Arthritis is inflammation of the joints that causes pain and restricts movement. Arthritis is caused by the breakdown of cartilage that normally protects the joint facilitating smooth movement. Without cartilage bones rub together which creates inflammation, pain, and stiffness. There are a variety of different types of arthritis but some common causes are autoimmune disease, broken bones, age related wear and tear, and infection.

Symptoms

• Pain
• Joint swelling
• Reduced ability to move the joint
• Redness of the skin
• Stiffness

Treatment

• Low-impact aerobic activity
• Range of motion exercises for flexibility
• Strength training for muscle tone
• Avoid placing extra stress on your affected joints
• Modify your home to make activities easier
• Medications
• Surgery

Ligaments are connective tissues, structures in the body made of collagen that hold together bones, muscles, and cartilage to improve the function of a joint. Ligaments provide stability and support to our joints that enables movement. Ligaments can become damaged or torn by acute pressure or general wear and tear.

Symptoms

• A loud pop in the joint at the time of injury
• Swelling of the joint immediately after sustaining the injury
• Restriction of movement in the joint
• Extensive amounts of pain after the injury occurs

Treatment

• Basic first aid to stabilize the joint and reduce swelling
• Physical rehabilitation program
• Reconstructive surgery
• Arthroscopic surgery

Carpal Tunnel Syndrome (CTS) occurs when there is pressure on the median nerve at the wrist. This nerve passes through a tunnel created by the bones and ligaments of the wrist, known as the carpal tunnel. When the median nerve is pinched in this tunnel, you can feel pain, weakness, numbness, or tingling, particularly in the thumb and index finger.

Symptoms

• Burning, tingling, and numbness in the palm of the hand and fingers
• Decreased grip strength
• Decreased sensitivity to hot and cold

Treatment

• Rest and ice
• Immobilization of the wrist
• Anti-inflammatory medication when necessary
• Cortisone injections when necessary
• Surgery to cut the ligament that forms the roof of the carpal tunnel

Rotator cuff injuries are caused by overuse of overhead arm movements, and can be quite painful. Aching pain occurs when arms are used over the head or directly to the side of the body.

Symptoms

• Pain associated with arm movement especially overhead arm movement
• Pain in shoulder when slept on at night
• Tenderness over general area

Treatment

• Rest and ice are very important
• Anti-inflammatory medication when necessary
• Continuous movement of the arm with rest periods to avoid reduction of mobility

Symptoms of Chronic Rotator Cuff Tear

• Often occurs on dominant side
• Weakness throughout range of motion
• Eventual loss of mobility

Treatment of Chronic Rotator Cuff Tear

• Rest and Ice
• Steroid injection when necessary
• Shoulder exercises prescribed by physician
• Physical Therapy

Symptoms of Acute Tear

• Sudden tearing feeling in shoulder
• Radiating pain down arm
• Limited mobility
• Tenderness in specific area of the Rotator Cuff
• Unable to lift arm out to side

Treatment of Acute Tear

• Ice to reduce swelling
• Medications when necessary
• Surgery to repair tendons and ligaments
• Resting of arm in sling if necessary

Frozen shoulder is a disorder caused by the inflammation, scarring, and shrinking of the shoulder capsule. Any type of injury to the shoulder joint may lead to a frozen shoulder.

Symptoms

• Aching shoulder pain
• Limited movement of the joint
• Pain, especially when sleeping on injured side

Treatment

• Anti-inflammatory medication
• Cortisone injections when necessary
• Exercise program and therapy
• Surgery for severe cases

Impingement Syndrome occurs when the tendons over the shoulder become inflamed from rubbing in the Subacromial Space. This irritation thickens these tendons, causing more pain.

Symptoms

• Pain in the front and side of the shoulder during forceful overhead motions
• Pain at the back and front of the joint during abduction or ER (external rotation)

Treatment

• Rest and ice
• Slow return to sport
• Anti-inflammatory medication when necessary
• Injection of steroids when necessary
• Stretching exercises
• MRI or ultrasound
• Physical Therapy

A sprain is caused by the stretching or tearing of ligaments the tissue that attaches bone to bone. A strain occurs when muscles or tendons are stretched or torn. Tendons are the fibrous tissues that connect muscles to bone. Sprains or strains occur throughout the body, but tend to be prevalent near joints.

Symptoms

• Swelling and Bruising
• Pain in effected area
• Tenderness in or around effected area
• Numbness
• Not capable or difficulty with weight bearing activities

Treatment

• R.I.C.E. (Rest, Ice, Compression, Elevation) method
• Anti-inflammatory medication when necessary

Fractures can occur for a number of reasons related to trauma to the bone. Traumatic injuries, including those sustained during falls, car accidents, or fights, can cause bone to break.

Symptoms

• Sharp, intense pain
• Popping, or snapping sounds
• Swelling and inflammation near or around injury location
• A visible, unnatural bend in a bone

Treatment

• Casting or bracing
• Surgery
• Locking plate technology

Plantar Fasciitis is the inflammation of a band of tissue that connects the heel bone to the toes. Inflammation originates from tightening of the Plantar Fascia, which will tear instead of flexing as the foot moves. Complications with the knees, hip, or back are common because inflammation changes the athletes walking motion, stressing other joints. Pain is common after exercise, when getting out of bed, or after rising from periods of inactivity.

Symptoms

• Sharp pain in heel or foot
• Heightened pain after waking
• Pain after sitting or standing for prolonged periods of time

Treatment

• Rest & Ice
• Keep weight off the foot until the pain and inflammation subsides
• Avoiding running, jumping, or walking without any support or cushioning
• Use of Orthotics
• Anti-inflammatory medication when necessary
• Stretching exercise

Iliotibial Band Syndrome (ITBS) is a common cause of lateral knee pain. ITBS develops among athletes who either run constantly or who repeatedly flex or extend their knees. Long distance runners and cyclists are extremely prone to ITBS, but it is also found in tennis, soccer and volleyball players.

Symptoms

• Pain on the outside of knee especially during exercise
• Tightness in the Illiotibial band
• Weakness during hip abduction

Treatment

• Rest and Ice
• Stretching and strengthening exercises
• Ultrasound and electronic stimulation
• Anti-inflammatory medication when necessary
• Surgery for severe cases

Tendonitis occurs due to overuse of tendons, connective tissue made of collagen fibers. Acute tendonitis can occur when use of the tendon is rapidly increased over a short period of time. This type of tendonitis normally fades with rest, but can become chronic tendonitis if untreated. Chronic tendonitis can be caused by increased activity, lowered recovery time between exertion, new footwear, or weakened muscles.

Symptoms

• Pain increasing over time
• Pain at the beginning of exercise but disappearing slowly during the activity
• Injured area is tender to touch

Treatment

• Rest and apply ice to injury
• Anti-inflammatory medication if necessary
• Sports massage or ultrasound
• Physical Therapy

Bursae are small fluid-filled sac-like structures that allow tendons to glide over bones or under the skin to facilitate movement. These structures provide a low-friction surface for tendons to move without getting irritated. Bursitis occurs when the bursa is irritated due to trauma, overuse, infection, or systemic disorders like arthritis.

Symptoms

• Affected area may be red or warm
• End-range of motion will be restricted moderately
• Tenderness at the location of the injury

Treatment

• Rest and protection following the injury
• Draining of the bursa by a physician if necessary
• Cortisone injection to limit inflammation and create a permanent solution to the injury if necessary
• Anti-inflammatory medication may be prescribed if necessary
• Surgery if the bursitis does not respond to other treatment options

Physical therapy is a medical specialty that utilizes a variety of modalities, manual treatments, exercises and education to help patients regain or improve their mobility. Physical therapists work with patients of all ages to maximize the quality of life and return patients to their previous physical abilities. Therapy is performed by a physical therapist or a physical therapist's assistant, both of whom are required to have extensive training. A diagnosis and treatment plan is established by the physical therapist based on the patient's history and a physical examination. Each treatment plan is individualized to meet the needs of each specific patient because all physical therapy techniques are not appropriate for every injury.

Rehabilitation includes a variety of common physical therapy techniques and treatments that are specifically designed to address injuries sustained by the structures of the musculoskeletal system: bones, ligaments, tendons, muscles, and cartilage.

Common techniques

• Hot/Cold packs can prepare muscles for exercise and manipulation or reduce inflammation to make movement less painful.
• Electrical stimulation activates nerves in damaged tissues to help develop strength and stability. It can also be used to reduce pain.
• Ultrasound generates sound waves that are transferred to a specific part of the body using a probe. The sound waves travel deep into tissue creating gentle heat.
• Medical massage is an outcome-based massage that applies specific treatments targeted to physical therapy to help muscles function.
• Strength and stability exercises are used to help the body reestablish the proper function of the musculoskeletal tissues.
• Stretching tight muscles and joints can help relieve pain and get patients back to their previous range of motion.
• Manual techniques are used to improve/restore range of motion, reduce dysfunction, improve biomechanics/strength, improve tissue mobility, and decrease pain.