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.
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