Common Injury Types

Injury Categories

Ankle Injuries

Achilles Tendonitis

DEFINITION:
The Achilles tendon is the largest in the body and connects the calf muscle to the heel bone of the foot. This condition involves the inflammation of this tendon which is often caused by repetitive stress on it through pushing the body beyond its abilities. An example would be trying to run a marathon when the body is only trained for a half-marathon. Symptoms include pain and stiffness along the tendon, thickening of the tendon, swelling and a bone spur is also possible.

TREATMENT:
Treatment includes stretching out the calf muscle and the tendon as well as strengthen the overall musculature of the foot to provide stability.






Posterior Tibial Tendonitis

DEFINITION:
The posterior tibial tendon is vital in supporting the arch and foot while walking and it attaches the calf muscle to the bones on the inside of the foot. This tendon can tear due to a fall or sudden twist in movement or through overuse. Symptoms include pain along the inside of the ankle that is often worse with activity and swelling may also be present.

TREATMENT:
Physical therapy will aim to strengthen the tendon and supporting muscles to prevent further injury and maintain full range of motion.






Foot Injuries

Hallux Valgus

DEFINITION:
An alternate name for this condition is a bunion in which the base of the big toe becomes prominent on the inside of the foot. This bulge is made of bone and soft tissue and is commonly caused by the prolonged wearing of ill fitting shoes, particularly ones that squeeze the toes into unnatural positions. Bunions can be prevented by wearing proper fitting shoes. The symptoms are pain in that area especially when walking, stiffness in the big toe and inflammation of the toe.

TREATMENT:
The primary mechanism to heal this is via surgery. Without surgery, physical therapy will work to ease the pain, which is limited, but with surgery treatment will include recovery in strengthening the toe and foot.






Plantar Fasciitis

DEFINITION:
This condition occurs when the strong band of tissue that supports the arch of the foot becomes irritated and inflamed. The strong band is designed to absorb the stress placed on the feet during every day activities, however, excessive pressure causes damage. Risk factors include obesity, a high arch, repetitive impact activity such as running, and engaging in a new strenuous activity. Common symptoms are pain on the bottom of the foot near the heel and a greater level of pain following activity.

TREATMENT:
Physical therapy treatment will work on stretching tight calf muscles and the plantar region as well as strengthen the foot overall.






Hip Injuries

Balance Dysfunction

DEFINITION:
This condition is characterized by feelings of unsteadiness while walking. Balance is an art managed by the eyes, ears and proprioceptors (receptors that register body position) working together. When any of these pathways are disrupted or degenerate, balance dysfunction occurs. Symptoms include inability to walk straight, feeling unsteady, unable to stand without swaying and overall lack of coordination.

TREATMENT:
Physical therapy works to restore the relationship between the ankle, leg and hip to move together in walking. By strengthening coordination, balance can be restored.






Greater Trochanter Bursitis

DEFINITION:
A bursa is a small jelly-like sac located around most important joints and they act as cushions between bones and overlying soft tissues. The greater trochanter is the bony part of the hip and it is an important attachment point for the muscles that move the hip. This condition is characterized by the inflammation of the bursae surround this joint. Symptoms include pain, sharp at first and then becomes more achy, around the hip and it may radiate to the outside of the thigh. Risk factors include overuse of the hip, previous hip injury, a spinal disease, rheumatoid arthritis and bone spurs.

TREATMENT:
The best treatment is an injection of corticosteroid with a local anesthetic and afterward physical therapy can work to stretch out the hip to ease inflammation.






Labral Tear

DEFINITION:
The labrum is cartilage that surrounds the hip joint. It is also present in the shoulder joint. There are two types of labral tear injuries: degenerative and traumatic. Degenerative is when repetitive use causes the tear and it is often seen accompanied by hip arthritis. A traumatic tear is when sudden twisting movements, a fall, an accident or a dislocation causes the tear. Symptoms include pain in the groin, snapping sensations in the hip and limited motion of the joint.

TREATMENT:
Physical therapy will delegate exercises to strengthen the surrounding muscles to ease pain as well as stretch to increase range of motion.






Osteoarthritis of the Hip

DEFINITION:
Arthritis is the result of the cartilage that surrounds the hip joint being worn away so there is increase friction between the bones. The main causes are extensive overuse of the joint and aging. Symptoms include stiffness in the groin, buttock and thigh when waking up, pain that flares during activity and is relieved during rest.

TREATMENT:
Physical therapy will engage the patient in gentle exercises to keep the joint functioning and to improve strength as well as range of motion.






Knee Injuries

ACL Tear

DEFINITION:
The ACL, or anterior cruciate ligament, runs diagonally through the knee, keeping the tibia (shin bone) from sliding forward. This tear usually occurs with a quick sudden movement such as rapid deceleration while the knee is bending, collision, pivoting quickly, or awkward landings. Immediately after the ACL is torn, the knee feels unstable and pain and swelling occurs. After a few hours, knee swelling is massive, there is ample pain and tenderness, and a full range of motion is lost.

TREATMENT:
The majority of the time, treatment requires surgery. Progressive physical therapy can attempt to restore the knee to its original function and strength and prevention exercises will also be taught so the patient knows how to keep the knee stablized.






IT Band Syndrome

DEFINITION:
Also known as "snapping hip", this condition results when a muscle or tendon moves over a bony structure. For the hip, it is when the iliotibial band (IT Band) moves over the greater trochanter portion of the thigh bone (this is where the thigh bone and hip connect). During movement, the snapping motion will be felt or heard. Causes include general aging, overuse of the joint and previous injury or trauma that allowed the band to start movement. This condition is also one that can occur over the knee.

TREATMENT:
If it is painless, treatment is not necessary. Otherwise, physical therapy will stretch the hip to prevent the band from snapping over the bone.






Knee Osteoarthritis

DEFINITION:
Knee Osteoarthritis is a degenerative condition in which the joint cartilage slowly wears away. Symptoms develop gradually and may include pain, sensation of knee buckling, stiffness, swelling, and increase pain after activity such as walking. Weather patterns, such as precipitation, increased humidity, or temperature drops may also heighten pain levels.

TREATMENT:
Physical therapy will employ techniques to reduce pain and symptoms as well as increase function despite the arthritis.






MCL Tear

DEFINITION:
Like the ACL, the MCL plays large role in stabilizing the knee joint. It runs down side of the knee joint, on the inside part of the leg, and connects the femur with the tibia. Most often, these tears occur due to rough contact that pushes the outside of the knee inwards. Pain will be felt on the inside of the knee and there will be sensations of the knee "giving way". Swelling is also a common reaction.

TREATMENT:
Treatment does not always require surgery, but it can. Physical therapy will concentrate on strengthening the joint as well as muscles supporting it to increase overall strength and motion.






Meniscus Tear

DEFINITION:
The menisci are two pieces of cartilage in the knee joint that absorb shock from putting weight on the knees with every step taken. In athletes, these tears occur by quick, sudden or collision movements. Another common cause is the natural wearing thin of the cartilage over time and use. Symptoms include pain in the area, stiffness and swelling, the knee locking, the sensation of the knee "giving way", and the knee cannot move its normal full range of motion.

TREATMENT:
Most of the time, treatment requires surgery. First, physical therapy will concentrate on range of motion exercises and then strengthening techniques will be introduced until original function is achieved.






Patellar Tendonitis

DEFINITION:
Knee Osteoarthritis is a degenerative condition in which the joint cartilage slowly wears away. Symptoms develop gradually and may include pain, sensation of knee buckling, stiffness, swelling, and increase pain after activity such as walking. Weather patterns, such as precipitation, increased humidity, or temperature drops may also heighten pain levels.

TREATMENT:
Physical therapy will employ techniques to reduce pain and symptoms as well as increase function despite the arthritis.






Patellofemoral Pain (Runner's Knee)

DEFINITION:
This condition is characterized by a dull or aching pain around or under the knee cap. Pain typically occurs when walking up or down stairs, squatting, kneeling and sitting with knees bent for an extended period of time. It is usually caused by any of the following: overuse of the joint, partial or complete dislocation of the kneecap, flat feet, a misalignment of the kneecap's position, and tight, weak or imbalanced thigh muscles.

TREATMENT:
Prevention methods include staying in decent shape, using proper running form, using proper running gear, and increasing training at a steady, healthy pace. Physical therapy will encompass exercises to strengthen knee, increase mobility as well as flexibility.






Quadricep and Hamstring Strains

DEFINITION:
Quadriceps are the muscles in the front of the leg, connecting the hip with the side and front of the knee joint. Hamstrings are the muscles in the back of the thigh that connect the hip to the back of the knee joint. The most common cause for these strains is muscle overload, which is when the muscle is stretched or challenged beyond capacity. There are several risk factors that increase the likelihood of these strains occurring: muscle tightness, imbalance where one muscle is stronger than another, weak muscles, or fatigued muscles. If the strain occurs during an activity, a sudden sharp pain in the front or back of the thigh, depending which muscle group it is, will be felt. Other symptoms include swelling, bruising and weakness that can last for several weeks.

TREATMENT:
Physical therapy will work to improve range of motion and strength.






Shoulder Injuries

Impingement Syndrome

DEFINITION:
The shoulder is made up of three bones that are connected and stabilized by the rotator cuff. Impingement occurs when the arm is raised above shoulder level and the space between one of the bones and cuff narrows causing rubbing within the point. This "impingement" causes pain and irritation. The main symptom for this condition is the pain from the rubbing.

TREATMENT:
In physical therapy, range of motion will be focused on as a mechanism to reduce the pain and then the goal will be to strengthen the muscles of the rotator cuff.






Labral Tear

DEFINITION:
The labrum is soft tissue that surrounds the shoulder socket to provide stability and it deepens the socket so the arm fits in nicely. A tear can result from falling on an outstretched arm, a direct contact hit to the shoulder, overreaching or a sudden pull in the shoulder. Symptoms include pain, usually when reaching overhead, sensation of instability in the shoulder, decreased range of motion and loss of strength.

TREATMENT:
If surgery is needed, physical therapy will work on motion and flexibility exercises and then engage in strengthening exercises.






Shoulder Instability

DEFINITION:
Once the shoulder is dislocated out of its socket, it is usually unstable. The joint can become loose and the shoulder can often slip out of the socket. The causes are the initial dislocation as well as repetitive strain on the shoulder joint from activities that typically overuse the shoulder such as swimming or tennis. Symptoms include shoulder pain, repeated dislocations and feelings of the shoulder “giving out”.

TREATMENT:
The key for treatment is strengthening the shoulder muscles and working on shoulder control to increase stability.






Shoulder Tendonitis

DEFINITION:
The shoulder is made up of three bones that are connected and stabilized by the rotator cuff. Irritation of the tendons that form the rotator cuff are responsible for this condition. Usually this is caused by overuse of the shoulder, especially in overhead motions. Symptoms include pain present during activity and rest, pain radiating from the shoulder down the arm, sudden pain with lifting, and eventual loss of strength and motion.

TREATMENT:
Physical therapy will initially focus on getting full motion back in the shoulder by doing stretching exercises. After motion is restored, strengthening exercises will be used to build up the rotator cuff muscles.






Spinal Injuries

Herniated Disc

DEFINITION:
A herniated disc is a condition in which the softer center of a vertebral disc pushes outside of the tough exterior casing. This can occur anywhere in the lumbar, cervical or thoracic spine. In some cases, this can be severe enough to obstruct movement in the spine or compress neural structures. Symptoms of this condition can be local to the spine or refer down the arms or legs, depending on its location, and include pain, weakness and loss of sensation.

TREATMENT:
Conservative treatment of herniated discs include strengthening of the muscle that support and protect the spine, flexibility, postural training and education of activity modification. Conservative treatments can be very successful in treating and managing this condition.






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