Conditions

An Achilles tendon injury (tendinopathy) is one of the most common causes of pain felt behind the heel and up the back of the ankle when walking or running. While Achilles tendinopathy affects both active and inactive individuals, it is most common in active individuals; 24% of athletes develop the condition. Males experience 89% of all Achilles tendon injuries, and an estimated 50% of runners will experience Achilles pain in their running careers. In all individuals, Achilles tendinopathy can result in a limited ability to walk, climb stairs, or participate in recreational activities.

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.

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.

Sprains are injuries to ligaments, the “bands” that hold joints together. Ankle sprains occur when the foot twists or turns beyond its normal range of movement, causing the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments may tear. An ankle sprain can range from mild to severe, depending on how badly the ligament is damaged or how many ligaments are injured. An ankle sprain is given a grade from 1 to 3 depending on the amount of ligament damaged. A grade 1 sprain is mild, grade 2 is moderate, and grade 3 is severe.

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.

Usually, you will be examined by a physical therapist or an orthopedic surgeon immediately following injury. Most people who sustain an ACL tear will undergo surgery to repair the tear; however, some people may avoid surgery by modifying their physical activity so that they don’t put a lot of stress on the knee. A select group can actually return to vigorous physical activity following rehabilitation without having surgery.

Your physical therapist, together with your surgeon, can help you determine if non-operative treatment (rehabilitation without surgery) is a reasonable option for you. If you elect to have surgery, your physical therapist will help you both prepare for surgery and recover your strength and movement following surgery.

There are several causes of facial paralysis, such as tumors of the facial nerve or tumors of the base of the brain, trauma, or a congenital condition (a condition that you’re born with). Bell palsy usually begins with a sudden weakness on one side of your face or a sudden feeling that you can’t move one side of your face. It’s important for you to know that these can be symptoms of such conditions as stroke.

Benign paroxysmal positional vertigo (BPPV) is an inner-ear problem that causes short periods of dizziness when your head is moved in certain positions. It occurs most commonly when lying down, turning over in bed, or looking up. This dizzy sensation is called vertigo.

A layer of calcium carbonate material is present naturally in one part of your inner ear (the utricle). BPPV occurs when pieces of this material break off and move to another part of the inner ear, the semicircular canals (usually the posterior canal). These tiny calcium crystals (otoconia) are sometimes called “ear rocks.”

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.

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.

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.

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.

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. If you are worried about falling or if you recently had a fall, your physical therapist can conduct a brief check (“screening”) of your fall risk. If the screening shows that you are at risk, the therapist will perform a thorough evaluation.

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.

A 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 symptoms—such as widespread chronic pain and fatigue—can show up earlier.

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.

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.

Your spine is made up of 33 vertebrae (bones) that are stacked on top of one another. Between each vertebra is a cushion-like piece of cartilage called an “intervertebral disk.” Imagine the disk as a tire, with gelatin filling the hole in the tire. The rubbery outer part is called the “annulus,” and the gelatin is called the “nucleus.” When we’re young—under 30 years of age—the disk is made mostly of gelatin. As we age, we start to lose some of that gelatin. The disk becomes flatter and less flexible, making it easier to injure. In some cases, the gelatin can push out through a crack in the rubbery exterior and lead to a herniation (bulge) or rupture (tear).

Iliotibial band syndrome (ITBS) occurs when excessive irritation causes pain at the outside (or lateral) part of the knee. The iliotibial band (ITB) is a type of soft tissue that runs along the side of the thigh from the pelvis to the knee. As it approaches the knee, its shape thickens as it crosses a prominent area of the thigh (femur) bone, called the lateral femoral condyle. Near the pelvis, it attaches to 2 important hip muscles, the tensor fascia latae (TFL) and the gluteus maximus.

Knee pain can be caused by disease or injury. Knee pain can restrict movement, affect muscle control in the sore leg, and reduce the strength and endurance of the muscles that support the knee.

The most common disease affecting the knee is osteoarthritis, which is caused by the cartilage in the knee gradually wearing away, resulting in pain and swelling.

Knee injuries can occur as the result of a direct blow or sudden movement that strains the knee beyond its normal range of motion, as can happen in sports, recreational activities, a fall, or a motor vehicle accident. Knee pain caused by an injury often is associated with tears in the knee cartilage or ligaments. Knee pain also can be the result of repeated stress, as often occurs with the kneecap, also known as patellofemoral pain syndrome. Very rarely, with extreme trauma, a bone may break at the knee.

The lateral collateral ligament is a thick, strong band of tissue that connects the thighbone to the shinbone. It is located on the outer side of the knee. It helps keep the knee joint stable. It is one of several collateral ligaments that support the knee. The LCL can be injured if the knee is hit on the inner side, which pushes the knee outward, or if the knee straightens too quickly or forcefully (hyperextends), which causes stress on the outer side of the knee. The LCL may be stretched, partially torn, or completely torn.

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.

The MCL is a small, thick band of tissue on the inner side of the knee joint. It connects two bones—the thighbone and the shin bone—preventing the knee from bending inward toward the other knee. When the knee is hit on the outer side of the leg (eg, the left side of the left leg), or if the knee is twisted violently, the MCL can overstretch resulting in a partial or complete tear. MCL injuries commonly occur in football players who get “clipped” or hit on the outer side of the knee. Other causes may include twisting and turning while skiing, blows received on the soccer field, trauma experienced in a car accident, or simply turning the knee sharply while the foot is planted on the ground. Healing times vary from a couple of weeks to a couple of months, depending on the severity of the injury.

The meniscus is a rubbery, C-shaped piece of cartilage that cushions your knee. Each of your knees has 2 menisci (plural of meniscus); one on the inner (medial) part of the knee, and the other on the outer (lateral) part. Together they act to absorb shock and stabilize the knee joint.

A meniscal tear typically is caused by twisting or turning quickly on a bent knee, often with the foot planted on the ground. Although meniscal tears are common in those who play contact sports, anyone at any age can tear a meniscus. When people talk about having torn cartilage in their knee, they usually are talking about a meniscal tear.

“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.
Physical therapists can help patients understand OA and its complications, and provide treatments to lessen pain and improve movement. Additionally, physical therapists can provide information about healthy lifestyle choices and obesity education. This is important because some research shows that weight loss can reduce the chance of getting OA. One study showed that an 11-pound weight loss reduced the risk of OA in women.