficient exercise exertion. Physical therapy can be effective to help identify the factors that may influence the development of compartment syndrome.
Complex Regional Pain Syndrome (CRPS) can be a painful and disabling condition. CRPS generally arises from a minor injury, such as a scrape, sprain, or strain and can result in the syndrome that is defined as being complex, regional (symptoms are generally in 1 region of the body), and painful. It is estimated that 80,000 people living in the United States are diagnosed with CRPS each year. A multi-disciplinary approach to treatment is currently recommended, consisting of care from physicians, psychologists, and physical therapists.
In the past few years, concussion has received a great deal of attention as people in the medical and sports worlds have begun to speak out about the long-term problems associated with this injury. The Centers for Disease Control estimate that in sports alone, more than 3.8 million concussions occur each year. Recent scientific evidence highlights the need for proper care to prevent complications from concussion.
Cubital tunnel syndrome is the second most common nerve compression occurring in the arm. (Carpal tunnel syndrome is the most common.) It is a condition caused by increased pressure on the ulnar nerve at the elbow. This pressure can result in considerable discomfort and may progress to loss of function of the hand. Cubital tunnel syndrome generally affects men more than women, especially those with jobs that require repetitive elbow movements and prolonged elbow flexion. Symptoms can occur in both the dominant and the non-dominant arm.
De Quervain’s (dih-kwer-VAINS) tendinitis is a condition that causes pain and tenderness at the thumb side of the wrist, at the base of the thumb and forearm. Pain is worsened with grasping or extending the thumb (pulling it back like “thumbing a ride”). People of all ages can develop this condition, which usually happens when the tendons are strained by prolonged or repetitive use of the hand, rapid or forceful hand use, or use of the hand or arm in an awkward position. Tendons at the wrist become irritated and thickened, resulting in pain when moving the thumb and grasping objects. Common forms of treatment for De Quervain’s include splinting and range-of-motion exercises. Injection for cortisone by a doctor is common treatment. Persistent cases may require surgery.
It’s estimated that as many as 75% of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery and conservative care such as physical therapy usually gets better results than surgery. Degenerative disk disease (DDD) is one cause of back and neck pain. Usually the result of the natural aging process, degenerative disk disease (DDD) is a type of osteoarthritis of the spine.
A discoid meniscus is an abnormally shaped meniscus (cartilage that cushions the bones of the knee) present in 1% to 3% of people born in the United States. The condition is the result of abnormal formation of the meniscus during development in the womb. While some people may be unaware of their discoid meniscus and never experience symptoms related to it, they live at a higher risk of injury than those born with a normal meniscus. A discoid meniscus is commonly detected in childhood or adolescence, and often requires surgical intervention. Physical therapists provide treatment prior to and following surgery, and for conditions not requiring surgery.
Dizziness is a common problem, especially among older adults. In fact, for people over the age of 65, dizziness is one of the most common reasons for physician visits and hospitalizations. Regardless of the cause of dizziness, the sooner you get help, the better.
Down syndrome affects about 1 in 700 babies, or approximately 6,000 babies born in the United States each year. About 400,000 people in America and over 6 million worldwide have Down syndrome. Most children with Down syndrome have delayed mental and physical development. Many children with Down syndrome have an intellectual disability, and approximately 45% of newborn babies with Down syndrome have congenital heart defects.
Elbow fracture can occur as a result of a trauma, such as a fall while you’re playing sports or while you’re just walking on a sidewalk. Fractures due to falls happen most often when people stretch the arm straight out to catch themselves as they fall. When you fall on the ground, the force travels up through the wrist, hand, and forearm and into the elbow. Fracture also can occur if you fall directly on the elbow itself.
There are 3 types of bone fractures:
Type I – a “nondisplaced” fracture, where the bone has a break but is still in normal position.
Type II – a fracture where a fragment of bone is shifted from its normal position.
Type III – the most serious type of fracture, because there are multiple breaks of the bone.
Type I and II fractures usually are treated without surgery, but type III fractures usually require surgery.
Falls can diminish your ability to lead an active and independent life. About one third of people over the age of 65 and almost half of people over the age of 80 will fall at least once this year. There usually are several reasons for a fall. Physical therapists can help you reduce your risk of falling by:
Assessing your risk of falling
Helping you make your home as safe as possible
Educating you about the medical risk factors linked to falls
Designing individualized exercises and balance training
Working with other health care professionals and community services to create programs for people who want to reduce their risk of falling
A femur fracture is a break, crack, or crush injury of the thigh bone. It is sometimes referred to as a “hip fracture”; or “broken hip” if the break is in the upper part of the bone near the hip-joint area. Femur fractures that are simple, short cracks in the bone usually do not require surgery. However, fractures that break completely through the bone, or cause the bone to be displaced or crushed, usually require immediate surgery.
chronic condition that is often difficult to diagnose, fibromyalgia affects almost 5 million people in the United States; 80% to 90% are women. Fibromyalgia usually is diagnosed in adults between the ages of 30 and 50, but the symptomsâ€”such as widespread chronic pain and fatigue can show up earlier.
Although there is no definitive cure at this time, there are treatments that can help.
Often called a stiff or “frozen shoulder,” adhesive capsulitis occurs in about 2% to 5% of the general population. It affects women more than men and typically occurs in people who are over the age of 45. Of the people who have had adhesive capsulitis in one shoulder, 20% to 30% will get it in the other shoulder.
Gait dysfunctions are changes in your normal walking pattern, often related to a disease or abnormality in different areas of the body. Gait dysfunctions are among the most common causes of falls in older adults, accounting for approximately 17% of falls. This guide will help you better understand how gait dysfunctions are categorized, and how treatment by a physical therapist can help you regain a healthy gait. Physical therapists are experts at identifying the root causes of gait dysfunctions, and designing treatments that restore gait.
Greater trochanteric bursitis, also known as greater trochanteric pain syndrome, is one of the most common causes of hip pain. While greater trochanteric bursitis affects both active and inactive individuals, it is most common in moderately active, middle-aged females or those who have recently increased their activity level. In all individuals, pain on the outside of the hip from greater trochanteric bursitis can result in a limited ability to lie on the involved side, walk, climb stairs, squat, or participate in recreational activities. To treat greater trochanteric bursitis, physical therapists typically prescribe a combination of stretching and strengthening activities to decrease irritation in the hip and resolve pain.
A groin strain is an injury to the groin area, the area of the body where the abdomen meets the leg and the inner thigh muscles attach to the pubic bone. Typically, groin strains occur in the muscles of the upper inner thigh near the pubic bone or in the front of the hip. Although more common in athletes than non-athletes, groin strains can occur during any type of forceful movement of the leg, such as jumping, kicking the leg up, or changing directions while running. Groin strains account for 10% of all hockey injuries and 5% of all soccer injuries. Physical therapists treat groin strains by reducing pain and helping patients improve muscle strength and leg motion and to increase the speed of recovery.
A hamstring injury occurs when 1 or more of the 3 hamstring muscles or tendons (a type of soft tissue connecting the muscle to the bone) tear. It is 1 of the most common injuries of the lower body, particularly affecting athletes participating in sports such as football, soccer, or track. After tearing a hamstring muscle, a person is 2 to 6 times more likely to suffer a subsequent injury. Surgery is required to treat the most severe cases. However, in most cases, hamstring injuries are managed with physical therapy.
Pain of any type that occurs in any part of the head is called a headache. There are many different types of headaches, with just as many causes. The International Headache Society describes several different categories of headache:
Migraine and cluster
Secondary headaches from an underlying condition, such as fever, infectious disease, sinus disorder, or in rare cases, a tumor or more serious illness
Cranial neuralgias, facial pain, and other headaches
It’s estimated that as many as 75% of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery and conservative care such as physical therapy usually gets better results than surgery. A herniated disk is one cause of neck and back pain.
Hip bursitis is a painful condition that affects 15% of women and 8.5% of men of all ages in the United States. The condition tends to develop more in middle-aged and elderly individuals. Hip bursitis can have many causes, but the most common is a repetitive activity, such as walking or running on an uneven surface, which creates friction in the hip area. Athletes often develop hip bursitis after running up and down hills repetitively. The condition can also be caused by abnormal walking, such as limping, due to an uneven leg length, or arthritis in the back, hip, knee, or other joints in the leg. It can also occur without any specific cause. Physical therapy can be an effective treatment for hip bursitis to reduce pain, swelling, stiffness, and any associated weakness in the hip, back, or lower extremity.
Hip impingement involves a change in the shape of the surface of the hip joint that predisposes it to damage, resulting in stiffness and pain. Hip impingement is a process that may precede hip osteoarthritis. It most often occurs in young, active people. A recent study found that 87% of teens and adults with hip pain showed evidence of hip impingement on diagnostic images taken of their hip joints. To treat hip impingement, physical therapists prescribe stretches and strengthening exercises to better balance the muscles around the hip to protect it, and use manual therapies to help restore range of motion and increase comfort.
Hip labral tears occur when the labrum, a band of cartilage surrounding the hip joint, is injured. Labral injuries can be the result of trauma, such as a fall or a car accident, but are most commonly caused by repetitive trauma to the hip joint. Individuals who participate in sports that require extremes of motion, such as figure skating, repetitive twisting and “cutting,” like hockey or soccer, or long-distance running are most often diagnosed with labral tears. To treat the symptoms associated with a labral tear, physical therapists typically prescribe a combination of stretching and strengthening activities to decrease irritation in the hip.
Iliotibial band syndrome (ITBS) is one of the most common causes of knee pain, particularly in individuals involved in endurance sports. It accounts for up to 12% of running injuries and up to 24% of cycling injuries. ITBS is typically managed conservatively through physical therapy and temporary activity modification.
Knee pain can be caused by disease or injury. The most common disease affecting the knee is osteoarthritis. Knee injuries can occur as the result of a direct blow or sudden movement that strains the knee beyond its normal range of movement. Knee pain caused by an injury is most often associated with knee cartilage tears, such as meniscal tears, or ligament tears, such as anterior cruciate ligament tears.
Lateral collateral ligament (LCL) sprain occurs when the ligament on the outer side of the knee is overstretched. Collateral ligament knee injuries make up about 25% of severe knee injuries in the United States. They most often occur in adults aged 20-34 years and 55-65 years. LCL sprains mainly happen during sporting activities, including contact and noncontact sports, and affect women and men equally. A physical therapist treats LCL sprains to reduce pain, swelling, stiffness, and any associated weakness in the knee or lower extremity.
If you have low back pain, you are not alone. At any given time, about 25% of people in the United States report having low back pain within the past 3 months.In most cases, low back pain is mild and disappears on its own. For some people, back pain can return or hang on, leading to a decrease in quality of life or even to disability.
Lower extremity stress fractures are a relatively common injury seen most often in athletes playing sports that require repetitive impacts (running and jumping). Stress fractures make up about 8% of all activity-related injuries of the lower extremities. Female athletes are about one-third more likely to develop stress fractures in the legs and feet. While athletes may be more susceptible to these types of injuries, individuals who walk, march, or spend much of their workday on hard floors are also at risk. A physical therapist can help with recovery after a stress fracture as well as identify potential risk factors for prevention of future stress fractures.
Medial apophysitis, or pitcher’s elbow, is a condition that occurs as a result of an injury or irritation to the inside of the elbow, commonly affecting young athletes. It is often classified as an “overuse syndrome” in baseball or softball players in the developmental stages of rapid growth (approximately 11 to 15 years of age). Pitcher’s elbowcan be identified and effectively treated by a physical therapist.
he medial collateral ligament (MCL) is the most commonly damaged ligament in the knee. The MCL can be sprained or torn as a result of a blow to the outer side of the knee, by twisting the knee, or by quickly changing directions while walking or running. MCL injury most often occurs in athletes, although nonathletes can also be affected. A physical therapist treats an MCL sprain or tear to reduce pain, swelling, stiffness, and any associated weakness in the knee or lower extremity.
Medial epicondylitis (commonly called golfer’s elbow or thrower’s elbow) is a condition that develops when the tendons on the inside of the forearm become irritated, inflamed, and painful due to repetitive use of the hand, wrist, forearm and elbow. It is often diagnosed in people who perform repetitive motions, such as swinging a golf club or tennis racket, or activities requiring gripping, twisting, or throwing. Even using a computer or performing yard work can cause the condition. It is most common in men over the age of 35. A physical therapist can help decrease the pain caused by medial epicondylitis, and improve the affected elbow’s motion, strength, and function.
The meniscal tear is a common injury. It can affect athletes who play individuals and team sports. It’s also common in people who have jobs that require lots of squatting, such as plumbers or coal miners. Your physical therapist can help you manage the injury and, if surgery is required, can help you prepare for the procedure and recover your strength and movement afterward.
Meralgia parasthetica, or Bernhardt-Roth syndrome, describes a condition in which numbness, tingling, or burning pain is felt in the outer portion of the thigh. It occurs as a result of nerve compression. Meralgia parasthetica most commonly affects middle-aged individuals, and men more than women. However, it can develop in people of all ages. Physical therapy is a safe and effective approach for managing the symptoms, and some causes, of meralgia parasthetica.
Multidirectional Instability of the Shoulder (MDI)
Shoulder instability is a common injury among people participating in contact and noncontact athletic activities. While many people associate shoulder instability with a traumatic event such as a dislocation, multidirectional instability (MDI) can occur without trauma. MDI commonly occurs in people who have increased a joint’s movement, or have not exercised the joint over a period of time. Weakness of the shoulder joint (rotator cuff) can increase the risk of MDI. After treating the pain and inflammation caused by MDI of the shoulder, physical therapy focuses on strengthening the muscles that support the shoulder blade (scapula) and shoulder joint (rotator cuff) to aid a return to activity and prevent reinjury.
Osgood-Schlatter disease (OS) is an overuse injury causing pain in the knee area and often a visible growth just below the kneecap. The development of OS is most often a consequence of excessive stress to the front of the knee during periods of rapid skeletal growth. Because adolescents typically experience the greatest rate of skeletal growth, this population is most commonly affected by OS. The condition can be effectively treated by a physical therapist.
“Arthritis” is a term used to describe inflammation of the joints. Osteoarthritis (OA) is the most common form of arthritis and usually is caused by the deterioration of a joint. Typically, the weight-bearing joints are affected, with the knee and the hip being the most common.
Osteoarthritis of the Hip, Knee, Shoulder, Spine, etc.
Hip osteoarthritis is inflammation of the hip joint. It can develop at any age, although it is more commonly diagnosed in older adults. Hip osteoarthritis can make everyday activities such as walking or climbing stairs difficult.
Osteoarthritis of the knee (knee OA) is the inflammation and degeneration of the bones that form the knee joint (osteo=bone, arthro=joint, itis=inflammation). The diagnosis of knee OA is based on 2 primary findings: radiographic evidence of changes in bone health (through medical images such as x-ray and MRI) and an individual’s symptoms (how you feel). Approximately 14% of adults aged 25+ and 34% of adults aged 65+ are diagnosed with radiographic osteoarthritis. Specifically, about 16% of adults aged 45+ have knee OA.
Shoulder osteoarthritis (OA) is a condition that occurs when the cartilage that lines the sides of the shoulder joint is worn or torn away. It may be caused by injury or dislocation of the shoulder, or “wear and tear” of the shoulder over time. Shoulder OA develops most often in people in their 50s and beyond. As people misuse or overuse their joints over time, more cases are seen with each advancing decade of life. However, shoulder OA can also develop in younger people after trauma or surgery to a joint. The condition occurs more frequently in women than men. Physical therapists treat shoulder OA with hands-on therapy and individualized exercise programs.
Osteoarthritis (OA) of the spine is a condition that usually occurs with aging and is typically diagnosed after age 50. Its causes include injury to the spine, wear and tear on the discs of the spine (often associated with obesity), or an inherited tendency to develop OA. Sometimes the cause is unknown. OA of the spine may cause pain and stiffness; and make it difficult to bend over, perform weight-bearing activities such as walking, and accomplish daily tasks such as dressing and bathing. Your physical therapist will help you manage your condition, lessen your discomfort, and get moving again.
Osteochondritis dissecans (OCD) is a condition that involves damage to the cartilage and underlying bone within a joint. When this damage occurs, a fragment of the cartilage comes loose from the bone. OCD most commonly occurs in individuals between the ages of 10 and 20, typically affecting males more than females. The most common joints in which this condition occurs are the knee and the ankle, as they are weight-bearing joints. OCD may be caused by repetitive trauma or from a single traumatic episode. If identified early, OCD is a condition that can be effectively treated by a physical therapist.
Osteopenia, now called low bone mass, is a term used to describe lower-than-normal bone density or thickness. Approximately 44 million adults in the United States have osteopenia.The condition is different than osteoporosis, which is a disease where normal bone structure becomes thinned out and porous.
Osteoporosis is a common disease that causes a thinning and weakening of the bones. It can affect people of any age. Women have the greatest risk of developing the disease, although it also occurs in men. Osteoporosis affects 55% of Americans aged 50 or older; one-half of women and a quarter of men will fracture a bone.
The International Association for the Study of Pain has defined pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” This definition indicates that pain may result from actual injury to a tissue (ie, bone, muscle, tendon, etc) or the potential for injury to a tissue. Whether actual or potential damage has occurred, however, people will experience pain as real.
Patellofemoral pain syndrome (PFPS) is 1 of the most common types of knee pain, particularly among athletes, active teenagers, older adults, and people who do physical labor. Patellofemoral pain affects more women than men and accounts for 20%-25% of all reported knee pain.
A pelvic fracture is a break in 1 or more bones in the pelvis. It is sometimes referred to as a “hip fracture” or “broken hip” because it occurs in the bones that make up the hip area. A pelvic fracture causes difficulty walking or standing. It can also cause abdominal pain, bleeding from pelvic cavities, and difficulty urinating. Pelvic fractures in the United States are relatively rare, making up 0.3% to 6% of all fractures. Pelvic fractures are most common in people 15-28 years of age. In people younger than 35, males suffer a higher incidence of pelvic fractures than females. In people older than 35, females suffer pelvic fractures more often than males.
Overuse injuries in sports account for 50% of all injuries. A majority of overuse injuries occur in runners, with 20% of injuries affecting the lower leg, 15% the ankle, and 15% the foot.
Peroneal tendinopathy is a type of overuse injury that often occurs in athletes, like long-distance runners and basketball players. Dancers, people who have had ankle sprains, or those who simply have weak ankles are also often affected. Peroneal tendinopathy is characterized by an aching along the outside surface of the ankle that worsens with activity, yet improves with rest. A physical therapist can help relieve symptoms caused by this condition by providing treatments, including stretching and strengthening exercises to help the ankle become more mobile, strong, and stable.
Pes anserine bursitis is a painful knee condition that occurs most commonly in young people involved in sports (such as running or swimming the breaststroke), middle-aged women who are obese, and people aged 50-80 who have osteoarthritis of the knee. Up to 75% of people who suffer osteoarthritis of the knee have symptoms of pes anserine bursitis. The condition is also commonly associated with type 2 diabetes; 24% to 34% of patients with type 2 diabetes who report knee pain are found to have pes anserine bursitis. Sometimes, however, no direct cause can be identified. A physical therapist treats pes anserine bursitis to reduce pain, swelling, stiffness, and any associated weakness in the knee or lower extremity.
When a limb (arm or leg) is amputated, a sensation that the amputated body part is still attached may persist. This phenomenon is called “phantom sensation.” Phantom sensation may be painful, and therefore is most often referred to as “phantom limb pain.” Approximately 80% of amputees experience phantom limb pain.
Plantar fasciitis is a condition causing heel pain. Supporting the arch, the plantar fascia, a thick band of tissue connecting the heel to the ball of the foot, can become inflamed or can tear. You experience pain when you put weight on your foot particularly when taking your first steps in the morning. The pain can be felt at the heel, or along the arch and the ball of the foot.
Plica syndrome is an irritation of the membrane in the knee joint that keeps the joint lubricated. When this tissue on the inside of the kneecap becomes irritated, it results in knee pain and tenderness to touch. Often the result of overuse, plica syndrome may also result from a direct-hit injury. Plica syndrome is most often treated with physical therapy to improve mobility and strengthening at the knee to decrease tension and irritation.
Posterior cruciate ligament (PCL) injury occurs when one of the ligaments on the inside of the knee is overstretched. Only 3% to 20% of knee ligament injuries are PCL injuries. Accidents, such as hitting the knee against the dashboard during a car collision, or falling onto a bent knee, are common causes of PCL injuries. Forceful straightening of the knee can also injure the PCL. Athletes who play sports, such as football and soccer, and skiers can experience PCL injuries. A newer source of PCL injury is the trend among dancers to land on the front of their shinbone from a high leap. Physical therapists treat PCL injuries to help reduce pain, swelling, stiffness, and any associated weakness in the knee or lower extremity.
Proximal humeral epiphysitis (PHE) is an injury to the shoulder of a throwing athlete who is still maturing physically. Although the injury is most commonly seen in young baseball players, the injury can occur in any child participating in repetitive overhead throwing activities. With an increased participation and sports specialization at a very early age, shoulder and elbow injuries in young athletes are common. Almost 10% of shoulder pain in pediatric patients can be attributed to athletic activities, such as throwing, and of these injuries, 26% are related to overuse and are preventable. As movement experts, physical therapists are uniquely qualified to analyze an athlete’s throwing mechanics, evaluate muscle strength and movement patterns, and develop exercises to return the athlete to pain-free sports participation.
A proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint that requires immediate treatment to preserve function of the shoulder. A fracture to the humerus bone is a possible consequence of a traumatic event, such as a fall or forceful collision. Depending on the specific location and type of fracture to the proximal humerus, surgical intervention may be required. Whether surgical or nonsurgical treatment is needed, physical therapy treatment is essential to safely and effectively restore shoulder function, and return an individual to normal activity.
Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects approximately 1% of the United States population. RA often results in pain and inflammation in joints on both sides of the body, and can become disabling due to its effect on the immune system. A physical therapist can help manage the symptoms of RA, enhancing an individual’s quality of life.
The “rotator cuff” is a group of 4 muscles that are responsible for keeping the shoulder joint stable. Unfortunately, injuries to the rotator cuff are very common, either from injury or with repeated overuse of the shoulder. Injuries to the rotator cuff can vary as a person ages. Rotator cuff tears are more common later in life, but they also can occur in younger people. Athletes and heavy laborers are commonly affected; older adults also can injure the rotator cuff when they fall or strain the shoulder, such as when walking a dog that pulls on the leash. When left untreated, this injury can cause severe pain and a decrease in the ability to use the arm.
Disorders of the rotator cuff and the tissues around it are the most common causes of shoulder pain in people over 40 years of age. Rotator cuff tendinitis occurs when a shoulder tendon (a bundle of fibers connecting muscle to bone) is irritated and becomes sore. With continued irritation, the tendon can begin to break down, causing tendinosis a chronic, long-term condition. People who perform repetitive or overhead arm movements, such as weightlifters, overhead athletes, and manual laborers are most at risk for developing rotator cuff tendinitis. Poor posture can also contribute to its development. A physical therapist can help you identify and correct risk factors for rotator cuff tendinitis, and help you decrease your pain while improving your shoulder motion and strength.
Sacroiliac joint (SIJ) dysfunction is a lower back/pelvic condition that can result from joint stiffness (hypomobility) or slackness (hypermobility) at the sacroiliac joints in the pelvis. The condition can affect both men and women of all ages, but is more common in females. Symptoms typically are present on 1 side of the back, and affect 10% to 25% of patients with complaints of low back pain. Physical therapists design individualized treatment programs to address SIJ dysfunction based on the specific cause of each person’s condition, and treatment goals.
Frailty is a common syndrome among older people. It’s associated with an increased risk of falling and increased hospitalization, disability, and death. The risk of becoming frail increases in the oldest-old, especially those aged 80 or older. Most older adults in nursing homes are frail. Sarcopenia, which is a decrease in the amount and quality of muscle, is a major contributor to frailty. The 5 factors for frailty are:
Unintended weight loss (more than 10 pounds in the past year)
General feeling of exhaustion 3 or more days per week
Scoliosis is a condition that affects the normal shape of the spine, altering a person’s overall trunk alignment and posture. Scoliosis causes the spine to move to the side and turn. This condition can occur at any time during the lifespan, but is more commonly detected during adolescence. Scoliosis affects 2% to 3% of the general population, and is more common in females than males. Scoliosis ranges from mild to severe cases, requiring a variety of treatments. The more severe cases may require surgery. Scoliosis is best managed with a team approach that includes the family, orthopedic physician or surgeon, orthotist, and physical therapist.
Medial tibial stress syndrome (MTSS) is a condition that causes pain on the inside of the shin (the front part of the leg between the knee and ankle). MTSS is commonly referred to as shin splits due to the location of pain over the shin bone. MTSS is one of the most common athletic injuries. It affects both the muscle on the inside of the shin and the bone to which it attaches. MTSS may affect up to 35% of athletes who run and jump, such as distance runners, sprinters, basketball or tennis players, or gymnasts. Military personnel, dancers, and other active people can also develop MTSS. A physical therapist can help you recover from MTSS and teach you exercises and tactics to prevent reinjury.
A joint dislocation is a separation of 2 bones where they meet at a joint. Joints may dislocate when a sudden impact causes the bones in the joint to shift out of place. Because the shoulder is the most mobile joint in the body and has such a wide range of motion, it is more likely to dislocate than any other joint in the body. Dislocations are among the most common traumatic injuries affecting the shoulder.
A shoulder dislocation most often occurs during contact sports, but everyday accidents such as falls can also cause the joint to dislocate. Athletes, non-athletes, children, and adults can all dislocate their shoulders.
Because the shoulder is the most mobile joint in the body and has such a wide range of motion, it is more likely to dislocate than any other joint in the body. Dislocations are among the most common traumatic injuries affecting the shoulder. Athletes, non-athletes, children, and adults can all dislocate their shoulders. They can occur during contact sports and everyday accidents, such as falls.
Shoulder impingement syndrome occurs as the result of chronic and repetitive compression or “impingement” of the rotator-cuff tendons in the shoulder, causing pain and movement problems. It can also be caused by an injury to the shoulder. People who perform repetitive or overhead arm movements, such as manual laborers or athletes who raise their arms repeatedly overhead (ie, weightlifters and baseball pitchers), are most at risk for developing a shoulder impingement. Poor posture can also contribute to its development. If left untreated, a shoulder impingement can lead to more serious conditions, such as a rotator cuff tear. Physical therapists can help decrease pain, and improve shoulder motion and strength in people with shoulder impingements.
An unstable shoulder joint can be the cause or the result of a labral tear. “Labral” refers to the glenoid labrum a ring of cartilage that surrounds the base of the shoulder joint. Injuries to the labrum are common, can cause a great deal of pain, and may make it hard to move your arm. A labral tear can occur from a fall or from repetitive activities or sports that require you to use your arms raised above your head. Some labral tears can be managed with physical therapy; in severe cases, surgery may be required to repair the torn labrum.
Snapping hip syndrome refers to a snapping or popping sensation that occurs in the side, front, or back of your hip when you forcefully lift, lower, or swing your leg. Snapping hip makes it more difficult to perform activities such as lifting, kicking, or twisting your leg, getting up from a chair, walking, running or cycling. While the condition most often affects dancers and athletes, a snapping hip can occur in anyone performing forceful leg movements. Snapping hip is mostly seen in people 15 to 40 years of age.
Snapping scapula syndrome is a condition that involves the popping, grating, grinding, or “snapping” of bones and tissue in the scapula (shoulder blade) area when lifting and moving the arm. The snapping symptoms may be painful, and are sometimes audible. Snapping scapula syndrome is most commonly diagnosed in young, active individuals who perform repetitive overhead movements, such as stocking shelves at the local store, or engaging in sports like weight-lifting, swimming, or baseball. Other causes can include scapula or rib-cage bone conditions, such as fractures, muscle weakness or atrophy, or tumors. Snapping scapula syndrome is usually the result of overuse of the arm, poor posture during sport activities, or incorrect joint motion, but can also be caused by a single episode of trauma to the scapula area. A physical therapist treats the pain, muscle weakness, loss of arm motion, and swelling of soft tissue that can occur with snapping scapula syndrome.
It’s estimated that as many as 75% of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery and conservative care such as physical therapy usually gets better results than surgery. Spinal stenosis is one cause of back and neck pain. It affects your vertebrae (the bones of your back), narrowing the openings within those bones where the spinal cord and nerves pass through.
Spondylolysis (spon-dee-low-lye-sis) is a stress fracture of a section of the lumbar spine; most frequently the fifth vertebrae. The injury can occur on the left, the right, or both sides of the vertebrae. Spondylolysis occurs in up to 11.5% of the general population in the United States, and is most frequently seen in young males. Spondylolysis is a common cause of low back pain experienced in late childhood and adolescence. Highly active teens, both boys and girls who engage in activities that require lifting heavy loads, repeated backward bending of the back, or twisting of the trunk, are most at risk for spondylolysis, including athletes participating in activities like football, hockey, gymnastics, or dance. Only a small percentage of cases of spondylolysis require surgery, and 85% to 90% of young patients recover in 3 to 6 months with proper treatment.
Sports hernia is a condition that mainly affects athletes who play soccer, hockey, football, and rugby, and who run track. It is more common in males than females. A full 94% of sports hernias occur gradually from unknown causes; the other 6% are caused by a specific traumatic incident, such as being “checked” from behind while playing hockey. Stress from repetitive twisting, kicking, and turning at high speeds is a likely cause of injury. Casual exercisers and nonathletes can also experience a sports hernia. Physical therapists can help individuals with a sports hernia improve their abdominal and hip strength and flexibility in order to safely return to their desired sport or activities.
Most people who get tennis elbow don’t play tennis! In fact, less than 5% of all cases of tennis elbow occur in people who play tennis. Tennis elbow can happen to anyone who repeatedly uses their elbow, wrist, and hand for their job, sport, or hobby.
Total hip replacement/arthroplasty is a common surgical intervention that is performed for severe arthritis or hip fracture when all other conservative treatments fail. The goal of total hip replacement surgery is to relieve pain, improve joint mobility, and restore or improve the ability to safely perform functional activities like walking, standing, stair climbing, or running.
The knee is the most commonly replaced joint in the body. The decision to have knee replacement surgery is one that you should make in consultation with your orthopedic surgeon and your physical therapist. Usually, total knee replacement (TKR) surgery is performed when people have:
Knee joint damage due to osteoarthritis, rheumatoid arthritis, other bone diseases, or fracture
Knee pain or alignment problems in the leg that cause difficulty with walking, performing daily activities, or life tasks
Total shoulder arthroplasty (TSA), often called a total shoulder replacement, is a surgical procedure in which part or all of the shoulder joint is replaced. It is estimated that 53,000 people in the United States have shoulder replacement surgery each year, according to the Agency for Healthcare Research and Quality. That number compares to the more than 900,000 Americans a year who have knee and hip replacement surgery. Physical therapists can help patients who undergo a TSA return to their previous levels of physical activity, including fitness training, or participation in sports like swimming or golf.
Turf toe injury is an injury to the main joint of the big toe. The formal medical name for the condition is metatarsophalangeal (MTP) joint sprain. This injury occurs when the big toe is forced into extreme positions of hyperextension (where the toe moves back toward the top of the foot past its normal range of motion). It occurs primarily in athletic environments, particularly in football, such as when an athlete pushes off to sprint or is tackled with the front of the foot fixed and jammed into the ground, causing the toe to get stuck or caught in a hyperextended position. In most circumstances, a turf toe injury does not require surgery and can be treated effectively by a physical therapist.
Ulnar collateral ligament (UCL) injuries occur when repetitive stress damages the inside of the elbow. UCL injuries are becoming more common given the popularity of “overhead” sports such as volleyball and baseball. They are often referred to as “Tommy John” injuries, named after the famous baseball pitcher who underwent the first surgery for a UCL injury in 1974. A physical therapist can help improve your arm’s strength and range of motion, and your body’s overall stability and balance following a UCL injury.
A wrist fracture is a break in one of the bones near the wrist, most frequently the radius. Because of the high-risk sports that they play, wrist fractures often occur in children. Due to osteoporosis, wrist fractures also are very common in women after menopause.
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