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.
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