Ankle Fracture

An ankle fracture occurs when a bone on 1 or both sides of the ankle is partially or completely broken. Most ankle fractures are caused by twisting injuries and falls, or injuries experienced during sports or play. Under the age of 50, most ankle fractures occur in men. Over the age of 50, women experience more ankle fractures. The type of fracture varies from simple to complex, and can involve 1 or all 3 bones that make up the ankle joint. It is important to seek treatment after an ankle injury to determine if you have a fracture. Physical therapy shares an important role in your treatment and recovery from an ankle fracture, for a return to normal activity.

Ankle Impingement

Ankle impingement occurs when either soft or bony tissues are compressed within the ankle joint at the extreme end of a motion, such as pointing the foot sharply downward. It typically affects people who experience forces through their ankle at these "end-range" positions, such as dancers, gymnasts, or people performing kicking activities. Additionally, people who perform repetitive tasks that involve squatting or stair-climbing are susceptible to this condition. Physical therapists help people with ankle impingement reduce their pain, heal and strengthen the affected area, and improve their overall balance.

Ankle Sprains

Ankle sprains are common injuries that occur when the foot twists or turns beyond its normal range of movement, causing the ligaments of the ankle to overstretch or tear. It is estimated that 23,000 Americans experience ankle sprains daily. Of all sports injuries in the United States, 45% are ankle sprains; basketball players are the athletes most often affected. People who have an increased risk of spraining an ankle include younger athletes, members of the military, and anyone who frequently runs, jumps, and changes direction quickly, while performing an athletic activity (“cutting motion”). Physical therapists help people who have experienced ankle sprains reduce their pain; regain their strength, motion, and balance; return to normal activity levels; and avoid reinjury.

ACL (Anterior Cruciate Ligament) Tears

An anterior cruciate ligament (ACL) tear is an injury to the knee commonly affecting athletes, such as soccer players, basketball players, skiers, and gymnasts. Nonathletes can also experience an ACL tear due to injury or accident. Approximately 200,000 ACL injuries are diagnosed in the United States each year. It is estimated that there are 95,000 ruptures of the ACL and 100,000 ACL reconstructions performed per year in the United States. Approximately 70% of ACL tears in sports are the result of noncontact injuries, and 30% are the result of direct contact (player-to-player, player-to-object). Women are more likely than men to experience an ACL tear. Physical therapists are trained to help individuals with ACL tears reduce pain and swelling, regain strength and movement, and return to desired activities.

Biceps Tendinitis

Biceps tendinitis is a common cause of shoulder pain and impingement (compression of tissue with movement), often developing in people who perform repetitive, overhead movements. Biceps tendinitis develops over time, with pain located at the front of the shoulder, and usually worsens with continued aggravating activity. When treating biceps tendinitis, physical therapists work to determine the exact source of the pain by assessing the entire shoulder, and typically prescribe a program of activity modification, stretching, and strengthening to resolve pain and return individuals to their desired activities.

Biceps Tendon Rupture

A biceps tendon rupture occurs when the biceps muscle is torn from the bone at the point of attachment (tendon) to the shoulder or elbow. Most commonly, the biceps tendon is torn at the shoulder. These tears occur in men more than women; most injuries occur at 40 to 60 years of age due to chronic wear of the biceps tendon. In younger individuals, the tear is usually the result of trauma (such as an auto accident or fall). Biceps tendon ruptures can also occur at any age in individuals who perform repetitive overhead lifting or work in occupations that require heavy lifting, and in athletes who lift weights or participate in aggressive contact sports.

Physical therapists help individuals regain flexibility, strength, and function in their arms following biceps tendon ruptures.

Back Pain

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 symptoms of low back pain vary a great deal. Your pain might be dull, burning, or sharp. You might feel it at a single point or over a broad area. It might be accompanied by muscle spasms or stiffness. Sometimes, it might spread into 1 or both legs.

There are 3 different types of low back pain:

Acute – pain lasting less than 3 months
Recurrent – acute symptoms come back
Chronic – pain lasting longer than 3 months

Most people who have an episode of acute pain will have at least 1 recurrence. While the actual cause of low back pain isn't often known, symptoms usually resolve on their own. Psychosocial factors, such as self-confidence and a perceived ability to cope with disability, have been shown to be predictors of who might not recover from low back pain as expected. We used to believe the cause of low back pain was related directly to the tissues of our body, but are now understanding the condition to be more complex.

Calf Strain (Tennis Leg)

A calf strain is an injury to the muscles in the back of your leg, below the knee. The calf is made up of 9 muscles. It is possible to injure 1 or more of these muscles at the same time. Calf strains can occur when a person is performing high-speed motions like running and jumping. They can also result from an awkward movement. Calf strains are a well-known problem for athletes such as runners, soccer and basketball players, gymnasts, and dancers. Advancing age can increase the chances of a calf strain. Physical therapists treat people with calf strains by reducing pain, restoring muscle strength and flexibility, and increasing recovery speed.

Collarbone Fracture (Clavicle Fracture)

The clavicle, or collarbone, connects the arm to the body, helping to stabilize the shoulder and arm as they move. Clavicle fracture is a common shoulder injury, making up 4% of all fracture types and 35% of all shoulder injuries. The injury is most often caused by trauma, such as a direct blow to the shoulder or a fall, and is most often diagnosed in people under the age of 20. It is seen most often in young men, as a result of sports injuries. As people age, it is more likely to occur with a fall. It also becomes more common for women to fracture their collarbones with age, and less likely for men.

Most clavicle fractures are treated without surgery, but more complex fractures may require surgery. In either case, a physical therapist can help promote healing and a safe return to normal activity by providing pain management, guided exercise, and functional training.

Core Muscle Injury (Sports Hernia)

Core muscle injury, often misleadingly called a “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 these injuries 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 this kind of injury. Physical therapists can help individuals with core muscle injury improve their abdominal and hip strength and flexibility in order to safely return to their desired sport or activities. Physical therapists are also part of the prehabilitation and rehabilitation team for people who require surgery for core muscle repair.

Degenerative Disk Disease

It is estimated that as many as 80% of us will have some form of back or neck pain at some point in our lifetimes. The good news is that most of us will recover without the need for surgery. Conservative care, such as physical therapy for many types of back pain, provides similar results to those obtained from surgery. Degenerative disk disease (DDD) can be one cause of back and neck pain. However, DDD is part of the natural aging process, like getting gray hair, and in many cases is not painful at all.

Frozen Shoulder (Adhesive Capsulitis)

Often called a stiff or “frozen shoulder,” adhesive capsulitis occurs in about 2% to 5% of the American population. It affects women more than men and is typically diagnosed in people over the age of 45. Of the people who have had adhesive capsulitis in 1 shoulder, it is estimated that 20% to 30% will get it in the other shoulder as well. Physical therapists help people with adhesive capsulitis address pain and stiffness, and restore shoulder movement in the safest and most effective way possible. Learn More…

Golfer's Elbow (Medial Epicondylitis)

Medial epicondylitis (commonly called golfer's elbow or thrower's elbow) is a condition that develops when the tendons on the inside of the forearm become irritated, inflamed, and painful due to repetitive use of the hand, wrist, forearm and elbow. It is often diagnosed in people who perform repetitive motions, such as swinging a golf club or tennis racket, or activities requiring gripping, twisting, or throwing. Even using a computer or performing yard work can cause the condition. It is most common in men over the age of 35. A physical therapist can help decrease the pain caused by medial epicondylitis, and improve the affected elbow's motion, strength, and function.

Greater Trochanteric Bursitis

Greater trochanteric bursitis (GTB) is one of the most common causes of hip pain. Although GTB affects both active and inactive individuals, it is most commonly diagnosed 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 GTB can result in a limited ability to lie on the involved side, walk, climb stairs, squat, or participate in recreational activities. Physical therapists treat people experiencing GTB with a combination of stretching, strengthening, and movement retraining activities to decrease irritation in the hip, resolve pain, and help restore normal function.

Groin Strain

A groin strain is an injury to the groin—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. This injury tends to be more common in athletes and men; however, certain activities can increase the risk for anyone to experience a groin strain. Groin strains can occur during sprinting or any type of activity requiring 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.

Hamstring Strain

A hamstring strain injury occurs when 1 or more of the 3 hamstring muscles or tendons (at the back of the thigh) is torn, either partially or completely. It is one of the most common injuries of the lower body, particularly affecting athletes participating in sports involving high-speed running, 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. In most cases, hamstring strain injuries are successfully managed with physical therapy.

Herniated Disc

A herniated disc occurs when the cushion-like cartilage (the disc) between the bones of the spine is torn, and the gelatin-like core of the disc leaks. Often mistakenly called a slipped disc, a herniated disc can be caused by sudden trauma or by long-term pressure on the spine. This condition most often affects people aged 30 to 50 years; men are twice as likely to be diagnosed as women. Repeated lifting, participating in weight-bearing sports, obesity, smoking, and poor posture are all risk factors for a herniated disc. The majority of herniated discs do not require surgery, and respond best to physical therapy. Physical therapists design individualized treatment programs to help people with herniated discs regain normal movement, reduce pain, and get back to their regular activities.

Hip Bursitis

Hip bursitis is a painful condition that affects 15% of women and 8.5% of men of all ages in the United States. The condition tends to develop more in middle-aged and elderly individuals. Hip bursitis can have many causes, but the most common is a repetitive activity, such as walking or running on an uneven surface, which creates friction in the hip area. Athletes often develop hip bursitis after running up and down hills repetitively. The condition can also be caused by abnormal walking, such as limping, due to an uneven leg length, or arthritis in the back, hip, knee, or other joints in the leg. It can also occur without any specific cause. Physical therapy can be an effective treatment for hip bursitis to reduce pain, swelling, stiffness, and any associated weakness in the hip, back, or lower extremity.

Hip Impingement (Femoroacetabular Impingement or FAI)

Hip impingement (FAI) involves a change in the shape of the surface of the hip joint that predisposes it to damage, resulting in stiffness and pain. Hip impingement is a process that may precede hip osteoarthritis. It most often occurs in young, active people. A recent study found that 87% of teens and adults with hip pain showed evidence of hip impingement on diagnostic images taken of their hip joints. To treat hip impingement, physical therapists prescribe stretches and strengthening exercises to better balance the muscles around the hip to protect it, and use manual therapies to help restore range of motion and increase comfort.

Hip Labral Tears

Hip labral tears occur when the labrum, a band of cartilage surrounding the hip joint, is injured. Labral injuries can be the result of trauma, such as a fall or a car accident, but are most commonly caused by repetitive stress to the hip joint. Individuals who participate in sports such as hockey, soccer, or long-distance running—which require extremes of motion, repetitive twisting, or sharp movements like cutting—are most often diagnosed with labral tears. To treat the symptoms associated with a labral tear, physical therapists typically prescribe a combination of stretching and strengthening activities to decrease irritation in the hip.

Ilitobial Band Syndrome (IT Band Syndrome)

Iliotibial band syndrome (ITBS) is one of the most common causes of knee pain, particularly in individuals involved in endurance sports. It accounts for up to 12% of running injuries and up to 24% of cycling injuries. ITBS is typically managed conservatively through physical therapy and temporary activity modification.

Knee Bursitis

Knee bursitis, commonly known as "housemaid's knee" and "clergyman's knee," involves swelling of 1 or more of the bursae at the front of the knee. Knee bursitis is one of the most common bursitis conditions; it can be painful when moving the knee, when kneeling, or even when at rest. The condition can also be painless, with only visible swelling present. Knee bursitis can have many causes. The most common is trauma, whether from a direct hit, or the result of activities that require crawling or kneeling on hard surfaces for long periods of time, such as laying carpet or tile, or scrubbing floors. Knee bursitis is most commonly seen in athletes; up to 10% of runners develop knee bursitis. However, its occurrence is not related to any particular age or ethnic group, and can also be caused by infection or autoimmune conditions. Physical therapists treat individuals with knee bursitis to reduce their pain, swelling, stiffness, and any associated weakness in the knee or leg

Knee Pain

Knee pain can be caused by disease or injury. Among American adults, approximately 25% have experienced knee pain affecting the function of the knee. The prevalence of knee pain has increased over the past 20 years, with osteoarthritis being the most common cause in individuals over the age of 50. Knee pain that is caused by injury is most often associated with knee cartilage tears. Knee injuries can occur as the result of a direct blow or sudden movement that strains the knee beyond its normal range of movement. Knee pain can cause difficulty performing activities such as walking, rising from a chair, climbing stairs, or playing sports. Physical therapists are specially trained to help diagnose and treat knee pain, and help individuals return to their normal activities without pain or limitation.

Lateral Collateral Ligament (LCL) Sprain

Lateral collateral ligament (LCL) sprain occurs when the ligament on the outer side of the knee is overstretched. Collateral ligament knee injuries make up about 25% of severe knee injuries in the United States. They most often occur in adults aged 20-34 years and 55-65 years. LCL sprains mainly happen during sporting activities, including contact and noncontact sports, and affect women and men equally. A physical therapist treats LCL sprains to reduce pain, swelling, stiffness, and any associated weakness in the knee or lower extremity.

Low Back Pain

If your low back pain is accompanied by the following symptoms, you should visit your local emergency department immediately:

Loss of bowel or bladder control
Numbness in the groin or inner thigh

These symptoms might indicate a condition called "cauda equina syndrome," in which nerves at the end of the spinal cord that control bowel and bladder function are being squeezed.

Lower Extremity Stress Fracture

Lower extremity stress fractures are fractures of the bones in the lower legs or feet that occur with repeated activities. They are a relatively common injury, seen most often in athletes playing sports that require repetitive impacts (eg, running and jumping). Stress fractures comprise 5% to 30% of all activity-related injuries of the lower extremities. Female athletes are more likely to develop stress fractures in the legs and feet than male athletes. Although athletes may be more susceptible to these types of injuries, individuals who walk, march, or spend much of their workday on hard floors (eg, concrete) also are at risk. Physical therapists help people with lower extremity stress fractures recover strength, movement, and flexibility, and help them identify risk factors for future injury.

Lumbar Radiculopathy and Sciatica

Lumbar radiculopathy (also known as sciatica or radiculitis) is a condition that occurs when a nerve in your low back is injured, pinched, or compressed, causing pain or other symptoms that can extend from the low back to the hip, leg, or foot. Lumbar radiculopathy can be caused by sudden trauma or by long-term stress affecting structures in the back. It most often affects people aged 30 to 50 years. Risk factors for lumbar radiculopathy include repeated lifting, participating in weight-bearing sports, obesity, smoking, sedentary lifestyles, and poor posture. The majority of lumbar radiculopathy and sciatica cases recover without surgery, and respond well to physical therapy. Physical therapists design individualized treatment programs to help people with lumbar radiculopathy reduce their pain, regain normal movement, and get back to their normal activities.

Medial Collateral Ligament (MCL) Injury

The medial collateral ligament (MCL) is the most commonly damaged ligament in the knee. The MCL can be sprained or torn as a result of a blow to the outer side of the knee, by twisting the knee, or by quickly changing directions while walking or running. MCL injury most often occurs in athletes, although nonathletes can also be affected. A physical therapist treats an MCL sprain or tear to reduce pain, swelling, stiffness, and any associated weakness in the knee or lower extremity.

Medial Patellofemoral Ligament (MPFL) Injury

The medial patellofemoral ligament (MPFL) helps to keep the kneecap centered along the front of the knee, so that it tracks well during knee movements. MPFL injuries typically occur during a forceful traumatic kneecap dislocation. This injury is most common among young, active females. Depending on the severity of an MPFL injury, treatment may involve surgical reconstruction, followed by physical therapy. Physical therapists design treatment programs for individuals with MPFL injuries to help them gently restore their knee strength and function.

Meniscal Tears

Meniscal tears are common injuries to the cartilage of the knee that can affect athletes and nonathletes alike. These tears can be either “acute,” meaning they happen as a result of a particular movement, or “degenerative,” meaning they happen over time. Your physical therapist can help you heal a meniscal tear and restore your strength and movement. If surgery is required, your physical therapist can help you prepare for the procedure and recover following surgery.

Multidirectional Instability (MDI) of the Shoulder

Shoulder instability is a common injury among people participating in contact and noncontact athletic activities. Although shoulder instability can result from a traumatic event such as a dislocation, multidirectional instability (MDI) can occur without trauma. MDI commonly occurs in people who have increased shoulder joint looseness (laxity) with small, usually unnoticed injuries caused by repetitive overuse. Weakness of the shoulder joint (rotator cuff) and shoulder blade (scapula) muscles can increase the risk of MDI. After treating the pain and inflammation caused by MDI of the shoulder, physical therapy focuses on strengthening the shoulder muscles to aid a return to activity and to prevent reinjury.

Neck Pain

Neck pain is pain felt in the back of the neck – the upper spine area, just below the head. When certain nerves are affected, the pain can extend beyond the back of the neck to areas such as the upper back, shoulder, and arm. It is estimated that neck pain affects approximately 30% of the US population each year. Neck pain can be caused by sudden trauma such as a fall, sports injury, or car accident, or by long-term problems in the spine.

Neck pain most frequently affects adults aged 30 to 50 years. Some studies indicate that women are more likely to suffer neck pain than men. Poor posture, obesity, smoking, repetitive lifting, office and computer work, and involvement in athletic activity are all risk factors for developing neck pain.

People with neck pain can have difficulty performing activities such as working, driving, playing sports, or simply turning their heads. The majority of neck pain episodes do not require surgery and respond best to physical therapy. Physical therapists design individualized treatment programs to help people with neck pain reduce or eliminate pain, regain normal movement, and get back to their regular activities.

Osgood-Schlatter Disease

Osgood-Schlatter disease is an overuse injury causing pain in the knee area. OS most often develops because of excessive stress to the front of the knee during periods of rapid bone growth. A visible boney growth may appear just below the kneecap. Because teens typically experience the highest rate of bone growth, this age group is most affected by OS. Physical therapists help people with OS ease their pain, increase their muscle strength, and restore their function and movement.

Osteoarthritis (OA)

"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.

An estimated 27 million Americans have some form of OA. According to the Centers for Disease Control and Prevention, 1 in 2 people in the United States (US) may develop knee OA by age 85, and 1 in 4 may develop hip OA in their lifetime. Until age 50, men and women are equally affected by OA; after age 50, women are affected more than men. Over their lifetimes, 21% of overweight and 31% of obese adults are diagnosed with arthritis.

OA affects daily activity and is the most common cause of disability in the US adult population. Although OA does not always require surgery, such as a joint replacement, it has been estimated that the use of total joint replacement in the US will increase 174% for hips and 673% for knees by the year 2030.

Physical therapists help patients understand OA and its complications, provide treatments to lessen pain and improve movement, and offer education about obesity and healthy lifestyle choices. Research has shown that light to moderate activities such as walking, biking, and swimming can provide more benefits than harm to your joints, and promote weight loss. One study showed that just an 11-pound weight loss reduced the risk of OA in the women studied.

Osteochondritis Dissecans (OCD)

Osteochondritis dissecans (OCD) is a condition that involves damage to the cartilage and underlying bone within a joint. When this damage occurs, a fragment of the cartilage comes loose from the bone. OCD most commonly occurs in individuals between the ages of 10 and 20, typically affecting males more than females. The most common joints in which this condition occurs are the knee and the ankle, as they are weight-bearing joints. OCD may be caused by repetitive trauma or from a single traumatic episode. If identified early, OCD is a condition that can be effectively treated by a physical therapist.

Patellar Instability

Patellar instability is the term given to a range of injuries that occur when the patella, or kneecap, is displaced from its intended resting place. Causes include a traumatic dislocation, such as occurs during a sport activity, or a displacement caused by daily activities. The condition affects an average of 7 out of 100,000 individuals in the United States, and is most often diagnosed in individuals in their teens and twenties, particularly adolescent female athletes. Once individuals have experienced an episode of patellar instability, they are at an increased risk of another episode, with 15% to 44% experiencing it again. To treat patellar instability, physical therapists typically prescribe a combination of strengthening exercises to decrease pain and improve function.

Patellofemoral Pain

Patellofemoral pain is pain at the front of the knee, under or around the kneecap (patella). PFP is one of the most common types of knee pain experienced in the United States. It often occurs among athletes, active teenagers, older adults, and people who perform physical labor. Patellofemoral pain affects more women than men. It accounts for 20% to 25% of all reported knee pain. Physical therapists design treatment programs for people with PFP to help reduce pain and improve function.

Peroneal Tendinopathy

Peroneal tendinopathy is an injury to the tendons of the foot and/or ankle. It often affects athletes like long-distance runners, basketball players, and dancers. People who have had ankle sprains, or those who have weak ankles, may also develop this condition. It commonly causes aching along the outside surface of the ankle that gets worse with activity, yet improves with rest. Physical therapists help people with peroneal tendinopathy reduce strain on the ankle and foot and strengthen their muscles.

Pes Anserine Bursitis

Pes anserine bursitis is a condition that produces pain on the inside of the knee and lower leg. It occurs most commonly in young people involved in sports (eg, running or swimming the breaststroke), middle-aged women who are overweight, and people aged 50 to 80 years who have osteoarthritis of the knee. Up to 75% of people who have osteoarthritis of the knee have symptoms of pes anserine bursitis. The condition is also commonly associated with type 2 diabetes; 24% to 34% of patients with type 2 diabetes who report knee pain are found to have pes anserine bursitis. However, in some cases no direct cause can be identified. Physical therapists treat people with pes anserine bursitis to reduce pain, swelling, stiffness, and weakness, as well as identify and treat the underlying cause of the condition.

Pitcher's Elbow (Medial Apophysitis) or “Little League Elbow”

Medial apophysitis, or pitcher's elbow, is a condition that occurs as a result of an injury or irritation to the inside of the elbow, commonly affecting young athletes. It is often classified as an "overuse syndrome" in baseball or softball players in the developmental stages of rapid growth (approximately 11 to 15 years of age). Pitcher’s elbowcan be identified and effectively treated by a physical therapist.

Plantar Fasciitis

Plantar fasciitis is a condition causing heel pain. Supporting the arch, the plantar fascia, a thick band of tissue connecting the heel to the ball of the foot, can become inflamed or can tear. You experience pain when you put weight on your foot—particularly when taking your first steps in the morning. The pain can be felt at the heel, or along the arch and the ball of the foot.

Plantar fasciitis is a common foot condition. It occurs in as many as 2 million Americans per year and 10% of the population over their lifetimes. Treatment generally reduces pain and restores your ability to put weight on your foot again.

Posterior Cruciate Ligament (PCL) Injury

Posterior cruciate ligament (PCL) injury occurs when one of the ligaments on the inside of the knee is overstretched. Only 3% to 20% of knee ligament injuries are PCL injuries. Accidents, such as hitting the knee against the dashboard during a car collision, or falling onto a bent knee, are common causes of PCL injuries. Forceful straightening of the knee can also injure the PCL. Athletes who play sports, such as football and soccer, and skiers can experience PCL injuries. A newer source of PCL injury is the trend among dancers to land on the front of their shinbone from a high leap. Physical therapists treat PCL injuries to help reduce pain, swelling, stiffness, and any associated weakness in the knee or lower extremity.

Proximal Humeral Epiphysitis (PHE) or “Little League Shoulder”

Proximal humeral epiphysitis (PHE) is an injury to the shoulder of a throwing athlete who is still maturing physically. Although the injury is most commonly seen in young baseball players, the injury can occur in any child participating in repetitive overhead throwing activities. With an increased participation and sports specialization at a very early age, shoulder and elbow injuries in young athletes are common. Almost 10% of shoulder pain in pediatric patients can be attributed to athletic activities, such as throwing, and of these injuries, 26% are related to overuse and are preventable. As movement experts, physical therapists are uniquely qualified to analyze an athlete’s throwing mechanics, evaluate muscle strength and movement patterns, and develop exercises to return the athlete to pain-free sports participation

Proximal Humerus Fracture

A proximal humerus fracture is a serious injury to the humerus bone in the shoulder joint that requires immediate treatment to preserve function of the shoulder. A fracture to the humerus bone is a possible consequence of a traumatic event, such as a fall or forceful collision. Depending on the specific location and type of fracture to the proximal humerus, surgical intervention may be required. Whether surgical or nonsurgical treatment is needed, physical therapy treatment is essential to safely and effectively restore shoulder function, and return an individual to normal activity.

Rotator Cuff Tear

The "rotator cuff" is the group of 4 muscles and their tendons responsible for keeping the shoulder joint stable. Injuries to the rotator cuff are common—either from accident or trauma, or with repeated overuse of the shoulder. Risk of injury can vary, but generally increases as a person ages. Rotator cuff tears are more common later in life, but also can occur in younger people. Athletes and heavy laborers are often affected; older adults can injure the rotator cuff when they fall on or strain the shoulder. When left untreated, a rotator cuff tear can cause severe pain and a decrease in the ability to use the arm. Physical therapists help people with rotator cuff tears address pain and stiffness, restore movement to the shoulder and arm, and improve their activities of daily living.

Rotator Cuff Tendinitis

Disorders of the rotator cuff and the tissues around it are the most common causes of shoulder pain in people over 40 years of age. Rotator cuff tendinopathy occurs when a shoulder tendon (a bundle of fibers connecting muscle to bone) is irritated and becomes sore. With continued irritation, the tendon can begin to break down, causing tendinosis—a more chronic condition. People who perform repetitive or overhead arm movements, such as weight lifters, athletes, and manual laborers, are most at risk for developing rotator cuff tendinopathy. Poor posture can also contribute to its development. A physical therapist can help you identify and correct risk factors for rotator cuff tendinopathy, and help you decrease your pain while improving your shoulder motion and strength.

Sacroiliac Joint Dysfunction

Sacroiliac joint (SIJ) dysfunction occurs when the sacroiliac joints of the pelvis become stiff or weak. The condition can develop at any age. Symptoms typically are felt on one side of the back. SIJ dysfunction is found in 10% to 25% of people who complain of low back pain. It is most often diagnosed in females. Physical therapists treat SIJ dysfunction to help reduce pain and restore movement.

Shin Splints (Medial Tibial Stress Syndrome)

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 splints” due to the location of pain over the shin bone; pain can be felt on the inside or the front of 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, causing the connection between them to become irritated or even develop minor tears due to overwork. 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 also can develop MTSS. Physical therapists help people who develop MTSS recover pain-free movement and learn exercises and tactics to prevent reinjury.

Shoulder Bursitis

Shoulder bursitis is a painful condition that affects people of all ages. The condition tends to develop more in middle-aged and older adults, and individuals who have muscle weakness. Shoulder bursitis can have many causes, but the most common is a repetitive activity, such as overhead reaching, throwing, or arm-twisting, which creates friction in the upper shoulder area. Athletes often develop shoulder bursitis after throwing, pitching, or swimming repetitively. The condition can happen gradually or suddenly, or can be a result of an autoimmune disease. It can also occur without any specific cause. Physical therapy can be a very effective treatment for shoulder bursitis to reduce pain, swelling, stiffness, and associated weakness in the shoulder, arm, neck, and upper back.

Shoulder impingement and tendinitis can occur along with shoulder bursitis. A physical therapist can effectively treat all of these conditions together.

Shoulder Dislocation

The shoulder is the most mobile joint in the body and is the most likely joint to dislocate. A dislocation is the separation of 2 bones where they meet at a joint. Shoulder dislocations most often occur during contact sports, but everyday accidents, such as falls, also can cause the joint to dislocate. Athletes, nonathletes, children, and adults can all dislocate their shoulders. A dislocated shoulder usually requires the assistance of a health care professional to guide the joint back into place. After the joint is realigned, a physical therapist directs the rehabilitation of the shoulder, and helps the affected individual prevent reinjury.

Shoulder Impingement

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.

Shoulder Labral Tear

An unstable shoulder joint can be the cause or the result of a labral tear. "Labral" refers to the ring of cartilage (glenoid labrum) 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 work 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.

Shoulder Replacement (Arthroplasty)

Shoulder replacement (arthroplasty) is a surgery to replace all or part of the shoulder joint. Although less common than a knee or hip replacement, around 65,000 people have shoulder arthroplasties in the U.S. each year. Physical therapists help people return to their prior activity levels after total or partial shoulder replacement surgery.

Snapping Hip Syndrome

Snapping hip syndrome refers to a snapping or popping sensation that occurs in the side, front/groin region, or back of the hip (ie, the “sit bone”) 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. Although the condition most often affects dancers and athletes, a snapping hip can occur in anyone performing forceful leg movements. It is mostly seen in people 15 to 40 years of age. Although snapping hip syndrome is estimated to occur in 5% to 10% of the population, the incidence may be higher in dancers, and athletes such as soccer players, weight lifters, and runners.

Snapping Scapula Syndrome

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 sports 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.

Spinal Stenosis

It is estimated that as many as 80% of us will experience some form of back or neck pain at some point in our lifetimes. Spinal stenosis can be 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 and Spondylolisthesis

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.

Spondylolisthesis (spon-dee-low-lis-thee-sis) describes the forward slippage of a vertebrae over the vertebrae beneath it. Because the mechanism of injury, age of the patient, symptoms, and treatment are similar for both conditions, spondylolysis and spondylolisthesis are often described together.

Physical therapists provide education, pain reduction, activity modification, and cross-training to aid healing for patients with these conditions. A physical therapist can help you increase your spine and leg flexibility, strengthen your core muscles, and return to your sport, work, and recreational activities without a recurrence of symptoms.

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow is a painful condition caused by overuse of the "extensor" muscles in your arm and forearm, particularly where the tendons attach to rounded projections of bone (epicondyles) on the outside or lateral aspect of the elbow. The muscles you use to grip, twist, and carry objects with your hand all attach to the "lateral epicondyle" at the elbow. That's why a movement of the wrist or hand can actually cause pain in the elbow. 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)

Total hip replacement (arthroplasty) is a common surgical intervention that is performed for severe arthritis or hip fracture when conservative treatments are ineffective. The goal of total hip replacement surgery is to relieve pain, improve joint mobility, and restore or improve a person’s ability to safely perform functional activities like walking, standing, stair climbing, or running. Physical therapists work with people who have had a total hip replacement to strengthen their muscles and restore movement to their highest potential.

Total Knee Replacement (Arthroplasty)

A total knee replacement (TKR), also known as total knee arthroplasty (TKA), involves removing the arthritic parts of the bones at the knee joint (the tibia, sometimes called the shin bone; the femur, or thigh bone; and the patella, or kneecap) and replacing them with artificial parts. The physical therapist is an integral part of the team of health care professionals who help people receiving a total knee replacement regain movement and function, and return to daily activities.

Turf Toe

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) Injury

Ulnar collateral ligament (UCL) injuries generally occur when repetitive stress damages the inside of the elbow, compromising stability. UCL injuries are most common in athletes who play "overhead" sports, such as volleyball and baseball, which require using the arms in an overhead position. These injuries are occurring in greater frequency with the rise of sport specialization. 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.