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Common Injuries & Conditions We Treat via Physical Therapy, Occupational Therapy, & Hand Therapy
The Licensed Physical Therapists and Assistants of PEAK Physical Therapy & Sports Rehabilitation, conveniently located in Williamsburg, VA., can assist you with the following conditions:
Achilles tendonitis is an overuse injury of the achilles tendon, the band of tissue that connects calf muscles to your heel bone. The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg and/or above the heel.
Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It’s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.
Initially, achilles tendonitis may be just tenderness or stiffness, especially in the morning, which usually improves with mild activity. But as it progresses, it will create pain, discomfort, and tightness regardless of activity. More- serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.
An ankle sprain is an injury to the ligaments (non-contractile bands of tissue) that hold your ankle bones together. Damage to the ligaments occurs when you roll, twist or turn your ankle in an awkward way. This can stretch and/or tear these ligaments.
Ligaments help stabilize joints, preventing excessive movement. A sprained ankle occurs when the ligaments are forced beyond their normal range of motion. Most sprained ankles involve injuries to the ligaments on the lateral (outside) aspect of the ankle.
Signs and symptoms of a sprained ankle vary depending on the severity of the injury. They may include: pain, especially when you bear weight on the affected foot; tenderness when you touch the ankle; swelling; bruising; restricted range of motion; instability in the ankle; popping sensation or sound at the time of injury. Although self-care measures and over-the- counter pain medications may be all you need, a medical evaluation might be necessary to reveal how badly you’ve sprained your ankle and to determine the appropriate treatment.
Carpal tunnel syndrome is a condition that causes hand weakness, muscle wasting, and numbness, tingling and other symptoms. Carpal tunnel syndrome is caused by a compressed nerve in the carpal tunnel, a narrow passageway on the palm side of your wrist.
Carpal tunnel syndrome symptoms usually start gradually. The first symptoms often include numbness or tingling in your thumb, index and middle fingers that comes and goes. The anatomy of your wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome. Proper treatment usually relieves the tingling and numbness and restores wrist and hand function.
A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Concussions are usually caused by a traumatic blow to the head. Violently shaking the head and upper body can cause concussions as well.
Some concussions cause you to lose consciousness, but most do not. It’s possible to have a concussion and not realize it. Concussions are particularly common if you play a contact sport, such as football. The signs and symptoms of a concussion can be subtle and may not show up immediately. Symptoms can last for days, weeks or even longer.
Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia usually involves forgetting the event that caused the concussion.
While concussion usually resolves on its own without lasting effect, it can set the stage for a much more serious condition. “Second impact syndrome” occurs when a person with a concussion, even a very mild one, suffers a second blow before fully recovering from the first. The brain swelling and increased intracranial pressure that can result is potentially fatal.
According to the Centers for Disease Control and Prevention, approximately 300,000 people sustain mild to moderate sports-related brain injuries each year, most of them young men between 16 and 25.
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
Your risk of developing frozen shoulder increases if you’re recovering from a medical condition or procedure that prevents you from moving your arm and/or history of diabetes.
Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months.
- Freezing stage. Any movement of your shoulder causes pain, and your shoulder’s range of motion starts to become limited.
- Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult.
- Thawing stage. The range of motion in your shoulder begins to improve.
Golfer’s elbow (medial epicondylitis) is a condition where pain is located on the inside (medial) of your elbow where the tendons of your forearm muscles attach to the bony bump (epicondyle) on your elbow. The pain is usually noticeable from your elbow to the forearm and wrist. This is a painful condition that occurs when medial muscles and tendons in your elbow are overloaded, usually by repetitive motions of the arm and wrist.
Golfer’s elbow is similar to tennis elbow, which occurs on the outside of the elbow. It’s not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer’s elbow.
Golfer’s elbow is characterized by: medial pain and discomfort; joint stiffness; muscle weakness; numbness or tingling. The pain of golfer’s elbow can come on suddenly or gradually. The pain might worsen with certain movements, such as holding an item or swinging a golf club.
Despite its name, athletes aren’t the only people who develop golfer’s elbow. People whose jobs requires a strong grip can lead to golfer’s elbow include plumbers, painters, carpenters and butchers.
Headache is pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a vise-like quality.
A headache may appear as a sharp pain, a throbbing sensation or a dull ache. Headaches can develop gradually or suddenly, and may last from less than an hour to several days.
There are three types of primary headaches: tension-type (muscular contraction headache), migraine (vascular headaches), and cluster.
Approximately 40-45 million people in the United States suffer chronic headaches. An estimated 18% of American women suffer migraines, compared to 6% of men. Cluster headaches affect fewer than 0.5% of the population, and men account for approximately 80% of all cases.
Hip & Knee Arthritis
To put it simply, arthritis is inflammation of the joint. Due to the weight- bearing nature of the hip & knee, they are very susceptible to arthritis.
There are two main types of Arthritis: osteoarthritis and rheumatoid. Osteoarthritis is where the cartilage, the hard, slippery tissue that covers the ends of bones where they form a joint, to break down. Rheumatoid arthritis is an autoimmune disorder which the lining of joints (synovium) is attacked & destroyed by the body’s own immune system. Uric acid crystals, infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.
The main symptoms of arthritis are joint pain, stiffness, swelling, decreased range-of-motion which typically worsen with age. Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.
The hip joint is one of the largest and strongest joints in the human body yet it is not immune from pain. One of the most common reported types of hip pain is bursitis (inflammation of the bursa). These fluid-filled sacs are found around the body and serve as cushions between bones and soft tissues such muscles, tendons, and the skin.
Each hip has two major bursae. The outside point of the hip, which is called the greater trochanter, has a bursa called the trochanteric bursa. (The other bursa, on the inside of the hip area, is called the iliopsoas bursa.)
When that outside hip bursa gets irritated, inflamed, and/or painful, you have trochanteric bursitis. It is a common condition and easily treatable. In most cases, bursitis pain goes away within a few weeks with proper treatment, but recurrent flare-ups of bursitis are common.
A swollen knee occurs when excess fluid accumulates in or around your knee joint. A medical specialist may also refer to this condition as knee joint effusion. Some people have called this condition “water on the knee.”
A swollen knee may be the result of trauma, overuse injuries, or an underlying disease or condition which is determined by obtaining a sample of the fluid to be tested for infection or disease. Removing some of the fluid can also help reduce the pain and stiffness associated with the swelling.
Swelling is the result of a condition, not a condition itself. Until the underlying cause of the knee swelling is determined, appropriate treatment cannot begin.
Low Back Pain
Low Back (or “lumbar”) pain is one of the most common reasons people go to the doctor, miss work, and it is a leading cause of disability worldwide. Most people have back pain at least once.
Low Back pain can be caused from a multitude reasons including but not limited to: muscle strain, nerve compression, disc injury, bone irritation. Normal signs and symptoms of low back pain can include: muscle ache; shooting or stabbing pain; pain that radiates down to your hip, leg and possibly to the foot; and pain that worsens with bending, lifting, standing, walking.
Fortunately, you can take measures to prevent or relieve most back pain episodes. Should low back pain occur, proper conservative treatment along with proper body mechanics often will heal your back within a few weeks and keep it functional. Surgery is rarely needed to treat back pain and should never be a first option unless in extreme cases.
Meniscus is a “C” shaped fibrocartilage that acts as shock-absorbing spacer between the femur (aka thigh bone) and the tibia (larger of the two lower leg bone). It can be injured or torn in multiple ways but the most common is via a twisting motion or the knee being hit when the leg is planted.
The meniscus can be damaged through repeated trauma, overuse, or prolonged daily living. Research shows that 78% of individuals have a torn meniscus and are asymptomatic (without any pain or discomfort). Symptoms of a meniscus tear include: pain in the knee; swelling; a popping sensation during the injury; difficulty bending and straightening the leg; a tendency for your knee to get “stuck” or lock up. Should you have in the past or are currently experiencing these symptoms with concurrent dysfunction with moving around and it is not getting better, seek a medical consult.
Neck pain (or cervicalgia) is a common problem, with two-thirds of the population having neck pain at some point in their lives. Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, pinching of the nerves emanating from the cervical joints, and/or joint disruption to name a few.
Neck pain can be a symptom of a more serious problem. Seek medical care if your neck pain is accompanied by numbness or loss of strength in your arms or hands or if you have shooting pain into your shoulder or down your arm.
Patellar Tendinitis / Tendinopathy
Patellar tendinitis/ tendinopathy is an injury to the tendon connecting your kneecap (patella) to your tibia (shinbone). The patellar tendon is the cable that is attached to the quadriceps (anterior thigh muscles) that enables you to extend your knee so that you can walk, run, kick, and jump.
Patellar tendinitis, also known as “jumper’s knee”, is most common in athletes whose sports involve frequent jumping — such as basketball and volleyball. However, even people who don’t participate in jumping sports can get patellar tendinitis.
Pain is the first symptom of patellar tendinitis. Initially, you may only feel pain in your knee as you begin physical activity or just after an intense workout. Over time, the pain worsens and starts to interfere with playing your sport. Eventually, the pain interferes with daily movements such as climbing stairs or rising from a chair. If the patellar tendinitis goes untreated for an extended period of time, it will be labeled as the chronic condition of patellar tendonopathy.
Patellofemoral Pain Syndrome
Patellofemoral pain syndrome is pain at the front (anterior) of your knee, around your kneecap (patella). Sometimes, it is called “movie-goers knee” Patellofemoral pain syndrome usually causes a dull, aching pain in the front of your knee. The knee pain often increases when you run, walk up or down stairs, sit for long periods, or squat
Pelvic pain is pain located in the lowest part of your abdomen and pelvis. Unfortunately, pelvic pain is a common issue amongst women. In women, pelvic pain might refer to symptoms arising from the reproductive, urinary or digestive systems, and/or from musculoskeletal sources.
Depending on the cause, pelvic pain may be sharp or dull; may be constant or fluctuate (ie: intermittent); can range from mild discomfort to severe pain; and be short lived or long term (ie: chronic).
Pelvic pain can also radiate (ie: appear in a different location) such as to your lower back, buttocks or thighs. Your pain may only appear at certain times, for instance when you urinate or during sexual activity.
Regardless, you don’t have to live with it and seeking proper medical assistance, Pelvic Health Physical Therapist, can have it become a distant memory.
A pinched nerve (radiculopathy: for more information see below) occurs when too much pressure is applied to a nerve by surrounding tissues, such as bones, cartilage, muscles or tendons. This pressure disrupts the nerve’s function, causing pain, tingling, numbness, weakness or any combination of the previous listed.
A pinched nerve can occur at a number of sites in your body. A pinched nerve in your neck can cause neck & upper back pain, shoulder pain, pain at your scapula (shoulder blade) and/or down your arm to your hand. A pinched nerve in your wrist can lead to pain and numbness in your hand and fingers (carpal tunnel syndrome). Having a herniated disk in your lower spine, for example, may put pressure on a nerve root, causing pain that radiates down the back of your leg.
With physical therapy and other conservative treatments, most people recover from a pinched nerve within a few days or weeks. Rarely but sometimes, a surgical intervention is needed to relieve pain from a pinched nerve.
Plantar fasciitis is one of the most common causes of heel pain. It involves pain and inflammation to the plantar fascia (thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes.
Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move more, the pain normally decreases, but it might return after long periods of standing or after rising from sitting.
Plantar fasciitis is more common in runners or fitness walkers who have changed their exercise regimen or developed and imbalance. In addition, people who are overweight and those who wear shoes with inadequate support have an increased risk of plantar fasciitis.
Radiculopathy refers to a condition in which one or more nerves are affected and do not work properly (ie. neuropathy). The location of the injury is at the level of the nerve root (level where the nerve exits the spinal
cord and surrounding bones). This can result in radicular pain, weakness, numbness, and/or difficulty controlling specific muscles.
In a radiculopathy, the problem occurs at or near the root of the nerve, shortly after its exit from the spinal cord. However, the pain or other symptoms often radiate to the part of the body served by that nerve. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or sacral spine can be manifested with symptoms in the leg and foot.
They’re a significant number of variables that cause radiculopathy so a thorough history and examination is needed to rule-out and implicate the cause for the reported pain and dysfunction.
Sciatica, a very common pain, refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.
Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.
Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. People who have severe sciatica that’s associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.
The term “shin splints” refers to pain to the lower leg near or on the tibia (shin bone). Shin splints is a vague term for pain in the lower leg emanating from issue with: muscles, tendon, bone, nerve, and/or vascular structures. Shin splints are common in runners, dancers and military recruits.
Medically known as medial tibial stress syndrome, shin splints often occur in athletes who have recently intensified or changed their training routines. The increased activity overworks the muscles, tendons and bone tissue.
Shin splint symptoms usually present as tenderness, soreness or pain along the inner side of the shinbone and mild swelling to the lower leg. Initially, the pain might stop once exercising has ceased. Eventually, however, the pain can be continuous regardless of activity and if not treated properly, shin splints can progress into a serious and debilitating stress fracture.
Shoulder Impingement syndrome is a common cause of shoulder pain. It occurs when there is impingement of tendons and/or bursa in the shoulder from bones of the shoulder. Overhead activity of the shoulder, especially repeated activity and poor biomechanics, is a risk factor for shoulder impingement syndrome. Other risk factors include bone and joint abnormalities.
With impingement syndrome, pain is persistent and affects everyday activities. The symptoms may increase with such motions as reaching overhead and/or reaching backwards. Often progressive weakness of shoulder ensues.
Over time, impingement syndrome can lead to inflammation of the rotator cuff tendons (tendinitis or tendonopathy) and bursa (bursitis). If not treated appropriately, the rotator cuff tendons can start to thin and tear resulting in a rotator cuff tear.
Shoulder pain is not a specific diagnosis. It is a general term to denote an area from which the individual reports their symptoms. They may arise from the shoulder joint itself or from any of the many surrounding structures, muscles, ligaments and/or tendons. Shoulder pain that usually worsens with activities or movement of your arm or shoulder generally comes from the joint. Shoulder pain is a very common complaint and it constitutes 16% of all musculoskeletal system complaints reported in physical therapy. For more specific possible and common causes of Shoulder Pain, see: Shoulder Impingement; Frozen Shoulder; Thoracic Outlet Syndrome.
Tennis elbow (lateral epicondylitis) is a condition where pain is located on the outside (lateral) of your elbow where the tendons of your forearm muscles attach to the bony bump (epicondyle) on your elbow. The pain is usually reported from your elbow to the forearm and wrist. This a painful condition that occurs when medial muscles and tendons in your elbow are overloaded, usually by repetitive motions of the arm and wrist.
Tennis elbow is characterized by: lateral pain and discomfort; joint stiffness; muscle weakness; numbness or tingling. The pain of tennis elbow can come on suddenly or gradually. The pain might worsen with certain movements, such as holding an item or swinging a tennis racquet.
Despite its name, athletes aren’t the only people who develop tennis elbow. People whose jobs feature certain types of repetitive motions can lead to tennis elbow include plumbers, painters, carpenters and butchers.
Thoracic Outlet syndrome is a group of disorders that occur when blood vessels and/or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck and numbness in your fingers. Physical therapy is indicated for all except those who failed conservative treatment.
There are 3 main types of thoracic outlet syndrome:
- Neurogenic: Affects nerves leading from the spinal cord to the neck to the arm.
- Venous: Affects veins
- Arterial: Affects arteries
About 95% of thoracic outlet syndrome cases involve nerves and it can affect anyone. You are most likely to feel them in your arms and hands which can include any or all the following: pain in the neck, shoulder, or arm; numbness and tingling: swelling; weakness; discoloration; cold hands.
The temporomandibular joint (TMJ) is a sliding hinge that connects your jaw (mandible) to your skull (temporal bone). You have one joint on each side of your jaw. TMD (temporomandibular disorder) occur as a result of dysfunction and/or pain with the jaw, jaw joint and surrounding facial muscles that control chewing and moving the jaw.
The exact cause of a person’s TMD (TMJ disorders) can be difficult to determine without a thorough history and examination. In most cases, the pain and discomfort associated with TMJ disorders is temporary and can be relieved with self-managed care or nonsurgical treatments. Surgery is typically a last resort after conservative measures have failed, but some people with TMJ disorders may benefit from surgical treatments.
TMD can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there’s no pain or limitation of movement associated with your jaw clicking, you probably don’t need treatment for a TMJ disorder.
People with TMD can experience severe pain and discomfort that can be temporary or last for many years. More women than men experience TMD and TMD is seen most commonly in people between the ages of 20 and 40.
Upper Back Pain
Upper Back pain is the spinal pain emanating from the “no-man’s land” – below the neck and above the low back. This pain can be caused from a multitude reasons including but limited to: muscle strain, nerve compression, disc injury, rib/bone irritation.
Normal signs and symptoms of upper back pain can include: muscle ache; shooting or stabbing pain; pain that radiates around your chest; and pain that worsens with bending, lifting, standing, walking or breathing.
Fortunately, you can take measures to prevent or relieve most back pain episodes. Should upper back pain occur, proper conservative treatment along with proper body mechanics often will heal your back within a few weeks and keep it functional. Surgery is rarely needed to treat back pain and should never be a first option unless in extreme cases.
Wrist pain can be caused by; rheumatoid arthritis; osteoarthritis; a nerve injury, ligamentous sprain; or a fracture(s) from a trauma. Because so many factors can lead to wrist pain, diagnosing the exact cause can be difficult, but an accurate diagnosis is essential for proper treatment and healing.
Wrist pain may vary, depending on the cause. For example, osteoarthritis pain is often described as being similar to a dull toothache, while carpal tunnel syndrome usually causes a pins-and-needles feeling or a tingling sensation, especially at night. The precise location of your wrist pain also provides clues to what’s behind your symptoms. If you are unsure of the origin of your wrist pain, please seek medical counsel.
Information gathered and compiled from Mayo Clinic, WebMD, and from personal knowledge gathered as a Medical Student & Clinician.
PEAK Physical Therapy specializes in the treatment of a wide variety of orthopedic injuries. Our area of expertise includes rehabilitation of sprains and strains, neck and back pain, pre and post surgical conditions, arthritis, joint replacements, and musculoskeletal injuries to the shoulder, elbow, wrist/hand, hip, knee, ankle/foot. Our physical therapists can evaluate your condition directly, and our office would be happy to schedule your referral appointment if you need a medical consultation.
Our therapists have extensive experience working with athletes from high school to the professional level. Whether you are a weekend warrior or an elite athlete, the therapists at PEAK Physical Therapy & Sports Rehabilitation are ready to evaluate your condition and design a program that is progressive, challenging and focused on returning you to your preferred sport as soon as possible. Our therapists are all recreational athletes, some are former collegiate athletes, and you can often find them outside the clinic living the active lifestyle including cycling, running, swimming, and golfing.
Back and neck pain can be debilitating. Our therapists are highly skilled at treating back and neck injuries that have been resistant to surgery and other therapies. Our physical therapy interventions have been widely proven in the medical literature to be highly effective in reducing the effects of low back injury. Our therapists use advanced manual therapy techniques such as joint mobilization and low velocity manipulation, modalities, and back and abdominal stabilization programs with the goal of returning you to your normal activity level as quickly as possible.
OVER 50? NO PROBLEM!
The Williamsburg community supports a large population of older adults who enjoy outdoor recreational activities. Our facilities are committed to promoting a healthy, active and energetic lifestyle across the lifespan. We offer programs to help our patients maintain a quality of life that is as active as possible. We have numerous octogenarians whom we’ve helped recover their ability to bike, hike and golf. Don’t let back/neck pain, arthritis, balance disorders, shoulder/knee pain, or a joint replacement slow you down. The therapists at PEAK Physical Therapy & Sports Rehabilitation are committed to helping you feel better so you can play longer.
WORK RELATED INJURIES
At PEAK Physical Therapy & Sports Rehabilitation, our goal is to restore your normal function and return you to your job in a safe and timely manner. If needed, we are able to perform a Functional Capacity Evaluation and communicate relevant information to your medical team. We have close communication with Worker’s Compensation companies and are committed to returning our patients to work as quickly as their healing bodies will allow. We accomplish this by implementing traditional therapy techniques, as well as work specific exercises that will expedite your recovery process.
MOTOR VEHICLE ACCIDENTS
Motor vehicle accidents can result in a variety of physical injuries, from mild to severe. Our staff can offer expert assessment of your injuries and set up a treatment plan to address your specific needs. Whether you are suffering from “whiplash” or other injuries caused by an accident, our therapists will effectively treat your symptoms, as well as address issues that could cause you problems or pain in the future, and expedite your return to work and play.